Pharmacists should ascertain whether self-treatment is appropriate and suggest medical care if it isn’t.
Dry eye disease (DED), also known as dry eye syndrome, dysfunctional tear syndrome, and keratoconjunctivitis sicca, is a chronic multifactorial illness of the ocular surface characterized by hyperosmolarity, inadequate production and/or instability of the tear film, and ocular surface area damage plus inflammation. 1-3
Data from a recent National Health and Wellness Survey show that an estimated 16. 4 million adults in the United States (6. 8% from the population) have received diagnoses of DED to some degree. 1, 4 Considered the most common disorder affecting the particular anterior vision, DED can be mild, moderate, or severe one, 5 and often correlates with ocular discomfort, fatigue, and visual disturbance that can significantly affect quality of life. 2, 6
Although the most common clinical symptom is a sandy, gritty sensation within the attention, DED can also cause blurry vision, discharge, excessive tearing, redness, inflammation, and photophobia. 1-5
Research results have established DED is often associated along with aging plus women are twice as likely as men to develop it. DED commonly occurs during pregnancy, menopause, and postmenopause and with Bell palsy, corneal defects, diabetes, loss of lid tissue turgor, lupus, Parkinson disease, rheumatoid arthritis, rosacea, Sjogren syndrome, thyroid-related eye disorders, and vitamin A deficiency. 1, 4, 5 DED is also an adverse effect of some pharmacological agents, including antidepressants, antihistamines, beta-blockers, decongestants, diuretics, and oral contraceptives. 5 Some study results have indicated an increased risk of DED in those with sleep apnea who use continuous positive airway pressure therapy. 7
Results associated with numerous cross-sectional studies have shown duration of digital screen use correlates with serious symptoms of DED in adults and long-term display times are usually linked to greater risk associated with DED in school-aged children. 8, 9 Allergens, environmental factors, and laser eye surgery may also contribute to or exacerbate DED. one, 5 As frontline health care professionals, pharmacists can be instrumental within identifying medical conditions and/or pharmacological brokers that increase the risk of DED. They can counsel patients about nonprescription products that provide symptomatic relief of mild to reasonable DED plus encourage those with undiagnosed or even severe DED to seek evaluation by an ophthalmologist.
Without timely diagnosis and treatment, DED may damage ocular tissues, especially the corneal surface. 1, five, 9, 10 The primary goals of therapy are to prevent or alleviate symptoms, maintain or even reestablish tears, minimize dryness and related discomfort, and support overall eye health. 5, 9, ten
First-line treatment often entails nonpharmacological measures to decrease the incidence of DED and treat any swelling of the eye- lids or eyesight surface that contributes to DED. 1, 5, 9 These measures include applying warm compresses to the eyes, avoiding smoky environments, discontinuing (if possible) medications that will cause DED, getting enough sleep, limiting screen time, staying hydrated, using a humidifier, and wearing sunglasses outdoors. one, 5, nine, 10
Artificial holes and nonmedicated gels plus ointments are the main self-treatments. 5 Mild DED cases may become treated with less viscous products, and severe ones along with products that are more viscous. five When no contraindications are present, some ophthalmologists may furthermore recommend omega-3 fatty acid supplements. 5
Tips For Patients Using OTC Products 1, 5, 9, 10
- Adhere to manufacturer directions and recommendations.
- Apply ocular ointments at bedtime to keep eyes moist while sleeping plus prevent fuzzy, dry eye upon waking.
- If you have questions, ask pharmacists and/or primary health treatment providers.
- Discuss frequency associated with use with primary health care provider. Artificial tears are typically used once or twice daily, in the morning and at bed time.
- Note that artificial tears without preservatives are usually less likely than those along with preservatives in order to cause allergic reactions and/or irritate ocular surface.
- Refrigerate synthetic tears for additional relief.
- Before applying ocular gels, products, or drops, wash hands thoroughly with soap and water plus remove contact lenses, if applicable.
Whenever possible, pharmacists ought to ascertain regardless of whether self-treatment will be appropriate and, if this isn’t, recommend patients look for medical care. They should tell patients whose symptoms don’t improve or worsen along with OTC items to ask an ophthalmologist for prescription medications like lifitegrast or cyclosporine ophthalmic emulsion. They need to encourage individuals with red or painful eyes, serious DED, or even signs of ocular infection to see a good ophthalmologist immediately. And they should recommend that sufferers visit www. allaboutvision. com.
About The Author
Yvette C. Terrie, BSPharm, RPh , is the consulting pharmacist and healthcare writer within Haymarket, Virginia.
1 . Dried out eye. National Institutes of Health. Updated April eight, 2022. Accessed August one, 2022. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/dry-eye
2 . Labetoulle M, Benitez del Castillo JM, Barabino S, et al. Artificial tears: biological role associated with their ingredients in the particular management of dry eyes disease. Int J Mol Sci . 2022; 23(5): 2434. doi: 10. 3390/ ijms23052434
3. Bron AJ, de Paiva CS, Chauhan SK, ainsi que al. TFOS DEWS II pathophysiology report. Ocul Surf . 2017; 15(3): 438-510. doi: 10. 1016/j. jtos. 2017. 05. 011
4. Farrand KF, Fridman M, Stillman IÖ, Schaumberg DA. Prevalence associated with diagnosed dry eye condition in the United States among adults aged 18 years and older. Am J Ophthalmol . 2017; 182: 90-98. doi: 10. 1016/j. ajo. 2017. 06. 033
5. Fiscella RG, Jensen MK. Ophthalmic disorders. In: Krinsky DL, Berardi RR, Ferreri SP, et al, eds. Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care . 20th ed. American Pharmacists Association; 2020: 507-530.
6. Stapleton F, Alves M, Bunya VY, ou al. TFOS DEWS II epidemiology statement. Ocul Browse . 2017; 15(3): 334- 365. doi: 10. 1016/j. jtos. 2017. 05. 003
7. Matossian C, Song X, Chopra I, Sainski-Nguyen A, Ogundele A. The prevalence plus incidence
of dried out eye disease among patients using continuous positive airway pressure or other nasal mask therapy devices to treat sleep apnea. Clin Ophthalmol . 2020; 14: 3371-3379. doi: ten. 2147/OPTH. S274949
8. Al-Mohtaseb Z, Schachter S, Shen Lee B, Garlich M, Trattler W. The relationship between dry eye disease and digital display screen use. Clin Ophthalmol . 2021; 15: 3811-3820. 2021. doi: 10. 2147/OPTH. S321591
9. Muntz A, Turnbull PRK, Kim AD, et al. Extended screen period and dry eye in youth. Cont Lens Anterior Eye . 2021; 101541. doi: ten. 1016/j. clae. 2021. 101541
10. Dry eye. United states Optometric Organization. Accessed August 1, 2022. https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/dry-eye?sso=