I’ve been practicing optometry nearly a quarter century and I have a confession to make: I have a love/hate relationship with dry eye. Here’s the thing about dry eye disease. Some people have classic symptoms of dry eye: gritty, sandy, watery eyes, but no ocular signs of dry eye when viewed behind the microscope. Others feel, “fine”, but have an ocular surface that looks downright parched. Still others have non-specific symptoms that may or may not be dry eye: redness, fluctuating vision, blurred vision, eye fatigue, contact lens intolerance.
Yep. The struggle is real.
Here’s the reality of dry eye. It’s exceedingly common and, due to the advent of digital devices, the prevalence is climbing. I was trained to think of dry eye as the ocular disease of the peri-menopausal woman. Perhaps because I am now a certified member of the aforementioned age group, my views are changing. I now recognize this fact: any person of any age and any gender is susceptible to dry eye.
It’s true that the dry eye statistics are changing in part because eye care practitioners are getting better at finding and diagnosing dry eye. New tests and tools help us recognize dry eye even without any signs or symptoms. We can now measure tear chemistry with simple, quick, effective in-office tests. We can scan the tear glands for changes in the structural integrity and function. We are capable of detecting dry eye risk factors like inflammation or gland atrophy before dry eye or ocular surface disease starts. Just like you get dental x-rays before your teeth have already fallen out, we now work to detect your risk of future ocular surface disease BEFORE the changes are irreversible and vision-threatening.
However, we aren’t just better at identifying dry eye. The reality is, dry eye is becoming more common. It’s not at all unusual to hear teens and young adults complain of dryness, fluctuating vision, contact lens intolerance and chronic redness. What’s even more startling, however, is the number of young children with signs and symptoms of dry eye. “Jimmy rubs his eyes all the time when using his tablet.” “Susie’s eyes seem to be red and watery when she plays video games.” These were pretty uncommon symptoms in kids when I began practicing.
Is all this just something we have to accept as an unfortunate side effect of the digital age? I certainly don’t think so. We need to recognize the environments and behaviors contributing to these changes and learn better, “visual hygiene”, to prevent it: taking visual breaks from electronics, using blink exercises (we don’t blink enough while using a device), assessing our environment for instigators of dry eye, like ceiling fans, vents, low humidity, and lighting, as well as our medications and diet. We need to use digital device eyeglasses, designed with appropriate filters, materials and prescriptions individualized just for you and how you use your eyes. Our eyes haven’t evolved to be capable of the demands of current digital devices, so we must use modern tools, techniques and technology to keep them comfortable, functional, and healthy.
On my end, that means acknowledging that dry eye disease and the dry eye patient may look different than it used to. In fact, they may, “feel”, nothing at all. Sometimes a person walks around so long with tired, uncomfortable eyes, they forget what normal used to look and feel like. For others, their eyes have been so dry for so long, the nerves sending the, “dry eye alerts”, to the brain stop working. Those patients are at high risk because they often cannot feel the damage occurring until it’s too late. I must also use new tools and techniques to prevent dry eye and ocular surface disease before it becomes a problem. And finally, I must not wait for my patients to feel or see badly to address the underlying dry eye issues.
On your end, you have to treat your eyes as well (or better) than your teeth. Think about it. You don’t wait to see your dentist once your teeth start hurting, turning black and falling out. You brush and floss and get cleanings and x-rays and fillings and crowns so they DON’T fall out. You take care of them daily (I hope). Don’t your eyes deserve AT LEAST that level of TLC? After all, fake eyes don’t work quite as well as fake teeth, right?
So think about your eyes, your digital device habits, your ocular comfort, and the quality of your vision. Talk to your eye doctor about good eye health habits like visual breaks and a healthy diet for your eyes. Learn about advances in eyeglasses designed for digital device users. Ask for tests and treatments for dry eye. Don’t think of dry eye as just a set of symptoms. Instead, remember that dry eye is an eye DISEASE that can contribute to permanent changes in the structure and function of your eyes.
Dry eye isn’t going anywhere but it is a treatable and sometimes preventable eye disease. Armed with new statistics, tests, treatments, and preventive measures, all of us, regardless of age, can lessen the impact on our day-to-day vision and comfort as well as our long term eye health.
Now altogether, everyone put down your cell phone, blink your eyes, and take a twenty second (or more) visual break. Then pick it up again and call your eye doctor. Your peepers will thank you.
Dr. Jodi Kessinger has been an expert in eye care for nearly 25 years. She specializes in family eye care, contact lenses, LASIK consultations, diagnosis, treatment and co-management of ocular diseases and conditions, including age related macular degeneration, diabetic retinopathy, glaucoma, cataracts and dry eye. You can find her practicing at Midwest Eye Consultants in Maumee and Toledo, Ohio.