Definition of Dry Eye Can Cause Delay in Relief and Treatment

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Although Winter Is the Dry Eye Season, Many People Fail to Seek Medical Attention Due to an Open-Ended Clinical Definition Reports Bio Logic Aqua Founder Sharon Kleyne.

Going into the winter dry eye season, it is important that people be able to recognize the symptoms of dry eye syndrome. Even though dry eye complaints are the number one reason for eye doctor visits in the United States, a large percentage of the population – estimated as high as 50% - have symptoms but are either do not notice them or do not feel they warrant medical attention. Part of the problem, according to Eye and Water Research Sharon Kleyne, is that the clinical definition of “dry eye syndrome” is misunderstood.

Sharon Kleyne hosts the globally syndicated Sharon Kleyne Hour Power of Water® radio show on VoiceAmerica and Apple iTunes. Kleyne also Founded Bio Logic Aqua Research, a fresh water and health research, education and product development center. Nature’s Tears® EyeMist®, the Research Center’s global signature product, provides a pure all-water mist that instantly supplements lost water in dry and dehydrated eyes.

Left untreated, Kleyne warns, dry eye syndrome can become a source of extreme eye discomfort that eventually threatens vision.    

Part of the problem for Ophthalmologists, Kleyne explains, is that dry eye is extremely common and can have multiple causes and symptoms. The syndrome is so common that doctors find it difficult to draw a precise line between “normal” eyes, and “abnormal” eyes that exhibit dry eye disease. Occasional dry eye is normal and experienced by most people at one time or another. Since their symptoms are usually transient and not severe, the majority does not seek medical therapy or attempt treatment.

There is considerable disagreement about the clinical definition of dry eye as a disease or the precise physiologic cause, says Kleyne. No physiologic variable correlates exactly with dry eye symptoms, although most measurable variables correlate to some degree. Instead, physicians look for an array of symptoms.

This open-ended clinical definition, Kleyne suggests, can cause a delay in treatment that could be potentially harmful. People are most likely to seek medical attention if symptoms are well defined and strongly associated with a disease, such as chest pains and heart disease. A major challenge to physicians has been to educate the public to recognize critical “red flag” diagnostic symptoms for dry eye.        

The presence of one or more symptoms, Kleyne explains, could indicate a dry eye condition. Major symptoms include: Eye irritation, burning eyes, eye fatigue and a feeling of dryness or scratchiness. Blurred vision is most often related to dry eye syndrome when it occurs late in the day and goes away when eyes are closed for a minute or two.    

In addition to symptoms, according to Kleyne, most – but not all – dry eye patients have at least one physiologic parameter outside the range of normal. Typically, tear production has decreased, tear volume is low, evaporation is high, and/or tear osmolarity is elevated. In addition, tears produced in dry eye contain elevated levels of substances (metalloproteases and other proteinaceous compounds) that increase surface inflammation.

This open-ended, symptom-based definition, Kleyne observes, works reasonably well as a basis for diagnosis by physicians. The degree and duration of symptoms are critical since a large percentage of the adult population complain of at least mild dry eye symptoms at any given time.

Winter is dry eye season because colder air cannot hold as much water vapor as warmer air. Also, people spend more time indoors with forced-air heating and cooling, insulated walls and windows, and recirculated air that also spreads bacteria. Air pollution tends to be worse in winter due to stronger weather inversion layers holding the polluted air closer to the ground. Air pollution is irritating and dehydrating to eyes.

In her report, Kleyne cites the findings of dry eye researcher William D. Mathers, MD, formerly of the Casey Eye Institute, Oregon Health and Sciences University, Portland Oregon. Mathers’ comprehensive report, “Tear Film and Treatment of Dry eye Disease,” was written in 2005 especially for Bio Logic Aqua Research.

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Mikaylah Roggasch
Bio Logic Aqua Research-Rogue Media
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