Issue 41.15
My wife and I arrived here to the home of our dreams about a month ago in the middle of 110 degree days. I must admit that we wondered if J. Golden Kimball might have been right when he purportedly said, “If I had a house in hell and one in St. George, I’d live in hell and rent out the one in St. George!” Luckily Willis Carrier discovered air conditioning since Elder Kimball’s last visit here such that we are able to gaze at the wondrous vistas of this heavenly place from the comfort of our cool home and car. Still we do live in the desert and though I’ve counseled patients about dry eyes for many years, my time here has been the first that I’ve needed to take my own medicine. What if we take a moment to discuss the common aggravation of dry eye and what we can do about it?
What Is Dry Eye?
When you blink, a film of tears spreads over the eye, making the surface of the eye smooth and clear. Without this tear film, good vision would not be possible.
Sometimes people don’t produce enough tears or the right quality of tears to keep their eyes healthy and comfortable. This condition is known as dry eye.
Normally, the eye constantly bathes itself in tears. By producing tears at a slow and steady rate, the eye stays moist and comfortable.
Causes
Hormonal changes such as menopause are a main cause of dry eye syndrome, causing changes in tear production.
Because people who work long hours at a computer are less likely to blink often, they are more susceptible to dry eye.
Diseases that affect the lacrimal gland or its ducts — including autoimmune diseases like lupus and rheumatoid arthritis — lead to decreased tear secretion and dry eye.
Tear secretion also may be reduced by certain conditions such as diabetes, herpes zoster, contact lens wear and prior refractive surgery which decrease corneal sensation.
A wide variety of common medications, both prescription and over-the-counter (i.e. diuretics or beta-blockers for blood pressure, antihistamines—allergies, sleeping pills, anti-anxiety meds, pain relievers) can cause dry eye by reducing tear secretion. Since these medications are often essential, figuring out how to deal with the resultant dry eyes may be necessary,
Another cause for dry eye is exposure to a dry, windy climate, as well as smoke and air conditioning, which can speed tear evaporation.
Symptoms
While it may sound strange, people with dry eye may find their eyes water quite a bit. This is because the eye is responding to the irritation of this condition. Dry-eye sufferers also may find that they feel like they cannot keep their eyes open for very long (i.e. reading, watching TV).
Dry eye symptoms usually include:
• Stinging or burning eyes
• Scratchiness
• Stringy mucus in or around the eyes
• Excessive eye irritation from smoke or wind
• Excess tearing
• Discomfort when wearing contact lenses
Diagnosis
In recent years specialized tests have been developed to test tears for increased osmolarity secondary to evaporation and inflammatory markers as well as decreased tear production. The results of this testing can guide treatment.
Treatment
Nonprescription eye drops called artificial tears (similar to your own tears) can be added. Some people requiring more frequent tears (>4 times per day) may need non-preserved formulations.
Conserving your eyes’ own tears is another approach to keeping the eyes moist. Tears drain out of the eye through a small channel into the nose (which is why your nose runs when you cry).
A temporary method of closing the channels may involve the use of punctal plugs. The plugs are inserted into the punctum (tear duct) and work much like a dam by blocking your eye’s drainage system. Your Eye M.D. may also choose to use heat to permanently close your tear ducts.
Other methods
Tears evaporate like any other liquid. You can take steps to prevent evaporation. A humidifier, especially when the air conditioning or the furnace is in use, can make a big difference. Wraparound glasses may reduce the drying effect of the wind.
A person with dry eye should avoid anything that may cause dryness, such as an overly warm room, hair dryers, ceiling fans, or wind. Smoking is especially bothersome.
Some people may find dry-eye relief by supplementing their diet with omega-3 fatty acids, which are found naturally in foods like fish and flax seeds. Ask your Eye M.D. if you should take supplements of omega-3 fatty acids and, if so, in what form and dosage.
If other methods do not give you adequate dry eye relief, your ophthalmologist may suggest that you use a prescription medication such as cyclosporine which stimulates tear production. Steroid eye drops may also be used, but not for long-term treatment. Other treatment options may include ointments, gels and inserts.
We are blessed to live in this wondrous place of red rock vistas and endless sunshine, but life even in our desert heaven can have its drawbacks. If you are bothered by dry eye or have not had an eye exam within the last year please contact your eye care professional or call Richens Eye Center for an appointment at 435-986-2020. This article was heavily referenced (with permission) from the American Academy of Ophthalmology’s EyeSmart® program (www.geteyesmart.org) in coordination with Richens Eye Center.