"Hey Doc...My eyes are Itching and Watery!"
Aaron Feser, O.D.
When our eyes are uncomfortable, the answer or reason is usually not as simple as you might think. Allergies, poor tear film, plugged oil glands, oral medications, systemic health problems (example arthritis), or a combination of those issues and others can certainly make our eyes itch and burn.
The term that is used to describe those factors together is Ocular Surface Disease. The ocular surface is the tissues that make up the front surface of the eye. They include the cornea, tear film, eyelids, and conjunctiva (the clear covering over the "whites" of our eyes). When the ocular surface is inflamed it not only causes discomfort, but also affects the quality of our vision.
We all know that inflammation in the joints in our body give us achy hands and knees, for example. Inflammation also makes our ocular surface hurt. The doctors and staff at Vision Care Associates are dedicated to providing you with the most clear and comfortable vision possible which goes beyond the prescription in your glasses or contacts as the health of our eyes can also affect the quality and comfort of our vision.
Because there are multiple issues that can cause your eyes to be uncomfortable, your doctor will take a close look at your ocular surface to determine what cause or causes are the reason for your problem. We use slit-lamp bio-microscopes to visualize the small details of dryness on the ocular surface. Diagnostic tests may also be performed to establish the severity of the issue. Fluorescein dye is often used to determine the quality of the tear film. Other non-invasive tests include tear break up time, Schirmer's test, grading tear lake, conjunctival staining, evaluation of meibomian gland oil, measuring blink rate and coverage, and grading of corneal staining. These tests help your doctor to differentiate between a poor tear film, oil gland dysfunction, an allergic reaction or some other underlying issue. We can then determine which treatment options will give you the greatest benefit.
There are many options to choose from when treating discomfort in our eyes and knowing what the primary cause of the underlying problem is makes treatment much more effective. Most issues with our ocular surface are chronic in nature which means that without intervention, our symptoms continue to worsen over time. That is why it is important for your doctor to diagnose what problems are evident and persistent in lieu of self-medicating with over the counter eye drops.
Some options like artificial tears, Restasis, and allergy eye drops are some of the primary methods for decreasing inflammation on our ocular surface which makes our eyes feel better, but eye drops are not the only options. Punctal occlusion, omega 3 supplementation, staying hydrated by drinking water, monitoring environmental factors (air flow from fans or dry heat) and eye lid hygiene with warm compresses or eyelid scrubs are a few choices for helping our ocular comfort as well. Instilling eye drops can be difficult for many of us, so if that skill is something that you have difficulty with or are unable to do by yourself there are other options.
Ocular discomfort is something that I experience personally; and for most of us the discomfort can vary from a slight annoyance in mild ocular surface disease to significant pain in severe ocular surface disease. Visual blur and fluctuations can also be caused by a poor tear film, so whatever the issue is, remember we can help improve your ocular comfort and visual quality by evaluating and treating the ocular surface.