Dry Eye Treatment: Getting Relief From Dry Eyes

 

Dry eye syndrome is a chronic and typically progressive condition. Depending on its cause and severity, it may not be completely curable. But in most cases, dry eyes can be managed successfully, usually resulting in noticeably greater eye comfort, fewer dry eye symptoms, and sometimes sharper vision as well.

Because dry eye disease can have a number of causes, a variety of treatment approaches are used.

The following is a list of dry eye treatments that are commonly used by opticians to reduce the signs and symptoms of dry eyes. Your optician may recommend only one of these dry eye treatments or a combination of treatments, depending on the cause(s) and severity of your condition.

Artificial Tears

For mild cases of dry eyes caused by computer use, reading, schoolwork and other situational causes, the best dry eye treatment may simply be frequent use of artificial tears or other lubricating eye drops.

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Artificial tears usually are the first step in dry eye treatment.

There are many brands of artificial tears that are available without a prescription. The challenge with using artificial tears is not lack of product availability — it’s the confusing number of brands and formulations available to choose from.

Artificial tears and other over-the-counter (OTC) lubricating eye drops are available in a wide variety of ingredients and viscosity (“thickness”).

Artificial tears with low viscosity are “light” and watery. They often provide quick relief with little or no blurring of your vision when you apply them. But often their soothing effect is very short-lived, and sometimes you must use these drops very frequently to get adequate dry eye relief.

On the other hand, artificial tears that have a high viscosity are more gel-like and can provide longer-lasting lubrication. But typically these drops cause significant blurring of your vision for several minutes immediately after you apply them. For this reason, these drops often are not a good choice for use during your work day or when you need immediate clear vision for tasks such as driving. Instead, high-viscosity artificial tears are recommended only for bedtime use.

Also, the ingredients in certain brands of artificial tears may determine which type of dry eye condition they are better suited for. For example, one brand might work better for aqueous-deficiency dry eyes, while another brand may be more effective for an evaporative dry eye condition.

If your optician recommends that you use one or more brands or formulations of artificial tears, be sure to follow the directions he or she gives you concerning when and how often you use the drops.

Steriod Eye Drops

Over the past several years, doctors have discovered the importance of inflammation as a cause of dry eyes. Inflammation frequently causes the redness and burning associated with dry eye disease; but in many cases, it may be present without any visible signs or symptoms at all.

Artificial tears usually do not adequately address these inflammatory changes, and your doctor may recommend steroid eye drops to better manage the underlying inflammation associated with dry eyes.

Often there’s no “quick fix” for dry eyes. Follow your eye doctor’s instructions and be patient for results from dry eye treatment.

Steroid eye drops are generally used short-term to quickly manage symptoms. They are often used in conjunction with artificial tears as a complement to these more long-term treatment strategies.

While a small amount of the steroid may get absorbed systemically, in the right candidate, the effects of steroid eye drops are generally not noticed beyond the eye. Still, it’s important to discuss your medical history with your eye doctor before starting steroid eye drops.

Many different types of steroid drops are available and differ in their potency. Most doctors prefer to start with mild steroids that are quickly degraded inside the eye. In some cases, however, more potent drops are required to address more severe symptoms.

Steroid eye drops can increase the risk of developing high eye pressure or even cataracts if used for extended periods of time. But these risks are low when the drops are used only on a short-term basis for dry eye treatment.

Punctal Plugs

Punctal plugs are sometimes used in dry eye treatment to help tears remain on the surface of the eye longer.

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This drawing shows the lacrimal glands and tear ducts. A lacrimal plug (or punctal plug) has been inserted into the lower tear duct to keep the eye’s moisture from draining away too quickly. Image: Oasis Medical, Inc


This drawing shows the lacrimal glands and tear ducts. A lacrimal plug (or punctal plug) has been inserted into the lower tear duct to keep the eye’s moisture from draining away too quickly. Image: Oasis Medical, Inc. [Enlarge]

A punctal plug is a small, sterile device that is inserted into one of the small openings (puncta) of tear drainage ducts that are located in the inner corner of the upper and lower eyelids.

After these openings have been plugged, tears can no longer drain away from the eye through these ducts. In this way the tear film stays intact longer on the surface of the eye, relieving dry eye symptoms.

So where do the tears go? Usually they will simply evaporate from the eye surface without symptoms. But if insertion of punctal plugs causes the eyes to “water,” one or more of the plugs can be removed.

Meibomian Gland Expression

A very significant percentage of dry eye cases are caused by inadequate oil (meibum) being secreted from meibomian glands located along the margin of the eyelids.

The openings of these glands are near the base of the eyelashes, and if these openings get clogged, the oil that is critical to keeping the tear film from evaporating too quickly cannot do its job. This is called meibomian gland dysfunction (MGD), which leads to a condition called evaporative dry eye.

To treat MGD and evaporative dry eye, your eye doctor may perform an in-office procedure called meibomian gland expression. In this procedure, warm compresses may or may not first be applied to your eyelids; then a forceps-type device is used to squeeze the clogged contents (hardened meibum and possibly other substances) from the meibomian glands.

To fully express the contents of the meibomian glands and get them functioning properly, significant pressure must be applied to the eyelids, which can be uncomfortable. But the results usually are worth putting up with the short-term discomfort of the procedure.

Warm Compresses

An alternative (and potentially more comfortable) way to help open clogged meibomian glands to treat dry eyes is to simply apply warm compresses to the closed eyelids to soften the hardened meibum.

Unfortunately, for warm compresses to work well, some researchers say you have to use a compress that can maintain a temperature of 108 degrees Fahrenheit for more than 10 minutes, and the compresses have to be applied for this length of time at least twice a day.

Most people are unable or unwilling to perform this type of dry eye treatment correctly, and shorter and less frequent use of variable-temperature warm compresses typically is ineffective.

Nutritional Supplements

Doctors sometimes recommend nutritional supplements as part of a holistic dry eye treatment plan. Studies have found that supplements containing omega-3 fatty acids can decrease dry eye symptoms.

Good sources of omega-3s include cold-water fish such as salmon, sardines, herring and cod. For a vegetarian source of omega-3s, some eye doctors recommend flaxseed oil to relieve dry eye.

Drinking more water can help, too. Mild dehydration often makes dry eye problems worse. This is especially true during hot, dry and windy weather. Simply drinking more water sometimes reduces the symptoms of dry eye syndrome.

Home Remedies for Dry Eyes

If you have mild dry eye symptoms, there are several things you can try to get relief

  • Blink more frequently. When using a computer, smartphone or other digital device, we tend to blink our eyes less frequently than normal, which can cause or worsen dry eye symptoms. Make a conscious effort to be aware of this, and blink more often when using these devices. Also, perform full blinks, gently squeezing your eyelids together to wash your eyes fully with a fresh layer of tears.
  • Take frequent breaks during computer use. A good rule of thumb here is to look away from your screen at least every 20 minutes and look at something that is at least 20 feet from your eyes for at least 20 seconds. Some eye care practitioners call this the “20-20-20 rule,” and abiding by it can help relieve both dry eyes and computer eye strain.
  • Remove eye makeup thoroughly. Eyeliner and other eye makeup can clog the openings of the meibomian glands at the base of the eyelashes, leading to meibomian gland dysfunction and evaporative dry eye. At the end of the day, be diligent about remove all traces of makeup from your lids and lashes.
  • Clean your eyelids. When washing your face before bedtime, gently wash your eyelids to remove bacteria that can cause blepharitis and meibomian gland problems that lead to dry eye symptoms. Apply a warm, moist washcloth to your closed lids for a minute or two. Then gently scrub your lids and lashes with a mild cleanser, such as diluted baby shampoo or premoistened eyelid wipes sold in drugstores.
  • Wear quality sunglasses. When outdoors during the day, always wear sunglasses that block 100 percent of the sun’s UV rays. It’s best if they feature a wrap-style frame to protect your eyes from wind, dust and other irritants that can cause or worsen dry eye symptoms.

Book an eye examination if you want a full eye health check.

Source Richard Adler, MD

 


New range of Stella McCartney frames, now in store!

Check out our fabulous new range of Stella McCartney frames, now in store!

We had a lovely evening at the Wesminster Abbey Cloisters thanks to Kering eyewear who supply Stella McCartney frames. We were lucky enough to view Kering’s entire range of frames and sunglasses……watch this space for more exciting new brands!

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Contact Lens Basics

Contact lenses are an excellent choice for nearly anyone who needs vision correction but doesn’t want to wear spectacles full time or undergo Lasik Surgery.

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Here are the basics you should know about contact lenses before seeing your optician if you are interested in wearing contacts.

 

Contact Lens Materials

The first choice when considering contact lenses is which lens material will best satisfy your needs. There are five types of contact lenses, based on type of lens material they are made of:

CONTACT LENS MATERIAL

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  • Soft lensesare made from gel-like, water-containing plastics called hydrogels. These lenses are very thin and pliable and conform to the front surface of the eye. Introduced in the early 1970s, hydrogel lenses made contact lens wear much more popular because they typically are immediately comfortable. The only alternative at the time was hard contact lenses made of PMMA plastic (see below). PMMA lenses typically took weeks to adapt to and many people couldn’t wear them successfully.
  • Silicone hydrogel lensesare an advanced type of soft contact lenses that are more porous than regular hydrogel lenses and allow even more oxygen to reach the cornea. Introduced in 2002, silicone hydrogel contact lenses are now the most popular lenses prescribed in the UK
  • Gas permeable lenses— also called GP or RGP lenses — are rigid contact lenses that look and feel like PMMA lenses (see below) but are porous and allow oxygen to pass through them. Because they are permeable to oxygen, GP lenses can be fit closer to the eye than PMMA lenses, making them more comfortable than conventional hard lenses. Since their introduction in 1978,gas permeable contact lenses have essentially replaced nonporous PMMA contact lenses. A significant advantage GP contacts have over soft or silicone hydrogel lenses is sharper optics due to the rigid nature of the lens material.
  • Hybrid contact lensesare designed to provide wearing comfort that rivals soft or silicone hydrogel lenses, combined with the crystal-clear optics of gas permeable lenses. Hybrid lenses have a rigid gas permeable central zone, surrounded by a “skirt” of hydrogel or silicone hydrogel material. Despite these features, only a small percentage of people in the UK wear hybrid contact lenses, perhaps because these lenses are more difficult to fit and are more expensive to replace than soft and silicone hydrogel lenses.
  • PMMA lensesare made from a transparent rigid plastic material called polymethyl methacrylate (PMMA), which also is used as a substitute for glass in shatterproof windows and is sold under the trademarks Lucite, Perspex and Plexiglas. PMMA lenses have excellent optics, but they do not transmit oxygen to the eye and can be difficult to adapt to. These (now old-fashioned) “hard contacts” have virtually been replaced by GP lenses and are rarely prescribed today.

 

Silicone hydrogel contact lenses are the most popular lenses in the UK, accounting for 68 percent of new contact lens fittings and refittings in 2015.

Contact Lens Wearing Time

Until 1979, everyone who wore contact lenses removed and cleaned them nightly. The introduction of “extended wear” enabled wearers to sleep in their contacts. Now, two types of lenses are classified by wearing time:

  • Daily wear— must be removed nightly
  • Extended wear— can be worn overnight, usually for seven days consecutively without removal

“Continuous wear” is a term that’s sometimes used to describe 30 consecutive nights of lens wear

 

When To Replace Your Contact Lenses

Even with proper care, contact lenses (especially soft contacts) should be replaced frequently to prevent the build-up of lens deposits and contamination that increase the risk of eye infections.

Soft lenses have these general classifications, based on how frequently they should be discarded:

LENS REPLACEMENT FREQUENCY

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  • Daily disposable lenses— Discard after a single day of wear
  • Disposable lenses— Discard every two weeks, or sooner
  • Frequent replacement lenses— Discard monthly or quarterly
  • Traditional (reusable) lenses— Discard every six months or longer

Gas permeable contact lenses are more resistant to lens deposits and don’t need to be discarded as frequently as soft lenses. Often, GP lenses can last a year or longer before they need to be replaced.

Contact Lens Designs

Many lens designs are available to correct various types of vision problems:

  • Sphericalcontact lenses are the typical, rounded design of contact lenses, which can correct myopia (nearsightedness) or hyperopia (farsightedness).
  • Bifocalcontact lenses contain different zones for near and far vision to correct presbyopia
  • Orthokeratologylenses are specially designed to reshape the cornea during sleep, providing lens-free daytime wear.
  • Toriccontact lenses correct for astigmatism, as well as for myopia and hyperopia

 

All of these lenses can be custom made for hard-to-fit eyes. Many other additional lens designs are available. Typically these are less common and fabricated for use in special situations, such as correcting for keratoconus.

 

More Contact Lens Features

Bifocal contacts for astigmatism. These are advanced soft contacts that correct both presbyopia and astigmatism, so you can remain glasses-free after age 40 even if you have astigmatism.

 

Contacts for dry eyes. Are your contacts uncomfortably dry? Certain soft contact lenses are specially made to reduce the risk of contact lens-related dry eye symptoms.


Coloured lenses. Many of the types of lenses described above also come in colours that can enhance the natural colour of your eyes — that is, make your green eyes even greener, for example. Other colored lenses can totally change the colour of your eyes, as in from brown to blue.

Special-effect lenses. Also called theatrical, novelty, or costume lenses, special-effect contacts take coloration one step further to make you look like a cat, a vampire, or another alter-ego of your choice.

 

Prosthetic lenses. Coloured contact lenses also can be used for more medically oriented purposes. Opaque soft lenses called prosthetic contacts can be custom-designed for an eye that has been disfigured by injury or disease to mask the disfigurement and match the appearance of the other, unaffected eye.

 

Custom lenses. If conventional contact lenses don’t seem to work for you, you might be a candidate for custom contact lenses that are made-to-order for your individual eye shape and visual needs.

 

UV-inhibiting lenses. Some soft contact lenses help protect your eyes from the sun’s ultravioletrays that can cause cataracts and other eye problems. But because contacts don’t cover your entire eye, you still should wear UV-blocking sunglasses outdoors for the best protection from the sun.

 

Scleral lenses. Large-diameter gas permeable lenses called scleral contacts are specially designed to treat keratoconus and other corneal irregularities, as well as presbyopia.

 

Myopia control contacts. Special contact lenses are being developed to slow or stop the progression of nearsightedness in children.

 

Which Contact Lens Is Right for You?

First, your contacts must address the problem that is prompting you to wear lenses in the first place. Your contact lenses must provide good vision by correcting your myopiahyperopia,astigmatism, or some combination of those vision problems.

Second, the lens must fit your eye. To do that, lenses come in tens of thousands of combinations of diameter and curvature. Of course, not every lens brand comes in every “size.”

Your Opician is skilled in evaluating your eye’s physiology, and your eyesight, to determine which lens best satisfies the two criteria above.

 

Third, you may have another medical need that drives the choice of lens. For example, your Optician might pick a particular lens if your eyes tend to be dry.

Finally, consider your “wish list” of contact lens features — colors, for example, or overnight wear.

Contact Lens Wear and Care

Caring for your contact lenses — cleaning, disinfecting and storing them — is much easier than it used to be.
A few years ago, you would have needed several bottles of cleaning products, and perhaps enzyme tablets, for proper care. Today, most people can use “multipurpose” solutions — meaning that one product both cleans and disinfects, and is used for storage.

People who are sensitive to the preservatives in multipurpose solutions might need preservative-free systems, such as those containing hydrogen peroxide. These do an excellent job of cleaning contacts, but it’s very important to follow the directions for using them. The solution should not come into contact with your eyes until soaking is complete and the solution is neutralized.Of course, you can avoid lens care altogether by wearing daily disposable contact lenses.

Contact Lens Problems

Trial and error often is involved in finding the perfect lens for you. People react differently to various lens materials and cleaning solutions.

Also, the correct “parameters” of your lens — that is, power, diameter, and curvature — can be finalized only after you’ve successfully worn the lens. This is especially true for more complex fits involving extra parameters, such as with bifocals or toric contact lenses for astigmatism.

If you experience discomfort or poor vision when wearing contact lenses, chances are that an adjustment or change of lens can help.

 

Today, more contact lens choices than ever are available to provide comfort, good vision, and healthy eyes. If your eyes or lenses are uncomfortable or you are not seeing well, remove your lenses and visit your eye care professional to explore available remedies for contact lens discomfort.

Source: Liz Segre

 


Eye Allergies: How To Get Relief From Itchy, Watery Eyes

Eye allergies — red, itchy, watery eyes that are bothered by the same irritants that cause sneezing and a runny nose among seasonal allergy sufferers — are very common.

If you think you have eye allergies, here are a few things you should know — including helpful tips on how to get relief from your red, itchy, watery eyes.

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What Causes Eye Allergies

Normally harmless substances that cause problems for individuals who are predisposed to allergic reactions are called allergens. The most common airborne allergens that cause eye allergies are pollen, mold, dust and pet dander.

Eye allergies also can be caused by reactions to certain cosmetics or eye drops, including artificial tears used for treating dry eyes that contain preservatives.

Food allergies and allergic reactions to bee stings or other insect bites typically do not affect the eyes as severely as airborne allergens do.

Eye Allergy Relief

To get relief from your eye allergies and itchy, watery eyes, you can take a few approaches:

Avoiding allergens. As the old saying goes: “An ounce of prevention is worth a pound of cure.”

The best approach to controlling your eye allergy symptoms is to do everything you can to limit your exposure to common allergens you are sensitive to.

What is the pollen count in your area of the country?
For example, on days when the pollen count is high, stay indoors as much as possible, with the air conditioner running to filter the air. Use high quality furnace filters that can trap common allergens and replace the filters frequently.

When you do go outdoors during allergy season, wear wraparound sunglasses to help shield your eyes from pollen, ragweed, etc., and drive with your windows closed.

Removing your contacts. Because the surface of contact lenses can attract and accumulate airborne allergens, consider wearing only eyeglasses during allergy season. Or consider switching to daily disposable contacts that you discard after a single use to avoid the build-up of allergens and other debris on your lenses.

Over-the counter eye drops. Because eye allergies are so common, there are a number of brands of non-prescription eye drops available that are formulated to relieve itchiness, redness and watery eyes caused by allergies.

If your eye allergy symptoms are relatively mild, over-the-counter eye drops for allergy relief may work very well for you and may be less expensive than prescription eye drops or other medication. Ask your optician to recommend a brand to try.

Prescription medications. If your allergy symptoms are relatively severe or over-the-counter eye drops are ineffective at providing relief, you may need your eye doctor to prescribe a stronger medication.

Prescription eye drops and oral medications used to relieve eye allergies include:

Antihistamines. Part of the body’s natural allergic response is the release of histamine, a substance that dilates blood vessels and making the walls of blood vessels abnormally permeable. Symptoms caused by histamine include a runny nose and itchy, watery eyes. Antihistamines reduce allergic reactions by blocking the attachment of histamine to cells in the body that produce an allergic response.
Decongestants. Decongestants help shrink swollen nasal passages for easier breathing. They also reduce the size of blood vessels on the white (sclera) of the eye to relieve red eyes. Common decongestants include phenylephrine and pseudoephedrine. Combination drugs are available that contain both an antihistamine and a decongestant.
Mast cell stabilizers. These medications cause changes in mast cells that prevent them from releasing of histamine and related mediators of allergic reactions. Because it may take several weeks for the full effects of mast cell stabilizers to take effect, these medications are best used before allergy season starts as a method to prevent or reduce the severity of future allergic reactions (rather than to treat acute allergic symptoms that already exist).
Nonsteroidal anti-inflammatory drugs. NSAID eye drops may be prescribed to decrease swelling, inflammation and other symptoms associated with seasonal allergic conjunctivitis, also called hay fever.
Steroids. Corticosteroid eye drops are sometimes prescribed to provide relief from acute eye allergy symptoms. But potential side effects of long-term use of these medications include high eye pressure, glaucoma and cataracts, so they typically are prescribed for short-term use only.
Immunotherapy. This is a treatment where an allergy specialist injects you with small amounts of allergens to help you gradually build up immunity.

EYE ALLERGIES SELF-TEST
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Common allergens include pollen, animal dander and mold.

Take this quiz to see if you might have eye allergies. Always consult your optician if you suspect you have an eye condition needing care.

Do allergies run in your family?
Do your eyes often itch, particularly during spring pollen season?
Have you ever been diagnosed with “pink eye” (conjunctivitis)?
Are you allergic to certain animals, such as cats?
Do you often need antihistamines and/or decongestants to control sneezing, coughing and congestion?
When pollen is in the air, are your eyes less red and itchy when you stay indoors under an air conditioner?
Do your eyes begin tearing when you wear certain cosmetics or lotions, or when you’re around certain strong perfumes?
If you answered “yes” to most of these questions, then you may have eye allergies. Make an appointment with an optometrist to determine the best course of action.

STRATEGIES FOR YOU
8 Tips For Eye Allergy Sufferers

  1. Get an early start. See your optician before allergy season begins to learn how to reduce your sensitivity to allergens.
  2. Try to avoid or limit your exposure to the primary causes of your eye allergies. In the spring and summer, pollen from trees and grasses are the usual suspects. Ragweed pollen is the biggest culprit in late summer and fall. Mold, dust mites and pet dander are common indoor allergens during winter.
  3. Protect your eyes from airborne allergens outdoors by wearing wraparound-style sunglasses.
  4.  Don’t rub your eyes if they itch! Eye rubbing releases more histamine and makes your allergy symptoms worse.
  5. Use plenty of artificial tears to wash airborne allergens from your eyes. Ask your optician which brands are best for you.
  6. Cut down your contact lens wear or switch to daily disposable lenses to reduce the build-up of allergens on your lenses.
  7. Shower before bedtime and gently clean your eyelids to remove any pollen that could cause irritation while you sleep.
  8. Consider purchasing an air purifier for your home, and purchase an allergen-trapping filter for your heating/cooling system.

Source: All about vision Author Gary Heiting