Many people living with dry eye feel misunderstood and unsatisfied with their treatment, according to a new survey.
Health Union interviewed 415 Americans with chronic dry eye about their experience managing the condition. Here’s what the survey found, and what ophthalmologists say could help.
The most frustrating thing about dry eye is ...
Difficulty finding relief from dry eye symptoms
- Almost half (48%) of patients with dry eye said they followed their treatment plan carefully, but only 13% experienced lasting relief
- Most people say that over-the-counter eye drops alone do not provide sufficient relief, and seek out additional treatments
- Home remedies include drinking additional water throughout the day (reported by 76% of survey respondents), using a warm compress (56%), blinking often (52%), avoiding cigarettes and secondhand smoke (45%) and thoroughly removing eye makeup (34%)
Frustration with how dry eye is diagnosed or perceived
- Between a quarter and a third of people say that their condition has been written off as an “old person’s disease” or attributed to something less severe such as allergies
- Nearly half of people feel others don’t understand what they’re going through or appreciate the reality of their discomfort
- Many people struggle with multiple symptoms such as dryness (76%), foreign body sensation (64%), eye fatigue (62%), light sensitivity (62%) and blurred vision (60%), as well as burning, scratchiness and itchiness
- Dry eye interferes with many aspects of everyday life, including driving at night (56%), reading (42%), using a computer (34%) and watching television (24%)
Experts say dry eye is often mistaken for other conditions
Dry eye is one type of ocular surface disease, a group of disorders that causes the eyes to not produce enough tears or the right quality of tears. Tears are essential for keeping your eyes healthy and comfortable.
“Ocular surface disease is very complex with many subtypes and overlapping symptoms. Getting to a correct diagnosis requires expertise and can take time,” says dry eye expert Christopher Starr, MD, an associate professor of ophthalmology at Weill Cornell Medical Center.
“A lot of symptoms are labeled and treated as dry eye, but patients may not be getting better because there are other things going on,” he says.
Allergic conjunctivitis, blepharitis, meibomian gland dysfunction, floppy eyelid syndrome, corneal dystrophies and toxicity to medications or cosmetics are just a handful of the many conditions that can be incorrectly referred to as dry eye disease, Starr says. While artificial tears can provide temporary relief in many of these cases, they don’t treat the underlying causes.
Here are some tools and tests for diagnosing dry eye
“People who are feeling frustrated should not give up. There are a growing number of diagnostic tools to pinpoint the root problems and an expanding number of treatments to address them,” Starr says. Turn to your ophthalmologist for education and support throughout the treatment process.
Your eye doctor will examine your eyes to look for the cause of your symptoms. They may use tests that measure the quality and quantity of tears. They may also perform tests to look for problems with the meibomian glands, which are glands in the eyelid that produce an oil found in healthy tears.
Other diagnostic tests that are sometimes used by dry eye experts include:
- Tearlab Osmolarity System: This tool may sometimes help determine if someone has dry eye disease and how severe it is when interpreted together with other findings from your eye exam by your doctor.
- InflammaDry: This test detects an inflammatory molecule that is often elevated in the tears of patients with many types of ocular surface disease, including dry eye. However, it does not differentiate dry eye from other types of ocular surface disease.
It’s important to note that these tests do not diagnose dry eye by themselves and may not be needed for every patient. Your eye doctor will guide you to the tests that will be most helpful in your case.
Treating dry eye is tricky, but not impossible
There are many devices and medications available today, and even more effective treatments are on the horizon. Finding a solution may involve some trial and error, as not every treatment may be right for every patient. Many people find it necessary to combine therapies and make a few lifestyle changes. The right treatment regimen can involve a lot of daily maintenance.
Depending on what your eye exam and testing shows, your eye doctor may suggest:
New treatments for dry eye
“If you’re struggling with ocular surface dryness or other symptoms, there has never been a better time to seek out treatment from an ophthalmologist,” said Dr. Starr. “With three new therapies recently approved by the FDA, we now have more targeted options for patients than ever.”
- VEVYE (cyclosporine ophthalmic solution) 0.1% by Novalique is a preservative-free, water-free drop that is designed to increase tear production in people with dry eye disease. It contains the same active ingredient — an anti-inflammatory called cyclosporine — as Restasis (cyclosporine ophthalmic emulsion) 0.05% and CEQUA (cyclosporine - ophthalmic solution) 0.09%. But VEVYE contains a slightly higher concentration of the drug and uses a different delivery method. Some patients may experience temporary blurred vision or eye redness after putting in the drops.
- Miebo (perfluorohexyloctane ophthalmic solution) by Bausch & Laumb is an eye drop that treats dry eye disease due to meibomian gland dysfunction. Miebo is water- and preservative-free, similar to VEVYE. Each Miebo drop is very small and spreads quickly over the surface of the eye to create a protective coating to reduce tear evaporation. Some patients may experience temporary blurred vision or eye redness after putting in the drops.
- XDEMVY (lotilaner ophthalmic solution) 0.25% by Tarsus is the first FDA-approved treatment for demodex blepharitis. In clinical trials, the drop reduced or eradicated the microscopic mites responsible for some cases of red and itchy eyelids after 6 weeks of use twice per day. Patients may experience a little stinging or burning when they use the drops.
These drugs are very new and have varying insurance coverage. Because of this, the cost may be quoted as several hundred to a thousand dollars or more out-of-pocket. But patients who are able to negotiate with their insurance providers, ideally with the help of their ophthalmologist, may find that the actual costs are much lower.
“Having more choices to treat different root causes of dry eye and ocular surface disease allows us to tailor therapies to each patient’s unique needs,” said Dr. Starr. “These medicines may still need to be used in combination with other treatments for best results such as daily scrubs and compresses, punctal plugs, device-based therapies and steroids, as well as others.”
Other therapies for ocular surface disease are expected to become available in coming years. Ask your doctor if you are eligible to participate in clinical trials for new treatments.
Turn to your ophthalmologist for education and support throughout the treatment process.
Other therapies for ocular surface disease are expected to become available in coming years. Ask your doctor if you are eligible to participate in clinical trials for new treatments.