5 Things I Wish I Had Known About Chronic Dry Eye
Last updated: April 2023
If I could go back in time and talk to myself the day my eye doctor first diagnosed me with dry eye disease, I’d definitely have a lot to say. Part of that is because we know so much more about chronic dry eye (CDE) now than 10 years ago when this started for me, but also because in hindsight I don’t feel like I took it seriously enough. So here’s what I’d tell myself:
What I know now about CDE
1. CDE can worsen over time
This is a chronic disease, and it can get worse over time if you do nothing about it. Your eyes are delicate and important. Don’t take them for granted. Right now they may only feel bad seasonally when the temperature and humidity drops, or when the pollen starts flying and kicks up the allergies. But those seasons of discomfort may grow over time until it’s a year round problem interfering with your life.
2. Balance is key
There are different types of dry eye disease, and it’s important to figure out the factors causing the discomfort. A healthy tear film is composed of water (tears) from the lacrimal glands, oils from the meibomian glands along the eyelids, and a mucus layer. All three are important and need to be in balance.1
Evaporative dry eye is the most common type, and it means your oil glands aren’t functioning right. Aqueous deficient dry eye is when you aren’t producing enough tears, and there are many causes such as medications or underlying autoimmune diseases causing damage to your lacrimal glands. Some people can have both types. The sooner you can figure out which type you have, the better.2
3. Find a specialist
A dry eye specialist can help you get to the bottom of things. Sometimes this may be your regular eye doctor (an optometrist or ophthalmologist), but not all are experienced in diagnosing and treating chronic dry eye. If you feel like you’re getting brushed off or your symptoms are not getting any better, start looking for a specialist in your area.
Unhappy dry eyes may seem like a pesky nuisance that you should just live with, or you may have feelings of dread about going in to another doctor’s office to be told who knows what. But your quality of life matters, and they can help you before the symptoms get worse. Learn more about dry eye specialists here.
4. Learn the state of your eyes through testing
There are many tests that can be done to figure out what exactly is going on with your eyes that’s making them feel dry and uncomfortable. A meibography is a simple test that will show what your oil glands look like and how healthy there are. I would tell myself: those styes and chalazions you’ve been getting could be signs of problems with them, and lead to further issues down the line.
The most common test to see whether you’re making enough tears is a Schirmer’s test. It’s a simple strip of paper placed under your eyelids for a few minutes which absorbs your tears during that time. These are just two of the most common tests, but there are many more a dry eye specialist can perform to tell you more about the state of your eyes. Learn about more types of dry eye testing here.
5. You can improve your symptoms
It gets better. No, trust me, it can get better! Just hearing the word “chronic” can make a dry eye diagnosis seem overwhelming, but with some direction from a dry eye specialist, you can make this a manageable part of your life. The outlook for improving symptoms of chronic dry eye has never been better.
There are prescription drops and a new nasal spray called Tyrvaya targeted at different types of dry eye. There are many different in office treatments such as Lipiflow and Intense Pulsed Light (IPL) that can also treat the underlying causes of your dry eye. Research is also underway to learn more about the causes of dry eye and investigate potential new treatments.
The bottom line is, with time and persistence, your eyes can definitely start to feel better.
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