Search Results

By Dr. Zach Skurski Board Certified Ophthalmologist, Cornea and Refractive Surgery Specialist Dry eyes, also known as dry eye syndrome (DES), is a broad term for a common eye condition affecting millions of people worldwide. It typically occurs when the eyes do not produce enough tears or when the tears evaporate too quickly. This can lead to a range of uncomfortable symptoms, including dry sensation, redness, itching, burning, blurred vision, and pain. While dry eyes can be a chronic and frustrating condition, there are numerous strategies and lifestyle changes you can employ to manage and alleviate its symptoms. In this article, we will explore the causes of dry eyes, the importance of early detection, and a variety of practical tips to help you manage and find relief. I'll also offer my perspective and recommendations for treatments that I use in my day to day ophthalmology and cornea practice. The essentials boil down to treating with consistent lubrication, heat, dietary change, and lifestyle adaptations. Contents Causes of Dry Eye Early Detection Tips for Treatment Causes of Dry Eye Before diving into strategies for managing dry eyes, it's essential to understand what causes this condition. Several factors can contribute to the development of dry eyes, including: Aging: One of the most common causes of dry eyes is the natural aging process. As we get older, our tear production tends to decrease, leading to a higher risk of dry eye symptoms. Environmental Factors: Environmental factors play a significant role in dry eye development. Exposure to smoke, wind, dry air, and air conditioning can all contribute to worsening symptoms. Additionally, prolonged screen time on digital devices can reduce the frequency of blinking, leading to quicker tear evaporation. Medical Conditions: Certain medical conditions can increase the likelihood of dry eyes. These include autoimmune diseases such as Sjögren's syndrome, diabetes, thyroid disorders, and rheumatoid arthritis. Medications: Some medications, including antihistamines, decongestants, and antidepressants, can have dry eye as a side effect. Contact Lenses: Wearing contact lenses for extended periods or not cleaning them properly can have a major contribution to dry eyes. Hormonal Changes: Hormonal changes in women, such as those experienced during pregnancy, menopause, or while using birth control pills, can affect tear production and increase the risk of developing symptoms. The Importance of Early Detection Recognizing the signs and symptoms of dry eyes early is crucial for effective management. If left untreated, dry eyes can lead to more severe complications in rare cases, such as corneal damage and vision impairment. Some common symptoms of dry eyes include: Persistent dryness, itching, or burning sensations in the eyes Redness and inflammation Excessive tearing (a reflex response to dryness) Blurred vision Light sensitivity Stringy mucus in or around the eyes Difficulty wearing contact lenses If you experience any of these symptoms regularly, it's essential to consult an eye care professional for a proper diagnosis and treatment plan. Early intervention can help prevent long-term complications and provide relief from discomfort. How to Manage Dry Eyes: My Practical Tips While dry eyes can be a chronic condition, there are several lifestyle changes and over the counter treatments that can help manage and alleviate its symptoms. Let's explore these in detail: 1. Artificial Tears: Over-the-counter artificial tear drops and lubricating eye gels can provide immediate relief from dry eye symptoms by supplementing your natural tear film. It's essential to choose preservative-free eye drops, especially if you find yourself applying drops more than four times a day, as preservatives can exacerbate dryness if used too frequently. Here are some examples of preservative free drops that I regularly prescribe for patients and use for myself: Refresh Plus: There are many variations on the Refresh brand and I find that Refresh Plus is the best for everyday use. TheraTears: Another common preservative free tear I frequently recommend for daily symptoms. For patients who regularly experience symptoms of dryness. I typically recommend starting one of these preservative free artificial tears as needed. If symptoms remain persistent this is usually increased to at least four times a day (breakfast, lunch, dinner, bedtime), even if there are no symptoms. I find that they lose efficiency after more than about 8 times a day. 2. Warm Compresses: Commonly the eyelid's oil glands are blocked like clogged toothpaste, instead of the healthy olive oil like secretions we need. Applying a warm compress to your closed eyes can help soften the blockages and open the oil glands (Meibomian glands), improving the quality of your tears. These oils protect your tears to prevent early evaporation that leads to drying out. Use a clean, warm, damp washcloth or commercial eye mask, and gently place it over your closed eyes for about 10 minutes minutes. Repeat this process initially 1-2 times a day. I also recommend using a finger to massage the edge of the eyelids to help open up the glands. There are many home remedies for the warm compress, including hot washcloth or towel, hardboiled egg, or uncooked rice microwaved a few seconds in a sock to name a few I've come across. Be careful that the heat is not too hot that it could cause a burn to the skin. For regular daily use, I've found that commercial eye masks that can be heated tend to be easier to manage. These can also serve as sleep masks, which I frequently recommend for night time and morning dry eye symptoms. Here are a few examples of simple heat masks: Myhalos Microwave Heat Mask Avenova Heat Mask 3. Omega-3 Fatty Acids: Omega-3s are found in foods like salmon, flaxseeds, and walnuts, can help reduce inflammation and may work to enhance the effectiveness of warm compresses. Omega-3 can help soften the oil secretions in the eye lids and make it easier to open and express these glands with the use use of warm compresses. In my practice I typically recommend dietary supplementation with 3,000mg (3 grams) of fish oil daily. If you find you can't tolerate fish oil, try a dietary adjustment to include salmon, nuts, avocados, and extra virgin olive oil. I often recommend one tablespoon of extra virgin olive oil a day. 3. Blink Regularly: If you're like me and spend long hours staring at screens, make a conscious effort to blink more frequently. Blinking helps distribute tears evenly across your eyes and reduces the risk of tear evaporation. When we focus intently on screens or reading our blink rate goes down and this dries the eyes out. You can also use the "20-20-20 rule": every 20 minutes, take a 20-second break, and focus on an object at least 20 feet away. 4. Humidifiers: If you live in a dry climate or frequently use air conditioning or heating, consider using a humidifier in your home or office. Adding moisture to the air can help prevent excessive tear evaporation. The dry air is also why flying on planes can really irritate the eyes. 5. Stay Hydrated: Drinking plenty of water is essential for overall health and can help maintain adequate tear production. Dehydration can worsen dry eye symptoms, so make a habit of staying well-hydrated. 6. Protective Eyewear: When exposed to windy or dusty environments, wearing wraparound sunglasses or protective eyewear can shield your eyes from irritants and reduce tear evaporation. Blue light reducing glasses are also controversial option in managing dry eye symptoms due to screen use. There is mixed scientific data but so far it seem there is little proven benefit for the use of these glasses. That being said, there is little downside to wearing them and I personally will use them from time to time, especially for longer computer session in the evening. There are a lot of affordable and stylish options on Amazon. You can find the pair I wear here. 7. Avoid Smoke and Allergens: If you smoke, I urge you to quit, as smoking can worsen dry eye symptoms, not to mention the extreme benefits of quitting. Additionally, minimizing exposure to allergens like pollen and pet dander can help reduce eye irritation. Over the counter allergy eye drops may help with allergies but these types of medications (antihistamines) can also seriously dry out eyes. If you live in an area where air quality is affected by forest fires, city pollution, or just bad seasonal pollen, consider an air purifier to filter out any irritants. Here you can find the one that I use. 8. Limit Contact Lens Wear: If you wear contact lenses, try limiting their use, especially in dry or windy conditions. Consider switching to glasses temporarily to give your eyes a break after 10 or more hours of wear. However, in some cases, like I personally experienced before laser vision correction, contacts can act as a protective barrier and dry eye symptoms may be worse without them while wearing glasses. 9. Prescription Medications: In some cases, your eye care professional may prescribe medications like cyclosporine (Restasis, Cequa) or lifitegrast (Xiidra) to help manage chronic dry eye symptoms. These medications are typically used twice a day on a long term basis and work to reduce inflammation and promote tear production. These are frequently prescribed in the U.S., however in my experience there is often modest, if any notable benefit by patients. These medications have also not been approved in Europe due to questions about their efficacy. 10. Punctal Plugs: For moderate to severe cases of dry eyes, your eye care professional may recommend punctal plugs. These tiny plugs block the tear ducts, preventing tears from draining away too quickly and keeping your eyes moist. They come in dissolvable and non-dissolvable forms. 11. Eyelid Hygiene: Keeping your eyelids clean and free from debris can help prevent blockages in the oil glands that contribute to dry eyes. If you have a lot of crusting around your eye lashes, this is often more suggestive of a related ocular surface disease, blepharitis. Keeping the lashes clear will help reduce inflammation and irritation. This classically has been recommended as using Johnson's Baby Shampoo to gently scrub the eyelashes. Conclusion Managing dry eyes is a multifaceted process that involves both lifestyle adjustments and potential medical treatments. By beginning to understand the causes of dry eyes and recognizing the importance of early detection, you can take proactive steps to alleviate discomfort and prevent complications. Whether you're using artificial tears, practicing good eyelid hygiene, or making dietary changes, the goal is to maintain the health and comfort of your eyes. Remember to consult with a doctor for a full examination and a treatment plan tailored to your specific needs. With the right approach, you can enjoy relief from dry eye symptoms and maintain optimal eye health. Additional Resources for Dry Eye Syndrome Research to Prevent Blindness: Dry Eye The Dry Eye Foundation NIH National Eye Institute: Dry Eye American Academy of Ophthalmology: Prevention

By Dr. Zach Skurski Board Certified Ophthalmologist, Cornea and Refractive Surgery Specialist Across the world, 2.2 billion people have vision impairment and in at least 1 billion of these people, the condition could have been prevented or treated. Cataract and refractive error are the leading causes of vision impairment and blindness globally. In the US, over 1 million people over 40 years old are blind, while 2.4 million are visually impaired. According to the NIH, this is expected dramatically rise with the aging Baby Boomer population,. Leading Causes of Blindness Blindness is a profound and life-altering condition that affects millions of people worldwide. In the United States alone, vision impairment is a significant public health concern and impacts the lives of many individuals and their families. While advancements in medicine have made it possible to prevent or treat several causes of blindness, there are still leading causes that continue to challenge healthcare providers and researchers. In this article, we'll take a look at the top seven leading causes of blindness in the United States, exploring their causes, risk factors, prevention, and available treatments. Contents Diabetes Age-Related Macular Degeneration (AMD) Glaucoma Cataract Refractive Error 1. Diabetic Retinopathy With the growing health trends and rise in diabetes, diabetic retinopathy is a common and leading cause of vision impairment. Diabetic retinopathy is a complication of diabetes that affects the blood vessels in the retina. Diabetes essentially makes small blood vessels become leaky an ineffective, which affects the eyes early in the disease. It is one of the leading causes of blindness among working-age adults in the United States. Causes: Prolonged high blood sugar levels in people with diabetes can damage the blood vessels in the retina, leading to diabetic retinopathy. Poorly managed diabetes and long-duration diabetes are significant risk factors. Prevention: The most effective way to prevent diabetic retinopathy is by managing blood sugar levels through a healthy lifestyle, regular medical check-ups, and following the prescribed treatment plan for diabetes. Treatment: Treatment options for diabetic retinopathy include laser therapy, injections of medications into the eye, and surgery in advanced cases. Early detection and intervention are crucial to preserving vision. 2. Age-Related Macular Degeneration (AMD) Age-related macular degeneration, often abbreviated as AMD or ARMD, is the leading cause of blindness in older adults in the United States. As the named, this condition primarily affects the macula, the part of the retina (inner nerve lining of the eye) responsible for sharp central vision. AMD comes in two forms: dry (atrophy or thinning) AMD and wet (neovascular, fluid collection) AMD. Causes: The exact cause of AMD is not fully understood, but genetics and age are the primary risk factors. Smoking, high blood pressure, and a diet lacking in antioxidants may also contribute to its development. Prevention: Regular eye exams, a healthy diet rich in vitamins and minerals (especially antioxidants), not smoking, and managing conditions like hypertension can reduce the risk of AMD. Eye vitamins in a form known as AREDS 2 (Age Related Eye Disease Study 2), have been shown to slow, and potentially stop the progression of intermediate macular degeneration into advanced stages. Patients are frequently provided with Amsler grid's by their ophthalmologist to screen for any changes or new symptoms as illustrated in the image above. Treatment: Treatment options for AMD vary depending on the form. While there is no cure for dry AMD, certain dietary supplements (AREDS 2) and lifestyle changes may slow its progression. Wet AMD can be treated with anti-VEGF (vascular endothelial growth factor) injections, photodynamic therapy, or laser therapy, which can help manage symptoms and prevent further vision loss. 3. Glaucoma Glaucoma is a group of eye conditions characterized most frequently by increased intraocular pressure (IOP) that is believed to stress and damage the optic nerve, causing slow and gradual vision loss. It is often referred to as the "silent thief of sight" because it can progress without noticeable symptoms until significant vision loss occurs. Causes: Elevated IOP is a major risk factor for glaucoma, but the exact cause is not fully understood. Some patients develop glaucoma with normal eye pressure (normal tension glaucoma). Family history, age, and certain medical conditions like diabetes may also increase the risk. Prevention: Early detection through regular eye exams is crucial for preventing vision loss due to glaucoma. Managing underlying health conditions and maintaining a healthy lifestyle can also help reduce the risk. Treatment: Treatment for glaucoma typically involves lowering IOP through medications (eye drops), laser therapy, or surgery. The choice of treatment depends on the severity of the condition and the individual's response to therapy. 4. Cataracts Cataracts are a common age-related eye condition that affects the clarity of the eye's natural lens, leading to vision impairment. Causes: Cataracts often develop as a natural result of aging, but they can also be caused or accelerated by factors such as smoking, excessive UV exposure, and certain medications. Prevention: While cataracts cannot be prevented entirely, wearing sunglasses, quitting smoking, and managing underlying health conditions can help reduce the risk. Treatment: Cataracts can be surgically removed and replaced with an artificial lens (intraocular lens or IOL). This is one of the most common surgeries that I perform, and is the most commonly performed surgery in the US. This outpatient procedure is highly successful in restoring vision. Unfortunately cataract surgery is often not widely available in underserved areas of the world, making this a major cause of treatable blindness. 5. Refractive Error Refractive error is a common vision problem that occurs when the eye is unable to focus light properly onto the retina, resulting in blurred or distorted vision. They are the leading cause of vision impairment in the world. There are several types of refractive errors, including myopia (nearsightedness), hyperopia (farsightedness), astigmatism, and presbyopia. Causes: Refractive errors are typically caused by the shape and size of the eye, which affect how light is bent (refracted) as it enters the eye. Common causes include: Myopia: The eye is too long or the cornea is too curved. Hyperopia: The eye is too short or the cornea is too flat. Astigmatism: The cornea or lens has an irregular shape. Presbyopia: Age-related loss of the eye's ability to focus on close objects. Prevention: Preventing refractive errors is not always possible, as some are genetic or age-related. However, there are measures to reduce the risk include regular eye exams to correct any error early with glasses, contact, or refractive surgery, and reducing eye strain by practicing good eye ergonomics (20-20-20 rule to break from screens). Treatment: Refractive errors can be corrected most commonly with eye glasses, either for reading or distance vision. Bifocals can help to treat both distances. Contact lenses are another common correction, worn directly on the eye. Refractive surgery (my specialty) is also an option, with procedures like LASIK, SMILE, and PRK to reshape the surface of the eye to focus better Conclusion Blindness is a significant and life-altering condition, and understanding its leading causes is essential for prevention and early intervention. Regular eye exams, a healthy lifestyle, and managing underlying health conditions are key strategies in preserving vision and preventing blindness. Advances in medical science and ongoing research offer hope for improved treatments and prevention strategies in the future, giving individuals at risk of vision loss reason to remain optimistic about their eye health. Ultimately, increasing awareness about the leading causes of blindness in the United States and globally can empower us to take proactive steps in safeguarding their vision. Stay healthy my friends.

My name is Dr. Zach Skurski, and I'm an Ophthalmologist and subspecialist in cornea, external disease, and refractive surgery. I started this site to develop a trusted resource for all things related to eye health and eye care. Vision 101 is your gateway to a world of knowledge and expertise in the field of ophthalmology. My mission at Vision 101 is to provide you with accessible, informative, and up-to-date educational articles on common and important eye care concerns and topics. Whether you're curious about cataracts, seeking relief from dry eye, exploring solutions for macular degeneration, or considering the possibilities of LASIK and laser vision correction, I hope my comprehensive articles will empower you with the knowledge you need to make informed decisions about your eye health. My journey in eyecare and surgery began at the Walter Reed Military Medical Center (aka the President's Hospital), in Bethesda, MD, where I went through the rigors of internship and residency as a medical officer in the US Army. With those four years of residency as a foundation, I was selected to further hone my skills and expertise through fellowship at the renowned Johns Hopkins University School of Medicine, Wilmer Eye Institute in Baltimore, MD. There I was fortunate to train with the best in ocular surgery and medicine to perform corneal transplants and other advanced eye surgeries. Now, with years of experience and a deep understanding of the complexities of eye health and challenges for patients, I've taken an interest in sharing my knowledge and insights with you through Vision 101. At Vision 101, I aim to share my dedication to promoting eye health, preventing eye disease, and enhancing your overall quality of life through insightful eye care education. I invite you to explore the articles and embark on a journey towards better vision and eye health. Your vision matters, and Vision 101 is here to guide you every step of the way. Thanks for reading! -Dr. Zach Skurski