dryeye2
A new treatment for dry eye: A viewpoint
1.Introduction
The scientific name for a condition commonly referred to as dry eye is Keratoconjunctivitis Sicca (KCS).
Dry eye is a condition in which the eye does not produce enough tears in order to lubricate the eye.
Dry eye is an incredibly difficult condition to deal with. By this I mean that it is both difficult to diagnose and it is difficult to treat.
I suffered from dry eye all of my life and it was only recently that one observant optometrist diagnosed the condition for me. She told me that she had observed scarring of my corneas through the microscope that she was using. At the time, my eyelids felt as though they were made out of sandpaper each time I blinked. Up until that time, I had no idea that I had dry eye and if anyone had told me that I had dry eye I would never have believed them. That is the type of eye condition that it is.
Dry eye is the type of medical condition which does not respect a person's station in life. It affects the poor and the rich alike. It even affects ophthalmologists, premiers of states, presidents of countries and even kings or queens. It does not respect the fact that a person may live a healthy lifestyle and refrain from drinking or smoking. It is the type of medical condition which, if acquired, is inevitably ignored by the sufferer in the hope that it will eventually go away. But it never does. Dry eye is a type of medical condition which lives with you for the rest of your life, only going away when you go to sleep at night. It is like walking with a pebble in your shoe, a pebble that you can never quite seem to be able to get rid of. It is the type of medical condition which every one of us will eventually acquire, that is, assuming that we live long enough.
2. Causes of dry eye
The main cause of dry eye is a decrease in the production of tears from the lacrimal gland which is located just above the eye.
3. Chemical composition of a tear drop:
A tear drop consists of water which comes from the lacrimal gland, an outer layer of fatty oils which come from the meibomian gland and mucus.
4. Dangers of dry eye
The decrease in the production of tears occurs gradually as we age because the lacrimal gland is not functioning properly, possibly due to a blockage from or within the lacrimal gland itself or from some other cause. You may think that the only possible damage that can occur to your eye as a result of dry eye is scarring of the cornea. This is not so.
The cornea, the clear, front part of the eye does not have any blood vessels running through it. Without ordinary blood vessels, the cornea must get its oxygen supply from some other source which it turns out is directly from the air. The oxygen first dissolves in the tear film and then diffuses throughout the cornea in order to keep it healthy. Equally important, the waste products in the form of carbon dioxide produced by the cornea must be disposed of by diffusing out of the cornea and into the tear film, and then into the atmosphere in the reverse process. Without a proper functioning tear film none of this is possible and the cornea gradually begins to perish.
The cornea consists of 5 layers:
The epithelium, Bowman's layer, the stroma, Descemet's membrane, and the endothelium .
Bowman's layer, the stroma and Descemet's membrane mainly consist of collagen fibre. However, the epithelium and the endothelium consist of living cells which require oxygen and glucose in order to survive. Without oxygen and glucose these 2 layers gradually begin to perish and a decline in the number of endothelial cells will eventually lead to blindness.
5. Diagnosis of dry eye
An easy way to diagnose dry eye is to check to see if you are constantly blinking. When a person develops dry eye syndrome, the tear film which acts like a lubricant is lost and hence the eye lid begins to act like sandpaper causing abrasions to appear on the surface of the cornea each time you blink. This causes great irritation to the eye and a person suffering from dry eye experiences great discomfort. In order to remedy the discomfort, the eye begins to blink more often than usual causing the eye to appear red. If you see someone who is constantly blinking or has red eyes, be sure to alert them to the possibility that they may be suffering from dry eye syndrome.
Ophthalmologists have invented a number of tests for dry eye, including the following tests:
Meibography, Osmolarity testing, Schirmer's test, ocular surface staining, InflammaDry (Quidel) detection of elevated levels of MMP-9 an inflammatory marker that is elevated in the tears of patients with dry eye, in vivo confocal microscopy, Optical coherence tomography , corneal topography and tear film break up time.
But what use are all of these tests, if at the end of it all there is no long term, efficient, treatment for dry eye?
6.Treatment of dry eye
The treatment of dry eye is a complex matter.
Firstly, there is a problem as to when treatment should actually commence. The decrease in the production of tears occurs gradually as we age. Thus, if you are diagnosed with dry eye in its early stages nothing much seems to happen to your eyes even if you do nothing at all. You only experience a mild discomfort and a slight redness of the eyes. As a result of this, you tend to ignore the problem. As time progresses, the situation gradually worsens. It becomes increasingly difficult to decide when to commence treatment and one tends to just keep putting off the decision. Then there is the problem of the actual treatment itself. The only worthwhile treatment for dry eye is the life long, daily application of eye drops. Many people would baulk at the prospect of using eye drops for the rest of their life. Only the dedicated few would be willing to do so and therefore the tendency is to again ignore the problem. Eventually, the symptoms of dry eye become so severe that the dry eye syndrome can no longer be ignored. This is how the condition progresses in most people. The problem that then arises is the question of which eye drop is the best to use? In an endeavor to discover a treatment for my own dry eye condition, I tried all types of eye drops. It was only a chance discovery on my part that led me to find my own dry eye formula and I have experienced amazing results from my own eye drops ever since.
When it comes to treating dry eye syndrome, there is no need to baulk at the prospect of using eye drops for the rest of your life. The fact that a person has to use eye drops for the rest of his or her life does not mean that it is the end of the world. So, that they are worth using, bearing in mind the fact that the daily application of eye drops is the only treatment that is currently available or will ever be available for dry eye. You can compare using eye drops for your eyes with brushing your teeth each day. After a while, brushing your teeth each day becomes second nature to you and you do not give it a second thought. It is the same when applying eye drops for your eyes each day, except that you need to apply eye drops a little more often. But the end result is worth it.
7. The problem with the modern day treatment of dry eye
Someone once said that looking for a cure for dry eye syndrome is like looking for the ideal eye drop.
The only treatment that is available for dry eye syndrome is the daily application of eye drops for the rest of a person's life. Thus, it is imperative that any eye drops used by a dry eye sufferer must be the best that can be produced by modern science.
The ideal eye drop has to meet the following criteria :
The ideal eye drop has to alleviate all of the symptoms.
The ideal eye drop has to be comfortable enough in order for it to be used by a dry eye sufferer for the rest of his or her life.
The ideal eye drop has to be convenient enough to use. By this I mean that the ideal eye drop has to come in a convenient form of packaging, such that a dry eye sufferer can have easy access to it at any time of day or night.
The ideal eye drop has to be easy to apply .
I would contend that the eye drops and packaging that I have discovered have met all of these requirements whenever I have used them.
8. Availability of my eye drops
Unfortunately, my eye drops are currently unavailable for sale or distribution anywhere in the world for legal reasons.
Further details shall be provided in my next article.
9. Reference
Review of Ophthalmology September 2019 Cover focus: dry eye, Diagnosing ocular surface disease (P. 28) , Knowledge and Tech: Treating dry eye 2019 (P. 36)
4 J u n e 2 0 2 0
W rit t e n b y:
The Eye Enigma
Sources:
https://sites.google.com/view/haigis
https://sites.google.com/view/dryeye3