12-14-2004, 06:22 AM
DRY YOUR EYES
We tell our children to dry their eyes after they've been crying, but for more than 10 million Americans -- mostly women -- dry eyes are the problem, causing itchiness and constant pain. If left untreated, dry eye syndrome (technically called keratoconjunctivitis sicca, or, more simply, dry eye) can cause scarring of the cornea and even lead to blindness.
ABOUT YOUR TEARS
Healthy tears are made up of three layers: The outer lipid layer prevents evaporation... the second provides antibodies, salinity and acidity to the cornea... and the inner layer contains mucus that coats the cornea (the better for sticking). Although aging eye glands are the most frequent culprits in dry eye syndrome, it also can result from several diseases and immune disorders that affect tear production, including rheumatoid arthritis, lupus and Sjogren's syndrome, as well as some allergies.
Dry eyes also can be a side effect of laser surgery, a procedure that involves cutting the nerve of the cornea, which disrupts tear production. Additionally, certain medications, including diuretics, beta-blockers, antihistamines, antianxiety and antidepression drugs, can cause dry eyes. (Once you stop taking the medication, dry eye problems usually go away.)
Although dry eye syndrome is largely incurable, there is movement on the research and treatment front. I talked with ophthalmologist Stephano Barabino, MD, who is a specialist in dry eye and currently on a research fellowship at Harvard University in Boston. He explains that there is exciting new research that is revealing more precisely what the syndrome is. The long-held belief about dry eye is that it is simply not having enough tears or having them evaporate too quickly. Now, though, it appears that the syndrome frequently involves inflammation as well, and that it affects both the tear glands and the surface of the eyeball. Consequently, says Dr. Barabino, current treatment research is focused on therapies that diminish inflammation, which in turn leads to an improvement in symptoms.
TREATMENT OPTIONS
Inflammation: Before discussing treatment options, Dr. Barabino stresses that anyone with dry eye must first go to an ophthalmologist to determine what is causing the problem. Treatment methodology is determined by the underlying cause.
The new drug cyclosporine (Restasis), which you probably have seen advertised on TV, is designed specifically to treat inflammation, and it seems to help many of these patients. A simpler approach is one that Dr. Barabino and his colleagues tried in Italy. They gave patients with inflammation supplements of the anti-inflammatory essential fatty acid omega-6. (Although they used omega-6 alone, he suggests that Americans take a balanced combination of omega-3 and omega-6 because of the common dietary imbalance here in which omega-6 vastly outnumbers omega-3.)
E. Michael Geiger, OD, an optometrist who specializes in using nutrients to combat eye disease and author of Eye Care Naturally, also advises essential fatty acids as a treatment for dry eye. He has patients take 1,000 milligrams of omega-3 three times a day with meals. He also advises buying omega capsules with a small amount of vitamin E in them (the vitamin E acts as a preservative). Flaxseed oil -- generally a good source of omegas -- is not effective in this case.
Daily Health News contributing editor Andrew L. Rubman, ND, adds another important element to help reduce inflammation -- improving immune function. This is accomplished by taking an antioxidant supplement and an additional source of selenium. Selenium, once plentiful in the American diet, has been lost to modern fertilization and farming techniques. Dr. Rubman recommends 80 micrograms (mcg) to 100 mcg of selenium a day, which you can get as part of a general supplement. Check the labels.
Eye infection: Patients with an infection of the eyelid glands, called meibomianitis, can use antibiotic drops. This requires cleaning the gland daily to remove the lipid buildup. Over time, the antibiotic generally improves the patient's condition, but Dr. Barabino stresses that these patients remain prone to recurrence. Patients who have insufficient tear production have the option of plugging the eye ducts that normally drain tears. Successful for about 90% of patients, the plugs can remain in place indefinitely -- but this is not available to patients with considerable eye inflammation.
As a general guideline, Dr. Barabino advises relieving discomfort with frequent use of artificial tears (avoid drops that reduce redness -- they may further dry your eyes), keeping humidifiers going in your home and avoiding smoke, dust, pollen and the like. Certain activities, including using a computer, watching TV, driving and reading, tend to reduce blinking. This aggravates dry eye even more, so remind yourself to blink regularly in these situations. For severe cases, your eye doctor can give you a special prescription for "moisture chamber" goggles. Similar ro ski goggles, they wrap around completely, protecting your eyes from outside forces, such as the wind and allergens, and they keep natural moisture in. Although these won't make a fashion statement, those who wear them value the comfort they provide.
We tell our children to dry their eyes after they've been crying, but for more than 10 million Americans -- mostly women -- dry eyes are the problem, causing itchiness and constant pain. If left untreated, dry eye syndrome (technically called keratoconjunctivitis sicca, or, more simply, dry eye) can cause scarring of the cornea and even lead to blindness.
ABOUT YOUR TEARS
Healthy tears are made up of three layers: The outer lipid layer prevents evaporation... the second provides antibodies, salinity and acidity to the cornea... and the inner layer contains mucus that coats the cornea (the better for sticking). Although aging eye glands are the most frequent culprits in dry eye syndrome, it also can result from several diseases and immune disorders that affect tear production, including rheumatoid arthritis, lupus and Sjogren's syndrome, as well as some allergies.
Dry eyes also can be a side effect of laser surgery, a procedure that involves cutting the nerve of the cornea, which disrupts tear production. Additionally, certain medications, including diuretics, beta-blockers, antihistamines, antianxiety and antidepression drugs, can cause dry eyes. (Once you stop taking the medication, dry eye problems usually go away.)
Although dry eye syndrome is largely incurable, there is movement on the research and treatment front. I talked with ophthalmologist Stephano Barabino, MD, who is a specialist in dry eye and currently on a research fellowship at Harvard University in Boston. He explains that there is exciting new research that is revealing more precisely what the syndrome is. The long-held belief about dry eye is that it is simply not having enough tears or having them evaporate too quickly. Now, though, it appears that the syndrome frequently involves inflammation as well, and that it affects both the tear glands and the surface of the eyeball. Consequently, says Dr. Barabino, current treatment research is focused on therapies that diminish inflammation, which in turn leads to an improvement in symptoms.
TREATMENT OPTIONS
Inflammation: Before discussing treatment options, Dr. Barabino stresses that anyone with dry eye must first go to an ophthalmologist to determine what is causing the problem. Treatment methodology is determined by the underlying cause.
The new drug cyclosporine (Restasis), which you probably have seen advertised on TV, is designed specifically to treat inflammation, and it seems to help many of these patients. A simpler approach is one that Dr. Barabino and his colleagues tried in Italy. They gave patients with inflammation supplements of the anti-inflammatory essential fatty acid omega-6. (Although they used omega-6 alone, he suggests that Americans take a balanced combination of omega-3 and omega-6 because of the common dietary imbalance here in which omega-6 vastly outnumbers omega-3.)
E. Michael Geiger, OD, an optometrist who specializes in using nutrients to combat eye disease and author of Eye Care Naturally, also advises essential fatty acids as a treatment for dry eye. He has patients take 1,000 milligrams of omega-3 three times a day with meals. He also advises buying omega capsules with a small amount of vitamin E in them (the vitamin E acts as a preservative). Flaxseed oil -- generally a good source of omegas -- is not effective in this case.
Daily Health News contributing editor Andrew L. Rubman, ND, adds another important element to help reduce inflammation -- improving immune function. This is accomplished by taking an antioxidant supplement and an additional source of selenium. Selenium, once plentiful in the American diet, has been lost to modern fertilization and farming techniques. Dr. Rubman recommends 80 micrograms (mcg) to 100 mcg of selenium a day, which you can get as part of a general supplement. Check the labels.
Eye infection: Patients with an infection of the eyelid glands, called meibomianitis, can use antibiotic drops. This requires cleaning the gland daily to remove the lipid buildup. Over time, the antibiotic generally improves the patient's condition, but Dr. Barabino stresses that these patients remain prone to recurrence. Patients who have insufficient tear production have the option of plugging the eye ducts that normally drain tears. Successful for about 90% of patients, the plugs can remain in place indefinitely -- but this is not available to patients with considerable eye inflammation.
As a general guideline, Dr. Barabino advises relieving discomfort with frequent use of artificial tears (avoid drops that reduce redness -- they may further dry your eyes), keeping humidifiers going in your home and avoiding smoke, dust, pollen and the like. Certain activities, including using a computer, watching TV, driving and reading, tend to reduce blinking. This aggravates dry eye even more, so remind yourself to blink regularly in these situations. For severe cases, your eye doctor can give you a special prescription for "moisture chamber" goggles. Similar ro ski goggles, they wrap around completely, protecting your eyes from outside forces, such as the wind and allergens, and they keep natural moisture in. Although these won't make a fashion statement, those who wear them value the comfort they provide.