Dry Eye: Awareness, Diagnosis, and Management

Written by on November 2, 2005 in dry eye, Ocular Rosacea with 5 Comments

A well written article about Dry Eye Syndrome, designed for a Primary Care Physician. See below for some interesting extracts from the article and a link to the full PDF of the article.

Dry Eye: Awareness, Diagnosis, and Management: Why prevalence increases after menopause, Women’s Health in Primary Care, Vol. 7, No. 2, March 2004, Joseph Mussoline, MD.

ABSTRACT: Dry eye is quite common in the population today, particularly among postmenopausal women. The condition greatly influences the patient’s quality of life by causing significant ocular discomfort. Dry eye is characterized by many symptoms, including dryness, grittiness, and burning. Development of dry eye can be influenced by various factors, including autoimmune diseases, use of certain medications, and environmental conditions. Identification of contributing factors can help clinicians establish a course of treatment. One of the simplest ways to alleviate dry eye symptoms is with the use of artificial tears. Current research in the dry eye field shows a promising future for the development of effective treatments for the causes of the disease.

Some interesting extracts:

Dry eye is an ocular condition affecting approximately 10% to 20% of the population. Its prevalence increases with age, and the majority of those affected are women which is not surprising because evaporative dry eye and dysfunction of the meibomian glands often occur during aging and menopause.

One of the simplest ways to alleviate dry eye symptoms is with the use of artificial tears.

Recently, some attempts to alleviate dry eye symptoms have focused on intake of essential fatty acids. Evening primrose oil has been investigated because it is a good source of A-linolenic acid (GLA).

Although GLA has alleviated dry eye symptoms in some patients, its role in eye health has not yet been defined. It is thought that GLA is a precursor needed to form prostaglandin E1, which helps regulate functioning of the lacrimal gland. Thus, higher GLA intake may help improve lacrimal gland functioning and decrease dry eye symptoms.

Furthermore, a study of 32,470 subjects from the Women’s Health Study found that women with a higher intake of omega-3 fatty acids had a lower risk of developing dry eye (odds ratio, 0.83; CI, 0.7 to 0.98).18 These preliminary results form a promising basis for future investigations into the role of essential fatty acids in the development of dry eye.

NEW TREATMENTS

There are many new dry eye products currently being studied. They are designed to treat the physiologic deficiencies underlying the signs and symptoms, rather than simply the immediate ocular discomfort.

For example, secretogogues (eg, INS365) are designed to bind and stimulate the receptors responsible for secretion of the aqueous layer of the tear film in those patients who suffer from aqueous-deficient dry eye, or to stimulate the secretion of mucins.

Another class of medications being investigated is the mucomimetics, which mimic the mucins that are present in the innermost mucin layer of the tear film. A third class of medications being investigated is that of immunosuppressive agents, including a cyclosporine ophthalmic emulsion that has been recently approved by the FDA. This product is thought to decrease ocular inflammation, thereby reducing the damage caused by the inflammatory response to the lacrimal gland.

Lacrimation is thus decreased, reducing the signs and symptoms of dry eye. A recently marketed dry eye therapy (a solution containing demulcents, polyquad, and hydroxypropyl guar) is designed to help establish an environment conducive to the healing of the ocular surface. It creates a shield of protection on the surface by preferentially adhering to damaged epithelial cells, creating a scaffolding to protect the damaged cells from the external environment. These medications will provide more effective treatment of the underlying causes of dry eye.

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Read more about: dry eye, Ocular Rosacea

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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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5 Reader Comments

  1. jane says:

    what about demodex and tea tree oil. could it be this simple????

  2. David Pascoe says:

    Hi Jane, I guess you are referring to http://rosacea-support.org/ocular-demodex-tea-tree-oil-as.html ? This shows that tea tree oil kills demodex in the eye lash hairs. This might help some ocular symptoms. I’m not sure that they have shown yet that this is related to dry eye though.

  3. A tiny bit of castor oil rubbed into the base of the lashes at night will not only get rid of the demodex but will also open the pores and hair follicules and allow your lashes to grow out better! Castor is totally safe, even if it accidentally gets into the eye. It is an ingredient of some products for eyes.

  4. Trudy says:

    whether anyone believes me or not, I have been suffering with some kind of mite, ( bird or rat ? ) that was brought into my house on my cats ,who are now all on Revolution, doctors have been no help and I have them living in my left ear, when i put anything in the ear to rid it of them ,they burrow into the flesh,their also on my scalp and private parts, does anyone think castor oil would be worth a try in the ear, is it safe in ears ?

  5. Maria says:

    Great article. Keep up the great work!

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