Dry eye doctors have a difficult job. There is no denying it.
Having dry eyes can be a complex and frustrating condition and not easily corrected. As a patient it can feel helpless when your doctor or specialist does not know how to treat the condition effectively.
Having red, irritated, dry eyes often feels socially awkward and uncomfortable.
Dispensing drops for dry eyes (artificial tears and gels) is not an effective, long-term treatment plan for resolving your dry eye problem. However, often this is all the weaponry specialists have for helping a patient.
While, tears and gels are important symptom relievers and aids for many people, ultimately patients are looking for alternative solutions.
What should I expect of my doctor or specialist?
Firstly, you need some compassion shown toward your condition.
Chronic dry eyes can have a severe effect on your life if not treated properly and with understanding. It is not trivial – specialists should know this.
Secondly, you need a dry eye doctor that can not only assess the severity of your condition through eye exams and other relevant testing, but that also understands your body from a holistic point-of-view. In other words, an integrative practitioner that has an understanding of eye health and associated diseases.
Finding a specialist with these skills is not easy but should definitely be a priority. For example, call a good integrative or functional medicine specialist in your area and ask for a referral.
Thirdly, you need to go in armed with some good information: clear details of your symptoms, studies you may have seen, and what you would like to get out of the session…. Remember, knowledge is power.
Ophthalmologists follow a fairly typical pattern of diagnosis.
A standard eye health exam along with a Schirmers test to assess how well the surface wetting of your eye is maintained.
This is typically measured by placing a strip of paper on the surface of one or both eyes for a short period time. The amount of surface wetting on the paper tells the eye doctor how well your eyes are producing tears to lubricate the surface of the eye.
Anecdotal evidence shows the Schirmer test is not a ‘catch all’ method of diagnosing dry eyes, hence should not be used as the sole diagnostic test.
A device called a Tear scope is sometimes used to directly assess your tear film for debris and abnormalities.
A dry eye doctor can also order specific blood tests to check for autoimmune diseases such as Rheumatoid arthritis, Lupus and Sjogren (Show-grins). These conditions are not their speciality, however all have shown links to dry eye syndrome and hence need to be ruled in or out.
You may also be asked if you have had recent lasik eye surgery.
Dry eyes can be a symptom of all of these conditions. Often, it’s at this point that you would likely be referred back to your doctor or to a specialist in autoimmune disease. It feels frustrating, right?
One of the hurdles facing many a patient is that of “referral exhaustion”.
As dry eyes and related conditions, including lacrimal and meibomian gland dysfunctions, are not easily treated, patients are often shuffled around to various specialists for further opinion or help. The result can be frustrating both for the patient and doctor or specialist involved.
Ophthalmologists were trained predominantly to treat diseases of the eye such as Glaucoma, Cataracts and other conditions. Dry eyes has been categorised more as a ‘nuisance’ and temporary condition, often as a side effect of too much TV, computer use and so on.
Unfortunately, it is a very real and serious condition for many people and needs to be treated as such.
Where to from here?
Dry eye conditions are fairly new in the last ten to fifteen years. As knowledge and support networks grow, many more treatment options will become available. While pharmaceutical and OTC solutions will keep being developed to assist, this as we know is not really the answer.
An emphasis on lifestyle and nutrition should be paramount in creating a healthy body and healthy eyes.
Our eyes cannot be separated from the rest of our body, necessarily, and then treated with topical solutions for a condition that essentially started as inflammation or an imbalance.
The ideal dry eye doctors of the future will have many more options at their disposal, including a knowledge of the whole body, a holistic view, whereby lifestyle, nutrition and hormone-related issues can be taken into account for a full and proper diagnosis.
This may be some way off but with luck, not too far off.
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