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Dr. Richard A. Adler is a surgeon and ophthalmology specialist with Belcara Health in Baltimore,
Dr. Richard A. Adler is a surgeon and ophthalmology specialist with Belcara Health in Baltimore, (Handout)

Computers and smart phones are wearing out people’s eyes. Dry eye, a condition that causes strain and fatigue of the eye, is just one of the conditions caused by looking at screens all day. Dr. Richard A. Adler, a surgeon and ophthalmology specialist with Belcara Health in Baltimore, said that eye drops used to be the main treatment for the disease. But now doctors are using many other medical tools to offer relief to patients, he said.

What is dry eye?

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Dry eye disease is a chronic inflammatory condition that affects over 30 million Americans. It is caused by deficiencies in the quantity and or quality of the tear film. The tear film is a complex system made of three different layers, each of which plays a unique role in the health of the eye’s surface. People suffering from dry eye may experience a wide range of symptoms, including a sandy, gritty, or foreign body sensation. People may also present with a sense of ache, strain, or fatigue to their eyes. This is often times accompanied by blurred vision. Surprisingly, even tearing is a common symptom of dry eye. The prevalence of dry eye is increasing rapidly and its impact on a person’s quality of life can be profound. Simple activities such as using the computer, reading, and driving can be negatively affected by this condition.

What are the myriad causes of dry eye?

There are many factors which can cause or worsen dry eye disease. It is difficult to find a person today who is not using a smart phone or computer, technologies which can be common causes of dry eye. People don’t blink as much while using these devices. Additionally, common medical conditions such as diabetes, high blood pressure, thyroid disease and arthritis can have an association with dry eye. Antihistamines, anti-depressants, anti-hypertensives, and even oral contraceptives can lead to tear film deficiencies as well. Caffeine and alcohol can also have a dehydrating effect on the eyes’ surface. It becomes difficult to find a person without a risk factor for dry eye.

Why does dry eye often go untreated?

One of the challenges of managing dry eye is identifying it in the first place. Many patients live with the symptoms of dry eye, unaware that the symptoms are a part of a treatable condition. For example, many of us have experienced a sensation of “eye fatigue” at the end of the day, possibly after hours of computer use. Many of us have also experienced fluctuations in our vision. Yet most of us do not visit our eye doctor to address these symptoms. We assume it’s simply the way “it’s supposed to be.” But it’s not. By discussing this condition with your eye doctor, a customized strategy to improve these symptoms can be created, significantly improving one’s quality of life and even one’s job performance. There are new diagnostic tools that allow eye doctors to identify the disease earlier and in a more sophisticated fashion.

What are the different ways to treat dry eye?

The treatment options for dry eye have improved dramatically over the past several years. While artificial tears still remain a mainstay of treatment (and we have seen significant improvement in their composition), we now have a number of FDA-approved prescription eye drops available for dry eye. These drops don’t just treat the symptoms, but actually treat the root inflammatory cause of the disease. Nutritional supplements and tear-drain plugs can also be used. Devices such as Lipiflow, which uses heat and pressure to unclog glands in the eyes, and IPL, which uses light pulses to reduce inflammation, have added yet another opportunity to treat the disease, even without eye drops.

The FDA also recently approved a treatment called TrueTear. TrueTear is a drop-free, drug-free hand-held device that patients can carry in their pocket and use to make more of their own tears, whenever they want. It is the first of its kind and works through gentle neurostimulation of the nose to produce more tears.

If dry eye is not treated, can it lead to more serious eye problems?

In some cases, if left untreated, dry eye can lead to permanent damage and vision loss. Chronic desiccation, or extreme dryness, of the eye’s surface can result in scarring and even infectious ulceration. The key is to identify the disease early, when treatment can be more effective and when damage can still be reversed. The time to visit your eye doctor is not once vision loss has occurred, but earlier on in the disease when the symptoms may only be perceived as a “nuisance.” With so much innovation in treatment and diagnostic options, individuals suffering from dry eye symptoms should take advantage of an eye care professional’s services. In general, eye disease need not cause blindness to be considered important. Early identification and treatment is essential to managing the disease and improving one’s quality of life. Remember, sometimes blurred vision doesn’t just mean you need your eyeglasses changed.

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