Dry Eye Season

As fall gives way to winter and the leaves begin the final descent temperatures will undoubtedly follow their lead plummeting below freezing. If you are anything like me you will wear your warmest pair of pants, a favorite sweatshirt, and pull out the extra blanket to keep warm before giving in to the urge to flip on the furnace. While trying to save on the heating bill is part of the reason for the hold out, the furnace also creates a dry air indoor environment. When combined with the natural dry air found with falling temperatures, sinuses, skin, and eyes can easily be affected.

The increased number of chronic dry eye patients complaining of burning, stinging, watery eyes that lead to fluctuating vision is a serious issue. It is something that I as an optometrist confront on a daily basis during the winter months.

Wait, did I just say watery eyes? "How can I have dry eyes when all I do is wipe away tears?" This is a question I hear quite often, and I am hopeful this article will show the importance of a healthy tear layer on the front surface of the eye, and some symptoms, causes, and treatment options related to chronic dry eye disease.

To understand dry eye disease, it is first important to understand the make up of the tear layer on the front of the eye. Three different components create a stable tear: the front lipid or oil layer, the middle aqueous or water layer, and the bottom mucous layer. (see photo, credit refreshbrand.com).

Each layer is crucial and a breakdown of one can and will affect the others. The two most common natural causes of chronic dry eye are insufficient production of the thick middle watery layer and a breakdown of the front oily layer, and secondly, having low quality of an oil called meibum. Both lead to the same problem, a thin or evaporating tear layer. The watery part of the tear is secreted by the lacrimal gland which is located above the eye, and the oily part is produced by meibum glands which live inside the eyelids. A balance between the oil and water is key for optimal vision and eye comfort.

As a result of being in a dryer atmosphere during this time of year the tear layer is under constant attack, and if already compromised by poor oil or water production it is likely the eyes will feel burning and stinging due to dryness. As the brain registers the gritty sensation of dryness it signals the lacrimal gland to overproduce water to wash the eye out as if there was something in it causing the irritation. This is why contradictory to its name one of the primary symptoms of chronic dry eye is tearing. It is quite common in the exam room for me to receive a confused look when recommending artificial tears as a remedy to a watery eye. More on treatments later.

Along with the change in weather, symptoms can be brought on by everyday things such as the use of screens or reading. As you are reading this article my hope is that you are reading intently, so intently that without even knowing it the rate at which you are blinking has likely drastically decreased. The purpose of blinking is to spread a layer of new tears on the front surface of the eye keeping it comfortable and clear. It has been proven that because of increased attention when reading or looking at screens the blink rate gets reduced by around 50%. This decreased blink rate leaves an unstable tear layer more susceptible to chronic dry eye symptoms.

So what can we do to alleviate dry eye symptoms? The answer to this question is at times trial and error but the first line of defense is the use of artificial tears as needed and a daily supplement of omega-3 fish oil pills. Artificial tears help stabilize all three layers of the tear providing longer lasting comfort and clarity for short periods of time when symptoms pop up. Omega-3 fish oil pills have been shown to help support healthier production of the oil layer of the tear with extended use. Both of these products are available over the counter and at our office as needed. For moderate to severe cases there are additional therapies used such as punctual occlusion which will slow down the drainage of tears from the eye, as well as prescription drops specifically for aqueous deficient chronic dry eye which stems from a poorly functioning lacrimal gland.

Just like most other things in life, your risk for chronic dry eye disease does increase with age. Other factors include smoking and occupations that demand many hours at a computer screen. If symptoms such as burning, variable clarity when reading or on a computer, constantly rubbing or forcefully blinking your eyes for comfort sound familiar, you may be a victim of chronic dry eye disease. It is important to note that chronic dry eye disease is treated and managed and rarely ever cured, so the right treatment plan that works for you is driven and crafted by the information found during your eye exam.

I would be happy to see you at Insight Vision Care right here in Newcomerstown. My staff and I take pride in serving this community with compassion and care, and our goal is to create a long term relationship that goes deeper than just caring for your eyes.

Also, I have had many patients ask about the for sale sign on our property It is positioned for the prior dentist office at 112 Cross Street adjacent to our office. Our optometry space is not for sale as we hope to serve the community for many years to come, and as always, are accepting new patients.

God Bless.