You Ask , They Answer
Q
: What ’ s dry eye disease and what are its symptoms ?
A
: This is a disease where the quality or quantity of the tear fluid is abnormal and causes decreased health of the surface of the eye . More commonly , some component of the tear ( quality ) is affected .
The tear fluid is the liquid mixture that coats the front of the surface of the eye . This protects the eye by rinsing or clearing away insults like dust , microbes , and foreign material . Tears nourish the living cells in the front of the eye , and when there ’ s a severe lack of tear , these cells suffer and die .
Tear quality can be affected by surgery , viral infection , inflammation , poor hygiene of the eyelids , or hormonal disturbances .
Symptoms of dry eye disease include irritation ( heaviness , redness ), light sensitivity , especially the glare of headlights when driving at night , and watery eye . This last condition seems paradoxical in ‘ dry eye ’, but actually dryness leads to reflex secretion of tears , which is actually a very common presentation of ‘ dry eye ’.
Q
: Which are the main health risks associated with the condition , especially if it isn ’ t treated promptly ?
A
: The main problem is reduced quality of life and reduced work productivity . It affects work in areas such as computer use , cosmetics , and air conditioning . Patients find it difficult to drive at night and incur problems because of time off work due to hospital visits and other issues , while medications are costly .
Only severe cases have sight-threatening issues or infection , but these are generally due to other medical conditions ( such as autoimmune disease and bone marrow transplant ) rather than late treatment . Infections are usually related to total surface breakdown in severe dry eye and lack of hygiene , for example , concurrent inappropriate contact lens care or in-growing lashes that impact the area with breakdown and poorer defence .
Q
: Which remedies and treatments are available against it ?
A
: The vast majority of people who suffer from dry eye do not need prescription eyedrops . They just need artificial tears which are over-the-counter and generally very safe . Primary care for dry eye disease consists of five pillars described by the acronym LEARN : 1 . Lubricants or artificial tears : The most common reason for lack of response is insufficient frequency . In general , newly diagnosed cases should be treated at least four times a day for two months .
2 . Eyemasks such as USB powered eye masks for eyelid warming : This unblocks the oil glands and also increases a sense of wellbeing . It needs to be done once a day for at least eight minutes at 40-45 degrees Celsius over the long term .
3 . Augmenting health such as omega-3 fatty acid supplements and vitamin D3 : There is evidence that in some patients these reduce inflammation of the eye .
4 . Restore general health : Patients should seek treatment for acne , thyroid , anxiety , and insomnia as all these can increase the severity of dry eyes .
5 . Non-standard therapy : This includes Traditional Chinese Medicine , acupuncture , and other treatments .
Specialist therapies include immunosuppressive eyedrops , mucus secreting eyedrops , punctal plugs ( tiny devices to place in the tear ducts ), and blood-based eyedrops . Only a small percentage of community dry eye cases requires specialist care .
Q
: Can people prevent or reduce the risk of dry eye disease ?
A
: They could follow the care strategy above ( LEARN ) and also pay attention to their general health , avoid allergens like preservatives in creams and cosmetics , exercise , get sufficient sleep , and avoid excessive use of cosmetics and exposure to video display monitors .
Professor Louis Tong
Professor Louis Tong is an eye specialist at Singapore National Eye Centre .
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