By Dr. Sophia Visanji

You may have heard these complaints before, “My eyes have been burning lately.” “They just won’t stop tearing. People will ask me if I’m crying.” “They feel sandy, like something is in them.” “Oh, I can’t wear contact lenses! My eyes are so dry!”

Dry eye syndrome (DES) is one of the most common medical diagnoses amongst eyecare professionals today, arguably more than ever before given that we are living in a digital era where we spend most of our time on devices such as computers, phones and tablets.

WHAT IS DRY EYE SYNDROME?

Dry Eye Syndrome occurs when a patient’s natural tears aren’t providing adequate lubrication for the ocular surface, either due to decreased tear production, increased tear evaporation or an imbalance in the makeup of their tears. Tears consist of 3 unique layers: the innermost layer being mucous, then water and oil on the outermost layer. Their purpose is to create a smooth and clear surface that helps protect their eyes from infection. This is why having dry eyes can pose a risk to your patient’s ocular health, as it increases the risk of eye infections. Furthermore, damage to the surface of their eyes can increase the prevalence of ocular inflammation and corneal abrasions, which can lead to corneal ulcers and vision problems; all of which can decrease quality of life. The risk factors are vast, so it is usually difficult to pinpoint the exact etiology of the condition.

RISK FACTORS

OLDER ADULTS

Increased age, typically patients over the age of 50, are at greater risk to develop this problem due to a decrease in their tear production as they get older.

WOMEN

Women are more susceptible to get dry eye symptoms due to hormonal changes, pregnancy, the use of birth control pills and menopause. Check out our previous blog by Dr. Visanji to help pregnant patients with their ocular issues.

ENVIRONMENTAL FACTORS

Environmental factors such as frequent flying, air-conditioners, heaters and increased screen time on digital devices due to not blinking frequently enough can also contribute.

CONTACT LENSES

Contact lens wearers usually complain of dry eye symptoms with prolonged use of lenses. Those that use biweekly or monthly lenses are usually more at risk for dry eye syndrome, so I often recommend daily lens use for these patients.

HEALTH CONDITIONS

Patients with systemic health conditions such as diabetes, thyroid disease, lupus, rheumatoid arthritis and Sjogren’s syndrome as well as the use of certain medications such as antihistamines, antidepressants, hypertension meds and birth control pills can also increase their risk of dry eye symptoms.

TREATMENT AND PREVENTION

So how do we treat this very common condition in our patients, and more importantly, how can we prevent dry eye syndrome from affecting their lives? As an Optometrist, my first line of treatment is usually artificial tears. The brands I often recommend include Blink, Refresh and Systane and can be purchased over the counter. Another option that I often suggest to my patients is the insertion of punctal plugs in the lower puncta of both eyes. The plug essential acts like a bath- stopper of sorts that allows the patient’s tears to stay on the ocular surface much longer. A non-permanent punctal plug usually lasts around 3 months and is then replaced by their Doctor. My last line of treatment is usually prescription dry eye drops such as Xiidra or Restasis. Speak with your patients who suffer from chronic dry eye symptoms about what course of action is best for them.

There are preventative measures you can recommend to your patients on how to prevent dry eyes symptoms.

Remind your patients to book an exam with their Optometrist to assess the prevalence of dry eye syndrome and to determine which treatment is the best option for them.

Resources:

https://www.allaboutvision.com/conditions/dryeye-syndrome.htm

https://www.mayoclinic.org/diseases-conditions/dry-eyes/symptoms-causes/syc-20371863

https://www.aao.org/eye-health/anatomy/tear-film-3