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Why Dry Eye is Important to Me

As a dry eye specialist, I see patients struggling with red, itching, irritated eyes on a daily basis in my clinic. In my day-to-day life, I encounter people all the time asking me how they can find relief from the blurry vision, how they can get back into their contacts comfortably, and how to manage the constant symptoms associated with dry eye. I can understand their struggle, as I have been struggling with dry eye since I started wearing contact lenses in my teens. As a teenager, I was on the medication Accutane as well, which lead to significant worsening of the dry eye and then as it worsened over time, it became almost impossible for me to wear contacts for any period of time, by the time I finished medical school.

I suffered through wearing contact lenses despite persistent discomfort because I was so nearsighted that my glasses were quite thick and sometimes uncomfortable. Having red, irritated eyes was normal for me, and I struggled but also came to a place where I accepted that I would be dealing with this on an ongoing basis. As I started my career in eye care, I learned about how the cornea, the clear covering of the surface of the eye, was the most highly innervated structure in the human body. No wonder it was so uncomfortable when the surface of the eye dried out and developed rough patches!

Finally, at the end of my ophthalmology residency, I had the opportunity to have LASEK surgery to correct my nearsightedness and avoid the need for glasses and contact lenses all together. I was hesitant as I had never had any kind of surgery. However, when I got a very small corneal ulcer after my eyes dried out while wearing my contacts, I knew moving forward with LASEK would be safer than continuing to wear contacts with such dry eyes. While I was excited to be free of contacts and for my eyes to be safer, it never occurred to me the incredible positive impact this may have on the comfort of my eyes. Again, I had come to a place where I just accepted that red, irritated eyes were a part of my life and there was not much that could be done.

Being out of contact lenses for a few months after LASEK surgery, I not only had better vision than I had ever achieved before in my life, but my eyes were white and much less dry. Getting out of contacts was a huge improvement. Still, I had irritation and needed to use artificial tears frequently throughout the day. Although my eyes felt dry, they would tear in windy environments and sometimes I would have tears running down my cheeks even though my eyes never felt moist. As I learned more about dry eye treatment options during my training, I experimented with different options. I realized I may not have enough tears overall, so the first thing I tried was punctal plugs, which are tiny silicone plugs that go into the eye’s tear drainage system, like plugging the drain in a sink – they keep more tears in the eye to maintain the eye’s natural moisture longer. I found this made an enormous difference, and have maintained plugs in my eyes ever since.

In the past few years I have had access to more technology for the treatment of dry eye, and I have tried it all. I have found particularly Intense Pulsed Light (IPL) and Lipiflow to be extremely helpful – and I have come to offer these treatments in our Dry Eye Center of Excellence at Vold Vision. I realized that in addition to not having enough tears, I also did not have high quality tears, due to a condition called evaporative dry eye, where the oil glands in the eyelid are not functioning well. This is generally due to a low level, chronic inflammation in the eyelid glands – and it is extremely common. Without high quality oil in the tear film, the water component of tears evaporates quickly, leaving eyes feeling dry and blurry. After two treatments with IPL at our office I noticed that my eyes felt more moist throughout the day. Following lipiflow, they felt less red and irritated. I also use Xiidra and preservative free artificial tears, both of which help me to feel comfortable throughout the day. In addition, during the many hours that I work in front of a screen each day, I constantly remind myself to blink to restore the tear film on the surface of my eyes. Sometimes I keep a sticky note on the side of my computer, telling me to blink!

I consider dry eye to be a chronic condition that I will always deal with, but I would no longer say that I suffer from dry eye – I would say that I manage it. My dry eye is not 100% cured – I still struggle to find a mascara that my eyes are not sensitive to, and usually go without eye makeup for this reason (although I have been known to indulge in lash extensions in the past!). I do often keep artificial tears on hand, especially in dry environments such as airplanes and when the heat or air conditioning is running. But I no longer feel uncomfortable during the day or have to stop to switch between contacts and glasses, or worry about my eye health or comfort throughout the day. Although many clinicians find dry eye challenging, I love treating dry eye patients because I empathize with their condition, and I have experienced both the symptoms and the treatments. I myself am an example that dry eye is manageable – and with recent improvements in technology we dry eye patients live in a time when we should no longer have to suffer.

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Dry Eye

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