20 Frequently Asked Questions
About Dry Eye

Excerpt from the book

Reversing Dry Eye Syndrome

Practical Ways to Improve Your
Comfort, Vision and Appearance

By Steven L. Maskin, M.D.


FACT:
Over 10% of the population suffers from dry eye syndrome,
causing significant loss of productivity in the workplace and
much personal suffering, pain, and even loss of vision.

1. What is dry eye syndrome?
Dry eye syndrome, or keratoconjunctivitis sicca, is a condition where the cornea and conjunctiva of the eye are extremely dry, due to abnormal tears, leading to damage to the eye’s surface.
It can be broken down into two types: Aqueous-deficient dry eye, due to problems with the lacrimal glands; or evaporative dry eye, usually due to problems with the meibomian glands. Symptoms include burning, itching, grittiness, and foreign body sensation in the eyes, with frequent redness and inflammation.
2. Is a “dry eye syndrome” and "dysfunctional tear syndrome"
the same thing?
Dry Eye Syndrome (or just "dry eye") and Dysfunctional Tear Syndrome are the same thing. In recent years, some scientists are leaning toward the name "dysfunctional tear syndrome" because it more clearly reflects complexity of the disorder.
3. Is dry eye syndrome a serious disease?
Absolutely. Although in its early stages, it may seem like a minor irritation that can be treated with over-the-counter eye drops, it can escalate quickly. It will not clear up on its own, like a cold. In fact, if left untreated, it can even result in blindness in severe cases.
4. I have heard that one’s environment plays a big role in
dry eye syndrome. Is this true? If so, how?
Environment is one of the primary factors affecting the development, exacerbation, and healing of dry eye. However, environment, refers not simply to one’s local climate-although that does play a part. Dry eye is affected also by the micro-environments of the home, workplace, automobile, and any other place where a dry eye sufferer spends a lot of time.
Also, an environment may not simply need to be "dry" to cause "dry eye". In fact, it often has more to do with circulating air from air conditioners and/or heaters, as well as the presence of allergens and other toxins. One’s environment is of the primary factors that require acknowledgment and control in order to heal dry eye.
5. Can wearing contact lenses cause dry eye?
In some cases, yes. Prolonged contact lens wear cuts down on corneal sensitivity, and the thus tears are not stimulated properly and dry eye can result.
6. If I am diagnosed with dry eye syndrome, does that mean
I can never wear contacts again?
You may be able to wear contacts, even after developing a dry eye. However, you must first resolve the dry eye problem, and then select a proper contact lens.
7. Can working long hours at a computer cause dry eye?
Yes. People who spend long hours staring at a computer screen may end up not "blinking" with a sufficient frequency to lubricate the eye surface. Over time, this may result in Computer Vision Syndrome and/or dry eye syndrome. The same is true for people who watch television frequently, sew, or read for long periods of time, or spend long hours driving. In other words, any activity that demands intense staring and not blinking frequently for long periods of time, may result in dry eye.
8. Does LASIK surgery cause dry eye syndrome?
LASIK surgery may cause dry eye, and a significant number of people who have had LASIK surgery develop at least transient dry eye. The most common explanation is because of the cornea nerves are cut during a LASIK surgery, thus the nerves no longer participate in the integrated circuit responsible for producing healthy tears.
9. I suffer from hay fever and often have itchy, irritated eyes
during "allergy season". Is my allergy related to dry eye syndrome?
Possibly, as a dry eye is unable to clear allergens from the surface of the eye and unable to adequately dilute any allergens that get in the eye. Also, the medication (that is, the antihistamine) you use to treat your hay fever, may lead to dry eye, or exacerbate existing mild dry eye.
10. I have heard that dry eye syndrome is a geriatric disease,
that only older people get it. Is that true?
The answer is both no and yes. First of all, dry eye can develop for many reasons having nothing to do with advanced age (prolonged contact lens wear, allergies, etc.) and therefore can be found in people of all ages. Nevertheless, the greatest number of dry eye sufferers are women over the age of 50. This may have to do with the decreased production of the androgen hormone as a result of menopause. Also, certain geriatric diseases are related to dry eye, including Parkinson's disease.
11. Is it true that dry eye syndrome is mainly a "female" problem, and only women get it?
Yes, it is true that most people (over 60%) who suffer from dry eye are women. However, many men, particularly older men, suffer from dry eye.
12. Why do more women than men suffer from dry eye syndrome?
The development of dry eye in post-menopausal women may have to do with the depletion of the androgen hormone. Paradoxically, androgen is primarily a male hormone; men have much more of it, and although men also lose androgen, they do so much more slowly. As a result, dry eyes shows up much more predominately in women, particularly menopausal women.
13. I have heard that dry eye syndrome is associated with
some very serious diseases. What are they?
Yes, dry eyes syndrome is related to a number of very serious, autoimmune diseases, including Sjogrens syndrome, diabetes, lupus, rheumatoid arthritis, and Graves' disease. Dry eye is also associated with Stevens-Johnson syndrome, rosacea, and other serious diseases, including Parkinson's disease.
14. If I have dry, irritated eyes, will commercial, over-the-counter
eye drops solve the problem?
Yes and no. In some cases, over-the-counter eye drops will prove to be sufficiently comforting. However, in other cases, using over-the-counter products can exacerbate the problem. Many commercial eye drops contain preservatives, which cause an irritation or burning sensation, and can be toxic (that is, damage surface cornea cells) for some eyes.
15. I've tried it using several different over-the-counter
eye drops to ease my irritated eyes, but none of them seem to work.
Is there anything I can do about this?
Yes, there are several things you should explore. First, you may be allergic or sensitive to OTC preservatives; try a preservative free drop. Also, your pain and irritation may be a moderate-to-severe case of dry eye demanding more than simple therapy with OTC eye drops. See a good eye doctor as soon as possible.
16. I've heard that Restasis is the cure-all for dry eye. Is this correct?
Restasis is the brand name for Cyclosporin A, and has enjoyed a lot of publicity and a certain amount of popularity. It is the first drug developed specifically for dry eye syndrome, and is aimed at reducing surface inflammation, which exacerbates dry eye. Although it can be useful therapy, it is not a cure-all. Since Restasis is prescription drug, you need to consult with your eye doctor in order to get it. He or she may well include additional therapies with the Restasis.
17. I have heard about special glasses or goggles for dry eye.
What are these?
Special "moisture goggles" have long been recommended for dry eye sufferers. Today, a number of attractive goggles are on the market. Also, if you use a computer more than three hours a day, I strongly recommend being fitted with glasses for use only when you are at the computer. "Computer glasses" can ease the eye strain and help prevent dry eye.
18. Are there any "home remedies" that can ease the irritation and pain of dry eye syndrome?
Yes, there are a number of "home remedies" you can use ease dry eye pain. Most of these involve controlling your environment, both at home and at work. Also, certain scrubs, soothing compresses, and natural remedies are available.
19. Do I need to see a doctor, if I suspect that I have dry eye syndrome? If so, what kind of doctor?
If you suspect that you have dry eye syndrome, I strongly recommend that you see a good eye doctor. Dry eye syndrome can be a tricky problem. At times, the pain from dry eye may be rather extreme, but the exam findings of dry eye disease may be mild. Conversely, because the surface can become known to do to lack of tears, the exam findings of dry eye disease may be much more serious than your symptoms indicate. It is very important that eye doctor take a close look.
See your optometrist or general ophthalmologist. If your condition is severe, you may need to see a specialist, usually an ophthalmologist who has received special training (or fellowship) in ocular surface disease, dry eye, or cornea diseases and surgery.
20. Is dry eye syndrome a chronic disease? In other words,
can I be cured?
The answer depends on how you define "cured". If, for you, "cured" means that you no longer are relying on any tear supplements and can ignore all environmental conditions as they no longer affect your eye comfort, then it would have to be stated that dry eye is a chronic disease, which is unlikely to be cured. However, dry eye can be managed to achieve absolute comfort and to stop further damage to the eyes; therefore, in that sense, it can be cured.