(July 10, 2009 - Insidermedicine) In this video, Dr. Penny Asbell, MD, FACS, MBA, discusses what she would do if she had dry eyes. Dr. Asbell is a Professor of Ophthalmology at Mount Sinai School of Medicine and Director of the Cornea Service and Refractive Surgery Center at the Mount Sinai Medical Center. In addition, she is currently on the Board of Directors of the International Society of Refractive Surgery, is Past-President of the Contact Lens Association of Ophthalmologists, and serves as editor in chief of the Mount Sinai Journal of Medicine.
At the American Academy of Ophthalmology in Atlanta, we had a chance to speak with Dr. Penny Asbell; Professor of Ophthalmology at Mount Sinai's School of Medicine. Dr. Asbell is also the director of the Cornea Service and Refractive Surgery Center.
If I had dry eyes...
Dr. Asbell: Diagnosing dry eyes is not as easy as we would like it to be we don't have one of those tests, one blood test to come up with a diagnosis. It’s a series of things that are done to come up with a correct diagnosis. Your ophthalmologist is going to ask you about your problem. They're also going to take a look at your eyes. To see if there is staining on the surface of the eyes that indicates damage to the ocular surface. It part of a normal exam but there are a few other things that they will do during that exam to specifically look for evidence of dry eye disease.
What causes dry eye?
Dr. Asbell: Dry eye is probably a multifactorial problem, meaning there are many things that can lead to this. Chronic pain or discomfort associated often with fluctuating vision. So we are not exactly sure what causes it but there are a couple of things we think about. One is evaporation. When we look at a computer we may not blink enough and get evaporation. Two is inflammation. There may be signs of inflammation on the ocular surface and if we treat that we can help the patient.
Who is at risk of developing dry eye?
Dr. Asbell: Dry eye is a very common problem. One of the things that we've learned however is that it increases with increasing age. We know that the whole population worldwide is graying. So we are going to see it as a more common problem. But it is not just people as they age; we can see it at any age. People who have autoimmune diseases like lupus and things like that. And we also see it due to environmental conditions. Everyone is using a computer today. When you stare at a computer you don't blink as often and you get a dry eye kind of syndrome. It’s really a common problem that can present in many different ways.
How is dry eye treated?
Dr. Asbell: Just recently there was actually a group of people, 70 people from around the world who experts in dry eye disease and they got together and put together a report called the DEWS Report, the Dry Eye WorkShop. And we have classified dry eye disease as 1, 2, 3, or 4 depending on its severity. We are beginning to get a feel for classify dry eye disease and how best to treat it. But typically we start out with artificial tears, which are available in most places over the counter. There is one type of artificial tear that is actually a prescription product, at least in the US, that is called Lacriserts, it’s a little bit different, that you might ask about. But you start out with artificial tears and then depending on how you are doing you may add an anti-inflammatory agent. One of the ones that is popular is in this area is cyclosporine which is available as an eye drop. So there are a bunch of things that you can try. And that’s one of the things to know.
Not all artificial tears are the same. You need to figure out which one is going to work for you maybe try a few to come out with the best opportunity to make you feel better. And that is what you are doing; you are treating your symptoms primarily to improve them so that you are feeling better.
If I had...
Dr. Asbell: If I had dry eyes I would really want to see somebody who is interested in my problem. Sometimes when you have these chronic problems that interfere with your quality of life your practitioner may not be taking you seriously. So I would want to see an ophthalmologist who is interested in dry eye disease, who is going to make the right diagnosis and come up with some recommendations that are going to help me. Start with a good diagnosis and somebody who really is listening to your story.