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Month: December 2014

These Cry’n Eyes

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.

“Will being overweight affect my vision?”

“Will being overweight affect my vision?” This is a question I almost never hear. Maybe because most of us don’t think there is a relationship between body weight and our eyes. Obesity has become a major health concern globally in recent years with well-established evidence linking overweight to illnesses and early death.

If we review the scientific literature, it quickly becomes apparent that being overweight has a strong link to several eye conditions. Diabetes and  high blood pressure can cause significant changes to the eyes. Diabetic and hypertensive retinopathy can lead to profound vision loss if left untreated. First line management of each of these conditions is achieving and maintaining a healthy body weight.

Age-related macular degeneration is the leading cause of vision loss in Canada. There is no single cause of macular degeneration, but several excellent studies have shown obesity to be a significant risk factor for progression and severity of the disease.

A recent meta-analysis of six important studies reveals an association between obesity and cataract development, particularly posterior subcapsular cataracts which tend to occur at a younger age and develop more quickly.

Pseudotumour cerebri, retinal vascular occlusive disease, floppy eyelid syndrome, entropion, sleep apnea related eye disease and stroke related vision loss each have an association with obesity.

Overweight is just one of the “lifestyle” factors which influence health. Regular exercise, smoking cessation, healthy diet, adequate sleep and stress reduction also contribute to eye health.

The individual and societal factors that influence healthy weight management are numerous and have been discussed extensively in many circles. Weight management is a billion dollar industry with magical products, quick weight- loss programs, fads, celebrities, countless books and organizations. Medical management often includes counselling and in extreme cases, bariatric surgery. In most instances though, achieving and maintaining a healthy weight is a lifelong task assumed by the individual.

A local physician has just published a valuable resource for those willing to confront their disease.“Overweight is a Disease, A Canadian Doctor’s Prescription for Self-management”, by Dr. Lori Teeple, is a new book designed to be a key resource for those who struggle with overweight who wish to understand their disease and gain the skills necessary to self-manage for life.

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