Caring for Dry Eye During an Autoimmune Flare
When you have chronic dry eye, keeping up with eye care can be challenging. Between eyelid cleanses, topical treatments, eye drops, prescription medications, heating masks, eyelid massages, blinking exercises, lens maintenance and care (if you wear them), and managing doctor appointments, it can almost feel like a full-time job.
For those of us who have dry eye along with an autoimmune disease, fatigue and pain can make keeping up with our eye care routine even more difficult.
Rheumatoid arthritis and dry eye
After several months of remission, my rheumatoid arthritis started flaring a few weeks ago, as of my writing this, which got me thinking about the ways it affects my ability to care for my eyes. I’ve often found that when my disease activity is higher, I tend to let my eye care slide.
My morning bathroom routine tends to be a natural time to do my eyelid cleaning, tea tree oil wipes and eye drops. Unfortunately, my rheumatoid arthritis tends to be worse in the morning, which makes standing at the sink and trying to open packages or squeeze bottles much harder and a literal pain. In spite of that, I usually do manage to get it done, though it does tend to use up a good chunk of my energy for the day.
Dealing with fatigue and pain
You would think lying down to use my heated eye mask would be an easy thing when I’m down and out, but I’m pretty bad at making time to do it even when I’m feeling good. When I’m hurting, the last thing I want to do is lay still and marinate in my pain.
The nightly routine of washing my face and brushing my teeth is another obvious time that probably many of us do our eye care, but when my fatigue levels are up, I can barely muster enough energy to drag my body into bed, let alone to maintain a technique cleaning my eyelids and applying various products.
It all adds up
Of course, when rheumatoid arthritis disease activity is up, the dry eye symptoms and inflammation are worse for me, and shirking my eye care duties sure doesn’t help with that. In comes the internal conflict of knowing I need to do it, but how hard do I push myself, and will I pay for the extra exertion later? Then that stress likely adds to my disease flare, causing more stress about all the things I can’t get done. It’s a unique circle of misery.
So, how do I fix this dilemma? I wish I had a perfect answer. I’ve decided to just the do the best I can with what I have to work with on any given day. That may mean just a quick swipe with my eyelid wipes once a day or even just caving into my fatigue and collapsing in bed without doing anything for my eyes and accepting the consequences.
I had always been a very high-energy and driven person, so it takes a lot of effort to practice self-compassion when I can’t keep up with all of the demands this disease has placed on me.
Looking to others
I think it’s natural for many of us to think that others are handling things much better than us, but rationally, I know that’s not true.
I’m curious, how do others handle eye care when their autoimmune disease is flaring?
Did you know patients can experience dry eye symptoms but have healthy-looking eyes under a slit-lamp exam?