DEAR MAYO CLINIC: My eyes have gotten drier as I’ve gotten older, and I’ve tried eye drops for relief. But some eye drops feel irritating, and others seem to have a rather thick consistency. What options do I have?
ANSWER: Dry eyes occur when your tears — a mixture of water, fatty oils and mucus — aren't able to provide enough lubrication for your eyes. This can happen because your eyes don't make enough tears or if your tears are poor quality. Aging is a common cause of dry eyes, but certain medical conditions and some medications also can result in dry eyes.
Some people with dry eyes find relief without buying any special treatments or eye drops. One option is to apply warm compresses to the eyes. You can use a warm washcloth or a heated beaded mask, and apply to the eyes for 10 minutes. Then, gently wash your eyelashes and eyelids using watered-down mild shampoo.
By unplugging any plugged oil gland pores on the eyelid margins, oil from the eyelid can freely glide over the surface of your eye to form a protective layer — much like a sheen of oil sometimes can be seen in parking lot puddles after rain. This can take a few days to benefit you, and it keeps your tears from evaporating so quickly.
If warm compresses and lid scrubs don’t work, you may consider using eye drops. Avoid eye drops that state they will reduce redness, as prolonged use of this type of eye drops can cause irritation. Instead, use artificial tears. Some contain preservatives to prolong shelf life, but these can cause eye irritation if used more than four times a day. For more frequent use, try preservative-free eye drops. These come in packages of multiple single-use vials. After you use a vial, you throw it away.
Lubricating eye ointments have a thicker consistency. They coat your eyes, providing longer-lasting relief from dry eyes. Since these products can blur your vision temporarily, they are best used just before bedtime.
If nonprescription eye drops aren’t helping, talk to your eye doctor. Sometimes, an underlying problem, such as Sjögren’s syndrome or rosacea, may need to be treated first. If a medication you take for another condition is causing your dry eyes, your doctor can discuss whether changing your prescription might help.
If an inflammation on the surface of your eyes is causing your dry eyes, it may be possible to control it with prescription eye drops that contain the immune-suppressing medication cyclosporine (Restasis). This medication may require several months of regular use before symptoms improve.
The U.S. Food and Drug Administration recently approved a new kind of eye drop solution, lifitegrast (Xiidra), which may work a little faster than cyclosporine. Lifitegrast also works to decrease surface inflammation, although in a different way than cyclosporine.
Other options that may provide relief from dry eyes are available, as well. Examples include tear duct plugs to keep tears from draining out, dissolvable eye inserts, other medications and select procedures to help increase moisture in your eyes. Sometimes, even special types of eyewear may help reduce dryness from outside air.
Talk with your doctor to determine the cause of your dry eyes. He or she can recommend a treatment that is right for your situation. (adapted from Mayo Clinic Health Letter) — Dr. Thelma Barnes, Ophthalmology, Mayo Clinic, Phoenix
Presbyopia: A cause of blurred distance vision?
Having trouble focusing your eyes at different distances? It could be an early symptom of an age-related vision change.
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Meniere's disease: It's not just dizziness
Meniere's disease is a disorder of the inner ear that causes episodes of vertigo and problems with hearing, including tinnitus and fluctuating hearing loss, with progressive, ultimately permanent, loss of hearing. It's considered a chronic condition, but various treatments can help relieve symptoms and minimize the long-term impact on your life.
Slideshow: Aquatic exercise
Aquatic exercise is a low-impact activity that takes the pressure off your bones, joints and muscles. Exercising in the water can be a great way to include physical activity into your life. You can even participate in aquatic exercise if you don't know how to swim.
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Are those white flakes in your hair snow — or dandruff? This scalp condition is often worse in fall and winter. Discover possible causes and treatments that can help.
The eye’s outermost tissue, the cornea, is a bit more substantial than you might imagine. It’s made up of lots of types of cells and structural proteins, arranged in highly organized layers. At about 560 µm (1/45 of an inch), the cornea is transparent, but about as thick and bendy as a credit card. For clear vision, it must be free of cloudy areas, but disorders can roll over it like a storm — the most common being an inherited, degenerative disease called Fuchs’ corneal dystrophy. Fuchs’ (pronounced “fooks”) affects almost five percent of middle-aged patients with some variance across ethnicities. Most people remain symptom free, but many lose their vision altogether; Fuchs’ accounts for more than 14,000 corneal transplantations in the U.S. annually.
On Mayo Clinic’s Rochester, Minn. campus, surgeon Keith Baratz, M.D., meets and treats Fuchs’ patients almost every day. The disease slowly kills off the cells responsible for regulating the amount of fluid entering the cornea. As the cells die, the first symptom patients usually notice is blurred morning vision. This happens because when their eyes are shut as they sleep, fluid builds up in the cornea, causing it to swell. While their eyes are open over the course of the day, the excess fluid evaporates, so they usually see better by evening. But as the disease advances, the periods of swelling, impaired vision and pain last longer. Read the rest of the article.
Find more research news on Discovery's Edge.
This week's case is in honor of the third annual Contact Lens Health Week (August 22-26). Contact lenses were received from a young adult male with bilateral conjunctivitis, photophobia and eye pain. These symptoms began shortly after he had been swimming in a freshwater lake while wearing his contact lenses. What was the cause?
Every week, Mayo Clinic microbiologist Dr. Bobbi Pritt posts a new case, along with the answer to the previous case. Read Dr. Pritt's blog, Parasite Wonders, and submit your answers, comments and questions. Learn more about Dr. Pritt's work, and enjoy science!
Note from Dr. Pritt: All opinions expressed here are mine and not my employer's. Information provided here is for medical education only. It is not intended as, and does not substitute for, medical advice. I do not accept medical consults from patients.
Every Fourth of July, emergency departments see an influx of injuries caused by fireworks. Mayo Clinic experts say the hands, face and eyes are particularly vulnerable.
Journalists: Broadcast-quality video pkg (:59) is in the downloads. Read the script.
ANSWER: Dry eyes happen when your eyes do not make enough tears or when those tears are poor quality. Treatment of dry eyes often includes medication, eye drops or ointment. But new treatments for a certain type of dry eyes may provide relief when standard treatments fail.
To keep your vision clear and your eyes comfortable, you need a smooth layer of tears consistently covering the surface of your eyes. The tear film has three basic components: oil, water and mucus. Problems with any of these can cause dry eyes.
Symptoms of dry eyes often include blurry vision, eye redness, sensitivity to light, and a burning, gritty or scratchy feeling in your eyes. Dry eyes may cause excessive tearing in some cases. They can make it difficult to wear contact lenses, too. Medications, age, eyelid problems, environmental factors (such as climate) and excessive eye strain can all result in dry eyes.
For some people with chronic dry eyes, the problem stems from glands in the eyelids, called the meibomian glands. Normally, these glands make oil that slows the evaporation of tears. If the glands become blocked, tears do not contain enough oil. Then the tears evaporate too quickly, and eyes become dry. This type of dry eye condition is known as evaporative dry eye. Inflammation of the eyelid skin — a disorder called ocular rosacea — can often result in blocked meibomian glands. [...]
DEAR MAYO CLINIC: I am 53 and have never had trouble with my eyesight, but my mother has glaucoma, which I know increases my risk of getting it. Is there anything I can do to prevent glaucoma? How often should I have an eye exam?
ANSWER: You are correct that a family history of glaucoma raises the risk of developing this serious eye disease. It is currently not clear if lifestyle changes can decrease your risk of glaucoma, so it is crucial that you get eye exams on a regular basis. A comprehensive eye exam can help detect glaucoma in its early stages when it is most successfully treated.
Glaucoma is a disorder that damages the optic nerve. In its advanced stages, it can impair vision and eventually lead to blindness. In most cases of glaucoma, the optic nerve is damaged by a rise in pressure within the eye due to a buildup of the fluid that flows in and out of the eye.
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HEALTH TIP OF THE WEEK
Snoring solution: Sleep on your side
Sleep on your side to help prevent snoring. Lying on your back allows your tongue to fall backward into your throat, which narrows your airway and partially obstructs airflow. To stay off your back, try sleeping in a tight-fitting T-shirt with a tennis ball sewn or attached to the back. This uncomfortable trick will remind you to roll over. Or raise up the head of your bed by about four inches.
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The eyes have it! March is Save Your Vision month and we hope you can join us Saturday, March 1, at 9 a.m. CT, when the topic is eyesight. Ophthalmologists Sophie Bakri, M.D.; and Michael Mahr, M.D. will be with us to discuss macular degeneration, glaucoma and cataracts, in addition to workplace eye safety.
Myth or Matter of Fact: Only patients with a family history can develop glaucoma.
To listen to the program LIVE, click here.
Listen to this week’s Medical News Headlines: News Segment March 1, 2014 (right click MP3)
Critically ill patients are benefiting from a new program designed to improve care and shorten hospital stays. The Mayo Clinic Enhanced Critical Care program offers 24/7 remote monitoring of the sickest patients at six Mayo Clinic Health System hospitals.
Critical care specialist at Mayo Clinic in Rochester and program medical director Sean Caples, D.O., says, “This is a more proactive way to take care of patients. The way we’re delivering care is changing, but our end goal remains the same: providing the best care possible to patients. We’re taking advantage of new technology to help us do that.” Pulmonologist and director of the critical care unit in Eau Claire Dany Abou Abdallah, M.D., says, “It’s like having an extra set of eyes on every patient. With this program, operations center nurses and physicians continuously review patients’ vital signs and other data. The minute they notice a potential problem, they can alert the local care team.”
Click here for news release
Journalists: Sound bites with Dr. Caples and Dr. Abdallah are available in the downloads. B-roll of the monitoring equipment is also available in the downloads
Optometrist Bert Moritz, D.O., of the Mayo Clinic Health System in Eau Claire, Wis., explains that six extraocular muscles firmly hold the eye in the socket, making it almost impossible for eyeball subluxing (what a relief!). And though it may feel as if pressure builds in your entire face before you sneeze, it doesn’t increase in your eyes. So why then do we clamp our eyes shut when we sneeze?
“This is an involuntary reflex,” explains Moritz. “When our brain sends this muscle message, one part of the message is to close our eyes. It’s similar to a deep tendon reflex.”
Read more in this article from NBCNews.com "The Body Odd"
Treatment for Dry Eyes Focuses on Relieving Symptoms
June 3, 2011
Dear Mayo Clinic:
Could you please tell me how I might treat and overcome dry eye? My right eye is constantly tearing.
Dry eye disease is common and can develop for many reasons. Usually, the condition is chronic and cannot be cured. Instead, treatment for dry eyes focuses on relieving symptoms.
To maintain eye comfort and good vision, the front surface of your eye needs to be covered with an even layer of tears that contain the right mix of water and oils. If tears are not of sufficient quantity or quality to maintain that layer, dry eye disease (also called ocular surface disease) can develop.
Symptoms of dry eye disease may include a stinging, itchy or burning sensation in your eye, sensitivity to light, blurred vision, and mucus in or around your eye. As you've experienced, excess tearing can also be a symptom. Normally, tears are produced very slowly. But if that process fails to make enough tears, a different tear production system may be activated. And, unfortunately, this reflex mechanism usually produces too many tears.
Before you begin treatment for dry eyes, review your current medications and medical history with your doctor. Some drugs — such as high blood pressure medications, antihistamines, acne medications and decongestants — can cause dry eyes. If medication is causing the problem, a change in prescription may be all you need to relieve symptoms.
Certain medical conditions can decrease tear production. These include rheumatoid arthritis, Sjogren's syndrome, diabetes and lupus, among others. In some cases, systemic treatment for these conditions may ease dry eyes.
Smoking has also been associated with an increased risk of dry eye disease. Not only is the particulate matter that is released into the air irritating to the surface of the eye, other toxins in tobacco smoke actually alter the quality of tears produced by the eye.
If switching medication or treating an underlying medical condition isn't the issue or doesn't give you enough relief, a number of treatments are available. For dry eyes caused by a lack of tears, the first therapy is over-the-counter artificial tear eyedrops. For many people, eyedrops, used about four to six times a day, are enough eye lubricant to relieve dry eye symptoms.
If artificial tears don't provide enough relief, the next step may be punctual plugs. These tiny silicone stoppers are inserted into tear duct openings, blocking the eye's drainage channel so more tears stay on the surface of the eye. The plugs can be removed if having them in place makes the eyes water too much.
Prescription cyclosporine eyedrops (Restasis) can increase the amount of tear production. However, some people with underlying medical conditions may not be able to use cyclosporine because it suppresses the body's immune system.
If none of these therapies are sufficient, additional remedies — such as moisture-chamber glasses, special contact lenses or permanent tear duct closure — are possible options. Rarely, eye surgery may be necessary for severe cases of dry eye disease that don't respond to any of these treatments.
If the source of dry eye disease is eye oil glands that aren't working properly — rather than insufficient tears — treatment is different. When these glands don't produce the right amount or consistency of oil, tears can become thick and sticky. Using warm compresses over closed eyelids for three to five minutes once or twice a day, followed by a gentle lid massage, can help melt the oil in the glands and move it to the eye's surface.
Antibiotics may also be useful for reducing inflammation in the glands that can lead to oil production problems. In addition, some evidence indicates that dietary supplements containing omega-3 fatty acids (flaxseed oil, fish oil) can improve the quality of tear oil.
Work with your eye care provider to find the appropriate dry eye treatment. For most people, dry eye disease is a chronic condition that requires long-term treatment. These therapies won't cure dry eyes, but they should help reduce symptoms enough so that you can be comfortable and function normally in your daily activities.
—Muriel Schornack, O.D., Ophthalmology, Mayo Clinic, Rochester, Minn.