First off, we now know that it is a disease entity with multiple parts. Just the very acknowledgement as a ‘disease’ entity has allowed our awareness to search for the multiple causes of the disease and the different ways to treat these causes. This is a boon in the field. We have dedicated large meetings of over a hundred specialists in the field from around the world to compile all of our knowledge to synthesize the complex nature of this seemingly ‘simple’ disease.
- It is multifactorial (i.e. many causes and risk factors)
- It is characterized by a loss of homeostasis (i.e. breakdown of the body’s natural balance)
- It is inflammatory
- It is rooted in sensory nerve network (i.e. pain can be out of proportion to dryness)
Therefore, our goal is to get the balance back however we can. Fortunately, we have multiple ways to do this. The research has exploded over the last 10 years. Here at NWEC, we are at the forefront of this research, implementing therapies as they become available.
Can Cataract Surgery Cause Dry Eye Disease?
Yes and no. Cataract surgery can cause temporary changes to the tear film that can worsen your dry eye symptoms (typically worst at the 1 week postop), but improves and settles out back to baseline at the 3 month postop.
We strive to make your cataract surgery as smooth as possible and are screening all patients for dry eye disease before their surgery to ensure that we treat before and after if need be.
Can Laser Refractive Surgery (i.e. LASIK/PRK/SMILE) Cause Dry Eye Disease?
The story is similar to cataract surgery. In most individuals, increased dry eye symptoms will be short-lived. The key to avoiding this is adequate preop diagnosis. Many patients become intolerant of contact lenses because of dry eye disease. Fortunately, contact lenses are a prime instigator for dry eye disease and thus, stopping them can improve the dry eye disease. Despite these things, patients will often have some dryness for weeks to months after surgery. Most of this has to do with sensory nerves of the cornea being cut by the laser during the procedure. These will grow back, but it can take several months. In general, treatment of dry eye should continue for at least 6-8 months.
Is there anything I can do on my own to treat dry eye?
Yes. Awareness of the condition and its exacerbating features is the first step. Adequate hydration can prevent dryness. Being aware of situations where dryness increases, such as high evaporative states and high stare activities, can arm you with the knowledge to be proactive and preventative.
- High evaporative states – windy days, overhead fan, vents on high in car, windows down
- High stare activities – basically what most of us are consumed by everyday – screen time, including phones, tablets, computers, TV in addition to reading and most indoor hobbies that demand high quality vision (i.e. woodworking, knitting, etc.)
There is increasing evidence that DIET plays a huge role in the health of our eyes. Whether it is increasing leafy greens and the Mediterranean for macular degeneration or increasing plant-based foods in preventing cataracts, the data is present. We have studied omega-3 fatty acid supplementation extensively in dry eye disease. Increasing omega-3 fatty acids by way of diet (flax seeds, walnuts, fatty fish, chia seeds, hemp seeds are all great sources) or by way of supplements can counteract the overarching pro-inflammatory effect from increased omega-6 fatty acids that are found in processed and refined foods, most of which are prepared with refined oils.
There is growing evidence on the connection of our health to the gut microbiome. This is true not only for chronic conditions, such as heart disease, diabetes and autoimmune disorders, but for dry eye disease as well. Increasing natural sources of fiber, which are found in fruits, vegetables, whole grains, nuts, seeds and legumes can improve your gut health and thus, improve your dry eye disease. Currently, an astounding 97% of Americans are deficient in daily dietary fiber and 95% do not achieve the daily minimum for fruits and vegetables. Changing your diet can improve your overall health and the health of the planet.
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