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Eye Exams - Dry Eye Syndrome

Kingsway Optometry provides in depth services with regards to both the diagnosis and treatment of dry irritated eyes. Dry Eye Syndrome is the most common ocular health condition encountered in the eye care profession, and needs to be taken and treated seriously as it can have profound effects on our daily lives. 

Please feel free to read through some general information in this section on both the diagnosis and treatment of dry eye syndrome. 

To learn whether or not you suffer from dry eye syndrome, and what treatment options might best suit your unique personal situation please schedule an appointment with one of our eye doctors for a routine eye health exam. 

What is Dry Eye Syndrome?

Definition: Dry Eye Syndrome is either a deficiency in the quantity or quality of a persons tear film layer. Medically the diagnosis goes under 2 names, either keratoconjunctivitis sicca or keratitis sicca, 2 big words that simply mean dry irritated eyes. Tears are a combination of water for moisture, oils for lubrication and mucous to help spread and adhere the tear film to the out layer of the eye, the cornea. Tears are produced by glands in your eyelids, which are different from the tears we shed when we cry or when our eyes water, which comes from the lacrimal glands located under the eyebrow area. Dry eye syndrome may simply be a mild irritation, or it can have serious visual consequences that require the aid of an eye care practitioner.

Symptoms: Sharp pain, burning sensation, light sensitivity, gritty sensation, feeling of a foreign body or sand sensation in the eye, itchy, redness, blurred vision, and watery eyes. Patients with chronic dryness may also notice the formation of small fatty tissue bumps on the white portions of their eyes called pingueculas. Eventually these can transform into pterygiums. In general these fatty tissue bumps are benign and require no special attention, however occasionally they can result in the need for surgery. Chronic or acute dryness symptoms can also lead to a persons inability to wear contact lenses or undergo refractive laser vision correction.

Tests: There are a number of tests that can be performed by your optometrist to confirm your diagnosis and more importantly rule out other more serious conditions. Specific tests include the Shirmer test, and the tear break up test (TBUT). The best testing however involves a detailed examination of the ocular surface and the tear film layer. An accurate case history can also shed light as to the diagnosis and the underlying cause of your dry eyes.

Causes: This is a broad question with an even broader answer. The bottom line is that there are numerous causes for dry eye syndrome. They may include medications (anti-histamines, birth control, anti-depressants, hypertensive meds, etc.), environmental factors (computer work, reading, dry office, dry home, etc.), lifestyle (sports, sunlight or wind exposure), contact lens wear (over wear, extended wear, poor lens fit, or chemical toxicity secondary to contact lens solutions, etc), age, menopause, and smoking. Dry eye syndrome may also be the result of underlying medical problems such as Sjogren’s syndrome or ocular rosacea.  

Treatments: Dry eye syndrome is usually seen as a chronic condition by most eye care professionals. However, with appropriate care and treatment it is possible to reduce or completely eliminate your symptoms. Always discuss your unique circumstances with your optometrist to determine the best treatment option that fits both your lifestyle, comfort level and budget. 

Treatment Options

Warm Compresses – Take a wash cloth and wet it with warm water. Close your eyes and gently hold the wash cloth over your eyes. Hold the cloth there until it cools off. Repeat this cycle 4 X’s or for approximately 1-2 minutes.  Warm compresses should be performed every morning and ideally every evening before bed. Performing warm compresses more regularly has no adverse side effects. The purpose of warm compresses to help open up your oil glands and tear glands. Showering or bathing alone will not do this. 

Lid Scrubs – Lid scrubs are performed in order to remove any oil buildup away from the eyelid area. Lid scrubs are always performed after warm compresses, as the warm compresses help to soften the oil. They are best performed in the shower, by placing a small amount or baby shampoo on a wash cloth. Than using this wash cloth, gently was alround the eye lid area, taking special attention around the oil gland area located right along the lid line by your eyelashes. Thoroughly rinse any soap residue away. Lid scrubs are always performed prior to using any medicated ointments or creams. 

Environment / Personal Factors – If your dry eye is being caused by any environmental or personal factors that you can control, try to reduce or limit your exposure. This may mean reducing how long you wear contact lenses for in the day. Looking up and away from your computer screen at work, or the newspaper at home every 15 to 20 minutes. It may also mean discussing alternative medical therapies with your family doctor if your dry eye is the result of a new or existing medication.

Water & Air Humidifiers – Drinking water and limiting your intact of dehydrating beverages that include caffeine and alcohol, is a simply way to keep your whole body feeling better. Humidifiers are also a great way to help decrease tear evaporation. Edmonton is a dry city that only gets dryer in the winter. Adding a humidifier to your home furnace and air conditioner can greatly improve your home environment. Using a standalone warm air humidifier in the bedroom can also dramatically reduce dryness in the morning. 

Fatty Acid Supplements – Oral polyunsaturated fatty acid supplements are the newest trend in dry eye treatments. A large study out of the University of Waterloo, found that adding fatty acid supplement to ones diet, either through supplementation or better dietary choices can help to reduce ocular inflammation, improve oil secretion and improves dry eye symptoms overall. Supplement options include: Flaxseed Oil, Omega 3 and Fish Oil.

Lubricating Eye Drops – Lubricating eye drops are a great way to add additional lubrication to your eyes and provide comfort. Please don’t get trapped into the mind set that all lubricating eye drops are the same however, as they are most certainly not. Each brand of eye drops on the market targets a specific area. Some lubricating eye drops may be better suited than others, depending upon your unique situation. In order to gain any positive affects from lubricating drops, they must be used religiously. Using lubricating eye drops only when your eyes feel sore and tired is like drinking water after you become dehydrated. Your playing catch up, verses being pro-active. In general, we also highly discourage our patients from using any 'red eye' lubricating eye drops, as they can often worsen dry eye symptoms, and increase healing times. Be certain to discuss any chemical or preservative allergies that you may have with your doctor, as there are now numerous 'preservative free' formulations available on the market. 

Lubricating Eye Ointments – If additional lubrication is required for longer periods of time, than lubricating ointments are a great alternative. Ointments however, do produce more matting or buildup around the eyelids and can greatly blur ones vision. So typically they are used only before bed or prior to having a nap. However in some severe cases, they may be our go to product. Most lubricating ointments are also 'preservative free' which allows them to be used more frequently and in greater amounts. 

Medications - In some dry eye syndrome cases, medications may be used to help treat either the underlying cause of your dry eye, or the symptoms. Occasionally using antibiotics or anti-inflammatory medications can help bring your dry eye under control, and make it easier to manage with over the counter medications or homeopathic treatments. You may also see commercials or ads for a product called 'Restasis', which is a prescription medication used to treat inflammatory dry eye. Unfortunately, this product is not available in Canada at this time. However, please speak to your optometrist, as their are alternative treatments at our disposal. 

☐ Temporary Punctal Plugs These are small collagen plugs that are placed in the lower and potentially upper punctual canals in your eyelids. They are invisible to the naked eye, but prevent tears from draining out of your eyes, thus maximizing the contact time with your eyes. Depending on the style of plug used, temporary punctual plugs can last for 3 days up to 3 months prior to dissolving away.

☐ Permanent Punctal Plugs – These are similar to temporary punctual plugs, but are usually made out of silicon. They are designed to last longer, and are used if temporary plugs are found to be successful.

☐ Surgical Options – Depending on the underlying cause of your dry eye, surgical options may be available. Ask your optometrist if you may benefit from receiving a surgical consultation by a local ophthalmologist.

Warning!

Always discuss both the risk and benefits with your optometrist, prior to starting any medical treatment. 

  

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