VIDEO: Dry eye prevention tips to offer patients

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I think being aware of the symptoms, that is probably the biggest thing I have learned in my career so far. Look, I don't care what diagnostic you have. I don't care if you have tear osmolarity, or MMP testing, or topographies. And we have a lot of great tools at our disposal as well, but I do think it's important just to listen to the patients. So I think the biggest thing we can do and tell our patients is to tell us their symptoms and for us to ask and inquire. Meaning, "Does your vision come and go throughout the day?" If someone tells me, "Yeah, doc, I have to blink after five seconds of reading or watching TV, and then it gets clear again for a few seconds," regardless there's some type of tear film instability as well. And so I do think that there's no doubt a lack of awareness from our patients to understand, to be aware for themselves that they have these symptoms. So tearing, burning, fluctuation are big things.

In fact, in our own unpublished studies, we found that fluctuating vision had the highest yield to identifying some type of pathology of the ocular surface. So my biggest question I tell my technicians, "just ask a patient, 'Does your vision come ’and go throughout the day when you blink your eye?’” If they say, “Yes,” and it’s significant, regardless, there's some ocular surface disease and some tear film instability as well. So the number one thing I would tell my colleagues is just to be aware and have your patients be aware of those symptoms as well so when they come in, they can actually divulge that.

Number two is just be aware of the blink reflex. I think that's a big thing. Whatever activity you're doing, you do the 20/20/20 rule. Every 20 minutes, look 20 feet away for 20 seconds. Sounds simple, but it's those simple things like that that just be having patients aware that when they're staring at a computer screen, close your eyes every once in a while, blink, just kind of help yourself. Use artificial tears before you're going to read for a long time, before you use a computer for a long time. Simple things like that as well.

Address meibomian gland dysfunction early on. I think the idea of eating healthier oils, and kind of taking either omega-3s, and other healthier oils for our body is important as well. And being aware for patients to divulge, "Hey, are they on systemic medications that could predispose them to some type of ocular surface disease?" These are all simple things that we can do to help our patients as well. And I think even wearing things like sunglasses can help a lot of the wind exposure. We know, we talk about UV, and blue light; we talk about AMD, and cataracts, and things like that. But even ocular surface disease, when you have people staring, especially in the sun, that can dry the eyes out more as well. So I think being aware more than anything else is probably the biggest impact we can have for our patients and letting them know these symptoms to watch out for. And then also explaining why some of these treatments.

One treatment I didn't mention earlier, which I've used a lot is something called varenicline, which is a nasal spray that allows us to actually stimulate the trigeminal nerve here in the nose that can stimulate the entire process, the entire tear of film; whether it's meibomian glands or goblet cells. It's not specifically to one part of tear film, but the entire tear of film as well. Because a lot of patients don't realize that it's whether you have one layer or another layer, any one layer that's disrupted will disrupt that natural homeostasis as well. So I think it's important for patients to recognize why these treatments are important to stay on those treatments and to let us know when they're having symptoms.