Dry Eye Disease: A Clinical View

by Laura Periman, MD.

Dry Eye Disease (DED) has emerged as a very hot topic in Ophthalmology and Optometry today.  

However, for all of the advanced diagnostics and therapeutics, there is a real patient with unique risk factors that needs our kindness, attention and excellent care.  

Prior to the availability of FDA approved medicines, DED was considered the bane of the post-menopausal female. The danger of this misconception is a frustrated, even dismissive attitude amongst many doctors.   

As a busy MD and dry eye specialist, the reality is that dry eye disease is simply not the domain of the over 50 year old female any longer. 

The condition impacts every demographic:  young, old, male, female, health nut or junk-food connoisseur.   

The Beaver Dam Offspring Study, a population study of over 3000 people, including young adults, shows us that the prevalence of DED in the 18-49 year age group is not statistically different than the 50 and above age group.  Now we see that this condition is not just the burden of the post menopausal female any more. 

The number of children I’ve seen clinically that have significant dry eye disease is alarming.

My practice is located in Redmond, nearby to Microsoft, and I see young female and male patients of every walk of life and nationality that suffer from overt and occult dry eyes. Quality of life and quality of vision consequences drive me to proactively identify patients and customize the best possible regimen for them.  

My passion is to continually hunt for and learn about new therapies, tailored to each patient,to achieve the healthiest tears, best feeling eyes and best visual performance possible.  It is true that dry eyes is a vision compromising disease.   

clinical research for dry eyes

Achieving physiologic restoration of the healthy tear producing system that nature designed is my clinical mindset.  It takes time and patience.  Each patient deserves my full engagement.  

The older patients I see with more advanced disease pose an additional challenge.  Years of neglected or inadequately treated dry eye disease results in more severe disease.  The compensatory mechanisms wear down and achieving physiologic restoration is  more intensive, more expensive and takes more time.   

The children I see often have a clear risk factor(s) for their DED.  When identified and corrected, children often have enough physiologic reserve to improve significantly with risk factor modifications and omega 3 supplementation.  

Occasionally, topical medications will be necessary as well.  As a person ages into young and mature adulthood, the need to increase the interventions increases.  As in most diseases, early identification and treatment leads to better outcomes. 

Each patient, whether young or mature, early stages or end stages, presents a unique situation.  Identifying the causes and customizing the treatments for each patient is my challenge and passion. Both myself and my patient are partners in the treatment process.  It takes time.  

Dr Periman has studied inflammation for over 25 years and is passionate about DED science, teaching and treatments.  She has written numerous articles, given hundreds of lectures and filmed several segments about DED.   As a dry eye sufferer herself, she delivers sympathetic and compassionate multi-disciplinary care with a positive and uplifting approach.  She lives in Seattle WA and works at the Redmond Eye Clinic in Redmond, WA.  She can be reached on Twitter @DryEyeMaster, or at www.redmondeyeclinic.com 


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