Q&A: Many patients unaware of dry eye, treatment options
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July is Dry Eye Awareness Month, but educating patients about symptoms and treatment is critical throughout the year, especially in light of recent data that show many American adults do not know relief is possible.
According to a Bausch + Lomb press release, the company’s inaugural State of Dry Eye Survey revealed that most respondents are unaware that symptoms like redness, fluctuating vision, itchiness or overall eye irritation may be associated with eye dryness. In addition, the majority of respondents (66%) do not know that dry eye is becoming increasingly common in young people.
“The prevalence of dry eye is growing, particularly among a younger demographic, in large part due to modern lifestyles and heavy digital device use,” Yehia Hashad, MD, executive vice president of research and development and chief medical officer at Bausch + Lomb, said in the release. “The survey results underscore the importance of raising awareness of dry eye so sufferers are empowered to speak with an eye care professional and seek relief.” Other key survey findings include that two in five respondents do not know that untreated dry eye could lead to other vision problems, and 70% of respondents do not know how to prevent or treat dry eye. More than half believe dry eyes are difficult to treat and something people must learn to live with.
Healio spoke with Jessilin Quint, OD, MBA, MS, FAAO, president of the Maine Optometric Association, about dry eye disease and considerations for providers when seeing patients.
Healio: How has digital device use affected dry eye?
Quint: As a whole, our population is on digital devices more than ever before. Because of that, I see a lot of dry eye in younger populations and also an uptick in overall complaints of digital eye strain compared with even a decade ago. Now it seems like almost every patient has some component of that, but the biggest difference is that I see it in a lot younger patient population than before. Even as an eye care community, we used to think that dry eye was just something that impacted older people, but now I see kids as young as 3 years who have some sort of dry eye disease process going on.
In fact, the Bausch + Lomb survey found that dry eye can impact quality of life, making it difficult to enjoy day-to-day activities like watching TV and spending time on electronic devices. The majority of people with dry eye (67%) even reported having to give up or cut back on something to relieve symptoms, with the most common being screen time use (32%).
Healio: What do you have to consider when treating younger patients?
Quint: Regardless of age or patient demographic, the first priority is making the patient aware of it, putting it on their radar and building awareness around the condition. Diagnosing it, talking about it with the patient and going over lifestyle factors are important. Dry eye is growing among younger generations due to modern day factors like increased digital device use, environmental stressors, anxiety and stress.
Certain treatment options are not approved for kids younger than 18 years, so even if they are symptomatic and clinically show signs of dry eye, our treatment options can be limited or different. We might start with a very specific dry eye hot compress vs. using pharmacological agents for patients older than 18.
Healio: Do you think the pandemic had an impact on dry eye?
Quint: Yes, there was definitely an uptick in everybody’s digital device use. At the same time, especially during the actual lockdown, there was a stark difference in having lots of screen time and then a break when the world shut down. When people had more free time, they could feel that difference in their eyes. Sometimes, if you have constant digital eye exposure and you don’t ever really get a break, it’s hard to appreciate what your eyes are supposed to feel like.
I think because we have had a lot of new dry eye innovations, with a lot of companies that have really built up a really good dry eye portfolio, there’s a lot more awareness of it too. While it’s not great that we’re on screens more after the pandemic, I do think the positive is that there is more awareness about the ocular surface than there was before the pandemic.
Healio: What can clinicians do to help patients with dry eye or digital eye strain?
Quint: It starts first by asking the right questions and not waiting for the patient to bring it up. I found with my patients that if you just say, “dry eye,” a lot of people don’t know what that means. Instead, ask questions like, “Does your vision ever fluctuate?” A lot of people think about comfort issues when they think about dry eye, but they don’t necessarily think about the vision impact. Early on in that disease process, it will often show up as fluctuating vision.
A good, comprehensive annual eye exam is a great start for looking at that ocular surface. I think among eye care providers, there’s this misconception that you have to have all this fancy dry eye diagnostic equipment. While that’s fun and nice to have, you really just need a slit lamp and a little bit of fluorescein staining, which we all have in our exam rooms. Starting there is a good place to catch those initial clinical presentations.
Also, sometimes patients might recognize that they have had symptoms of dry eye and acknowledge that they have this disease process, but they don’t want to do anything about it. That’s OK. At least the conversation opens up communication to address it down the road. Other patients are ready to hear what their options are and how to keep it from progressing. That opens up a whole other discussion.
Healio: How can clinicians educate patients about digital eye strain?
Quint: Patient education is a team approach, and it takes everybody in the office, not just the doctor. The doctor education piece is such a big part of it, but sometimes our staff have more face time with our patients than we do: They’re checking the patient in, taking insurance cards, navigating them through the optical and performing pretesting, and in the process of all that, natural conversations may happen. If your staff is educated on dry eye, as well as digital device use and digital eye strain, and they’re listening to the patient, they can help detect some of that.
Healio: Are there particular patient populations that are more vulnerable to digital eye strain?
Quint: What we’ve learned after the pandemic is that everybody can be impacted by digital eye strain. I would say people who work in front of a computer, students and younger populations who may have more screen time are more at risk — anybody who encounters a digital device on a daily basis.
We are of a day and age that the long-term impacts of digital device use will still play out over time. People are on their devices, for entertainment and sometimes working from home, and that can impact things. Computers and digital devices have made almost every industry more efficient and more modern. It allows us to work faster and cleaner and to work from remote locations. It doesn’t matter what your job is, technology has had an impact in it over the last decade or two.
While in one way it’s advantageous to have an improvement in efficiency, the tradeoff is that we’re on those digital devices a lot more, and that can definitely cause some ocular surface disease and digital eye strain.
Healio: Is there anything else you would like to add?
Quint: The biggest thing for clinicians is to just be proactive. Don’t wait for your patient to bring this up, because they might not, even if they are experiencing those symptoms. With any disease process and any vision-related condition, if you can catch it earlier on, there’s a much better prognosis for the patient. That’s a win for everyone.
References:
- Millions of Americans experience dry eye symptoms, yet new national survey shows sufferers struggle to find relief. https://ir.bausch.com/press-releases/millions-americans-experience-dry-eye-symptoms-yet-new-national-survey-shows. Published July 8, 2024. Accessed July 18, 2024.
- Prevent Blindness joins in July’s Dry Eye Awareness Month, providing educational resources on eye disease that affects millions. https://preventblindness.org/2024-dry-eye-awareness-month/. Published June 27, 2024. Accessed July 18, 2024.
For more information:
Jessilin Quint, OD, MBA, MS, FAAO, is president of the Maine Optometric Association and an adjunct professor at the Indiana University School of Optometry. She can be reached at @jessilinquint on Instagram.
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