Dry Eyes Stinging Burning – Dry eye disease is tough! I understand. I have struggled with dry eyes for several years due to wearing contact lenses and spending countless hours staring at a computer screen. In college, my dry eyes got so bad that I couldn’t wear contact lenses because of the constant “foreign body feeling” when I had them on. I had to stop reading every 30 minutes because my eyes started to burn and my vision became blurry. I tried many treatments and nothing worked. Dry eye disease affected not only my eyes, but also my emotional well-being. It prevented me from enjoying life and interfered with my professional training. I felt depressed, frustrated and hopeless.
It wasn’t until I realized that my dry eyes were related to my lifestyle, environment and overall health that it all started to make sense. I noticed that on days when I spent less time on the computer, my eyes felt better. My symptoms flared up when it was windy or when the humidity was low. I knew that if I wanted to overcome dry eyes, I needed to not only treat my eyes, but also change my lifestyle. I started a consistent regimen of artificial tears and eyelid hygiene. I switched from monthly contact lenses to daily contact lenses. I started taking scheduled breaks to look at the computer. I ate a healthier diet focused on anti-inflammatory/antioxidant foods and bought a humidifier for my room. At first it all seemed impossible to do, but over time it became part of my regular routine. Not only did my eyes feel better, but I was healthier and happier overall! It seems that what was good for my eyes was also good for my mind and body. I took this lesson with me as I began my career to become an ophthalmologist and eye surgeon.
Dry Eyes Stinging Burning
Because of my personal journey and professional training, I believe that treating dry eye begins with listening and empowering the patient. I listen to their struggles and talk about their strengths as we replicate their lifestyle. Only then do we begin to put together a treatment plan that includes good eye hygiene with small but significant lifestyle changes. Sight is our most important sense, which is closely related to our very being. I want dry eye patients not only to control their dry eye, but also to have good mental and physical health and live fulfilling lives. What is good for the eyes should also strengthen the mind and strengthen the body!
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Maximilian R. Padilla, MD, or Dr. Max as his patients call him, is a board-certified ophthalmic and facial plastic surgeon with extensive experience in ophthalmology and facial plastic surgery. Dr. Max’s goal is to combine his love of art with his passion for surgery to provide his patients with the most pleasing aesthetic and optimal functional results. Through his dynamic practice, Dr. Max personally understands the connection between dry eye, eyelid anatomy, and overall body health. Dr. Max treats his patients like family, so for him, dry eye treatment begins with listening and developing a plan tailored to the patient’s eyes, health and lifestyle.
Dry eye disease (DED) is also known as dry eye syndrome, keratoconjunctivitis sicca, and ocular surface disease. DED is not just about dry eyes; has a wide-ranging impact on a person’s physical, emotional, and functional well-being. Common symptoms of dry eyes include redness, irritation, grittiness, pain, blurred vision, and more.1 We all experience these symptoms at times, such as after working on the computer for hours or watching a long movie. For many of us, these symptoms are temporary, but for DED patients, these symptoms are permanent, debilitating, and can be detrimental to eye health and overall well-being.
To understand how and why you develop dry eye symptoms, let’s take a quick look at the types and causes of dry eye disease. There are two main types of DED: 2
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In the case of a water deficit, there is a decrease in the production of tears from the lacrimal gland, which leads to a deficiency of the tear film. It can be caused by autoimmune diseases (Sjogren’s syndrome, rheumatoid arthritis and sarcoidosis), diseases (menopause, hormonal changes, cancer and thyroid problems) and side effects of oral medicines (antihistamines, antidepressants, decongestants, diuretics and birth control pills) .
In evaporation DED, tear film instability and rapid tear evaporation are observed. This can be caused by contact lens wear, eye surgery (LASIK), meibomian gland dysfunction, blepharitis, eye infections (corneal ulcers), and long-term use of eye drops with preservatives that can damage the surface of the eye. Various other diseases and eye problems can be associated with evaporative DED (allergic conjunctivitis, viral conjunctivitis, and glaucoma).
The tear film protects the cornea, which is the clear part at the front of the eye. The cornea has more nerve endings per square millimeter than anywhere else, making it the most sensitive part of your body! In DED, the tear film does not function properly either due to decreased tear production or rapid tear evaporation. Without the protection of the tear film, the corneal nerves can become overexcited, leading to dry eye symptoms. For example, you may experience a “foreign body sensation” where the eyelids move across the cornea when you blink. You may have watery eyes or excessive tearing because the cornea overstimulates the lacrimal gland to produce tears. On examination, the eyes may appear completely normal, but the patient may have severe dry eye symptoms because the corneal nerves are affected.
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DED can cause a variety of symptoms, but listing them is one thing, experiencing them is quite another. That’s why we pay so much attention to each DED patient, because their symptoms and how they experience them are important to building a trusting relationship and treatment plan.
How can dry eyes cause problems for your body? Ask any DED patient and they will tell you that DED is a whole body condition. Constantly experiencing or worrying about dry eye symptoms can take a physical and emotional toll. Many patients express restlessness and an inability to “sit still.” Some people also experience fatigue and general malaise, especially if dry eye symptoms interfere with sleep. Headaches are another common complaint that results from difficulty concentrating due to blurred vision.
Also, let’s not forget that DED is associated with several systemic diseases that have their own physical symptoms. For example, Sjögren’s syndrome can cause dry mouth, rheumatoid arthritis can cause joint pain, thyroid disease can cause heart problems, and menopause can manifest itself in many different ways. Having DED increases the severity of these systemic conditions, which means you need to take care of both the overall health problem and the chronic dry eye symptoms.
Dry Eyes Syndrome
In most cases, dry eye is a combination of water deficiency and evaporation with multiple risk factors, including environmental, occupational, and lifestyle factors.5
We use our eyes to navigate our environment. When you have DED, not only do you stop enjoying your surroundings, but your surroundings can make your symptoms much worse. For example, dry climates (low humidity), strong winds, high UV index (intense sunlight), and poor air quality can worsen DED symptoms. Air conditioning and ceiling fans are important environmental factors to consider in the home. These environmental factors can give you dry eye symptoms and turn a pleasant outdoor activity into a scary experience.
DED can significantly reduce a person’s ability to function.6 When we talk about functioning, we mean what you do at home and at work. Everything from paying bills to mowing the lawn to doing household chores can be challenging. It is not easier at work. An important occupational risk factor for DED is screen time. Almost all of us use a computer every day, at work and at home. Blinking can be significantly reduced when looking at a computer screen, causing or worsening dry eye symptoms. Scaling emails and calls can be a hassle, and switching to an Excel spreadsheet can be a nightmare.
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When your eyes are constantly experiencing dry eye symptoms, it takes a significant physical and emotional toll on you. In fact, depression and anxiety levels are 2-3 times higher in patients with DED compared to people without DED. Not to mention, no one around you takes your dry eye symptoms seriously. The “go get some eye drops” advice doesn’t work and undermines DED sufferers. All this leads to hopelessness, frustration and apathy, which eventually become the cause of treatment failure.
Being on social media can be stressful if you have DED.8 Having to constantly think about your eyes distracts your mind and makes conversation difficult. Not only that, but people may wonder why you blink so much, why your eyes water, or why you have to use artificial tears. Your family, friends, and colleagues probably don’t
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