Dry eye affects more than 30 million Americans and is the number one reason for an eye doctor visit. Definition of dry eye according to the International Dry Eye WorkShop 2007 (DEWS) Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tear instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface. Dry eye affects more than 30 million people nationwide, and while dry eye is more prevalent in women over 40, more than one million men over the age of 50 also suffer from dry eye. If untreated, dry eye can cause sharp stabbing pains, eye strain and fatigue, and even blurred vision or blindness.
Signs and Symptoms:
- Feeling of dryness and discomfort
- Irritation/pain
- Need to blink constantly
- Gritty sensation
- Sensitivity to light (photophobia)
- Blurred vision/vision disturbances
- Lack of tears alternating with excessive tearing
- Difficulty opening eyes after sleeping
- Contact lenses tend to “stick”
- More and more frequent need to use artificial tears
Functions and activities people with healthy eyes take for granted are disrupted or limited in people with Chronic Dry Eye, such as:
- Reading for any length of time
- Working on the computer for any length of time
- Doing “close” work (such as embroidering, sewing, etc)
- Driving at night
- Being in bright sunlight
- Being in an environment with bright or fluorescent lights
- A number of medications have side-effects capable of causing such eye problems.
- Some antidepressants
- Antihistamines
- Birth control pills
- Nasal decongestants
- Some acne drugs
Underlying conditions that may cause dry eye:
- Sjögren’s syndrome—a relatively common chronic, autoimmune, systemic, inflammatory disorder of unknown cause. Sjögren’s syndrome is characterized by dryness of the mouth, eyes and other mucous membranes and occurs most frequently among middle-aged women. For more information on Sjögren’s syndrome, please visit the Sjögren’s Syndrome Foundation (link to http://www.sjogrens.org/) or consult your physician.
- Nocturnal lagophthalmos—a rare disorder characterized by the inability to close the eyelids during sleep. Nocturnal lagophthalmos is most commonly found in men in their 20s, but it occurs in both sexes at any age. For more information on nocturnal lagophthalmos, consult your physician.
- Fuch’s Dystrophy
- RCE
Environmental Causes:
- Hot, dry and/or windy climates, High altitudes, Excessive sun exposure, Central heating, Air conditioning, Hair dryers, Cigarette smoke, Air pollution, Air travel
- Medications:(prescription or over the counter)
- Allergy medications, esp. antihistamines, Antidepressants,(e.g. amitriptyline, diazepam), Some blood pressure medications, Parkinson's medications, Birth control pills, Diuretics, Beta blockers, Sleeping pills, Many pain medications, Certain medications which regulate heart rhythm irregularities, Decongestants
- Contact Lens Wear
- Two million individuals abandon soft contact lens wear altogether each year with nearly 50% of these contact lens "dropouts" attributing dryness or discomfort as the primary reason.
Diseases:
- Parkinson's disease, Sjögren's syndrome (an auto-immune disease), Rheumatoid arthritis, Lupus, Lacrimal gland deficiency, Diabetes, Sarcoidosis, Stevens-Johnson syndrome, Rosacea: Facial rosacea is commonly associated with ocular rosacea, which causes conditions such as blepharitis
- Refractive eye surgeries
- Dry eye is the most common complaint or adverse event following LASIK.
- Hormonal deficiencies or changes
- Thyroid conditions, Hormonal changes during menopause, Decreased production of androgen, Estrogen supplementation -(there are reports both of this improving dry eye conditions and worsening them)
- Low blink rate
- Blinking is critical in spreading tears over the surface of the eye and stimulating tear production. A chronic low blink rate is associated with dry eye symptoms. Computer use, reading, and watching TV are the three activities most commonly associated with a low blink rate.
Diagnosis
Your doctor can test for dry eye and the severity of dry eye by:
- TearLab – Testing the osmolarity
- The Schirmer test - detects an aqueous tear-deficient dry eye and if positive, further evaluation for Sjögren’s syndrome is needed.
- The tear breakup test - detects evaporative dry eye.
Treatment
- FreshKote® is the only prescription drug that treats all three layers of the tear film, essential to effective dry eye treatment.
- Traditional eye lubricants only provide temporary relief of symptoms and do not address underlying causes of dry eye.
- For optimal treatment, use FreshKote® to completely wet the ocular surface and heal the damaged epithelium.