Preventing Dry Eye Syndrome

Dry Eye Syndrome

Dry eye syndrome is a common condition with symptoms including blurred vision, redness, burning, stinging, and itchy eyes. Although the condition is typically chronic and progressive over time, most cases can be managed using effective treatment strategies.

Although chronic dry eyes can affect people of any age, it occurs most frequently among older individuals as the body’s ability to produce tears diminishes naturally over time.

Environmental factors, such as exposure to excessive winds, dry air, enclosed air-conditioned spaces, can also contribute to dry eye syndrome. Avoiding these types of environments for long periods of times, or using a humidifier in dry spaces, can help to alleviate symptoms.

Those who wear contact lenses are often affected, as the lenses tend to absorb too much moisture from the eye. If dryness and discomfort occur, an optometrist may prescribe a different type of contact lens or recommend moisturizing eye drops.

Certain medications have been known to aggravate chronic dry eyes, such as antidepressants, birth control pills, cold decongestants, diuretics, and painkillers.

Dry eye syndrome can also arise concurrently with pre-existing illnesses and conditions, like rheumatoid arthritis, diabetes, lupus,  vitamin A deficiency, menopause, shingles, Bell’s Palsy, scleroderma, Sjogren’s Syndrome, and refractive eye surgeries.

Prevention and Treatment

Preventative measures include adopting a healthy diet to support the proper functioning of the eyes. Eye health can be improved and maintained with diets high in vitamin A, as well as foods containing omega-3 fatty acids, such as certain kinds of fish, olive oil, canola oil, flax oil, flax seed, hemp seed, pumpkin seeds, soybeans, walnuts, cauliflower, and tofu.

Over-the-counter eye drops designed to moisturize and lubricate are recommended over those solely aimed at reducing redness. If these fail to work, optometrists can prescribe specialized eye drops to alleviate the uncomfortable, and sometimes painful, symptoms associated with dry eyes. For instance, eyedrops such as Restasis are commonly prescribed for chronic dry eyes and work to increase the production of tears while reducing discomfort and inflammation.

Although there is no cure for chronic dry eyes, awareness of its causes and treatment options can help to alleviate and minimize its symptoms.

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How is Macular Degeneration Diagnosed?

Macular Degeneration

Resulting from retinal damage that is often considered the byproduct of aging, macular degeneration typically impacts those ages 60 and older. Both forms of macular degeneration, dry and wet, impair the visual faculties used in day-to-day activities such as reading and driving.

The part of the eye affected by macular degeneration is called the macula, which is responsible for relaying images directly in front of the eye up to the brain. Aging, high blood pressure, and smoking tobacco are associated with higher chances of developing the condition.  

Macular degeneration is diagnosed by ophthalmologists in a few different ways. A common method involves first dilating the pupils, at which point the eyes can be examined using an ophthalmoscope. Symptoms can then be assessed using an Amsler grid. Photographs of the eyes may also be taken using optical coherence tomography (OCT) or fluorescein angiography. An OCT scan is used to detect abnormal blood vessels. A fluorescein angiography involves taking photographs of an abnormality-detecting fluorescent dye that travels through the veins after it has been injected.

Preventative measures include getting regularly checked by an eye specialist, and taking vitamin supplements that contain vitamins C, B6, B12, lutein, and folic acid.

Although there is currently no cure, there are effective treatment options. For instance, anti-vascular endothelial growth factor (anti-VEGF) drugs can be injected into the affected eye (after being anesthetized), which prevent certain proteins from causing fluid leakage and instigating abnormal blood vessel growth. Another option is thermal laser treatment, in which cold laser beams attack abnormal blood vessels to arrest their growth and inhibit new ones from forming.

Some ophthalmologists recommend photodynamic therapy (PDT), which entails a dye injected directly into the eye that directionally assists a laser in destroying abnormal blood vessels.

Annual eye exams are recommended for those over 30. Those over 50, or those with diabetes — who are especially susceptible to — may require optometrist or ophthalmologist consultations on a more frequent basis.

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Treating Macular Degeneration

Macular Degeneration

Although there is no cure for macular degeneration as of yet, there exist several effective treatment strategies that work to alleviate and minimize symptoms, while preventing the condition from progressing further. Medical research is ongoing toward finding improved ways of restoring lost vision faculties.

Here are some of the methods currently used to treat macular degeneration.

Photodynamic Therapy

Using laser technology, photodynamic therapy involves the injection of a photosensitizer drug into the bloodstream that gets absorbed by the abnormal blood vessels in the retina. A cold laser beam is then directed at the eye in hopes of attacking the macular degeneration-causing blood vessels. Other conventional laser therapies are sometimes also used.

Photodynamic therapy is slowly becoming more and more unpopular among ophthalmologists in favor of anti-angiogenic drugs.

Anti-Angiogenic Drugs

Currently, one of the most effective and popular ways of treating macular degeneration, anti-angiogenic drugs are typically injected into the eye where they work to inhibit leakage from abnormal blood vessels and stop further growth of new abnormal blood vessels. In most cases, anti-angiogenic drugs halt the progression of macular degeneration, thereby stabilizing vision. In a minority of cases, lost vision is partially restored.

Implantable Telescope Lens

A relatively new treatment strategy that is currently available only in some parts of the U.S., this surgical procedure involves the removal of the lens in the eye affected by macular degeneration and replacing it with an implantable telescope lens (IMT). This specialized procedure is only conducted by ophthalmologists highly qualified in the field.

After intensive rehabilitative therapy for up to one year, many patients experience a significant degree of their visual faculties restored.

Vision Specialists

An optometrist is one kind of eye doctor who is able to diagnose health disorders in the eyes and prescribe medications and other forms of treatment to correct vision issues. In cases where eye surgery is required, optometrists usually refer their patients to ophthalmologists.

Ophthalmologists have the same training as optometrists in addition to surgical training and licensing, as well as access to specialized equipment used to diagnose macular degeneration. Those with a family history of macular degeneration are recommended to consult with an ophthalmologist.

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What is Macular Degeneration

Macular Degeneration

Age-related macular degeneration (AMD) primarily affects those 55 and older, with over 10,000 diagnosed in the U.S. alone. According to the Macular Degeneration Foundation, those numbers are predicted to rise dramatically over the next decade.

Although there currently exists no cure for AMD, treatment strategies are constantly improving, allowing for improved symptom management, and sometimes their reversal.

AMD attacks the retina; particularly, the center part known as the macula, which is responsible for relaying what is seen directly in front of the eye. The macula takes images from the eye and sends them to the brain, and plays a crucial role in day-to-day functions that require the visual faculties (i.e. driving, reading).

The deterioration of the macula that occurs in cases of AMD is most commonly attributed to aging. Macular degeneration is generally divided into two major types: dry and wet.

Dry macular degeneration comprises the majority of cases. Symptoms include impaired or blurry vision, poor night vision, haziness, blind spots, and difficulty making out faces or words clearly.

Considered the more severe version of AMD—occurring in about a tenth of all cases—wet macular degeneration also affects the center field of vision. Resulting from blood vessel abnormalities that cause fluid leaks, wet macular degeneration usually progresses from dry macular degeneration. Symptoms include distorted vision, blind spots, and difficulty differentiating gradations of light and color.

Although old age is thought to be the chief cause of AMD, no other specific cause is directly linked to its development. Family medical history has been associated with increased chances of developing the condition. No cure exists yet, but there are preventative measures available to maintain eye health, such as vitamins, regular eye exams, and ophthalmology consultations. Whereas dry AMD progresses gradually, symptoms of wet AMD tend to accelerate quickly. It is therefore critical to speak with your doctor about AMD to manage (and hopefully reverse) symptoms if they appear.

In the case of wet AMD, certain medications can be prescribed to prevent further growth of abnormal blood vessels in the retina. Being aware of the potential for AMD as you grow older, as well as the symptoms to watch out for, are the best ways to prevent potential vision impairment and loss from negatively impacting your quality of life.

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Macular Degeneration: The Terms you Need to Know

Macular Degeneration

Age-related macular degeneration (AMD) is an eye condition that involves impaired vision resulting from the deterioration of one or both of the retinae. Typically not leading to total blindness, difficulty reading is a common symptom occurring in both the dry and (more serious) wet form of this condition. Many sufferers continue to perform day-to-day activities that require their visual facultieseven still being able to drive.

Here are some of the terms you need to know when speaking about macular degeneration.

Macula

The macula is located at the center of the retina and is responsible for producing a sharp, clear vision of objects located in front the eye. This area is specifically targeted by macular degeneration.

Dry Macular Degeneration

Dry macular degeneration represents a slow deterioration of cells in the retina (known as drusen) which eventually causes decreased sharpness in vision, as well as blurriness. As drusen start to break down, tiny, yellow-white spots form in the back of the eye, and can only be seen using specially-designed lenses. Dry macular degeneration represents the majority of cases (approximately 90%). Although there currently exists no prescribed treatment, most patients continue performing their normal day-to-day tasks while being closely and regularly monitored by their ophthalmologists.  

Wet Macular Degeneration

Representing roughly a tenth of all cases, the wet form of macular degeneration entails blood vessels growing from the choroid, eventually causing detachment of the retina. Wet AMD cases involve a higher degree of people partially losing their vision. However, wet AMD is treatable and sometimes reversible through blood vessel regeneration.  

Coherence Tomography

Coherence tomography is used to diagnose dry macular degeneration and involves using light waves to procure images of possible drusen deposits behind the retina. These high-resolution images are obtained by first administering pupil-widening dilation drops and then using non-invasive imaging technology to take cross-section photos of the retina.

Fluorescein Angiogram

Fluorescein Angiogram is also used to diagnosis AMD, and consists of injecting a fluorescent fluid into the patient’s arm. While this dyed fluid passes through the blood, special photographs are taken to reveal the possibility of leakages or abnormalities. Complications of this angiogram include nausea, allergic reactions, and other side effects.

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Treating Dry Eyes

Treating Dry Eyes

Dry eye syndrome is typically caused by the eyes not producing enough tears, or the tears produced being of poor-quality. So how do you go about treating dry eyes?

In most mild to moderate cases, over-the-counter eyedrops effectively reduce symptoms—artificial tears or home remedies are generally preferred over those solely aimed at reducing redness.

Other treatments aim at improving tear quality, or the prevention of tears draining too quickly. More severe or persistent cases of dry eyes are treated by assessing their underlying causes, often reversing or managing symptoms.

Dry eyes are a common side-effect of certain medications, in which case a doctor may prescribe their patient something different.

More serious cases, such as anatomic abnormalities in the eyelids, may be treated by plastic surgery. Other causes can include autoimmune conditions, such as Sjogren’s syndrome and rheumatoid arthritis, in which case the patient may be referred to a specialist.

Given the wide variety of factors causing dry eyes, no single cure exists as of yet that solves dry eye syndrome in all of its incarnations. However, medical research is advancing toward a consolidated solution for the correction and control of tear-flow in those dealing with dry eyes.

Medications currently prescribed to treat dry eyes include antibiotics, which reduce inflammation around the edges of the eyelids that impair the oil glands from secreting oil functionally.

Cornea inflammation may be treated by immune-suppressing eyedrop medication, such as cyclosporine or corticosteroids.

For those unable to use artificial tears in eyedropper form, there exist prescription eye inserts that work in the same way. Lacrisert, for instance, is a hydroxypropyl cellulose in the form of a tiny clear pill that gets inserted between the eyelid and eyeball, then dissolving and lubricating the eye.

Sometimes a doctor will recommend means of partially or completely closing the tear ducts to prevent tears from leaving the eye too quickly. Common methods include silicone plugs, which save both naturally-produced and artificially-added tears. Another method is called thermal cautery, in which a local anesthetic is applied followed by a hot wire that shrinks, scars and ultimately closes the tear duct.

Specific dry eyes contact lenses (called corneal shields or bandage lenses) may be prescribed, which protect the surface of the eyes and trap moisture in.

Newer treatments involve unblocking oil glands using thermal pulsation techniques. The treatment involves an eyecup being placed over the eye, after which the lower eyelid is gently massaged.

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What Causes Dry Eyes

Dry Eyes

Dry eyes are generally caused by either not enough tears being produced or tears being produced at a poorer quality. A mixture of mucus, fatty oils, proteins, antibodies, and water, tears are essential for the lubrication and moisturization of the eyes, as well as their infection-resisting properties. Dry eye syndrome may result for a number of reasons, including malfunctioning tear glands, environmental factors, eyelid defects, and side-effects from certain medications.

The eyes’ tear film consists of three layers: oil, water, and mucuseach causing eye problems in different ways when they function improperly. The outer layer produces oil; specifically, fatty oils known as lipids. This oil is secreted from the edge of the eyelids, which then act to slow down evaporation of the water component in the middle layer. A deficiency in oil —often caused by clogged glands — results in the water layer evaporating too quickly, thereby causing irritation and redness. Eyelid inflammation and rosacea are other contributory causes.

The middle layer of the tear film consists of water and a small amount of salt. Its fluids are secreted through the tear glands and act to purify the area of foreign particles and irritants. When the eye produces insufficient amounts of water, secretions from the other layers may end up in a stringy discharge.

The inner layer consists of mucus and works to spread tears consistently over the surface of the eyes, with an insufficiency of mucus causing dry spots on the surface.

An inadequate production of tears may occur for a number of reasons, including being older than 50, postmenopausal, and having certain medical conditions such as diabetes, rheumatoid arthritis, lupus, scleroderma, and Sjogren’s syndrome. Malfunctioning of the eyes’ tear system may also occur as a result of laser eye surgery, or general tear gland damage caused by inflammation or radiation.

Problems with eyelid functionality are another major contributor. Blinking essentially serves to spread tears evenly over the surface of the eyes. Defects in the eyelids, such as ectropion or entropion (out-turning or in-turning of the eyelids, respectively), can cause tears to evaporate too quickly as a result of the uneven distribution.

Dry eye syndrome is a side-effect of certain medications, such as antidepressants, blood pressure medications, decongestants, acne medications, and hormone replacement therapies.

Environmental factors such as overexposure to winds, air-conditioning, dry air, as well as watching too much television, can also cause dry eyes.

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Dry Eyes Explained

Dry Eyes

Dry eyes syndrome occurs mainly in older adults and those with autoimmune conditions (e.g. arthritis), causing the eyes to be irritated, itchy, and scratchy, as a result of the tear glands not producing tears properly. Causes include wearing contact lenses, smoking tobacco, and certain medications, like antidepressants, antihistamines, decongestants, and diuretics.

The ocular tear system works to moisturize and lubricate the eyes for the maintenance of proper vision and overall comfort. Secreted through special glands around the eye, tears are a mixture of antibodies, oils, mucus, proteins, and water, which all function in different ways to ensure the normal functioning of the eyes. Dry eyes represent an imbalance in the tear system and, subsequently, an impaired functioning of its ability to resist infections, moisturize, lubricate, and consistently spread its fluid.

Dry eyes may occur as a result of not enough tears being produced, or the production of tears that are lacking in their required richness. Dry eyes may also occur because of aggravating circumstances, such as exposure to winds (i.e. skiing or bicycling), watching too much television, or being in air-conditioned spaces for too long.

Sign and symptoms include eye redness, stinging or burning, excess mucus around the eyes, sensitivity to light, feeling as if something is stuck in the eyes, trouble wearing contact lenses, blurred vision, easily provoked eye irritation, and general eye fatigue.

In those with situationally-caused, or mild to moderate recurrent symptoms, the most common form of treatment entails over-the-counter eyedrops. Artificial tears and other home remedies are often recommended over those that are solely aimed at eliminating eye redness.

More serious or persistent symptoms may warrant other treatment options, which work to reverse or manage symptoms. In some cases, treatment options involve improving tear quality or preventing tears from draining too quickly. In other cases, such as an anatomic abnormality, which impairs the eyelid’s ability to blink correctly, plastic surgery of the eyelids may be required.

In other instances where dry eye syndrome is caused by an autoimmune condition (i.e. Sjogren’s syndrome or rheumatoid arthritis), a doctor may refer the patient to a rheumatologist. Given that dry eyes are a common side effect of certain medications, a doctor may prescribe a patient something different if dry eye symptoms persist. Overall, the causes of dry eye syndrome are effectively treatable in the vast majority of cases.

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