Dry Eye Syndrome: Common Questions and Treatment Options

Inquiries related to dry eye syndrome?

Hello, Doctor.
Two weeks ago, I began experiencing symptoms of dry eye: dryness, burning sensation, and light sensitivity.
I visited two different hospitals; one prescribed artificial tears and fatigue relief eye drops, while the other, considering my youth, only prescribed two bottles of anti-inflammatory eye drops, stating that artificial tears could lead to lacrimal gland degeneration.
Other recommended methods for improvement include warm compresses in the morning and evening, avoiding excessive eye strain, taking adequate breaks, and going to bed early.
I have the following questions:
1.
Can I use artificial tears? The two doctors provided different opinions.
Online articles suggest that they can be used, but it’s important to use them correctly, preferably those without preservatives.
However, sometimes my eyes are so dry that I have no choice but to use them!
2.
I still feel dryness and even a burning sensation.
Although the discomfort has slightly improved compared to when the symptoms first appeared, there doesn’t seem to be significant improvement.
Is the relief period for dry eye syndrome generally longer than for other eye conditions? I’m worried that the lack of improvement might indicate a worsening condition.
3.
The doctor did not specifically mention whether there was any damage to my cornea but prescribed anti-inflammatory eye drops.
Is the classification of dry eye syndrome into mild and moderate based on the presence of inflammation in the cornea or conjunctiva?
4.
If my dry eye symptoms improve and are well-maintained, can I return to a symptom-free state?
Thank you for taking the time to address my questions!

Li, 20~29 year old female. Ask Date: 2018/11/16

Dr. Gao Pilin reply Ophthalmology

Hello Ms.
Li,
1.
Can artificial tears be used? Artificial tears can generally be used by anyone; however, most commercially available artificial tears contain preservatives to prevent spoilage.
It is advisable to use them no more than four times a day.
If you wish to use them more frequently, you can purchase preservative-free artificial tears, which are typically available at pharmacies.
2.
There are many potential causes for dryness, burning, and light sensitivity, with the most common being conjunctivitis and dry eye syndrome.
Based on your age, it is more likely to be conjunctivitis.
Dry eye syndrome can also lead to inflammatory responses, causing discomfort, so the relief period for dry eye syndrome may sometimes be longer.
If allergic conjunctivitis is present, it is important to avoid exposure to allergens.
3.
Dry eye syndrome is often classified into stages: Stage 1 involves unstable tear film, Stage 2 is punctate keratitis, Stage 3 is filamentary keratitis, and Stage 4 is corneal ulceration.
This classification is based on clinical examination.
4.
If dry eye syndrome does occur, it may require ongoing use of artificial tears to alleviate dryness, as it is rare for symptoms to completely resolve.
However, current research indicates that inflammatory responses play a crucial role in dry eye syndrome.
Consequently, some individuals are using an immunosuppressant, designed to reduce rejection reactions, in the form of eye drops to treat dry eye syndrome, which can be effectively combined with artificial tears to improve symptoms.
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Please note that online responses are for reference only; it is necessary to seek medical attention at a healthcare facility if needed.
I hope to have the opportunity to assist you.
Best regards,
Gao Pilin

Reply Date: 2018/11/16

More Info

Dry Eye Syndrome (DES) is a common condition that can significantly affect a person's quality of life. It is characterized by symptoms such as dryness, burning, and sensitivity to light, which can be exacerbated by environmental factors, prolonged screen time, and certain medical conditions. Your experience of receiving different treatment recommendations from two different doctors is not uncommon, as the management of dry eye can vary based on individual circumstances and the underlying causes of the condition.

1. Use of Artificial Tears: Artificial tears are generally considered safe and effective for managing dry eye symptoms. They help to lubricate the eye and provide relief from dryness. However, there are important considerations regarding their use. The recommendation to use preservative-free artificial tears is particularly relevant for individuals with chronic dry eye, as preservatives can sometimes exacerbate irritation and inflammation. It's essential to follow the instructions provided by your healthcare provider and to choose products that suit your specific needs. If you find that your symptoms are severe and require frequent use of artificial tears, it may be worth discussing this with your doctor to explore alternative treatments or formulations that may be more suitable for your condition.

2. Duration of Dry Eye Symptoms: The duration of dry eye symptoms can vary widely among individuals. Some people may experience relief relatively quickly with appropriate treatment, while others may find that their symptoms persist for an extended period. Chronic dry eye can take time to manage effectively, and it is not uncommon for patients to experience fluctuations in their symptoms. Regular follow-up with your healthcare provider is important to monitor your condition and adjust your treatment plan as necessary. If you are concerned about the progression of your symptoms, it may be beneficial to seek a second opinion or further evaluation.

3. Classification of Dry Eye Severity: The classification of dry eye severity is often based on clinical findings, including the presence of inflammation in the conjunctiva or cornea. The severity can be categorized into mild, moderate, and severe, with varying degrees of symptoms and signs. In general, the presence of inflammation or damage to the ocular surface may indicate a more severe form of dry eye. Your doctor may assess the health of your cornea and conjunctiva through various tests, such as tear break-up time or ocular surface staining, to determine the severity of your condition.

4. Potential for Symptom Resolution: Many individuals with dry eye syndrome can achieve significant improvement in their symptoms with appropriate management. While some may experience chronic symptoms, others may find that their condition stabilizes or improves over time, especially with lifestyle modifications and consistent treatment. Factors such as maintaining proper hydration, using humidifiers, taking breaks during prolonged screen use, and adhering to a prescribed treatment regimen can all contribute to better management of dry eye symptoms. It is essential to have realistic expectations and understand that while complete resolution may not always be possible, significant improvement is often achievable.

In conclusion, managing dry eye syndrome requires a comprehensive approach that includes appropriate use of artificial tears, lifestyle modifications, and regular follow-up with your healthcare provider. If you continue to experience discomfort or have concerns about your treatment plan, consider discussing your symptoms and treatment options further with your doctor or seeking a referral to a specialist in ocular surface disease.

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