How to cope when dry eye flares

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Climate and weather have a big impact on eye health and comfort. This is particularly true for people with dry eye. The disease is characterized by an unbalanced tear film that causes pain and blurry vision.

Fall and winter can be particularly challenging. Cold outside air and windy conditions tend to worsen symptoms. Indoor humidity falls to its lowest point since people are using their heating systems. Upper respiratory infections also peak, which means patients are turning to decongestants that have the side effect of decreasing tear production.

If this season brings out the worst in your eyes, it’s a great time to talk with an eye doctor. Dry eye is a very common condition, affecting 7 to 10 percent of the population. The disease is concentrated in older adults and most common in post-menopausal women. Many medications — antihistamines, diuretics, antidepressants, sleeping pills, birth control pills, and some blood pressure medications — can worsen symptoms.

As an ophthalmologist at Vancouver Clinic, I see a range of dry-eye symptoms in patients, including:

Intermittent blurry vision (particularly in the morning and late at night)

Eye pain (scratchy, stinging, or burning sensation)

• Difficulty wearing contacts

• Light sensitivity

• Tired or strained eyes.

Watery eyes are also a likely symptom. Without a healthy oil layer tears evaporate quickly. The lacrimal gland tries to compensate, which results in an overproduction of the watery portion of tears.



The good news is that patients have a number of options for managing these symptoms. Milder cases may be controlled with over-the-counter and home remedies. One of the first things I advise patients to do is stay hydrated by drinking plenty of water. If their eyes seem to be worse in cold weather, they may want to consider purchasing a humidifier. Taking fish oil or omega-3 supplements, limiting medications that contribute to dry eye and avoiding smoke and other irritants are also important. 

Warm compresses and eyelid scrubs can help some patients.

Over-the-counter artificial tears can add much-needed moisture to eyes — preservative-free vials are the best option. Patients should avoid drops that offer redness relief, as these tend to make things worse. 

For patients whose symptoms are the worst when they wake up, it’s wise to use a lubricating ointment before bed and artificial tears immediately upon waking.

When these solutions aren’t enough, a prescription solution — short-term steroid eye drops or drops that increase tears over the long term — may help. A punctal plug, inserted during an office visit, can help prevent liquid from draining from the eye surface.

Finally, it’s important for everyone to give their eyes a break when they’re reading, working at a computer, watching TV or scrolling on their cellphone. This is particularly true for patients with dry eyes. 

A practical rule of thumb is to follow the 20-20-20 rule. Every 20 minutes, look at something 20 feet away for 20 seconds. Many people do not blink often enough, so blinking repeatedly for a few seconds every so often can help.

If you suspect you have dry eye, talk to your eye doctor to get an accurate diagnosis. Your physician can then determine which treatments are right for you.

 

Dr. Evan Olson is a comprehensive ophthalmologist at Vancouver Clinic. He has a particular interest in cataract surgery, laser surgery and advanced technology intraocular lens implantation.