Dry Eye, Facts, Symptoms, Treatments
Excerpted with permission from Glow Beauty Magazine, interview by Sharon Marantz Walsh
Dr. Christopher E. Starr, M D, FACS, currently serves as the Director of Ophthalmic Education and Director of the Fellowship Program in Cornea, Cataract & Laser Vision Correction Surgery at Weill Cornell Medical Center, New York-Presbyterian Hospital.
Dry eye is a potentially serious eye condition, which if left untreated can affect the vision. Here’s a conversation about dry eye, facts, symptoms, treatments. TV personality, fashion entrepreneur, and star of “The Real Housewives of Beverly Hills,” Kyle Richards joined my interview with Dr. Christopher E. Starr, Associate Professor of Ophthalmology, Director of Laser Vision Correction Surgery and Director of the Fellowship Program in Cornea and Refractive Surgery at Weill Cornell Medical Center, New York Presbyterian Hospital.
Dr. Starr, what is Dry Eye?
Dry Eye syndrome, is also referred to as Keratoconjunctivitis. Simply put, Dry Eye is a condition where the eye produces an insufficient amount of tears to nourish the eye.
Kyle, why did you decide to come forward and talk about Dry Eye?
I wanted to share my experience with the hope of encouraging others to talk to their eye doctor about their symptoms and the best options for treatment.
What made you think that you had a problem which needed medical attention?
During the beginning season of “Housewives,” I began to notice that my eyes were really bothering me. I started using artificial tears all day, every day, on the set and even at home. I stashed them in my pockets, purses, drawers and in the glove compartment in my car. I had to switch to waterproof mascara because my eyes kept tearing and mascara ran down my checks. But despite how often I used the artificial tears, hoping for temporary relief, the condition did not improve. Finally, I went to my eye doctor. To my surprise, I was diagnosed with an actual disease; it’s called Chronic Dry Eye Syndrome.
Where do our tears come from?
Tears are produced by glands surrounding, and in, the eyelids. Each time we blink, tears spread across the front surface of the eye, called the cornea. The function of tears is to lubricate the eyes, reducing the risk of infection by cleansing the eyes of foreign debris. Eyes remain clear and smooth when our tears function properly.
What are some of the contributing factors of Dry Eye?
I diagnose Dry Eye in patients when the normal amount of tear production either decreases or evaporates too quickly. There are a number of factors that can contribute to Dry Eye. Age is one factor. A majority of people over 65 will experience symptoms. Environmental conditions, dry climates, excessive wind, smoke, and diet can play a part, along with various medical conditions and certain medications that effect tear evaporation and volume. Women are more likely than men to develop Dry Eye due to hormonal changes and oral contraceptives.
Dry Eye is one of the most under-diagnosed ocular diseases. Symptoms vary. Usually the eye feels somewhat gritty. There is often a burning sensation, accompanied with the feeling that something is actually in the eye itself. Eyes can have excessive watering including blurred vision, especially in sunlight. I strongly advise anyone with these symptoms to see a board certified Ophthalmologist. If left untreated, the risk of infection as well as serious visual impairment can occur, along with permanent damage and scarring to the front of the eye.
How is Dry Eye diagnosed?
Your Ophthalmologist will be able to diagnose Dry Eye by performing a comprehensive eye exam, including an evaluation of your medical history, paying note to environment, and all medications including prescription drugs, vitamins and any over the counter supplements you are taking. Your doctor will perform an external examination of the structure of your eyelids, including blink dynamics. The condition of your cornea will be evaluated using magnification and bright lights. Special dyes will be used in drop form to closely observe tear flow and any changes of the eye’s outer surface due to the insufficient production of tears.
Once Dry Eye is diagnosed how is it treated? Is there something I can do at home that will decrease my symptoms?
The answer to that question is definitely yes! There are things you can do at home or in the office to keep your eyes more comfortable. Optimally, when air is moist, tears evaporate at a slower rate. Air conditioning in summer months and heat in winter can rob the air of humidity.
Using a humidifier will aid in replacing lost moisture in the room. I tell my patients to avoid using, or decrease the speed of, high-powered oscillating fans and ceiling fans. Using an air filter to keep your living environment dust free will also help.
You can also try lying down and relaxing with a hot compress over your eyes. The heat generated from the compress will warm up the glands enabling tears to flow easily.
Clean your eyelids, massaging gently with baby shampoo to eliminate any bacteria that may interfere with oil production.
Many of my patients tell me that their eyes feel dry while working on their computer, reading or watching TV. When that occurs, I suggest taking a break, every couple of minutes; let your eyes rest for about ten seconds and remember to blink frequently.
In terms of diet, I recommend drinking plenty of water and taking an omega-3 fatty acid supplement every day.
Which eye drops, gels, or lubricants do you recommend?
You probably need to try a few to determine which brand works best for you. Gels, lubricating eye drops, and artificial tears can be purchased over the counter at most pharmacies.
Most can be used as often as needed to make your eyes feel more comfortable. I recommend preservative free solutions if a patient tends to use drops more than six or seven times a day.
Lubricating eye ointments are thicker in consistency than drops and even gels. So I advise them to be used at night before sleep, because they tend to blur vision for a few minutes after application.
For my patients that do not want to be bothered with putting in drops or gels several times a day and using lubricants at night, I recommend Restasis® (Cyclosporine Ophthalmic Emulsion) 0.05%*, first thing in the morning and at night if needed to help increase your eye’s natural capacity to produce tears. Restasis® is available by prescription only.