How to Recognize & Treat Dry Eye Disease

If your eyes are often red, feel scratchy or even sore, there is a good chance you are one of the estimated 20 million Americans who have a dry eye disease (DED).  

Caused by a lack of adequate tears on the surface of the eye, DED can cause significant discomfort in one or both eyes. Symptoms include a stinging, burning or scratchy sensation; stringy mucus in or around your eyes; sensitivity to light; blurry vision; eye redness; a feeling of having something in your eyes; difficulty wearing contact lenses; difficulty with nighttime driving; tired or sore eyes.

While anyone can get DED, it is more common in people who work on a computer for long stretches at a time; are age 50 or older; are female, especially post-menopausal; wear contact lenses; have certain medications (e.g., antihistamines, antidepressants, hormone replacement therapy, oral contraceptives); have certain autoimmune conditions, like lupus or Sjögren syndrome

While DED can be controlled, it’s usually a chronic and progressive condition. Left untreated, it can lead to permanent damage including inflammation, abrasion of the corneal surface, corneal ulcers, increased risk of infections, and vision loss. Individuals with severe DED may find it difficult to engage in or perform daily activities that require acute vision, such as reading.  

The good news is that DED is treatable. Because it’s easier to treat in the early stages, it’s important to contact your eye doctor as soon as you notice any symptoms. There are several painless and non-invasive tests that can be easily administered in order to determine if you have DED and how severe your condition may be. The tests measure the amount of tears your eyes produce and how long it takes your tears to dry.

Because other factors can contribute to DED, it’s important to tell your doctor:

• About any medications you take, including prescription and over-the-counter drugs
• About any chronic health problems you have, such as diabetes, rheumatoid arthritis, sarcoidosis, and thyroid problems
• If you’ve had shingles
• If you’ve had LASIK eye surgery

Treatment for DED, especially in the early stages, typically involves applying cold and warm compresses or use of artificial tears to soothe the eyes. If those efforts don’t offer relief, prescription eyedrops or sustained-release eye lubricants may be recommended.

For extreme cases, your doctor might suggest increasing the amount of Omega-3 fatty acids in your diet via daily supplements of flaxseed or fish oil. Your doctor might also suggest one of the following in-office treatment options as well:

• Tear duct plugs. Loss of tears via the tear ducts can also be limited by inserting tiny silicone plugs into the duct on a temporary or permanent basis.  
• Special contact lenses. Referred to as scleral lenses, these special lenses work by trapping moisture on the surface of the eye. 
• Intense pulse light therapy. This treatment delivers gentle pulses of light to the skin adjacent to the eyes to reduce inflammation and eliminate any bacterial infection. These pulses also work to melt any thick secretions on the eyelids and unclog glands along the eyelid. While you may experience immediate relief from this treatment, it may need to be repeated for the maximum—and permanent—benefit.
• Tear duct surgery. A rarely performed procedure, this surgery helps retain moisture in the eye by closing the tear ducts—either partially or fully—to keep them from draining tears away from the eye.

If you have questions or concerns about DED, contact your eye care professional to schedule an appointment.

Michael Porter, OD, is an optometrist with Advanced Eye Care with offices in Bennington and Manchester, VT and North Adams, MA.