Category: Dry Eyes

Dry Eye and Diabetes

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November is National Diabetes Month. Last year and in previous blog posts, I wrote about diabetes and the eye. Today I want to talk about dry eye disease (and diabetes).

Dry eye can lead to decreased vision, corneal scarring and secondary bacterial infections. Not to mention the general discomfort and reduced quality of life from the symptoms.

There are 8 Risks Factors for the Development of Dry Eye Disease:

  • AGE The older you are the greater the risk for dry eye.
  • GENDER Women are twice as likely to develop dry eye than men.
  • ENVIRONMENT This includes smoking, airplane travel, computer use, low humidity environments and several other considerations
  • LID MARGIN DISEASE This is especially true of meibomian gland dysfunction. Meibomian, an icky sounding word on its own, but you should see the glands under a microscope when they are plugged or inflamed. It’s not pretty.
  • CONTACT LENS WEAR Contact lens wear contributes to dry eye and increased symptoms
  • OCULAR SURGERY Surgical procedures  such as LASIK or cataract removal can cause temporary dry eye in patients who have predisposing risk factors.
  • MEDICATIONS Many drugs including oral anti-histamines or anti-acne medications like (Isotretinoin)

And for the risk factor that ties this all in with Diabetes Month…

  • SYSTEMIC CONDITIONS This includes not only diabetes but also rheumatoid arthritis and thyroid disease.

The mechanism responsible for dry eye disease in diabetic patients is unclear, but many studies have been done. One study found that the rate of dry eye disease was higher if the HbA1c values were higher. Yet another good reason to maintain diabetic control and lower HbA1c values.  Another study showed that the tear proteins of diabetic patients are different from those of healthy subjects. More than half of the people who have diabetes experience dry eye symptoms and suffer from ocular dryness. Controlling the diabetes and managing the dry eye disease can lessen or alleviate the discomfort of ocular dryness.

Eye Irritation

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The skin condition, Acne Rosacea, may affect the eyes. A recent survey by the National Rosacea Society reports that 60 percent of rosacea patients also have eye involvement. In fact, ocular symptoms may appear before the effects of rosacea appear on the skin. Ocular Rosacea is characterized by redness around the eyelids, bloodshot eyes and watery appearance. Sufferers of Ocular Rosacea experience foreign body sensation, burning or stinging, dryness, itching, light sensitivity and blurred vision.

Gentle, consistent cleaning and oral medication may relief the symptoms of ocular rosacea. If ocular rosacea is not treated, patients could endure potentially serious consequences, such as scarring or corneal damage that could lead to decreased vision.

If you have any questions or would like more information about ocular rosacea, call the office or post a comment.

Save Your Vision Month

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March is Save your Vision Month

It is important to be proactive and protect your eyesight and vision for the future. 

For adults in their 20s and 30s, the eyes are generally healthy as are the other organs in the body. Start protecting your vision now.

 Eat right! Include lots of fruits and vegetables in your diet
 Quit smoking
 Wear sunglasses to protect against harmful ultraviolet radiation.

For adults in their 40s and 50s, you are probably noticing some significant changes in vision, especially close-up. Menopause can increase dry eye symptoms for women.

 Ask family members about eye diseases. Many conditions run in the family
 Invest in accurate and quality reading glasses
 Your general health can have profound effects on your eyes. Be prepared to discuss medications and health conditions with your optometrist

After 60 it is crucial to maintain regular eye examinations. The incidence of many eye diseases increases. Many of these conditions like glaucoma, have no symptoms.

 Schedule annual exams or as recommended.
 Report all changes in general health to the eye doctor. Don’t accept declining vision as just a part of aging.

Contact Lenses and Comfort

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Eye Hygiene Care - set of contact lens casesMost contact lens wearers use their lenses for an average of 13 hours a day. To stay comfortable all day it is important that the lenses maintain hydration (stay wet).   There are many factors that can make the lenses dry out quickly, dry environment, medications and poor tear quality. Sometimes the type of lens is to blame. The newer silicone materials allow more oxygen to the eye, but silicone is hydrophobic which means it does not absorb moisture. Contact lens manufacturers use special surface treatments on the silicone lenses to improve wettability and comfort. Not all contact lens solutions and lens materials are compatible with each other. Some disinfecting solutions work better on the silicone lenses than others, both in maintaining comfort and safety. If your lenses feel dry and or filmy, it could be the contact lens solution that you are using. If the lenses are older than recommended, the effect of the special surface treatment may be gone too. Use recommended solutions and replace your lenses as prescribed for optimal wearing comfort.

I think the safest and most comfortable lens choice are the dailies. The lenses are used one time and thrown away. There is no confusion or complications with solutions and the user has a new clean lens each day.

Dry Eye Syndrome

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dry-eye-syndromeDry Eye Syndrome
Red, gritty and scratchy eyes can have a number of causes and possible treatments. In addition to discomfort and fluctuating vision, dry eyes can lead to styes and infection. Regular eye examinations can prevent complications and provide the opportunity for you to get help with treatment.

If you have dry eyes, you may notice that the discomfort worsens as the day progresses. Air conditioning, smoke, drafts, and cold temperatures become difficult to tolerate. It may feel like there’s a foreign body in your eye, or your eyes may have a sandy feeling. In spite of the fact that you are suffering from “dry” eyes, you may find that your eyes are watering reflexively and that strands of mucous are accumulating.

What’s Going On? Normal tear film consists of three layers: mucin, aqueous, and lipid. Abnormalities in production, content, or distribution of these three layers or in eyelid function will cause the various conditions commonly known as dry eye.

  • Lipid Problems: These are the most common cause of dry eye. Glands in the eyelid produce lipids. Greasy lotions, incomplete removal of makeup, or skin conditions like dandruff can plug the glands and prevent lipids from secreting.
  • Aqueous Deficiency: This can be a side effect of certain medications you’re taking. The culprits include antihistamines, diuretics, hormones, and psychotropics.
  • Mucin Deficiency: Chronic infection or trauma to the eye can cause a lack of mucin. Autoimmune diseases negatively effect the mucin layer too.
  • Eyelid Problems: The eyelid may turn in or out as a result of the aging process or of scarring. Tears then spill over the eyelid, allowing the eye to become dry. Depending on the severity of the situation, this problem can be treated with plastic surgery.

Also, dry eye can be aggravated by inflammation of the eyelid margin. In this case, the lid, where the eyelashes attach, will be red and irregular.

No one treatment for dry eye has proven completely successful. A combination of the following may improve comfort: good eyelid hygiene, the use of artificial tears and lubricating ointments, newer agents designed to heal tissue such as Cyclosporine, supplements and punctal occlusion (the insertion of a silicone plug into the tiny opening that drains the tears). Examining controllable factors such as medications, topical creams and lotions, and environment enhances treatment success.