Is there a magical drop there that can make my dry and red eyes go away?
That's a very good questions. However, dry eye cause is multi-factoral, and the treatment can range from simple to extensive depending on which cause(s)!
I say causes, because, have you met an accountant that wears contacts lenses for more than 8 hours, spends lots of time on the computer on excel files, and works in an office that is dry in winter?
Her causes for dry eyes could be,
contact lens wear,
contact lens wear for more than recommended hours on some days,
high visual demands, maybe reduced blinking on the computer,
and dry environment.
Let's look at the causes for the average person,
1. Medications: including current and previous use (during teenage years) of Accutane, Allergy medications by mouth/antihistamine, eye medication/allergy drops with preservatives, birth control medications (pills, ring or patch), beta-blockers, antidepressants, and other meds.
2. Systemic disease: diabetes, thryroid eye disease, rhematoid arthritis, sjogren's syndrome, Lupus.
3. Environmental factors, high air, low humidity, ceiling fans.
5. Low androgens
6. Previous surgery, including lid surgery for trauma or cosmetics, or LASIK surgery.
7. Cosmetics, many eye and facial products have EDTA, including eye make up removers; and retinol affects the eyes. Salicyclic acid that is used to treat acne on the skin affect the eyes too. Tatoo eyeliners may have metals that affect the lids.
8. Contact lens wear; contact lens decreases oxygen flow to the eye, especially coloured contact lenses and lenses that haven't been cleaned properly.
(This is not an exhaustive list)
These factors can all cause changes to the eye.
There is a layer of tear that is in front of the eyes all the time to lubricate it. These factors mostly disrupt the tear film. These factors either lead to oil gland change in the lids, reducing that amount of oil layer to keep the tears from evaporating; or lead to slow cell death in the cornea from lack of oxygen or minor trauma. Both lid and corneal changes can lead to tear film instability that lead to higher salt content in the tears, which lead to inflammatory factors to act on the healing cells (goblet cells), and lead to more epithelial (top layer of cornea) cell death. It leads to more tear film instability and repeats the cycle.
The goal of treating the dry eyes is the get rid of the cause and restore the eyes' normal physiology.
How can that be achieved?
When you visit the Optometrist, she can take a thorough history, check your eye's lids, cornea and osmolarity to determine the causes and severity of your dry eyes. See Dry Eye Service here.
In mild dry eyes, all factors that can be removed is to be removed, unpreserved artificial tears can be used, eye mask can be added for oil gland changes.
In moderate cases, can add omega 3 fatty acid in triglyceride form. Ask your Optometrist which one, not all omega 3 fatty acids are made the same. A prescription for anti-inflammatory medications may be necessary in some cases to control the inflammation.
In severe cases, autologous serum, daily contact lenses/scleral lenses, amniotic membrane or moisture chambers are required.
Delay in dry eye treatment would make it more severe. It's harder to reverse it when it's severe.
Most cases would need continued monitoring. Dry eye may come easily, but it doesn't go away that easily.
(Reference, Dr. Kyle M. cheatham, OD, and Dr. Laura M. Periman, MD)
Dr. Yan L. Liang, OD
Contact Warden Optometry to book your contact lens consult.