Dry or Watery Eyes?
Dry Eyes? Watery Eyes? It may not be what you think...
Watery Eyes? It may not be what you think… Fresh cut onions, a pollen-filled Georgia spring, a tear-jerker movie, a brisk wind - all triggers for those teary eyes. Some of these triggers are obvious, but the underlying cause for watery eyes in some of us could be much more nefarious. Believe it or not, the leading cause of teary eyes is an ocular surface issue called Dry Eye Syndrome (DES). However paradoxical, DES is a clinical diagnosis closely associated with a range of issues ranging from a simple and watery distraction to a sight-threatening loss of vision.
At its most basic cause, DES is the result of one of three, often combined, physiologic issues: reduced tear production; excessive tear evaporation; and/or, sub-optimal tear composition. What, you might ask, would cause these types of issues? Maybe one or more of these sound familiar: medications (antihistamines, decongestants, antidepressants, antihypertensives), hormone changes, birthdays (age), poor air quality,
medical conditions (RA, lupus, Sjogrens disease), and the list goes on.
It should come as no surprise that 38% of adults experience symptoms associated with DES with nearly 16.4 million Americans suffering from diagnosed chronic DES (Am. EyeQ Survey, 2014; Am. Journal Ophth, 2017), and the number of undiagnosed patients suffering from chronic DES is thought to be considerably higher.
There are short and long-term consequences - significant ones for you, your work, and your lifestyle. Issues include susceptibility to infection, inflammation and redness of lids and ocular surfaces, corneal ulcers, abrasions, variable vision, and fatigue--all rendering one of our most precious senses compromised.
In many cases, further ocular surface assessment as a part of a specialized dry eye evaluation may be beneficial. Such evaluation assesses important diagnostic measures of tear volume and composition, gland anatomy and function, and ocular surface condition.
Treatment options for DES are numerous and need to be customized to the patient's underlying causes. Over-the-counter eye drops and supplements, prescription medication, and regular lid cleansing are among the most conventional. Some of the most interesting data in recent studies clearly identify 86% of the time DES is driven by a deficiency in the oily component of our tears; quite simply this means if we can address the oil deficiency alone, the vast majority of DES sufferers would be positively impacted. Accordingly, new, more intentional treatment options include thermal gland
expression, serum tears, lid inserts, amniotic membranes, and specialized contact lenses. The effectiveness of these newer procedures are significant for emerging or ongoing symptoms.
For those of us motivated by prevention, there’s more good news. Avoiding non-essential medications, improving air quality (decrease pollution, increase humidity), turning off ceiling fans, wearing protective eyewear (sunglasses), taking breaks from screen time, and staying hydrated are all preventative measures strongly associated with reducing symptoms. These improvements to the environment and routine can go a
long way toward combating DES.
To better serve our patients Oconee Vision Group offers Johnson & Johnson’s LIPIFLOW thermal pulsation therapy and Lumenis Optilight IPL therapy, both FDA approved, highly effective treatment for symptoms associated with dry eye.
