Category: Blog Posts

🔊 Listen
If you’re a patient wondering why your Dry Eye symptoms aren’t getting better, you might ask yourself these three questions.

1. Are you describing your symptoms accurately?

There’s not much a doctor can do for you if all you say is your left eye doesn’t feel good. Your doctor will have to ask more questions before she knows what’s really going on. But if you’re specific from the start about what you’re feeling, e.g.: my left eye burns all over and I see bubbles in the tear film, your doctor might still have to ask a few questions (and even examine you), but at least you’ll be one step closer to an accurate diagnosis.

It helps the doctor if you’re clear, concise, and descriptive. Take a few moments, focus on what you’re eyes are feeling, and find the words that accurately describe your symptoms.

Plus, be sure to tell your doctor right away if you experience a new symptom. Let her know if treatment isn’t giving you the expected relief. You doctor can’t help you if she doesn’t know what’s going on.

2. Is your doctor really listening to you?

As long as you’re very clear about your symptoms and reporting them in a timely manner, your doctor should listen and not be dismissive. Your doctor probably knows something you don’t. But a doctor who doesn’t really listen to what you’re saying, or a doctor who’s rude or dismissive, just might not be the right one for you.

Sometimes it’s not just doctors who don’t listen. Sometimes it’s the organizations that represents doctors. We came across this last year when we reached out to the Tear Film and Ocular Surface Society (TFOS). As a patient organization we had hoped to provide the patient perspective to the upcoming Dry Eye Workshop II. Unfortunately, the organization’s leadership declined our participation. So instead we wrote a letter.

Not A Dry Eye Foundation’s Letter to DEWS II

We sent the letter to the over 100 DEWS II participants. None of the participants wrote back. (So much for welcoming patient input). Maybe they’re just not aware of the importance of patient participation in healthcare. Here’s an example. The National Academy of Medicine (NAM), will be holding a meeting on July 17, 2017, in Washington D.C. to improve diagnosis in health care. One break-out group focusing on Patient-Centered Health Care, Education and Policy to Improve Diagnosis, will be asked these questions:

How can patient advocates improve the emphasis on patient-centered policies related to diagnosis in clinician practices, hospitals, and within the larger policy arena?

How can patient involvement in the diagnostic process be encouraged at all levels, including in the creation and implementation of policy, in addition to clinician-patient interactions?

Are you/Is your organization considering opportunities to better involve patients and families in promoting and improving patient-centeredness in diagnosis?

These are just a few sample questions, but do you notice the focus on patient input and patient participation?

Needless to say, we’re looking forward to reviewing the DEWS II reports when they come out later this year. We may even write them another letter.

3. Could it be the drops you’re using?

You’ve probably heard the saying, the treatment is worse than the disease. It’s true for eye treatments too.

It’s possible to develop allergies, or sensitivities, to the medicine that’s supposed to make you feel better. Preservatives and other compounds in drops and ointments can cause irritation. So if your symptoms persist, and you’re using a drop or ointment, or any other topical treatment, let your doctor know. Ask if the medicine could be the cause. Your doctor might suggest a different medication or tell you to stop the one you’re using altogether.

There are countless reasons why Dry Eye patients suffer with chronic symptoms or why new symptoms crop up. Asking yourself these three questions can help you embark on your journey to healing faster.

 Please note, the Dry Eye blog will be on vacation for the rest of the summer. Be sure to subscribe to our blog to hear from us as soon as we get back.

Reference

Improving Diagnosis in Health Care: Implementation Workshop
Quality Chasm Series
Briefing Book
July 17, 2017
The National Academy of Sciences
Lecture Room
2101 Constitution Avenue NW
Washington D.C. 20418

 

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🔊 Listen

Living with Dry Eye isn’t easy. Eventually you figure out what you can do to avoid additional pain, but it can take a lot of trial and error. I hope my 50 tips for living with Dry Eye will help you avoid, or manage, the pain of Dry Eye.

Read Susie Brockman’s amazing Story of Hope

Dry and Windy Places

1. Turn off all ceiling fans. The air movement will dry eyes out even more.

2. Turn off overheard air vents on planes as soon as you board.

3. Close air vents in cars and bedrooms.

4. Keep windows rolled up in the car.

5. When flying, use nighttime gel and drops. Drink lots of water. Lower the window shade on your row.

6. If possible, vacation in humid environments. Climates that are dry can make the eyes much, much worse.

7. Avoid windy conditions and places whenever possible e.g. make sure the vent in a restaurant isn’t going to blow on your face before you sit down.

Lighting, Computers

8. Remove half of the fluorescent bulbs in your office if you are light sensitive. Consider desk lamps for lighting.

9. Use a screen filter on your computer to minimize glare and reduce eye strain.

10. Use computer glasses (prescription strength are available through optometrists) to minimize glare and reduce eye strain.

11. Dim computer monitors and cell phone screens to minimize glare and reduce eye strain.

12. Take breaks from your computer and while reading anything.

13. Consider audio books to reduce eye strain.

14. Remember to blink. Put a Post-it note on your computer, or download an app to remind you.

15. Limit computer and electronic device use as much as possible.

Light Sensitivity

16. Wear wrap-around sunglasses. (I like Fitovers). I wear two pairs of regular sunglasses on bad days. Or sometimes I put the disposable glasses I get at the optometrist’s office inside my regular sunglasses for added protection from the bright sunlight.

17. Ask your ophthalmologist to approve extra dark tinted windows for your car if you are light sensitive.

Filaments

18. Wear bandage contact lenses when your eyes are burning or you have filaments. The lenses reduce pain when air hits the cornea. These lenses have been a lifesaver for me, especially on bad days. I get a prescription for Biotrue ONEday disposable lenses by Bausch & Lomb. They don’t come in Plano (no prescription), so I get the -0.25 prescription lens. You may need to work with your optometrist and try several brands to see what is most comfortable for you. Wear the bandage lenses only when you’re having filaments, or when the burning sensation is intense, because long-term contact lens use can also cause dryness.

Sleeping

19. Use nighttime gel at night in the corners of both eyes, or inside the lower lids. (I like Systane Nighttime Ointment). Be sure to reapply during the night if you wake up for any reason.

20. If you sleep with your eyes even partially open, wear an eye mask or moisture chamber goggles. The parts of the eyes that are exposed to air dry out while you’re sleeping and you wake up in pain, with burning eyes. A mask can help to keep your lids completely closed (but not always), and moisture chamber goggles keep the moisture in.

Clearing Debris

21. Flush your eyes with sterile saline several times a day. Flushing clears out any irritating particles. Sterile saline is safe and preservative-free, available OTC or with a prescription. Just don’t use it so much that you dry out your eyes and make things worse. Use an emergency eyewash station only short-term if sterile saline is not available.

Nutrition and Supplements

22. Take fish oil supplements to increase Omega-3 consumption. (I use the Thera Tears brand). It takes a while to see any improvement, but it does help.

23. Reduce sugar intake. It feeds inflammation

24. Reduce caffeine intake. It dehydrates you and alters meibum production.

25. Drink Lots of water! Stay hydrated.

Doctors

26. Find an ophthalmologist who specializes in Dry Eye, not one who just prescribes eye drops. (Ophthalmologists are MD’s who can diagnose and treat more complicated conditions and perform surgery if you need it). Find an optometrist who will work with you on glasses, or fit you for bandage, or wet, contact lenses.

27. It’s important to treat underlying causes of Dry Eye and any other systemic conditions to prevent further damage to your eyes. Find doctors who know your conditions and are willing to take the time to listen to what you’re going through.

Air Quality and Humidity

28. Use humidifiers in the bedroom and office to put moisture in the air. Many environments are dry, and offices keep the air dry because of copier paper curling. If possible, keep humidity levels around 40% . Mold can grow if there’s too much moisture in the air,

29. Use an air purifier in the bedroom to reduce dust and pet dander.

30. Try keeping pets out of the bedroom. I know this one is hard for some, but it helped me.

31. Avoid dusty and moldy places like basements, attics, and storage facilities.

Fumes and Smoke

32. Avoid smoke. The smoke from fires, fire pits, bonfires, cigarettes, and fireplaces can be very irritating. Check which way the wind is blowing if you’re going to watch fireworks.

33. Ask for help with housework so chemicals and irritants, and their fumes, don’t get in your eyes.

34. If hiring a maid isn’t an option, try wearing onion glasses (available at Bed Bath & Beyond or Williams Sonoma) whenever you clean or are around irritants. Even natural cleaning products, like white vinegar, can be irritating to the eyes.

OTC/At Home Treatments

35. Use warm and cold compresses — warm for MGD to open the glands and keep the meibum flowing, and cold to relieve pain.

36. Use cold compresses on the eyes as a last resort because they lower the temperature of the meibum and make it harder to flow.

37. Keep OTC drops and bandage lenses with you at all times.

38. Only use preservative free eye drops.

39. Use lid scrubs for crusts on your lids and lashes. (I like the Systane lid wipes which are individually packaged and great for travel).

Pain and Medications

40. Take Vicodin for extreme pain. It can dry out your eyes more, but gets you over the hump.

41. Review your medication list and avoid pain relievers, hormones, anti-depressants and all meds that cause dryness. Talk to your physician about substitutions.

42. Take Pilocarpine 3-4 times a day to increase tear production.

43. Ask for lots of gel in the eyes when having surgery to reduce further drying.

Life-Style

44. There will be some days when you’re just not able to drive. Always have a backup driver on deck for those unexpected bad days.

45. Wash your hands often. Dry Eye sufferers tend to touch their eyes frequently to clear away debris, instill drops, blot, or a host of other reasons. Hands need to be impeccably clean to avoid contamination or getting anything in the eye. Just washing with warm soap and water, and drying thoroughly, is usually enough to remove dirt and microorganisms that can cause infection. (OcuSoft makes a special hand soap for contact lens wearers that I like).

46. Surround yourself with positive people who will lift you up, and not tear you down, so you don’t spiral into depression. You need a strong support group!

47. Try to reduce stress and avoid stressful situations. If you have Dry Eye from an autoimmune disease it will always flare up when you are under stress.

48. Don’t wear eye makeup or try serum that boosts lashes. Makeup can flake and get into your eyes and glands, and cause more discomfort

49. Get plenty of rest.

50. Never give up!

Susie Brockman, Chronic Dry Eye Patient

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🔊 Listen

If you’re like many Dry Eye patients, you’re always on the lookout for new Dry Eye therapies, information about existing therapies, or wondering what might be on the horizon.

Here are our latest product updates. (View our advertising policy).

CyclASol®, Reduces Fluorescein Staining

According to its manufacturer, Novaliq GmbH, CyclASol, a preservative-free cyclosporine A solution, reduced corneal fluorescein staining in a phase 2 clinical trial for patients with moderate to severe Dry Eye.

Cyclosporine A is an antibiotic and the active ingredient in RESTASIS (a.k.a. IKERVIS). It’s good to hear about a preservative-free version, especially for those who might benefit from the drop, but would prefer to avoid long-term exposure to preservatives.

http://www.novaliq.com/2017/01/05/novaliq-announces-positive-topline-results-of-phase-2-clinical-trial-evaluating-cyclasol-in-adults-with-moderate-to-severe-dry-eye-disease/

Seciera™, Proprietary Cyclosporine A

Sun Pharma announced Phase 3 confirmatory clinical trial results for Seciera, another preservative-free cyclosporine A drop with a “patented, novel, proprietary nanomicellar formulation.”

http://www.sunpharma.com/media/press-releases

Klarity, Rehabilitates and Stabilizes

Imprimis announced exclusive rights to Klarity, a preservative-free, topical solution and gel containing chondroitin sulfate, for patients with Dry Eye. According to its press release, Klarity protects and rehabilitates the eye’s surface after surgery, wearing contact lenses, or in cases of moderate to severe Dry Eye. It treats edema and free radical formation associated with Dry Eye and “can serve as a cell membrane stabilizer.”

http://irdirect.net/prviewer/release/id/2426340

Cannabinoid-based Therapy (Yes, Cannabis)

Ora Inc. has been retained by AXIM Biotechnologies for product development and clinical trials on glaucoma and Dry Eye treatments using cannabinoid-based ingredients. From the sound of it, the therapy is likely focused on reducing pain or other discomfort, rather than treating any underlying cause of disease.

http://aximbiotech.com/wp-content/uploads/2017/05/AXIM_03212017_ORA-CSA-MEDIA_FINAL.pdf

Human Lubricin ECF843, Improves Dry Eye Signs

Novartis will in-license ECF843 (a human lubricin protein) worldwide (outside Europe). In a phase II study, with 28-days patients showed improved signs of Dry Eye. More testing is to be expected.

https://www.novartis.com/news/media-releases/novartis-strengthen-rd-pipeline-licensing-ecf843-ophthalmic-indications

TrueTear™ Intranasal Tear Neurostimulator

The FDA recently approved Allergan’s TrueTear hand-held tear stimulator. The device has two prongs that emit small pulses. Choose the strength level, place prongs in nostrils, and voilà, tears!

Doctors sometimes place Q-tips in nostrils to test reflexive tear production, a tear that is more caustic then normal tear film. So, could TrueTear exacerbate Dry Eye symptoms?

http://www.truetear.com/

Probing Restores Meibomian Glands

Although more studies are likely, and necessary, this one suggests meibomian glands can be restored, or regrown, with probing. That’s good news for anyone with obstructive meibomian gland dysfunction.

http://bjo.bmj.com/content/early/2017/06/06/bjophthalmol-2016-310097.full

P-321, Keeps Eyes Hydrated

Parion Sciences agreed to grant Shire “exclusive worldwide rights to develop and commercialize P-321. P-321 is “an investigational epithelial sodium channel (ENaC) inhibitor” for treating Dry Eye. P-321 may block tear absorption and keep the surface of the eye hydrated. Additional clinical studies are still required.

https://www.shire.com/en/newsroom/2017/may/o53zxn

Zerviate, for Allergies

Nicox received FDA approval for Zerviate, a topical eye drop containing the antihistamine cetirizine, for ocular itching associated with allergic conjunctivitis. Cetirizine is the active ingredient in Zyrtec. Allergic conjunctivitis can contribute to Dry Eye symptoms.

http://www.nicox.com/assets/files/ZERVIATE_FDA_Approval_20170531_EN.pdf

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🔊 Listen
Many years ago, before I learned I was a bad blinker, I attended a job-related rally being covered by the local news stations. When a reporter approached and asked to interview me, I happily agreed. That evening the interview aired on the local news channel. I was excited about being on TV, that is, until I saw myself. I was blinking a lot, a whole lot.

Still young and vain, I’d hoped anyone who was watching and knew me wouldn’t notice my crazy blinking. Beyond that, I didn’t give the excessive blinking too much thought, brushing it off as something having to do with my nerves. Maybe it was some kind of nervous tic, like when people wrinkle their noses or grind their teeth when they’re talking to someone.

I Was Always the One Ruining Photos

Eventually I noticed that in photographs I was always the one caught blinking, making me look like I’d had an adult beverage, or two, too many. If my eyes happened to be open, they always looked tired, making me feel self-conscious. I began avoiding cameras like the plague, unless I was wearing sunglasses or, if not those, my reading glasses.

By now you’re probably wondering why I’m going into so much detail about my bad blinking. It’s simple. Before being diagnosed with chronic Dry Eye, I took blinking for granted (except as noted above). Blinking to me was just a natural process, and while I blinked a lot, I really had no clue about the important role blinking plays in eye health.

Who Knew Anyone Could be a Bad Blinker?

Then, with the onset of Dry Eye, I would wake every day with a foreign body sensation in my eyes. It felt as if sand was imbedded in them. The feeling would cause me to blink like a maniac. My husband said my head bobbed with every blink. So with painful eyes, and a bobble head, I visited a Dry Eye specialist who sat me in front of a computer that tests blink rate. I found out I was a partial blinker, meaning when I blink my eyes don’t close completely. The condition even has a name: lagophthalmos. Who knew anyone could be a bad blinker?

It turns out the average person blinks 15 to 20 times per minute. That adds up to a lot of blinking throughout the day. With every blink, tear film in the eyes renews. Tear film consists of three layers: a mucus layer near the surface of the eye; a watery layer in the middle; and an oily layer on top that prevents the watery layer from evaporating. (Some research suggests that these layers aren’t completely separated).

My-Bow-Me-An Glands

Meibomian glands (pronounced my-bow-me-an) are tiny finger shaped glands in the eye lids. With every blink, they secrete the oil, known as meibum, through openings along the lid margin. At the same time, lacrimal glands — almond shaped glands beneath the outer corner of the eye brow — secrete the watery layer. The oily and watery layers spread across the ocular surface during the blink, lubricating the eyes. Tear film drains out through the tear ducts, carrying bacteria and other debris.

When the eyes need to, they automatically blink again, and the entire process repeats itself. A bad blinker, with a low blink rate or a partial blink, interrupts the delicate tear film cycle, reducing tear film production and leading to dryness.

Once I learned all of this, I understood how important it was for me to blink consciously, making sure I closed my eyes completely with each blink. I constantly struggle with this, but I’m determined to improve and stop being a bad blinker. You know how it is. You’re watching TV, talking the phone, or checking Facebook, and you catch yourself with that deer-in-the-headlights stare. Not good. Staring only makes things worse for a bad blinker.

Blinking Exercises

Blinking exercises can improve what you secrete and how you blink. I’ve tried them, but I find it hard to remember to do them. It’s something you might discuss with your doctor. He or she might recommend one or more of these exercises to improve blinking and reduce dryness.

While I’m still a partial, bad blinker who blinks too much, I make a conscious effort to blink fully throughout the day. Maybe one day I’ll even be able to say “cheese” in front of a camera without my sunglasses. So here’s to blinking, the right way!

Susan Howell

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🔊 Listen
When you first started treating Dry Eye symptoms, you may have started out using lubricating eye drops, most likely the less expensive ones with preservatives. For a while, maybe they helped. Maybe they still do. Or, maybe they don’t.

If you progressed beyond just lubricating drops, along the way you probably used some prescription medications to treat infections, inflammation, or allergies.

It’s possible you used something to clean your eyelids and lashes, or something to get rid of demodex mites.

Some of you had in-office procedures — tear duct cautery, meibomian gland probing, Lipiflow, gland expression, IPL, to name just a few.

Some even underwent surgeries.

What about supplements like omega-3 or lutein? Did you add those to your diet? Did you change it in other ways?

How about water, do you drink lots more now?

Some of you use lenses, like Scleral lenses or Dailies Total 1’s.

Warm compresses anyone? How many times a day and for how long?

Maybe you sleep with moisture chamber goggles at night and go out with wrap-around glasses during the day? Don’t’ worry, no one thinks you’re fooling around. Although some people might say you’re crazy. Have you heard, “It’s all in your head?”

It would be comical if it wasn’t so serious. Dead serious. And expensive. Did we mention PAINFUL?

Are You Treating Your Dry Eye or Someone Else’s?

Whenever we Dry Eye patients get together we like to talk about our symptoms and treatments. It goes something like this.

This is how I feel. How do you feel?

This is what helps my symptoms. What helps your symptoms?

We ask and we tell because we’re all desperate to feel better and get our lives off permanent hold. But there’s a risk, one that we should all be aware of.

Are you treating your Dry Eye or someone else’s?

What works for one person won’t necessarily work for another person, because all of our Dry Eye conditions are unique and special to each of us, just like our fingerprints.

Does knowing that make you feel any better?

We didn’t think so.

Consider a broken leg. If you show up at the ER with a broken leg, it’s quite likely the doctor will order an X-ray before setting the bone. Why? Because your bone and the break are unique. The doctor can’t treat yours the same way he treated the broken leg that came in the ER two hours ago.

If later, you run into someone who has a broken leg, you’ll probably compare notes. This is how I broke my leg, what the doctor did, and what I’m doing now. You might even exchange tips on how to scratch those hard to reach spots, how to keep your cast dry, or how to manage pain.

Each Dry Eye Patient is Unique

But you probably won’t rip apart your cast and try to reset your leg yourself. For one it would be hard to do (not to mention foolhardy), but you also recognize that your broken leg is unique to you

So just be mindful, when you’re chatting or talking with someone about your Dry Eye symptoms and set of conditions, that you don’t start treating something you don’t have. It’s a good idea to check with your doctor before you try anything new.

And yes, ask questions. Lots of them. The more you know the better, because your Dry Eye condition is unique to you and needs to be treated that way.

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🔊 Listen
Whenever I run into someone who tells me they have Dry Eye, one of the first questions I ask is how they manage it. I want to know their diagnosis and the treatments they’ve been prescribed, especially if it’s something they need to do every day.

Many of these people say their doctors diagnosed Dry Eye. They use nothing more than over-the-counter lubricating eye drops and they’re good to go. Sometimes the best remedy is natural allergy relief. Years ago I was one of them — diagnosed with Dry Eye and sent on my way with a sample of preservative-free lubricating drops. Sadly, those days are long gone.

A Spiral of Worsening Symptoms

As my disease progressed, doctors neglected to diagnose — and also treat — other related conditions. This caused a spiral of worsening symptoms. When things got really bad, and as I became more and more frustrated, I began my own intelligence gathering. I discovered what might be happening with my eyes, and what might be done to improve my symptoms.

Gathering intelligence took many forms. I listened to my eye doctor(s), spoke with other patients or found them on social media, and read what I could. All of this intel helped me weed out the viable treatments from the vast sea of nonsense out there, or what just might not be a treatment appropriate for me.

How I’m Managing Dry Eye Today and Every Day

Now, after surgeries, many other treatments, and years of applying a slew of medications to my eyes, my routine, is much less involved. Though it’s still nothing to sneeze at.

This is how I’m managing Dry Eye today and every day. When I wake up I rinse my eyes with sterile saline solution, then clean my lids with Ocusoft Plus, a foaming lid scrub. After that I use a prescription allergy eye drop, one in each eye.

It doesn’t end there.

I take supplements daily — Omega 3 fish oil, a probiotic, and turmeric. At day’s end I apply a warm compress to my eyes. (This late-night compress gives me a few minutes to relax while enjoying the warmth of the compress on my eyes). Afterwards there’s another lid scrub. Then finally, a drop of Azasite goes into each eye to combat bacteria that causes my tear film to be soapy. Phew!

What If I Stopped?

With so much eye care to administer at home, I sometimes ask myself, what would happen if I stopped my daily routine altogether? Would my eyes feel even worse? I suspect the answer would be yes, but I’m just not willing to find out, at least not yet.

Or sometimes I wonder if all of that care really helps my eyes feel better. Honestly, it’s hard to be absolutely certain. Even with a daily routine, my symptoms are like a roller coaster ride. Some days my pain is manageable. On other days I want to rip my eyes out. Sadly, it’s like that for many chronic Dry Eye patients.

Inflammation, My #1 Enemy

One thing I learned when I was in intelligence gathering mode is how inflammation effects my symptoms. Whatever the condition — meibomian gland dysfunction, ocular rosacea, anterior blepharitis, poster blepharitis, or demodex mites – most treatments aim to reduce inflammation. It’s often the inflammation that leads to pain, swelling, redness, dry or watery eyes, and leaves us feeling miserable.

The question is, what’s causing the inflammation in the first place? When my doctors treated the inflammation itself, I never really felt better. Now, I’m addressing the underlying causes – demodex mites, bacteria, and so on – and that’s why my symptoms continue to improve.

Some causes of inflammation are obvious, but others not so much. Figuring out my triggers was the key, because there are many things that can cause inflammation.

Diet

One is diet. I’ve learned that my diet is a huge factor in the inflammation associated with many of the ocular surface conditions I face. Sugar, in particular, is the mortal enemy of my eyes. Unfortunately, I have a sweet tooth. Aaaargh! Over the years I replaced sugar with fruits, vegetables, whole grains, and nuts. It wasn’t easy, but it was a change that helped a lot.

At a recent office visit with my ophthalmologist, he confirmed just how important a low-sugar diet is for me. When he examined my meibomian glands and found I was producing less oil, he asked if I had changed my diet. Reluctantly, I confessed to eating three jelly donuts the day before, too embarrassed to even mention I had washed them down with a root beer float! I was busted, but also more determined to be disciplined about what I eat.

If you’re thinking about making changes to your diet, vitamins, or the supplements you take, it’s always a good idea to check with your doctor first.

Hydration

Another thing I learned was how important it is for me to stay hydrated. When I drink a lot of water my eyes feel better. (Up to 60% of the adult human body is composed of water). Making sure I drink plenty of water throughout the day is essential. I keep a glass filled with water on the kitchen counter as a reminder that I need to drink up.

Do My Part, Stay Informed.

When I leave my eye doctor’s office with the hope that a prescribed treatment will bring me some relief, I remind myself that I need to do my part, stay on course, and be disciplined about the treatment, whatever it may be. If a treatment is making things better, great! If things get worse, I tell my doctor so my treatment can be adjusted.

Plus I continue to stay informed. If I hear or read about some new treatment or supplement through the Dry Eye grapevine, I ask my doctor about it. (We’re all on the lookout for that magic bullet that might bring us relief, right?). In this way, I stay an engaged and informed partner in my own health care.

Choose Hope

There was a time when I thought I was running out of options, depressed, and losing hope. I know now that there was no need to lose hope. There are lots of treatments out there, and some made my eyes feel a whole lot better. It took some time to get diagnosed and find the right combination of treatments, but I finally did. As a result, managing Dry Eye today and every day has become a lot easier. Even though there are still days when my eyes are miserable, my worst day these days is miles better than my best day 1.5 years ago.

So I choose hope. I hope you will too.

Susan Howell

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🔊 Listen
Anyone with moderate or severe Dry Eye symptoms knows how much the environment influences how their eyes feel each day.

Is it cold outside? You’re probably having a bad eye day.

Is it windy? Go out there without eye protection and you’ll probably regret it.

Pollution, fumes, debris in the air, you name it, and we’re all looking for cover somewhere indoors, somewhere safe.

Though we all seem to enjoy some warmth and humidity, look out if the pollen count is high.

So it was interesting to learn what the American College of Physicians (the organization of doctors who practice internal medicine) had to say recently about president Donald Trump’s executive order on climate change. In a nutshell, they don’t like it, because they don’t think it’s good for people.

Doctors Comment on Climate Change

The ACP criticized the president’s executive order noting that it “will have a devastating impact on public health.”

According to a March 28, 2017 ACP press release, Trump’s order directs the Environmental Protection Agency (EPA) to reduce the U.S. push on combating air pollution.

“[The] executive order moves us in the wrong direction on this issue,” ACP’s president Nitin S. Damle, MD, MS, MACP, said in the release. “It signals a retreat from our nation’s efforts to curb carbon emissions and address climate change.”

In a 2016 paper, ACP noted the consequences of climate change on public health and the health of individuals. The paper cited increasing rates of respiratory and heat-related illnesses, insect and water-borne diseases, and issues related to behavioral health. ACP had estimated that previous environmental rules reduced mortality and morbidity rates annually: 3,600 fewer deaths, 1,700 fewer heart attacks, and 90,000 fewer asthma attacks.

ACP regretted that less, rather than more, action will be taken to protect seniors, people suffering with chronic illnesses, the poor, and children.

Exacerbating Dry Eye Symptoms

Unfortunately, Dry Eye is one of those chronic conditions. Plus, many of us also suffer from autoimmune conditions. So great. Double whammy.

Even though environmental changes can be slow, it may be prudent to listen when doctors comment on climate change. They may have a point that’s important for those of us who can’t take eye comfort for granted.

Reference

ACP American College of Physicians
ACP Decries Devastating Impact of Climate Change Order
Retrieved from https://www.acponline.org/acp-newsroom/acp-decries-devastating-impact-of-climate-change-order March 30, 2017

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🔊 Listen
You probably remember a time before you had any Dry Eye symptoms. Looking at anything for as long as you wanted wasn’t a problem. There was no pain or burning . You could read or work for hours without watery eyes or other discomfort. Driving was once a breeze. Just get in the car and go.

You didn’t give a thought to your eyes back then, unless you wore glasses or contacts. But they weren’t nearly as much of a bother as what you’re going through now.

Now, it’s like being on a Dry Eye roller coaster that never ends. Some days are OK (the “good eye days”). Others are bad or worse. Plus, there’s an endless array of treatments.

Endless Treatments

Warm compresses. A variety of drops. Ointments. Contact or scleral lenses. Lid cleansers and demodex killers. Maybe surgery. Procedures to open your meibomian glands. Endless appointments with your doctors (the good ones). Brief encounters with some doctors (the bad ones). Prescriptions galore. Countless tiny plastic bottles adorn your bathroom. Your diet changes: no sugar, no dairy, no caffeine, more water. A lot more water. Prescription pills and supplements. And who knows what else.

Plus there’s the endless variety of possible diseases. Some, everyone’s heard of, like Dry Eye, styes, bacterial infections.

Others…not so much.

Meibomian gland dysfunction? Demodex mites? Lagophthalmos? Blepharitis? Lid wiper epitheliopathy? Conjunctivochalasis?

For these you might even need a dictionary just to help with pronunciation. (Even our website’s digital voice has a hard time pronouncing some of these correctly, like conjunctivochalasis. It doesn’t recognize that the “ch” is pronounced “k,” not “ch.” Click on the Listen button at the top of the page. You’ll see what we mean).

Getting off the Dry Eye Roller Coaster

All of this can be incredibly overwhelming, especially if you learn you have several of these conditions happening at the same time, in your tiny little eyes. You might even wonder if that much can go wrong with the heart at the same time? With the liver? With the blood?

It can feel as overwhelming as a cancer diagnosis, although we’ve heard that some (of the bad) doctors say, “At least you don’t have cancer.”

Well, at least your doctor was able to diagnose all of these conditions. Now you can start doing something about them, whatever that may be, even if it takes a long time.

It’s a sign that finally your Dry Eye roller coaster ride is slowing down, and maybe even coming to an end.

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🔊 Listen

In my last blog post I promised to share 11 tips for keeping busy because, if you have Dry Eye symptoms, keeping busy can help distract you from your symptoms and give you some relief. Or, even if you don’t find relief, at least you’re accomplishing something, staying positive, and feeling like you’re the one in control, not your eyes. It’s not always possible, but it’s always worth a try if you can manage it.

These are 11 things I do to help keep me busy and distracted from my Dry Eye symptoms.

11 Tips for a Better Dry Eye Day!

1. Keep a Schedule, Make a List

Keep a schedule or make a list of tasks you plan to accomplish. Even if you feel horrible, keeping to a schedule and knowing that you’ve accomplished the tasks you set out to do, will help to maintain order in your life. That alone can help reduce stress.

2. Talk to Someone who Makes You Laugh

Talk to family members and friends who make you laugh. Laughter in the Dry Eye world can set the tone for your day or night. Plus it can also bring tears to your eyes. Laughter, no matter where it comes from, can be amazing for your frame of mind.

3. Find Support

Join a Dry Eye group. Interacting with others that are also afflicted with this disease can help you gather valuable information. You’ll find support and realize that you’re not alone. There are many of us out there.

Remember, we’re all different. What might work for some may not work for you. So don’t get discouraged if you find that a particular medication or treatment worked well for someone, but you aren’t getting the results you hoped for. That just means you’ll have to keep working at it until you get better results.

4. Eat Something Crunchy

Crunchy foods seem to distract the mind. Consider a bowl of celery, carrot sticks, radishes, pretzels or nuts. Even just chopping vegetables can be a good distraction for the mind.

5. Listen to a Recording

If reading is no longer an option, try relaxing with an audio book or some good music.

6. Plant a Garden

Plant a garden or, if you already have one, spend time pulling weeds and maintaining it. If sunlight bothers your eyes, wait for a shady time of the day or wear your sunglasses. I’ve found pulling weeds, as tedious a task as it is, puts me in a Zen like state.

7. Rediscover the Great Outdoors

Rediscover the natural world. Find a comfortable outdoor location and just close your eyes and listen to the sounds of song birds, the breeze rustling through the trees, or water lapping along a shoreline. Connecting with nature eases the mind, body and soul.

If you can, take a walk or engage in any other outdoor activity. Just be mindful of your eyes and wear sunglasses, preferably wrap-around.

8. Take a Nap

If your day allows it, take a short nap in the afternoon. I find resting my eyes for a period helps me through the later part of my day.

9. Play with your Pet

If you own a pet, spend some quality time each day together. Playing with my dog or taking her for a walk gives us a chance to spend some time together while we’re getting a little exercise. Speaking of which…

10. Exercise

Exercise when you can. A brisk walk, dancing, running, whatever gets you moving, helps release endorphins, which in turn provide a sense of well-being.

11. Color

Finally, one of my favorite stress reducers is an adult coloring book. On days when I find myself obsessed and worried about my eyes, sitting down and coloring a picture seems to calm me down. Just don’t try it if you’re eyes are feeling bad already because you might not blink enough.

Facing each day as a Chronic Dry patient is an enduring task. We have to learn to cope with what’s now our new normal. We may have limitations, pain, maybe fear, or even sadness, but we still need to live and move forward with our lives.

Hopefully, my tips for a better Dry Eye day will help some of you get through your day. In the meantime, stay strong, hopeful, and remember to always be your own advocate.

Susan Howell

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Subscribe to our blog to keep up with Not A Dry Eye.

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