All eyes on dry eye

Excerpted from page 36 of the May 2017 edition of AOA Focus.

According to the National Eye Institute (NEI), an estimated 5 million Americans 50 years of age and older are thought to have dry eye. Age is just one of the risk factors.

Patients are suffering, in some cases needlessly, because they have not been diagnosed by an eye care professional, doctors of optometry say. Dry eye is not easy to diagnose given that its cause can be traced to any number of factors. The cause can range from age, allergies and computer use to environmental conditions, medications and inflammation of the eye lids. Getting to the heart of dry eye can take time.

"A lot of contact lens failures come from dry eye," says Sue Lowe, O.D., chair of the AOA's Health Promotions Committee. "Dry eye is one of the most underdiagnosed problems, because a lot of times we don't listen or ask patients, and they don't tell us." 

Dr. Lowe adds, "There is no one-size-fits-all. If there were, we'd all have really happy patients. I try to tell them that this is a very difficult, chronic problem. It's an episodic condition." 

Some patients may need more than the oft-prescribed artificial drops, doctors say. Many people with dry eye prefer to treat and tough it out themselves with over-the-counter medications rather than seeing their doctor. 

That presents an opportunity for doctors of optometry, as does making referrals. "I get more referrals from ophthalmologists," says Whitney Hauser, O.D., clinical development consultant at the Southern College of Optometry's (SCO's) TearWell Advanced Dry Eye Treatment Center and an assistant professor at SCO. 

Dry eye takes a physical and psychological toll on patients. A June 2016 study of 158 patients in Investigative Ophthalmology & Visual Science linked patient efficiency at work with the disease. 

"Dry eye is associated with reduced functional visual acuity, as well as impaired performance of vision-dependent daily activities such as reading, driving, watching TV and using a computer," the study authors write. "Quality-of-life studies indicate that dry eye symptoms have a detrimental effect on social and physical functioning, vitality, psychological well-being, and general health." 

Dr. Hauser will present a continuing education course on the psychological effects of dry eye at Optometry's Meeting ^®, June 21-25 in Washington, D.C. 

"There is an emotional, mental health correlation to dry eye," she says. "We need to consider how to better connect to patients so they don't feel as if they aren't being heard. There is a large population that needs our help."