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Do You Have Symptoms of Dry Eye?Dry Eye Q&A

Can dry eye be cured with treatment?

Recent years have seen research on dry eye progress significantly, particularly in regard to the development of new testing methods and drugs, and the understanding of its mechanisms and how it occurs. Because of this, there are now effective treatments for dry eye. If you feel eye pain or discomfort, you should visit an ophthalmologist as soon as possible. Occasionally, what is thought to be dry eye symptoms can turn out to be those of another disease, or resulting from incorrect strength glasses or contact lenses. You should also avoid self-diagnosis or assume that you just have eye fatigue. In addition, it is important to review your life style when being treated for dry eye; take precautions against overstraining your eyes such as using a humidifier to prevent dry air indoors, resting your eyes regularly when working at a PC, eating a balanced diet and getting adequate sleep.

Even though I am using eye drops, my eyes are not getting any better. What can I do?

If you are using over-the-counter eye drops and your symptoms have not improved, you should first visit an ophthalmologist for a dry eye test. If you have mild dry eye, the treatment will be appropriate eye drops for your symptoms. However, if these do not alleviate the symptoms, the alternative treatment is to insert a plug into the puncta lacrimalia (tear ducts) to prevent the drainage of tears. Various types of glasses that prevent eye dryness have also been developed.

What will happen without treatment?

Visual display terminals (VDTs) such as televisions and PC screens are indispensable for our modern lifestyles, and eyestrain is becoming a common problem. We tend not to take it seriously, thinking that it will probably get better with a good night’s sleep. However, if you ignore dry eye, not only can your vision deteriorate, but it may also cause other health problems such as headaches, sore shoulders and lower back pain. Moreover, it could also be concealing systemic diseases such as Sjogren’s Syndrome or Stevens-Johnson Syndrome, or serious conditions that can lead to blindness such as diabetic retinopathy, glaucoma and cataracts. The subjective symptoms of dry eye vary between individuals, making it hard to distinguish. We recommend regular eye exams for early diagnosis and early treatment.

Do I have to remove my contact lenses when I apply eye drops?

Recently, there has been an increase in the number of eye drops that can be used while wearing contact lenses. Generally, you are told to remove oxygen permeable hard lenses and soft lenses before using eye drops. This is because many eye drops contain preservatives, and the preservatives prevent oxygen from permeating them. In addition, chemicals in eye drops can stick to lenses and possibly cause them to deteriorate. This depends on the eye drops, the type of lens and frequency of use, so you should consult your doctor or pharmacist.

Are there any diseases associated with dry eye?

There are various diseases that cause symptoms of dry eye. Sjogren’s Syndrome causes abnormality in the aqueous layer of the tear film. Diseases which cause abnormalities in the mucin layer include ocular pemphigoid, Stevens-Johnson Syndrome and allergic conjunctivitis. Meibomian gland dysfunction causes abnormality of the lipid layer. In addition, diabetes is thought to lead to dry eye by causing changes in the composition of tears, which leads to a loss of sensitivity in the sensory nerves on the surface of the eye and a decrease in the frequency of blinking. Each of these diseases has different causes and different therapeutic treatments. Some are accompanied by serious systemic symptoms, so if you suspect dry eye having used our check list, you should visit an ophthalmologist for an examination as soon as possible.

Can eye makeup cause dry eye?

Eye problems have increased as a result of the popularity of cosmetics, including eye makeup. The eye mucous membranes are extremely sensitive, so care is needed when applying eye makeup. If the openings of the Meibomian glands on the edge of the eye are blocked by eyeliner or mascara, this can cause dry eye due to tear evaporation. Because the oily substance that coats the surface of the tear film cannot be secreted. In recent years, various beauty procedures have been developed that require the use of irritant chemicals, adhesives and dyes, such as eye lash perms, eye lash extensions and cosmetic tattooing. You should be aware that these procedures can cause not only dry eye, but also problems such as eye inflammation and corneal disorders and can harm the health of the eye.

Do the tests for dry eye hurt?

General tests for dry eye such as the Schirmer’s test, BUT measurement, and staining tests, do not cause any pain. Even a whole series of the tests can be carried out quickly and painlessly.

Is dry eye after LASIK surgery different from common dry eye?

In LASIK surgery, nerves in the cornea are severed, so post-surgery secretion of tears declines and blinking decreases temporarily, and these cause dry eye symptoms. Therefore, subjective symptoms such as feelings of eye dryness and fatigue appear and vision can deteriorate. After surgery it is important to prevent post-surgery dry eye by treating appropriately in accordance with your doctor’s instructions, including continuing to apply artificial tears.

I am allergic to pollen but my symptoms match those of dry eye. Is it better to get treatment for dry eye?

The itchy eyes, redness and foreign body sensation experienced in allergic conjunctivitis due to an allergy to pollen are also seen in dry eye symptoms. If your eye problems do not improve with treatment of your hay fever, we recommend having an ophthalmologist examine your eyes. In addition, allergic conjunctivitis and dry eye can occur together, and if tear volume decreases due to dry eye, the inability to wash out pollen can cause eye inflammation. More damage to the cornea can further exacerbate dry eye.

Are there any foods or supplements that are good for dry eye?

There are some reports that people with a high intakes of n-3 essential fatty acids (omega-3) are at lower risk of experiencing dry eye. The typical n-3 fatty acids include eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and alpha-linolenic acid (ALA), which have been recognized as having a preventive effect against dyslipidemia and cardiovascular disease. Foods that contain a lot of EPA and DHA include blue skinned fish, salmon and tuna. A variety of supplements are also sold; whilst you can start taking them without any concerns you cannot expect immediate results. However, excessive intake of n-3 fatty acids can lead to side effects such as prolongation of bleeding time, so it is important to not take more than the recommended dose.

Why are tears produced when people feel strong emotions?

In addition to basal tears, which constantly lubricate our eyes, and reflex tears, which are produced in response to irritants such as when particles enter our eyes, there are also emotional tears which are triggered by emotions such as happiness and sadness. Emotional tears are related to the functioning of the autonomic nervous system. As we get more emotional, the cerebral prefrontal area acts to temporarily stimulate the action of the autonomic nervous system, and a large volume of tears produced by the lacrimal gland flow out through our eyes. Emotional tears are unique to human beings and are not observed in other animals.

What is mucin?

Mucin is a viscous substance secreted by mucosal cells. It is one of the main components of mucus. Mucin is found throughout the human body. In the gastric mucosa, it plays a protective role against gastric acid. In the eyes, it forms a mucin layer that protects the surface of the eyes and also acts to maintain the stability of lacrimal fluid. Mucin also protects wounds and promotes repair when any part of body tissues is damaged.

Why is mucin important?

Mucin, a key component in mucous, plays a role in making water, which is the main component of tears, stay on the cornea uniformly. Corneal cells are essentially hydrophobic, and the action of mucin (membrane mucin), which is made up of oligosaccharides and proteins, makes the cornea associate more readily with water. Without the mucin foundation, tears could not stay on the eye surface and would drain off.

Is dry eye on the rise only among Japanese people?

The number of dry eye patients is thought to be rising around the world due to changes taking place in our living environment (along with the popularization of air conditioning and computers), but there are no detailed reports comparing prevalence by country because of differences in the patient populations and methods of studies. However, there are reports that the prevalence of dry eye in Asia, including Japan, is high compared with Europe and North America.

Do animals also get dry eye?

Pets that are kept indoors such as cats and dogs can get dry eye. In humans, one of the causes of dry eye is a dry indoor environment which leads to an overtaxing of the eyes, whereas for dogs it seems that it is often caused by the destruction of cells in the lacrimal gland due to an immune system dysfunction. Other causes may include nerve damage, aging, and congenital absence of the lacrimal gland. Symptoms include a large amount of sticky eye discharge.

What is the right way to apply eye drops?

Tilt your face up and gently pull your lower eyelid down. Apply the eye drops under the lower eyelid without touching the eye or the eyelid with the container. After applying the eye drops, gently press beneath the inner corner of your eye to make sure that the solution does not drain out through the tear duct, and close your eye for a short time. Do not blink repeatedly to try to spread the solution. If you do, the solution will drain out through the tear duct along with tears into the throat, causing a bitter taste in your mouth. When you use two or more types of eye drops, leave an interval of five minutes between applications. Also, do not forget to maintain hygiene including washing your hands thoroughly before application and not touching the mouth of the container after opening it.

Is it a bad idea to just use over-the-counter eye drops?

With the increase in the number of dry eye patients in Japan, the number of over-the-counter eye drops for dry eye has also risen. Whilst they are easy to purchase and convenient to use, we recommend visiting an ophthalmologist for an examination and proper diagnosis, and eye drops that are appropriate for your specific case. Habitual use of over-the-counter eye drops based on a self-diagnosis of eye fatigue or eye dryness might exacerbate your symptoms or may lead to chronic symptoms. In addition, many over-the-counter eye drops contain preservatives, of which dry eye patients need to be particularly careful, as frequent use can lead to the preservatives in the drops remaining in the eye, causing further damage to the cornea.

What is the difference between hard and soft contact lenses?

Using contact lenses is one of the factors that can contribute to dry eye, and may lead to a vicious cycle in which the symptoms become worse. If you really must wear contact lenses, hard lenses are a better choice than soft lenses. Soft lenses are made from material with a high water content, so when the lenses are used for a long period, they lose water and absorb water from the tears on the surface of the eye. Hard lenses do not contain water, so tear evaporation is lower than with soft lenses. Also, hard lenses are smaller than the cornea, so the lens moves up and down on the cornea each time you blink which makes them better for tear exchange efficiency whereas soft lenses, which are bigger than the cornea, make tear exchange more difficult.

Do You Have Symptoms of Dry Eye?