 More On The Reality of Dry Eye and LASIK
Dry Eye Syndrome a Rapidly Growing Health Problem
BY DRU SEFTON
c.2005 Newhouse News Service
Dry eye sounds like a slight annoyance, and sometimes it is. But for a
rapidly growing number of Americans, it's a huge lifestyle issue.
Phyllis Knapp of Kalamazoo, Mich., endures hours of a complicated daily
regime to care for her dry eyes. And Linda Mistretta of Lodi, N.J., was
once in so much pain while out to dinner, "I had to go sit in the car
and close my eyes, just to get some relief."
Treatment for the malady, technically known as dry eye syndrome,
includes drops, ointments, mists, duct plugs, eye compresses, lid
scrubs, moisture-retaining glasses and nutritional supplements.
As many as 20 million Americans cope with some level of dry eye,
according to Market Scope, an ophthalmological market research firm in
suburban St. Louis. Worldwide, sufferers spend some $522 million
annually on dry eye products; Market Scope estimates that will jump to
$1 billion by 2010.
Experts agree the causes are many and the problem is increasing. Aging,
air conditioning, pollution, prescription side effects, contact lens
use, laser eye surgery and hours spent in front of computers all
contribute.
Among the symptoms are burning, itching, pain and even excess tearing
-- yes, too many tears may signal dry-eye syndrome.
Tear film is made up of three layers: mucus, which helps tears adhere
to the eye; water; and oil, which keeps the water layer from
evaporating. In bright sunlight or strong wind, dry-eye sufferers often
find their eyes actually producing too much water in the form of reflex
tears, upsetting the balance of tear composition.
Glands in the eyelids and above the eyes that produce each layer may
become clogged, which also leads to problems.
William Mathers, an ophthalmology professor at Oregon Health Sciences
University in Portland, has studied dry eye for more than 20 years. He
said that tear film is "very complex. And the concentration of nerves
on the surface of the eye is higher than anywhere else on the body, so
any disturbance is felt."
Phyllis Knapp first felt it in early 2000, about a month after having
LASIK surgery to correct her vision.
"Something wasn't right," Knapp said. "My eyes burned all the time. The
doctor just said I was still healing."
But months and years later, her eyes kept getting drier. Now there are
eroded areas on their surfaces. "Dry eye does a lot to impair your
vision if it's severe, and mine is," she said.
After subsequent cataract surgery led to further dry eye complications,
she left her job as a secretary in the president's office at a
community college. She can no longer drive. In addition to a clinic in
her own city, she's been to Dallas, Atlanta and Boston in search of
relief.
Knapp describes the pain: "It feels like a grittiness in my eyes --
that's called foreign-object sensation. It feels like I haven't slept
for three days, or I've been staring at a computer for 12 hours and
can't focus my eyes."
She uses warm compresses, drops, ointments and other prescriptions to
manage the condition -- every day, 12 different steps. Insurance covers
some but not all of the cost.
Linda Mistretta also watches her diet, which is helpful for some
patients. "I can't have caffeine or anything high in fat," she said.
"This really changes your life. Last night I had wine, and today I'm
suffering."
Mistretta's problems also began after LASIK surgery, in November 2002.
"You can't wear eye makeup, your eyes are always ugly," she said. "I
was an avid reader and I had to stop reading."
She even resorted to punctal plugs, tiny silicone tubes inserted into
tear-duct openings to seal in moisture. Unfortunately, those also
irritated her eyes. She ultimately had the openings cauterized closed,
which helped somewhat.
Now Mistretta does daily lid scrubs to keep glands in her eyelids
clear, and takes flaxseed oil.
Mathers, in Portland, said he has found that flaxseed or fish oil taken
orally helps reduce inflammation. "If you can suppress this
inflammation, then you can restore the surface of the eye to a happier
state," he explained.
Such techniques are often topics of conversation at the Dry Eye Support
Group that meets every other month at the university of California,
Irvine.
Facilitator Kathy McCaleb, a licensed clinical social worker, oversees
the first half of the 90-minute session. About 30 participants exchange
ideas and frustrations.
"Dry eye isn't something simple to cure," McCaleb said. "Lots of people
in the group have had to quit jobs and curtail daytime activities due
to light sensitivity. They need to put drops in their eyes every hour."
The second half of the meeting is a question-and-answer session with
group founder Jonathan R. Pirnazar, an assistant professor in the
university's department of ophthalmology and a dry eye sufferer
himself.
"It's amazing how much dry eye I see every day," he said of his
practice. "I'll see around 45 patients a day. Probably three to five of
those will be getting punctal plugs. And I'm just one doctor."
Both Knapp and Mistretta say that although their eyes are not back to
normal, with attention and work the discomfort is tolerable.
That's the good news, said Portland ophthalmologic researcher Mathers.
Dry eye "can be treated. It's not inevitable that you'll be left with
irritation that you can't do anything about."
And as experts better understand the syndrome, more treatments will
become available. "Then people will not have to be bothered with this,"
Mathers said.
Aug. 31, 2005
|
Last Thread
Next Thread
09-24-05 07:39 PM
