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Dry Eye

May 24, 2017

 

Almost everyone has experienced gritty or sandy feelings in the eyes. If such discomfort only occurs occasionally, it may just be caused by dust. However, if it happens frequently or even on a daily basis, it is most likely a symptom of chronic dry eyes.

 

Dry eye syndrome affects 25 to 30 million Americans, according to MedicineNet.com, an on-line healthcare publishing company. It is a common disorder of the tear film that comes from decreased tear production, excessive tear evaporation, and an abnormality in the production of mucus or lipids normally found in the tear layer, or a combination of the above.

 

People tend to develop dry eye syndrome after working with the computer over an extended period of time. That is because concentration on the computer screen decreases blinking and thus allows excessive tear evaporation.

 

Environmental factors often contribute to dry eye syndrome as well. When air or water pollution causes an infection along the eyelids, creating a condition called blepharitis, the bacteria may break down the oil in the lipid layer of the tear film, or the oil glands in the eyelids may be blocked. In either case, there will not be enough oil to cover the watery tear layer to prevent its evaporation. Tears also evaporate faster in low humidity. Excessive air movement, from either natural winds or fans, dries out the eyes, too.

 

Meanwhile, between 50 percent and 75 percent of contact lens wearers experience dry eyes at some point. Many of them therefore discontinue or limit lens wear. Dry eye syndrome is also found in many patients having undergone refractive surgery, especially LASIK.

 

Besides the common reasons stated above, chronic dry eyes may also result from autoimmune diseases. The autoimmune disease most frequently associated with dry eyes is Sjögren’s syndrome, which misdirects the immune system to cause inflammation in glands of the body that are responsible for producing tears and saliva. About 90 percent of Sjögren’s patients are female while the cause of Sjögren’s syndrome is currently unknown. The dry eyes caused by Sjögren’s syndrome are generally treated like dry eye syndrome resulting from other causes.

 

The most commonly used treatment for dry eye syndrome is artificial tears, a solution specially  formulated to moisten the eyes. While artificial tears supposedly mimic natural ones, some of their ingredients may trigger allergies. Even if the patient is not allergic to any of the ingredients, long-term use of artificial tears may create dependency, which means the tear glands may lower their own production after getting used to the easy supply.

 

There is a prescription medicine called RESTASIS® Ophthalmic Emulsion that helps increase the eyes’  natural ability to produce tears. However, RESTASIS cannot be used by patients with active eye infections or while wearing contact lenses. In the patients it can work, it may produce side effects including a temporary burning sensation, eye redness, discharge, watery eyes, eye pain, foreign body sensation, itching, stinging, and blurred vision.

 

RESTASIS cannot be used in patients wearing punctual plugs, which are tiny devices inserted into tear ducts to block drainage. The risks of punctual plugs are usually small, but may include eye irritation, excessive tearing, and, in rare cases, infection. What makes punctual plugs less appealing though is their inability to entirely replace artificial tears in many cases. Patients after punctual plugs insertion often still need to use artificial tears.

 

Since the Western medical treatments for dry eye syndrome are all far from ideal, it will greatly benefit  dry eye patients if they see a highly qualified acupuncturist who knows how to treat dry eyes.

 

While acupuncture is mostly recognized as a pain relief method in the United States, some research studies in Europe have validated its effect on treating dry eye syndrome. Austrian ophthalmologist Johannes Nepp, MD, cites a few of these studies in his article “Acupuncture in Dry Eye Syndromes.”

 

In the article, Dr. Nepp states that changes in pupil reaction and habituation were seen after acupuncture in a double-blind study. He explains, “The outcome showed a sympathetic tension like in stress before acupuncture which seems to cause the dry eye symptoms, and after acupuncture there was a decrease of this tension in combination with the improvements of clinic signs of dryness.”

Dr. Nepp also cites other studies which showed decreased pain in dry eyes after acupuncture. In addition, he brings up the possibility of a psychic cause in dry eye patients because they appeared more emotionally unstable and depressive in comparison with the control group in a study. According to Dr. Nepp, another study was performed to show effects of acupuncture on emotional dry eye patients, and the study resulted in a stabilization of their emotions.

 

Dr. Nepp concludes that “we can use acupuncture as a additional tool especially to influence the psychic and vegetative tension in patients with dry eye symptoms.”

 

In China, where acupuncture originated, its effect on dry eye syndrome has also been recorded. Clinical observations at Tong-Ren Hospital in Beijing have found significant improvement in most dry eye patients after one to three acupuncture sessions. After 10 to 20 acupuncture sessions at Tong-Ren Hospital, about 10 percent of the patients fully recovered and 85 percent had most of the symptoms relieved. As for the remaining five percent, the hospital explains that acupuncture did not work as well as it was supposed to on them because they had other diseases, unhealthy lifestyles or unfavorable working conditions. This seems to promise a near 100 percent success rate if the dry eye patient has no other diseases and environmental factors can be controlled.

 

Most of the acupuncturists who treat dry eyes usually choose acu-points around the eyes because they are connected with the nerves that directly go into the tear glands. However, the patient may be concerned about having needles inserted too close to the eyes. To remove this concern, Dr. Ching Chi of Sunnyvale, California usually manages to avoid the acu-points around the eyes.

 

Dr. Chi knows other acu-points which are farther from the eyes but influence the tear glands just as much as those around the eyes. Her dry eye patients, without needles near their eyes, can blink freely during the acupuncture session, and they will feel their eyes getting moist before she takes the needles out. The immediate result will last two or three days. Then it is time for the next session.

 

According to Dr. Chi, the dry eye patient initially needs two acupuncture sessions a week. A few weeks later, as the conditions improve, the treatment can be reduced to once a week. It may take months to completely eradicate the problem, but if it is affordable to the patient, it will be worth the time and money because it has powerful effects but no side effects.

 

“Acupuncture won’t create dependency,” said Dr. Chi. “It helps your system establish a new habit, a much better habit than the old one that caused you problems. In the case of dry eyes, it helps your tear glands get into a new habit of producing more tears. Once the good habit is established, you can stop receiving acupuncture, and dry eye syndrome won’t come back if you learn how to avoid triggers in your lifestyle and the environment.”

 

As for lifestyle advice for dry eye patients, Dr. Chi agrees with ophthalmologists to recommend taking breaks while working on the computer, using a humidifier along with an air-conditioner or a heater, and consuming more Vitamin A as well as Omega 3. In addition, she suggests making tea with goji berries and chrysanthemum flowers, both available in dried form at Chinese markets. In Chinese medicinal theories, these herbs nourish the eyes.

 

REFERENCES

http://www.medicinenet.com/dry_eyes

http://www.drugs.com/mtm/artificial-tears.html

http://www.restasis.com/_footer/faq.htm

http://en.wikipedia.org/wiki/Punctal_plug

http://scielo.isciii.es/scielo.php?pid=S0365-66912005000500002&script=sci_arttext&tlng=en

http://www.haodf.com/zhuanjiaguandian/weilixin929_34309.htm

 

DISCLAIMER
The information provided in this article is designed to help readers better understand the nature of dry eye syndrome and the solutions available. None of the information should be construed as or is intended to be used for medical diagnosis or treatment.

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