Why are we dry?
Watch/listen
August 14, 2020 episode
Hosts
Rebecca Petris, moderator
Aidan Moore, technical support
Participants
We didn’t find time to recruit panelists for this particular session, so it became a discussion amongst Amanda Mott (who serves on the Foundation’s board), participants Kathryn and Phyllis who joined us spontaneously, and Rebecca. We normally ask all panelists to introduce themselves by sharing where they live, what they’re drinking, how long they’ve had dry eye and why, where they are in their journey, and what drops they used most recently.
AMANDA MOTT joins us from Madison, Wisconsin with a local beer (Hazy Hopalicious, from a brewery local to her called Ale Asylum). She has had dry eye since she was 19 and does not know the cause. It has progressed from aqueous deficient to (as a result of inflammation) MGD as well. In her 24-year journey she has come to a point of accepting dry eye as part of her life and deal with it, allowing for the reality of some bad days. She most recently used Retaine HPMC, which comes in a preservative-free bottle that is not as stiff as some of the other PF bottle technologies. Amanda describes Retaine HPMC as like Refresh Celluvisc minus the flaky reside, and a little thicker than Refresh plus.
REBECCA joins from the Dry Eye Foundation office with tea (rather than coffee which she would have preferred but was out of). She’s had dry eye since LASIK nearly 20 years ago and describes herself as up, down and all over the place but… generally pretty stable. Her eye journey is more driven by vision at the moment. She tends to avoid drops but the most recent she used was Oasis Tears Plus.
AIDAN joins from the DEF office as well, and does not have dry eye but works with people who do. He hasn’t used drops very recently.
KATHRYN joins us from Jackson, Wyoming, though she lives primarily near Washington, DC and Florida. She has a corneal dystrophy and a history of corneal transplants, which turned out perfectly in one eye but much more complicated in the other. She now wears PROSE on the worse eye. She doesn’t something comparable to the collection of remedies some of us describe and was motivated to join in the discussion to learn.
PHYLLIS joins us from San Diego and is drinking water. She has a history of contact lens wear (hard contacts beginning in 1963) and preservative intolerance. When she eventually developed cataracts, she was advised to wait for technological improvements, and she found her dry eyes worsening both during the wait and after having cataract surgery in both eyes finally in 2006 (though the vision results were good). Cataract surgery was followed by LASIK to correct residual astigmatism. She has traveled internationally a lot and learned tips from fellow travelers. In 2014, a tumor recurred, requiring surgery which then resulted in damaged nerves, poor eyelid function and no more tear production in the affected eye. She had a gold implant to help hold the lid down; she uses Refresh Celluvisc all day, and Soothe preservative-free just before bed, plus goggles. She feels she’s learned to live with it and ensures that she always brings lots of tear vials in her purse and uses a timer to ensure she applies drops frequently enough (30 to 45 minutes) as she gets hemorrhaging and pain if she fails to do this. She found it very helpful to learn how many different reasons there are for dry eye, and is always looking for new things to try. Salty foods seem to exacerbate her dryness. She feels fortunate not to be on any drying medications. Phyllis finds it somewhat ironic that her tumors (of which she has a 21-year history) are considered benign - in the big picture, given the impact on her eyes, they are not benign to her.
MARLA joins us from Chicago with a question. She’s had dry eye for 15 years and feels she’s tried everything and seen every doctor. Her problem for the past year has been is extreme, constant eye watering and she would like to know if there are others that experience this. She’s puzzled about why her doctors keep urging her to stick with Restasis when it doesn’t seem to be helping, and we got into a bit of a discussion about her situation.
Why are we dry? Rebecca’s introduction
Rebecca introduced todays topic of why we are dry - what the causes of dry eye are. This is a large, complicated topic, partly because “dry eye” is a bucket term for many unrelated conditions, from reduced tear production to incomplete eyelid closure. There are many different levels at which “causes” can be discussed, from what started it to what makes our symptoms worse to what eye or systemic diseases seem to be associated to anatomical causes to the big picture of lifestyle and environment (e.g. computer use, office air, diet, drugs and surgeries). So, it may never be entirely accurate to say simply “X caused my dry eye”.
Rebecca’s perspective on dry eye causes is that most of us have a unique, personal collection of:
Causes,
Contributing factors
Triggers, and
Risk factors
She feels that when you break it down and identify all these different things, it becomes empowering, because you find that while you may not be able to change some causes (e.g. age, gender), you CAN change others. She mentioned her experience with the epidemiology team of TFOS DEWS II, where they broke down “who gets dry eye, and why” in terms of modifiable versus non modifiable causes. It’s important that we are able to identify some things that we have control over.
Discussion highlights
Listen to the discussion in the video above (starts about 30 minutes in) as we talk about all different types of dry eye causes and the significance.
Quotables
It’s always a daily struggle, but I’ve kind of learned to just deal with it and accept that it is part of my life and who I am.
I’m also human and I have some bad days, and I just let myself wallow on those days, and then try to jump back into life on the next day.
- Amanda