• Dr. Choong Yean Yaw

Dry Eye

Dr. Choong Yean Yaw

MBBS (Mal), FRCS Ed, M.Med (S’pore), Am (Mal), Corneal & Refractive Surgeon

Dry eye syndrome, or simply dry eyes, is one of the most common problems treated by ophthalmologists. Dry eyes occur when the eyes do not produce enough tears or when the tears evaporate too quickly. Most of these patients are middle-aged to elderly women experiencing hormonal changes, contact lens users, persons with abnormalities of the eyelids or lacrimal gland, and individuals who had a history of laser eye surgery for the correction of refractive errors.

Patients with dry eyes normally complain of:

• Heaviness of eyelids

• Blurred and fluctuating vision

• Excess ropy mucus

• Burning, itching, scratchiness, gritty sensation, sandy

• Foreign body sensation

• Sensitive to light

• Tearing

• Pain

These symptoms usually get worse as the day goes on or on awakening in the morning. Patients may experience symptoms when working on a computer, reading, or watching TV, and are usually intolerant to air-conditioners, smoky environments, and low humidity in airplane cabins. Normal blinking is essential to maintain a healthy ocular surface. People tend to blink less when they need to use their eyes to perform works that require concentration such as working on the computer. This causes the ocular surface to get dry faster.

A diagnosis of dry eye syndrome is based on a combination of symptoms, signs, and clinical tests.

Treatment options

The primary goals in the treatment of dry eyes are to relieve discomfort, provide a smooth optical surface and prevent structural damage to the cornea. The initial treatment is to supplement tear deficiency with artificial tears to help moist eyes and relieve the symptoms. Underlying causes, if any, have to be treated as well.

• Artificial tears

A variety of artificial tears are available in the market. If patients are getting an eye drop from a pharmacy without consultation from an ophthalmologist, then choose the one that makes the eyes most comfortable. Otherwise, the ophthalmologist will recommend eye drop, if a patient is required to use tears more than 6 times a day, then preservative-free tears are a more appropriate option.

• Surgical treatment

Surgical treatment is mainly reserved for cases in which the tear film instability is due to abnormal ocular structures. Besides correction of abnormal ocular structures through surgical interventions, tear puncta can be plugged (temporary) or cauterized (permanent) to reduce tear outflow (i.e. preserve natural tears and prolong the effect of artificial tears). As a result, the ocular surface is kept moist for a longer duration.

What should a patient do?

• Consult an ophthalmologist if he or she experiences symptoms of dry eye.

• Upon diagnosis, the ophthalmologist will prescribe medications or artificial tears.

• Follow medication instructions given by ophthalmologist upon diagnosis of dry eyes.

• Keep follow-up visit appointments as scheduled.

• Remember to blink while using computer or reading

• Avoid straining the eyes for a long period of time.

• When eyes are strained, apply artificial tears to relieve the symptoms. To learn more about Dry Eye, tune in to the podcast by Stevens and Dr. Choong Yean Yaw

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