October 11, 2011
Are your vision problems caused by dry eyes?
A few months ago, I saw a patient who had blurry vision and tired eyes at the end of the day. Although he assumed that new computer glasses would correct the problem, he had already been told by three other optometrists that his prescription was unchanged. When I checked his eyes and found similar results, I suspected that the appropriate solution had nothing to do with his glasses.
As technology shifts, the increasing prevalence of dry eyes is not surprising. When people spend long hours in front of a computer screen, their blink rate slows down from an average of 15 to seven blinks per minute. Because a slower blink rate increases the risk for faster tear film evaporation, both daily use and long hours at a computer can create variable dry-eye symptoms. Like my patient, computer users can feel their vision is “off,” which is a common concern of patients with dry eyes.
Age, gender, medical history, diet, lifestyle and environmental factors are other common triggers for dry eyes. In 2009, the National Eye Institute estimated that nearly 5 million Americans age 50 and over had severe symptoms, and many more had mild or moderate symptoms. Women are at increased risk due to the hormonal changes of pregnancy, oral contraceptives and menopause.
Dry eyes can be caused by medical conditions such as allergies, acne rosacea (a problem of the oil glands), rheumatoid arthritis, diabetes and thyroid problems. They can also be side-effects of certain medicines, including antihistamines, decongestants, blood pressure medications and antidepressants.
Long-term use of contact lenses and poor contact lens hygiene can be a factor in the development of dry eyes. Exposure to smoke, wind and dry climates can also increase tear evaporation, resulting in dry eye symptoms.
For mild symptoms, there is no harm in starting with a home treatment of preservative-free artificial tears. Be sure to avoid eyedrops with preservatives to prevent anything from further drying out your eyes. A careful evaluation by your eye care provider will help get you appropriate treatment for moderate to severe symptoms. Therapies range from subtle dietary and environmental changes, to over-the-counter artificial tears, to aggressive treatment with topical or oral medications.
Diagnostic tests include evaluating tear quality and quantity as well as other health issues that can slow down proper healing. Contact lens wearers may need to try a different lens material or switch to a preservative-free cleaner. In patients with lower tear-film volume, inserting a plug to temporarily or permanently block the drainage system of the eye can help retain natural tears longer.
Just as it takes time for symptoms and dryness to develop, it takes time for the eyes to heal. My patient began to notice improvements after two months of applying preservative-free artificial tears, warm compresses on his eyes, gentle eyelid scrubs and an antibiotic ointment. For maintenance, he continues to use moisturizing tears throughout the day and takes timed 15-second breaks every 15 minutes when working at his computer.
Even if you dont wear glasses, talk to your doctor about an appropriate schedule for routine eye exams and make an appointment promptly if you have any concerns or changes in your vision.
Nancy Ross, O.D., is a teaching associate and optometrist with the UW Department of Ophthalmology. Her practice is located at the UW Medicine Eye Institute at Harborview and UW Neighborhood Clinic – Belltown. For more information, call (800) 852-8546 or visit www.uwmedicine.org/uwpn