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Dry Eye Disease

Over the last three decades, our understanding of dry eye has evolved considerably. Dry eye is no longer considered a disorder of the tear film, but an actual disease. Dry eye disease (DED) is estimated to affect approximately 25 million Americans. It results in symptoms of discomfort, visual disturbance and tear film instability. When the production of natural, healthy tears is reduced, osmolarity of the eye will increase leading to Dry Eye Disease. Long-term untreated dry eye can cause serious damage to the front of the eye, particularly the cornea, with a potential for loss of vision.

Dry eye symptoms may include any of the following:

• stinging or burning of the eye • a sandy or gritty feeling

• episodes of excess tears following very dry eye periods

• a stringy discharge from the eye• pain and redness of the eye

• episodes of blurred vision• heavy eyelids

• inability to cry when emotionally stressed

• uncomfortable contact lenses

• decreased tolerance of reading, working on the computer, or any activity that requires sustained visual attention like driving or watching TV

• eye fatigue

Steps you can take to reduce symptoms of dry eyes include remembering to blink regularly when reading or staring at a computer screen and increasing the level of humidity at work and home. In addition, wearing sunglasses to reduce exposure to drying winds and sun, using nutritional supplements containing essential fatty acids and by drinking plenty of water and avoiding dehydration all help reduce symptoms.

The good news is the treatment of DED continues to evolve and improve. Dry eye is unlike treating an eye infection, where eye drops are used for a week and the problem resolves. Managing dry eye and its symptoms is an ongoing process. The first priority is to determine if a disease is the underlying cause of the dry eye such as Sjögren’s syndrome or meibomian gland dysfunction. If this is the case, then treating the underlying disease will be the initial approach.

Surprising to many patients, oral prescription medications are a common cause of dry eye. In fact, the top ten prescribed oral medications in the US cause dry eye. Many times alternative drugs can be considered, however, in some cases, the necessity outweighs the side effect.

If contact lens wear is the problem, we may recommend another type of lens or reduce the number of hours you wear your lenses. In the case of severe dry eye, you may have to discontinue contact lenses altogether.

Treatment of DED can sometimes be as simple as adjusting an individual’s environmental factors and using artificial tears 2-4 times a day. In other cases, steroids, gel drops, copious lubrication and possibly plugging where tears drain out with punctal plugs is necessary. Topical prescription drugs available to treat dry eye include cyclosporine, sold under the name Restasis and lifitegrast, sold as Xiidra. Both drops produce an anti-inflammatory type of effect and work well in conjunction with topical lubricants. Restasis decreases corneal damage, increases tear production, and reduces symptoms of dry eye. Xiidra has been studied in more than 1,000 patients with dry eye in four separate, 12-week clinical studies. Xiidra was proven to reduce the symptoms of dryness in all four studies. To determine the best course of action for your dry eye, an evaluation by an eye care professional is necessary. Self-treating with over the counter artificial tears alone may lead to low grade chronic inflammation and progression of Dry Eye Disease.

Cockrell Eyecare Center is proud to be an Accredited TearLab Dry Eye Center. If you think you may have Dry Eye Disease and would like to be evaluated, please contact our office in Stillwater at 405-372-1715. We also invite you to visit our website at www.cockrelleyecare.com and like us on Facebook at Cockrell Eye Care Center!