The eye’s tear film is a vital but often neglected component of clear vision and comfortable eyes. It is one of the most frequently encountered conditions we see in our practice. An individual with dry eye disease (DED) may complain of dryness, burning, itching, stinging, watering, “stickiness”, “grittiness”, fluctuating vision, “smeary” vision, and contact lens intolerance. Symptoms can be severe or nonexistent. Curious, isn’t it, that watery eyes can be a symptom of DED! Some people are bothered with symptoms just occasionally and others continually.
Dry eye disease (DED) has recently been defined as a “multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tear film instability with potential damage to the ocular surface…”1 In other words, there are several possible causes of DED with a variety of symptoms and consequences to the eye.
Along with a detailed history, there are several different tests we do to help differentiate the cause and severity of a patient’s DED. Risk factors for DED include:
- Age – DED increases with age
- Gender– Females have an increased risk, especially post-menopausal
- Environment – Exposure to harsh environments, outdoor work, computer work, exposure to dust, dry air, airplanes, cosmetics
- Smoking – Is a risk for many conditions including dry eye
- Previous eye surgery or disease – chronic allergies, refractive surgery, abusive contact lens wear
- Medications – Certain medications such as anti-histamines, anti-depressants, diuretics, and others.
- Systemic disease – A higher risk in diseases such as rheumatoid arthritis, diabetes, rosacea, thyroid disease, etc..
Targeted treatment of DED, following a proper diagnosis, may be prescribed as periodic or continual and often over a long term. It may involve environmental or lifestyle modifications, lid care, targeted tear lubricants, topical medication, punctual occlusion (blocking the tear drainage ducts), oral medication/supplements, chronic disease management, and sometimes in severe cases, more advanced procedures.
Treatment carries a high degree of success when diligent self-management is in place. Comfortable eyes and consistent clear vision is the welcomed reward of a collaborative effort between the doctor and patient.