Dr. King:
Hi, and welcome to Days of Our Eyes. I’m Dr. King. I’m Dr. Cha. In this video, we’ll be talking about dry eyes. Sounds pretty dry, right? Is it painful, treatable. Keep watching to find out.
I think dry eyes, really, that’s a misnomer. It’s a whole constellation of ocular surface problems. I wish we could say ocular surface disease, but it’s too many syllables. So we never say that. Some of the symptoms can involve gritty, scratchy eyes, red eyes, fluctuating vision, which is a real big one.
Dr. Cha
Itchiness on their eyes. They have some kind of sensation like, like an eyelash stuck in their eyes. Even like some people say like a boulder. People also describe it as being tired, or they feel like their eyes are straining or they have a pressure around their eyes.
Dr. King:
Yes, pressure around the eyes, just wanting to close ’em. By the end of the day, if you’re experiencing any of this, you may think, oh, I just need to change my glasses. Well, there could be a little bit more going on and that’s when you need to see your doctor. Literally, anybody can get dry eye at any age. So when we stare at a digital screen, it’s different than if you’re staring at a printed page or having a conversation with somebody. We blink at different rates. Our eyes will dry out just through evaporation. Plus, when we’re blinking at slower rates, the glands and the eyelids that help produce tears start to block up and you end up not producing good quality tears. People think dry eye, I just need to stick more tears on there. I need to just wet the eye down. And it’s so much more than that. Folks that tend to have autoimmune and inflammatory conditions, they’re gonna be more susceptible. If you’re living in an area with a lot of particulates in the air or a lot of pollution, that’s going to add to the problem. And medications. Literally 80% of the most commonly prescribed medications in the United States can help contribute to dry eye. So you put this all together. Any, it can happen to anybody. What do you think? Oh, I’m getting older so I just have to put up with it. Right?
Dr. Cha:
No, I mean, you know, I have sometimes worse dry eye than Dr. King over here. Mm-Hmm. I have like the eyes of like a geriatric patient. You know, I’m an elderly man. Some of the, some of our patient base coming in, you know.
Dr. King:
It kind of does.
Dr. Cha:
Yeah. And it’s and it’s something that you want to get on top of before you start feeling it.
Dr. King:
The funny thing is, there’s a lot of folks that they’ll come in going, I have blurry vision. And it’s not that they need glasses, it’s their tear film it’s not
smooth, it’s not regular, it’s not good quality. And it makes it harder to focus. It’s like looking through water, beating up on the windshield or your car. You just can’t stay in focus and your vision, you, you’re just constantly blinking to see better. And a lot of people think that means they need new glasses. And that’s not necessarily the case. We have to find ways to improve the quality of the tears. How do we do that? Well, certainly we are gonna use artificial tears. We need to look at the tear production mechanism. Where are tears made? They’re actually made in our eyelids. Okay. And there are different types of cells that help produce the water, the oils, the mucins, and all the stuff that goes together to create our tears. Our tears should be thick like lotion to soothe the surface of our eyes. So first we have inflammation, then we get lower quantity and end up with all kinds of symptoms.
Dr. Cha:
And Dr. King likes to describe to our patients when the tears are out of balance like this. They’re almost like they’re toxic to our eyes. When they’re supposed to be present and helping. Another symptom that patients come in and say they feel like they’re crying all the time. I cry all the time. Or like their eyes just are watering. I can’t have dry eye. I have all this extra water. Well that’s because the tears are so outta whack out of balance. They don’t have the right components. This inflammation is actually irritating the eyes and the bodies reacting by introducing more water. But just like how Dr. King was kind of breaking it down its not just water, there’s, there’s mucus component, mucinex component, an oil component. And it has to be in a cocktail of sorts to actually be beneficial right to our eyes versus it being a detriment.
Dr. King:
Otherwise they cry for help. That’s what I call it. Yeah. It’s a cry for help. Can be mistaken for something else?
Dr. Cha:
Don’t just assume it’s dry eye. It could be an infection, it could be uveitis. But I’ve been dealing for dry eye for a better part of a decade or so. Now, if it goes untreated, are there adverse effects? There can be. You could think of it. We always use the skin as kind of an analog. When your skin is dry and it cracks, it’s more prone to infections. That’s the same idea with dry dryness in our eyes, the ocular surface disease is what we call it. So instead of a topical skin or dermal surface, it’s our surface of our eyes and we can be prone to it becoming worse. We want to make sure that we’re doing our best to make sure that we’re not increasing the risk.
Dr. King:
If it’s left long enough, it can lead to scarring and decrease in vision. Not just a temporary, but a permanent decrease in vision. You know, you start to wonder, will contact lenses cause me to get dry eye? No, but what happens is contact lenses float on your tear film. If you have a poor tear film, now your lenses are gonna irritate you. But we can’t cure it. All we can do is manage it and we can certainly make it much more livable. There’s so many things we can use. It’s not just eyedrops. It has to do with heat and lid massage to keep the glands open. We have in-office treatments nowadays, things like LipiFlow, which helps express the glands. We have intense pulse light treatment, which is kind of groundbreaking for me. Because we’re able to treat inflammation in the skin around the eyes. That’s huge. You know, when we, when we can treat the environment around the eyes. Cuz I’m, for years I’ve been talking to patients about their lids, what’s going on around the eyes that are, that’s leading to some of this inflammation. And we have so many more tools at our disposal. The key is, is get into your eye doctor and get checked out. Make sure it’s not something else. I mean, it could be another type of inflammation, it could be an eye infection, it could be dry eye.
Dr. Cha:
What do we usually recommend to our patients when they come to our dry eye clinic?
Dr. King:
Well, I always get people started on the basics. I call it Dr. King’s basics. You want to treat the eyelids, you want to treat the surface. So I like heat in the form of a heat mask on the eyes that’s gonna help dilate the, the glands in the eyelids and help soften up the stuff that tends to block those glands. Oil sebum and that kind of stuff. And we do a little lid expression and a lid wipe. We wanna keep all that stuff wiped away. And then artificial tears, depending on your computer use and a few other things, want you to stay hydrated, drink your water. If you get dehydrated, guess what? Tears are 90% water. You don’t have water in your body. You don’t have anything to work with. There’s nutritional supplements such as Omega-3s, which have anti-inflammatory effects. Something that’s ocean-based versus land-based. Omega3s such as krill oil or fish oil versus flax seed oil. That’s just starters. That’s just my basics. And then from there we tailor it to the patient. And the patient’s needs. There’s a lot of stuff we can do.
Dr. Cha:
Yeah. We are just, you know, cracking open the toolbox. Some people aren’t even aware that there is a toolbox or a tool shed that we can, that we can go to to help you. You know, that’s what you know we’re making this video for so that people can realize that this exists. So you can bring it up to your eye doctor and they’ll point you in the right direction.
Dr. King:
Yeah. The end of this year, I’ll have more tools in my toolbox. In our toolbox.
Dr. Cha:
Yeah.
Dr. King:
So stay tuned.
Dr. Cha:
It’s exciting stuff. Please do us a huge favor and hit the subscribe button for more Days Of Our Eyes content. If you have any questions about dry eye, drop them all in the comments below. Thanks for tuning in. We’ll catch you next week on Days of Our Eyes.
Dr. King:
See you then.