The wind makes me cry! Dry eye syndrome can damage vision if left unchecked, leading ophthalmologists explain key countermeasures
Nowadays, people stare at screens for long periods of time and stay in air-conditioned environments, leading to the early onset of many eye diseases, and the incidence of dry eye is on the rise. Ophthalmologists describe dry eye as a chronic eye condition. If left untreated over time, it not only makes your eyes dry and uncomfortable, it can damage your vision and, in severe cases, require surgery. For Heho readers, we are sharing comprehensive measures to combat dry eye and help you win the battle for your vision.
Chi-Chin Sun, chairman of the Taiwan Society of Cataract and Refractive Surgeons, pointed out that an analysis of the National Health Insurance database completed two years ago showed that the prevalence rate of dry eye syndrome in the total population of Taiwan is about 7.84%, and 70% of them are women. The incidence rate of dry eye syndrome in people over 65 years of age is higher, reaching about 20%. A study conducted by the Veterans General Hospital also found that 33.7% of elderly people over 65 years of age suffer from dry eye syndrome.
What are the symptoms of dry eye syndrome?
However, many people have misunderstandings about the symptoms of “dry eye syndrome.” Chi-Chin Sun said that some people think that “dry eyes” is the only symptom of dry eye syndrome, but in fact, the common symptoms of dry eye syndrome include “pain or burning sensation,” “foreign body sensation,” “frequent tearing or overflowing tears,” “fear of light,” “blurred vision,” “filaments adhering to the eyes,” “easy fatigue of the eyes,” “redness of the eyes,” and so on.
Chi-Chin Sun noted that patients with dry eye syndrome typically experience more pronounced symptoms in the afternoon and evening. Although dry eyes are commonly associated with dry eye syndrome, abnormal tearing is also a symptom of the condition. Before the secretion of the related glands in the eye is exhausted, external stimulation may trigger a reflex reaction. Therefore, if there is a puff of smoke, many patients with dry eye syndrome will start to shed tears.
If you suspect that you have dry eye, you can use self-testing scales to confirm your condition. According to Chi-Chin Sun, the OSDI scale is one of the most commonly used scales for assessing dry eye syndrome. It calculates scores based on subjective answers and differentiates the risk level of the condition. Patients can also provide it to doctors as a reference when seeking medical treatment.
Why does dry eye syndrome occur?
Dry eye syndrome is often a result of modern lifestyles. According to Chi-Chin Sun, dry eyes may develop at birth in a few individuals due to congenital underdevelopment of lacrimal gland secretion or other issues. However, for most people, dry eyes are caused by the use of electronics, accidental injuries, or other risk factors.
Chi-Chin Sun explained that the transparent cornea is the outermost structure of the human eyeball. A layer of protective tears, approximately 0.7 microns thick, covers the cornea. The layer of tears can be divided into three layers, from the inside out: the mucus layer, tear layer, and lipid layer. Each layer has distinct properties and is secreted by different glands.
Regarding the characteristics of tears, Chi-Chin Sun explained that the mucus layer is secreted by goblet cells on the conjunctiva, the tear layer is secreted from the lacrimal glands, and the fat is secreted from the glands on the eyelids. These three layers are essential and must work together closely. Insufficient secretion, uneven distribution, or poor quality of any layer can cause dry eye syndrome.
Who are at high risk of developing dry eye syndrome?
Chi-Chin Sun identified six main categories of high-risk groups for dry eye syndrome. These include elderly individuals over 65 years old, patients who have recently undergone eye surgery (such as myopia laser or cataract surgery), long-term drug users (such as patients with glaucoma and hypertension), individuals with prolonged exposure to air-conditioned environments (such as office workers, engineers, and flight attendants), individuals who wear contact lenses for extended periods, and those with hormonal changes due to menopause or other factors.
Furthermore, Chi-Chin Sun noted that recent research has indicated that individuals with diabetes may also suffer from dry eyes. If individuals believe they are part of a high-risk group, they should heighten their awareness of the disease, identify any unusual symptoms, and promptly seek medical diagnosis and treatment. It is not advisable to hastily seek medical advice or purchase eye drops with unknown ingredients from cosmetic stores, as this may not only harm your eyes but also delay proper medical treatment.
Can dry eye syndrome be treated?
Treatment strategies for dry eye syndrome vary depending on the severity and stage of the condition. According to Chi-Chin Sun, in less severe cases, symptoms can be alleviated by reducing the use of electronics and applying hot compresses to the eyes. However, if the injury is severe enough to cause corneal rupture or other wounds that affect vision, the patient may require surgery or autologous serum therapy.
However, Chi-Chin Sun cautioned that these surgeries are not designed to treat dry eye disease itself, but to treat the damage caused by dry eye syndrome, such as amniotic membrane transplantation or lid suturing, etc., to prevent very serious or permanent vision damage. He noted, “In most cases, I would say that dry eye is not going to get better, especially in the second and third stages. The goal is to prevent it from worsening. If there are any issues with the immune system, an immuno-rheumatologist may need to be involved in the treatment.”
Shiuh-Liang Hsu, Director of the Taiwan Society of Cataract and Refractive Surgeons, stated that artificial tears are the primary treatment for dry eye syndrome. Doctors evaluate tear secretion, surface inflammation symptoms, corneal skin damage, and the presence of inflammatory substances on the surface of the eye to determine the severity of dry eye, rather than relying on subjective scales such as OSDI.
Can I use the eye drops I bought?
When people suspect they have symptoms of dry eye syndrome, they may buy over-the-counter eye drops to relieve the symptoms. However, Chi-Chin Sun emphasized that this is a “very dangerous and highly unrecommended behavior.” Although people may feel better after using eye medication and believe they are fine, the underlying problem has not been resolved, and this may delay seeking medical attention. Dry eye is associated with several risk factors and is a problem that requires attention.
Furthermore, Chi-Chin Sun clarified that there is a common misconception that prolonged use of artificial tears can lead to dependence or even cause issues such as glaucoma. However, there is no dependency issue when using artificial tears. Feeling uncomfortable after using artificial tears may be a warning sign that the disease has progressed, and you should see a doctor for evaluation as soon as possible.
How to choose artificial tears?
For those who require artificial tears to alleviate symptoms, Shiuh-Liang Hsu recommends paying attention to three key factors when selecting a product: “main ingredients,” “excipients,” and “preservatives.” The main ingredients should have a high affinity for the ocular surface or provide prolonged comfort after use.
Regarding excipients, Shiuh-Liang Hsu suggests selecting items that can effectively combine with the main ingredients to enhance therapeutic effects, prolong moisturizing effects, and alleviate dry eyes. For instance, hyaluronic acid can be a suitable option. In terms of preservatives, many bottled artificial tears on the market contain preservatives and are not suitable for frequent use (more than 4 times a day). It is recommended to use single-pack artificial tears without preservatives.
How to avoid dry eye syndrome?
To prevent dry eye syndrome, it is crucial to maintain a healthy lifestyle, get sufficient sleep, avoid staying up late, consume a balanced diet, and reduce intake of irritating foods. For individuals who spend extended periods reading or using computers, it is advisable to take a 5-10 minute break every 50 minutes and be mindful of blinking frequency. In dry environments, placing a cup of hot water on the desk can help regulate humidity levels.
Additionally, you can use a clean towel to apply a hot compress to your eyes for 5 to 10 minutes when you have time. When washing your face, pay attention to cleaning the eyelid margins. If needed, use cotton swabs dipped in water to clean the eyelid margins and release secretions from the eyes, allowing the gland openings to remain unobstructed. Individuals with dry eyes should quit smoking to prevent worsening the condition.
Text/ Zhi-Yi Lin, Pictures/Huai-Xian Huang and Pei-Qun Sun
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For inquiries: Shiuh-Liang Hsu, Director of the Taiwan Society of Cataract and Refractive Surgeons
Reference: https://news.m.pchome.com.tw/healthcare/heho/20230828/index-69323611418782323012.html
