Dry eyes affect 25 million people in the United States and you could very well be one of them!
There are many over-the-counter eye drops and artificial tears on the market as well as one which can be prescribed by your optometrist called Restasis.
Learn from Carol Johnson, OD about how to identify dry eye syndrome and ways to create relief.
Selected Podcast
Dry Eyes – Something To Worry About?
Featured Speaker:
Carol Johnson, OD - Optometry
Dr. Johnson is a licensed optometrist at Allina Health Inver Grove Heights Clinic. She has been practicing for 27 years and studied at Pacific University College of Optometry in Forest Grove, Oregon. Dr. Johnson has professional interests in ocular disease, macular degeneration, corneal ulcers, conjunctivitis and iritis. In her free time, Dr. Johnson enjoys listening to and playing music, swimming, skiing and skating. Transcription:
Dry Eyes – Something To Worry About?
Melanie Cole (Host): Dry eyes affect 25 million people in the United States, and you could very well be one of them. My guest today is Dr. Carol Johnson. She’s a licensed optometrist at Allina Health Inver Grove Heights Clinic. Welcome to the show, Dr. Johnson. Tell us a little bit. What exactly are dry eyes?
Dr. Carol Johnson (Guest): Dry eyes is a broad term used to include scratchy, gritty, and a bothersome feeling that can be caused by a myriad of conditions.
Melanie: What would the symptoms -- would it feel like you had something in your eye all the time? Would it feel scratchy, gritty? What would it feel like?
Dr. Johnson: The most common symptoms are a scratchy feeling in your eye, as if something’s in there that doesn’t belong. And occasionally it can interfere with the vision.
Melanie: If you rubbed your eyes when you’ve got that feeling, can that be damaging when you’ve got that feeling like there’s something gritty or something like sand in your eyes?
Dr. Johnson: The feeling of the scratchiness or the uncomfortable feeling comes from the corneal nerve. When they are being replaced, as they are weekly, sometimes scratching it just kind of fast forwards that replacement process. It often doesn’t cause a problem, but if the cornea is fragile, it can cause an abrasion.
Melanie: Nothing is more painful than a scratch on the cornea.
Dr. Johnson: Exactly.
Melanie: I’ve had one, and if you’ve ever had one of those, you even look to the left or the right, and pain shoots through your head like somebody stuck a knife in there. Who really is at risk for dry eye?
Dr. Johnson: The most common demographic is in the elderly and in women. However, people who have had LASIK surgery or have autoimmune diseases, such as thyroid disease or rheumatoid arthritis, patients on hormone therapy or antidepressants or they have some eyelid abnormalities, or contact lens patients who overwear their contact lenses can develop that corneal process that can be described as dry eye.
Melanie: Why would those hormonal changes -- and certain women of a certain age or the autoimmune disorders that you mentioned, why would those contribute to dry eye?
Dr. Johnson: There’s a few different schools of thought. Females from the age of 24 to 48 can often have some fluctuating messages from the thyroid piece, and that can cause the dry eye. The autoimmune diseases often have a predilection for females, and the answers are not really super clear as to why that happens. But they also can have issues if they are on some hormone therapy, like birth control pills or hormone replacement therapy.
Melanie: How do you diagnose somebody with dry eyes? Is there some kind of test that you can do that says, yes, this is a bit of a chronic condition with you?
Dr. Johnson: Some of the signs of dry eye are most easily diagnosed well in an eye exam under microscopic evaluation. A drop with some tint is put in to check and see if the cornea is smooth like an apple peel or if it’s dimpled like an orange peel. That dimpling can be a sign that the cornea is not lubricated enough. The best way to have that evaluated is by your eye health practitioner under the microscope in an exam room.
Melanie: You can just look under the microscope right at their eye and see and if there’s those dimpled or other signs, then you can tell. Now, Dr. Johnson, with all the computers and screen time we are in these days, is there correlation between the amount of time we spend in front of a screen and dry eyes?
Dr. Johnson: One of the studies that discuss these two concepts has shown that with prolonged screen use, there is a decrease in the blink rate. And the blink rate lubricates as well as sort of replaces some of those surface layers on the cornea. The best thing to do with excessive screen time is to take a break, remember to blink, and keep in mind that everything in moderation.
Melanie: Absolutely. You don’t want too much screen time for your eyes. Now, how do you treat it when you’ve diagnosed somebody with it? What can they then do about it?
Dr. Johnson: There are four categories, usually: artificial tears—and they can be preservative-free if people have a reaction to the preservatives—ointments, oral therapy—sometimes fish oil can be a preventative component in modulating inflammation—as well as punctal plugs. And there are some really surface surgeries that can be used in extreme circumstances.
Melanie: Dr. Johnson, how long do these treatments work if you’re talking about something topical, like artificial tears or ointments? Do you have to keep taking these things for the rest of your life? Is this something that goes away? Are you going to be one of those people? I’ve seen those people sometimes with the artificial tears, and they keep blinking them in their eye all day long. Is it something that you…?
Dr. Johnson: Yeah, it’s a very chronic condition oftentimes. The cornea is the clear window in front of the iris or the colored part of the eye, and it is perpetually replacing itself. Each week, we get a new cornea. The chronic nature of the usage is because we get a new tissue that is suffering each week, based on how the process started. If it is because there is a contact lens solution reaction, sometimes those artificial tears can be short-lived. If the reason that the dry eye exists is because of autoimmune diseases, that is a lifetime and chronic issue to pay attention to.
Melanie: I’ve heard about a prescription currently in the market called Restasis. Tell us a little bit more about it.
Dr. Johnson: Restasis is an eye drop that is prescribed two times a day for several months, usually through the life of the disease. It requires a daily commitment, and it’s about six to nine months before the maximum medical benefit is received. It’s common in patients to have underlying autoimmune disease—for instance, rheumatoid arthritis. The stem cells around the cornea that help make the cornea have a little hiccup, and so Restasis actually addresses a little bit of the hiccup on how the lacrimal system or the system that makes tears rebuilds itself. It takes several months for the maximum medical benefit to be achieved. It does require commitment as twice-a-day eye drops. It is a commitment for the patient, and it is a responsibility for the person that is trying to make that better.
Melanie: In just the last minute or two, Dr. Johnson, give us your best advice, please, on people suffering with dry eye and what they can do about it, and possibly even ways to prevent it.
Dr. Johnson: I’d like to have people know that artificial tears can be helpful for the short term. They don’t affect the distance vision to the degree that ointments can. Ointments at night can be very helpful. Taking fish oil for the long haul can help with the inflammatory piece of this process as well as in your body. Restasis is an option for folks that are having vision problems as it relates to their dry eye issue. Talk to your healthcare provider and talk to your eye doctor, because eyes should always be white and pain-free.
Melanie: Thank you. That’s great information, Dr. Carol Johnson. You’re listening to the WELLcast with Allina Health. For more information, you can go to allinahealth.org. That’s allinahealth.org. This is Melanie Cole. Thanks so much for listening, and have a great day.
Dry Eyes – Something To Worry About?
Melanie Cole (Host): Dry eyes affect 25 million people in the United States, and you could very well be one of them. My guest today is Dr. Carol Johnson. She’s a licensed optometrist at Allina Health Inver Grove Heights Clinic. Welcome to the show, Dr. Johnson. Tell us a little bit. What exactly are dry eyes?
Dr. Carol Johnson (Guest): Dry eyes is a broad term used to include scratchy, gritty, and a bothersome feeling that can be caused by a myriad of conditions.
Melanie: What would the symptoms -- would it feel like you had something in your eye all the time? Would it feel scratchy, gritty? What would it feel like?
Dr. Johnson: The most common symptoms are a scratchy feeling in your eye, as if something’s in there that doesn’t belong. And occasionally it can interfere with the vision.
Melanie: If you rubbed your eyes when you’ve got that feeling, can that be damaging when you’ve got that feeling like there’s something gritty or something like sand in your eyes?
Dr. Johnson: The feeling of the scratchiness or the uncomfortable feeling comes from the corneal nerve. When they are being replaced, as they are weekly, sometimes scratching it just kind of fast forwards that replacement process. It often doesn’t cause a problem, but if the cornea is fragile, it can cause an abrasion.
Melanie: Nothing is more painful than a scratch on the cornea.
Dr. Johnson: Exactly.
Melanie: I’ve had one, and if you’ve ever had one of those, you even look to the left or the right, and pain shoots through your head like somebody stuck a knife in there. Who really is at risk for dry eye?
Dr. Johnson: The most common demographic is in the elderly and in women. However, people who have had LASIK surgery or have autoimmune diseases, such as thyroid disease or rheumatoid arthritis, patients on hormone therapy or antidepressants or they have some eyelid abnormalities, or contact lens patients who overwear their contact lenses can develop that corneal process that can be described as dry eye.
Melanie: Why would those hormonal changes -- and certain women of a certain age or the autoimmune disorders that you mentioned, why would those contribute to dry eye?
Dr. Johnson: There’s a few different schools of thought. Females from the age of 24 to 48 can often have some fluctuating messages from the thyroid piece, and that can cause the dry eye. The autoimmune diseases often have a predilection for females, and the answers are not really super clear as to why that happens. But they also can have issues if they are on some hormone therapy, like birth control pills or hormone replacement therapy.
Melanie: How do you diagnose somebody with dry eyes? Is there some kind of test that you can do that says, yes, this is a bit of a chronic condition with you?
Dr. Johnson: Some of the signs of dry eye are most easily diagnosed well in an eye exam under microscopic evaluation. A drop with some tint is put in to check and see if the cornea is smooth like an apple peel or if it’s dimpled like an orange peel. That dimpling can be a sign that the cornea is not lubricated enough. The best way to have that evaluated is by your eye health practitioner under the microscope in an exam room.
Melanie: You can just look under the microscope right at their eye and see and if there’s those dimpled or other signs, then you can tell. Now, Dr. Johnson, with all the computers and screen time we are in these days, is there correlation between the amount of time we spend in front of a screen and dry eyes?
Dr. Johnson: One of the studies that discuss these two concepts has shown that with prolonged screen use, there is a decrease in the blink rate. And the blink rate lubricates as well as sort of replaces some of those surface layers on the cornea. The best thing to do with excessive screen time is to take a break, remember to blink, and keep in mind that everything in moderation.
Melanie: Absolutely. You don’t want too much screen time for your eyes. Now, how do you treat it when you’ve diagnosed somebody with it? What can they then do about it?
Dr. Johnson: There are four categories, usually: artificial tears—and they can be preservative-free if people have a reaction to the preservatives—ointments, oral therapy—sometimes fish oil can be a preventative component in modulating inflammation—as well as punctal plugs. And there are some really surface surgeries that can be used in extreme circumstances.
Melanie: Dr. Johnson, how long do these treatments work if you’re talking about something topical, like artificial tears or ointments? Do you have to keep taking these things for the rest of your life? Is this something that goes away? Are you going to be one of those people? I’ve seen those people sometimes with the artificial tears, and they keep blinking them in their eye all day long. Is it something that you…?
Dr. Johnson: Yeah, it’s a very chronic condition oftentimes. The cornea is the clear window in front of the iris or the colored part of the eye, and it is perpetually replacing itself. Each week, we get a new cornea. The chronic nature of the usage is because we get a new tissue that is suffering each week, based on how the process started. If it is because there is a contact lens solution reaction, sometimes those artificial tears can be short-lived. If the reason that the dry eye exists is because of autoimmune diseases, that is a lifetime and chronic issue to pay attention to.
Melanie: I’ve heard about a prescription currently in the market called Restasis. Tell us a little bit more about it.
Dr. Johnson: Restasis is an eye drop that is prescribed two times a day for several months, usually through the life of the disease. It requires a daily commitment, and it’s about six to nine months before the maximum medical benefit is received. It’s common in patients to have underlying autoimmune disease—for instance, rheumatoid arthritis. The stem cells around the cornea that help make the cornea have a little hiccup, and so Restasis actually addresses a little bit of the hiccup on how the lacrimal system or the system that makes tears rebuilds itself. It takes several months for the maximum medical benefit to be achieved. It does require commitment as twice-a-day eye drops. It is a commitment for the patient, and it is a responsibility for the person that is trying to make that better.
Melanie: In just the last minute or two, Dr. Johnson, give us your best advice, please, on people suffering with dry eye and what they can do about it, and possibly even ways to prevent it.
Dr. Johnson: I’d like to have people know that artificial tears can be helpful for the short term. They don’t affect the distance vision to the degree that ointments can. Ointments at night can be very helpful. Taking fish oil for the long haul can help with the inflammatory piece of this process as well as in your body. Restasis is an option for folks that are having vision problems as it relates to their dry eye issue. Talk to your healthcare provider and talk to your eye doctor, because eyes should always be white and pain-free.
Melanie: Thank you. That’s great information, Dr. Carol Johnson. You’re listening to the WELLcast with Allina Health. For more information, you can go to allinahealth.org. That’s allinahealth.org. This is Melanie Cole. Thanks so much for listening, and have a great day.