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Why is it so challenging to treat dry-eye

Why is it so challenging to treat dry-eye?

Friday 27 September 2024

Dry-eye occurs when your eyes fail to produce enough tears, or the tears lack the quality needed to keep your eyes sufficiently moist. This can result in redness, long-term irritation, and a persistent feeling of soreness. While it can affect people of all ages, the condition is most common in individuals over the age of 50. The reason why tear ducts become less effective with age remains unclear.

Chronic Dry-Eye is surprisingly widespread, affecting approximately 1 in 10 people. For sufferers, the condition brings added challenges to everyday tasks, often causing discomfort throughout daily life. It can make driving at night more difficult, reduce your ability to work at a computer for long periods, and make hobbies like reading or sewing less enjoyable.

Adding to the frustration is the often dismissive treatment many patients experience. Dry-eye is sometimes perceived as "an older person's issue," and there’s a tendency for doctors to misdiagnose it as an allergic reaction. Even more discouraging is the lack of effective over-the-counter treatments. Only about 15% of sufferers see long-term improvements with non-prescription eye drops, leaving many searching for more meaningful solutions.

The Challenge of Treating Dry-Eye

Dry-eye can be particularly challenging to treat, as it often appears as a symptom of several underlying conditions. Without an accurate diagnosis, treatment can be ineffective.

For example, if your tear production is insufficient, simply increasing tear flow may not help if the quality of the tears remains poor. Similarly, if your tear ducts are inflamed, improving the tears’ quality alone won't alleviate discomfort. This complexity can lead to a long and frustrating treatment process for both patients and physicians. Diagnosing the root cause often involves trial and error, making meaningful progress slow.

What Treatment Options Are Available?

For those seeking medical treatment, there are a number of potential options depending on the severity of the condition. Prescription eye drops that include anti-inflammatory medications can help to reduce irritation and improve tear quality. In more severe cases, procedures such as punctal plugs, which are small devices inserted into the tear ducts to block drainage and keep the eyes moist, may be recommended. Some patients also benefit from intense pulsed light (IPL) therapy, which can help unclog the glands around the eyelids and improve tear production.

What Can Patients Do?

According to the NHS, lifestyle changes can help reduce the severity of dry-eye. These include cutting back on alcohol consumption, reducing smoking, and avoiding prolonged exposure to dry, air-conditioned environments.

Additionally, simple steps like removing contact lenses more frequently and using a humidifier to add moisture to the air can also offer some relief. However, treatment options can quickly become more complex. While your local pharmacist may be the first stop, if improvements aren’t noticeable, consulting your GP for further evaluation is essential. If progress remains slow, a referral to an ophthalmologist may be necessary to explore more specialised treatments.


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