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Last Updated: Jan 15th, 2009 - 22:28:17 |
(ARA) - Do your eyes feel itchy, gritty or like you have something in them? You may have dry eye and don’t know it.
Dry eye is one of the most common reasons patients visit an ophthalmologist. It’s estimated that as many as 25 million Americans suffer from it. Most commonly, it afflicts women and the elderly, and it can make you or your family member’s life miserable.
The good news is that in most cases an eye doctor can easily diagnose dry eye, identify the cause and prescribe treatment. “It’s surprising how many patients don’t realize they have dry eye,” says Dr. Eric Donnenfeld, a clinical professor of ophthalmology at New York University Medical Center and Chair of the Cornea Clinical Committee of the American Society of Cataract and Refractive Surgery. “As a doctor, one of the rewards of treating dry eye is that patients feel better, their lives improve and they see better as well.”
The tear film keeps the eye moist and properly lubricated. The tear film is composed of three different parts: water, mucin and oils. The oils are produced in the eye lids, the water comes from the lacrimal glands, and the mucin comes from the white of the eye. If there is damage to any one part of the eye, it will result in varying degrees of dry eye.
Dry eye has several causes. The most common are inflammation in the lacrimal gland, causing the gland to reduce the production of tears that lubricate the eye, and by blocked oil glands in the eye lids.
Most Common among Women
About 80 percent of patients with dry eye are women. There are several different risk factors:
* Hormonal changes during and following menopause.
* Hormonal changes related to pregnancy. Women may become intolerant of contact lenses and need lubricating drops to treat symptoms, which usually disappear after pregnancy.
* Age.
* Eye surgery.
* Systemic diseases, such as rheumatoid arthritis.
* Prescription and non-prescription medicines such as anti-histamines.
* Environmental changes, such as visiting a location that has high winds or low humidity.
Diagnosing and Treating Dry Eye
Because of the different kinds of symptoms, many people who have dry eye don’t realize what it is. Sometimes patients will say their eyes simply feel “unusual.” Others may complain of irritation or a foreign body sensation (like you have something in your eye), itching, grittiness and changing vision. Patients who feel their vision changes during the course of the day, when they look at a computer for long periods of time, or experience vision changes when they blink may have dry eye.
Your ophthalmologist is best equipped to diagnose dry eye, relying on the patient’s medical history and a physical exam. Once he or she has determined the cause and severity of the condition, it’s possible to decide what the best therapy will be.
“With mild dry eye, we’ll start with simple environmental changes, such as putting a humidifier in the bed room, or directing the heat flow in your car down towards the feet rather than at the face. Simple things, but they can help a lot,” Donnenfeld says.
If dry eye is more serious, patients usually require therapy as well as environmental changes. Again, ophthalmologists will look at what medications patients are on and try to change those oral medications that can cause dry eye, such as antihistamines, and transfer them to other drugs that may reduce symptoms. Therapy usually begins with lubricating eye drops called artificial tears. “Remarkable new artificial tears that coat patients’ eyes to give them temporary relief have become available, but they don’t treat the cause of the problem, which is usually inflammation,” Donnenfeld says.
The biggest breakthrough in dry eye therapy has been the understanding that it is caused by inflammation. “Anti-inflammatory therapy for the first time can now improve patients’ quality of life by lubricating the eye and by reversing the cause of the problem so that patients can make their own tears,” says Donnenfeld. Ophthalmologists can now prescribe several topical medications that can help relieve symptoms, reverse inflammation and allow the patient’s body to begin producing more and better quality tears.
Doctors now know that nutritional supplements can also improve dry eye, and they have become a first-line therapy. Research shows that omega-3 fatty acids found in medical grade fish oil and flax seed oil can improve the quality of tear film and reduce eyelid disease. “The reason we specify ‘medical grade’ is that we don’t want patients to take fish oils that may be high in mercury,” Donnenfeld says. “These oils have side benefits of reducing other inflammation, such as arthritis, lowering cholesterol, improving the luster of one’s hair; so there are a lot of side benefits.”
Fortunately, about 99 percent of dry eye cases can be treated with environmental changes or medication. Surgery is required in only about 1 percent of the cases. If you have dry eye symptoms, a visit to the ophthalmologist is the first step towards feeling -- and seeing -- better.
Dr. Donnenfeld is in private practice at Ophthalmic Consultants of Long Island in Rockville Centre, N.Y.
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