Perhaps you’ve been suffering from burning, gritty sore eyes or perhaps even watery eyes that don’t seem to respond to any treatment whatsoever and you’ve been through every kind of dry eye product on the market, it seems, with no luck. Well, in this blog post, I’ll explain some important considerations that could make all the difference between you successfully having your dry eyes treated or not.
So this is the final blog post in a three-part series designed to give you the basics of what dry eye is, its causes, and its treatments. This post will be covering its treatment and like other posts in the series, I’m going to draw from the leading DEWS II research to give you what I think is a very important overview on treatment strategies that may help to explain why some treatments work and others don’t work at all.
Hopefully, you’ve been reading the other two posts in the series if not, here is a link (Part 1 – What is dry eye? https://youtu.be/o4oZIGSYz50 Dry eye basics playlist https://www.youtube.com/playlist?list…) for you to watch and, then come back to this for a fuller context.
So when it comes to treating dry eyes, you must know whether you’re treating one of the two types of dry eyes, first of all, Aqueous Deficient Dry Eyes or Evaporative Dry Eye.
As a quick reminder, Aqueous Deficient Dry Eye is when you don’t produce enough tears and Evaporative Dry Eye is when your tears evaporate away too quickly. Once you know which type of dry eye you have, then you need to know what is the underlying cause of your aqueous deficient or evaporative dry. This is the job of your optometrist or your ophthalmologist to figure this stuff out. Once they know, I think it’s important for you to know also because you can then take charge of your dry eye recovery if you are aware of what exactly is going on.
So my tip is to ask your eye care professional, these two questions. Firstly, do you have aqueous deficient or evaporative dry eye? Secondly, do you know the likely cause of your aqueous deficient or your evaporative dry eye?
Now, most eye care professionals may not tell you this stuff unless you ask simply because they don’t want to confuse and overwhelm people with too much information. As I pointed out earlier in the second post of the series, all of the ways to go about treating dry eyes should involve treating these three aspects. First of all, tear instability, tear concentration or Osmolarity as we call it, and inflammation.
Tears become unstable, mainly because the outer oily layer of your tears may become low in supply, and the main cause of this is blockage of or clogging up of the gland that releases the oil and we call this gland the Meibomian gland. And we also call the condition Meibomian Gland Dysfunction or MGD.
You can also have problems with the mucus layer of production from the mucus-producing goblet cells, as we call them, being low, particularly when evaporative dry has been going on for some time. The result of all this can be that your eye may sting when it’s overly concentrated or you may feel so blurred or even watery.
Treating new cases of relatively new Evaporative Dry Eyes.
First of all, eyelid hygiene and keeping your eyelids regularly clean from oil and bacteria clogging up is really important, particularly in conditions such as Blepharitis where the eyelids may become inflamed and this may be due to bacteria. You can use dilute baby shampoo to do this with the cutting bud just to wipe around the lead margins but I think is even better is to use some of the specially created eyelid hygiene wipes, just keep that area nice and clean regularly.
Hot compresses with a heat mask are excellent that helping to unclog the Meibomian glands with a gentle eyelid massage routine. It’s also worth noting that a hot compress and a good eyelid hygiene routine can potentially be enough to cure evaporative dry eye.
Lubricating eye drops are a source of immediate eye relief from sore, gritty eyes. There are a huge number of lubricating eye drops in the market and it’s easy to assume that they all do the same thing or try and achieve the same thing. In reality, some are better than others for your type of dry eye.
If you find that your eyes are watering a lot, this is usually because dry patches are forming in the tears and this triggers your eyes to your watering glands to produce excess tears to try and fill in the gaps, a bit like the triggering of tears that happens when you chop up onions. In this case, you might want to try a Carboma based lubricant such as Viscotears and these are good at having a longer retention time for your eye to fill in the gaps.
If your vision consistently goes blurred because, as the water evaporates, it leaves more of the mucus layer, which then may also get thicker then you should consider using a lubricant product that has more quality properties. That’s to say that it contains agents such as Glycerin or Acetylcysteine which are designed to break down the excessive mucus and reducing the blurring at the same time, as well as these some lubricants are designed to replace the oily layer of your tears, while others may try and mimic the complete composition of your tears altogether.
Selecting the appropriate lubricant drop for your type of dry eye may make a significant difference to the overall comfort. To treat long-term chronic cases of evaporative dry eye. Now, the problem here could be that an effective treatment that’s been going on for some time has led to inflammation to build up, so in these cases, it may be that the sufferer may need to use steroids for a short term to get the inflammation under control and then after which you may well find then that the hygiene regime and the lubricants may work a lot more effective.
Aqueous Deficient Dry Eye treatment.
When it comes to aqueous deficient dry eyes, this is usually the most serious of dry conditions because it’s often linked to whole-body systemic health conditions such as autoimmune conditions.
Now, because your eye doesn’t produce the water component of your tears sufficiently, it’s important to get medical treatment in the initial stages to manage your condition and particularly any inflammation that may be present. As far as dry eyes are concerned, inflammation is the biggest threat to healthy eyes.
If you are somebody who, for example, has tried everything you feel like you’ve tried everything to soothe the dry eyes, apart from seeing a dry eye specialist, then it may well be the case that you have aqueous deficient dry eyes, but you simply been treating it like it was evaporative dry eye, and that simply won’t work. It can be, something that leads to more long-term, worsening of your symptoms or even worsening damage to the surface of the eye.
The treatments for Aqueous Deficient Dry Eye.
First of all, want to make sure that we retain the small number of tears that you may well be producing by limiting or blocking the drainage, and we do this using a lot of plugs that go into the drainage holes.
Treating inflammation with steroids or non-steroidal anti-inflammatory drugs such as methotrexate where necessary.
Another popular option is to use cyclosporine-based drugs such as Restasis to try to stimulate the production of extra tears.
It may be worth considering the creation of personalized blood serum eye drops from the individual’s blood supply.
So there are many more tools and treatments and all of these should be used on top of the normal eyelid hygiene and lubricant options we talked about for evaporative dry eye as well, may not be possible to cure aqueous efficient dry eyes unless you can get tear production levels up, but it should be possible to minimize the symptoms that can be so disabling for sufferers of dry eyes.
The other key thing that is important for treating dry eyes over the long term is having a consistent dry eye regime. The aim here with the dry regime is to keep dry eyes free from inflammation and to allow your eyes to recover naturally as much as possible. It’s also very important in dry eye regime is nutrition, and particularly in the case of aqueous deficient dry eyes, nutrition is critical to dealing with inflammation, helping to get it right down and really should form part of any long term chronic dry eye regime.
Research suggests that one of the reasons that many people don’t have success with their dry eye treatment is because they don’t continue with the treatment and any regime for a long enough period with most people stopping their regime before two weeks. Typically I would recommend about five weeks system designed to be intense in the first two weeks and then gradually reduce in intensity over the following weeks. In my experience, consistency and intensity is the key to getting dry eye under control.
Now I’m interested to know what you have tried for your dry eyes and whether any of them has worked before? Leave me a comment in the comment section below, and I look forward to reading your thoughts and your experiences in the comments section.
There are so many things that I could have covered over this three-part basic dry eye series, and I could have gone into a lot more specific in detail, but the plan here really is to give you somewhat of an introduction to dry eye over these three and an overview of three options, but plan to be back with a lot more detailed information on treatments, product reviews and other useful tips for dry eye management on this channel.
Please make sure to stay tuned for more help with your dry eye.
Thank you so much for reading and I look forward to catching you guys in the next blog post.
Take care.
