Reversing Dry Eye Syndrome

Reversing Dry Eye Syndrome: Practical Ways to Improve Your Comfort, Vision, and Appearance

STEVEN L. MASKIN
WITH PAMELA THOMAS
WITH A FOREWORD BY SCHEFFER C. G. TSENG
Copyright Date: 2007
Published by: Yale University Press
Pages: 272
https://www.jstor.org/stable/j.ctt1nq7rx
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  • Book Info
    Reversing Dry Eye Syndrome
    Book Description:

    This clear, accessible book combines detailed medical information with expert treatment advice for the estimated twenty million Americans who suffer from dry eye syndrome. Dr. Steven L. Maskin, an ophthalmologist who has been caring for dry eye patients for more than fifteen years, explains exactly what the syndrome is, why it occurs, and how it can best be managed and treated. He dispels the misunderstandings that surround dry eye syndrome and presents an easy-to-understand guide that may be read cover-to-cover or dipped into for specific topics of interest.Dr. Maskin begins with an overview of dry eye syndrome, then explains the myriad ways it can develop (allergies, aging, contact-lens use, LASIK surgery, diabetes, and various other diseases). He discusses how it can be successfully diagnosed and treated, offers guidelines for choosing a doctor and appropriate medications, and describes useful home remedies. In a concise final chapter, the doctor provides welcome answers to frequently asked questions. For patients who want to understand their disease and to participate actively in its management, this book is an essential reference.

    eISBN: 978-0-300-13525-1
    Subjects: Health Sciences, Public Health

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. FOREWORD
    (pp. ix-x)
    Scheffer C. G. Tseng

    Why are my eyes irritated, sandy, and itching? Why did my eyes become so uncomfortable all of a sudden after menopause, after wearing contact lenses for many years, or after LASIK surgery? Why do my eyes still burn so after I’ve seen several eye doctors and had many kinds of eyedrops? These are questions frequently asked by dry eye sufferers.

    Dry eye (or dysfunctional tear) syndrome is one of the most common eye diseases, and affects close to 10 percent of the U.S. and European populations. At a mild stage, dry eye presents as an annoying nuisance, but at a...

  4. PREFACE
    (pp. xi-xviii)
  5. CHAPTER 1 What Is Dry Eye Syndrome, and Who Gets It?
    (pp. 1-15)

    Sandy, aged 48, says her eyes are so red, dry, and irritated that it has become difficult for her to drive, even if she is wearing dark sunglasses. She’s been meaning to see her eye doctor, but has put it off. In the meantime she has been relying heavily on over-the-counter eyedrops bought at her local pharmacy. They don’t help. In fact her eyes hurt when she puts the drops in, but the bottle said the contents were for dry and irritated eyes, and her eyes certainly fit that description. Maybe after a while, Sandy hopes, pain relief will kick...

  6. CHAPTER 2 An Overview of the Eye
    (pp. 16-30)

    In order to better understand how dry eye develops and to comprehend what may be necessary in order to solve the problem, you need a basic course in eye anatomy. You probably learned all of this in high school biology class, but it’s worth a quick review before moving on to the issues related to dry eye problems.

    The human eye is frequently compared to a camera—so often, in fact, that the association is almost a cliché. However, like most clichés, the comparison is based in fact. Actually, it wouldn’t surprise me if the inventor of the first camera...

  7. CHAPTER 3 The Dry Eye
    (pp. 31-43)

    Tears perform a number of functions. Working together with the eyelids, tears protect, cleanse, and nourish the eye. In one way like miniature wipers, the eyelids distribute tears over the eyes, clearing off and flushing away dust, dirt, everyday debris, and—most important—bacteria and other potential disease causing agents. In addition, they transport proteins, vitamins, and other important nutrients onto the eyes, where they are absorbed into the cornea. Tears also lubricate the eyeballs and prevent dehydration of conjunctival mucus membranes and other tissues associated with the eyes. Finally, when all is working well, tears create a smooth optical...

  8. CHAPTER 4 The Causes
    (pp. 44-71)

    Dry eye is a syndrome. By definition, a syndrome is an abnormality characterized by a group of signs and symptoms that often occur simultaneously. We’ve seen that dry eye manifests as mild to extreme dryness of the cornea (the clear “window” at the front of the eye) and the conjunctiva (the mucus membrane that covers the eyeball, excluding the cornea, as well as the lining of the eyelid). This dryness is due to inadequate tear production, increased tear evaporation, or both. The symptoms may include a constant sense of itchiness, scratchiness, or grittiness; the feeling of a foreign object in...

  9. CHAPTER 5 Aging and Gender
    (pp. 72-82)

    Viewed from a certain perspective, it might be said that aging is the most common cause of dry eye syndrome. However, it is not just the reality of growing older that brings on dry eye symptoms. It is also the fact that many diseases (such as rheumatoid arthritis), disorders (blepharitis), and other health problems (especially hormone changes related to menopause) usually associated with aging are closely related to dry eye.

    Among the diseases, primary acquired lacrimal gland disease (also known as non-Sjögren’s aqueous tear deficiency) is the most common cause of dry eye syndrome. Primary acquired lacrimal gland disease involves...

  10. CHAPTER 6 Allergies, Toxicities, and Other Sensitivities
    (pp. 83-98)

    Ocular allergies are commonly encountered by allergists and eye doctors. Statistics vary, but it is fair to say that 50 percent of Americans have some type of allergy, and about 20 percent of Americans (more than 50 million people!) suffer from some sort of allergy that affects the eyes. Since more than 9 million Americans suffer from moderate to severe dry eye (with figures going as high as 20 to 30 million for mild cases), it seems reasonable to surmise that the two often coexist. And, unfortunately, they do. Indeed, some people think ocular allergies and dry eye are the...

  11. CHAPTER 7 Contact Lenses
    (pp. 99-110)

    Problems with contact lens wear are a hallmark of dry eye syndrome and, not surprisingly, dry eye is one of the most common complaints of contact lens wearers. It would be safe to say that the majority of patients who come into my office wearing contact lenses and experiencing chronic pain and irritation are likely to be diagnosed with dry eye syndrome.

    Contact lens wear and dry eyes create an interesting relationship in that the wearing of the contact lens—a foreign body—requires a greater volume of tears for the lenses to work properly. Ironically, however, the long-term presence...

  12. CHAPTER 8 LASIK and Other Refractive Surgeries
    (pp. 111-123)

    Refractive surgery is used to correct refractive eye problems: nearsightedness, farsightedness, and astigmatism. Many types of refractive surgery have been developed over the past twenty or thirty years, but today the procedures most frequently performed are LASIK (laser in situ keratomileusis), PRK (photorefractive keratectomy), LASEK (laser subepithelial keratomileusis), and epi-LASIK (epithelial laser in situ keratomileusis).

    All of these procedures use laser surgery to reshape the cornea, the goal being to focus light directly onto the retina. Ideally, vision is thereby improved to the point where spectacles or contact lenses are no longer needed. In theory, refractive surgery corrects vision to...

  13. CHAPTER 9 The Diagnosis
    (pp. 124-141)

    Dry eye syndrome is an extremely complex malady. However, if you are a dry eye sufferer, most likely the one fact that is totally clear to you is your pain! And no doubt that extreme eye pain is what has driven you to see your doctor—and to read this book.

    For doctors, the difficulty in diagnosing and treating dry eye syndrome is its very complexity. The cause of your pain—and the appropriate treatment for your pain—can be hard to pinpoint. Therefore, it is an enormous help to your doctor if you are as knowledgeable as you can...

  14. CHAPTER 10 Treatment
    (pp. 142-171)

    As we’ve seen repeatedly, dry eye syndrome is extremely complicated and can be caused by any number of variables from prolonged contact lens wear to a severe case of Sjögren’s syndrome. For doctors, it may be difficult to diagnose properly, and it may be difficult to treat.

    In April 2004 an international panel of doctors and researchers presented its recommendations for the treatment of dry eye disease, using the Delphi Consensus Approach. (The name refers to a concept that goes back to the ancient Greek oracle of Delphi, who offered wisdom and advice from the “elders” or “sages.” Today the...

  15. CHAPTER 11 Remedies for Home and Work
    (pp. 172-194)

    Dry eye often requires therapeutic measures that are almost as serious as the syndrome itself. Yet dry eye can also be controlled in a number of ways that are surprisingly simple and straightforward—maybe even fun. Easy-to-manage changes in your environment and your lifestyle can all lessen the pain and irritation of dry eye syndrome. Try a few of these; if necessary, try them all!

    The first element of your lifestyle that must be considered is the climate. Do you live in a moderate climate with changing seasons? If so, you need to think about how best to use fans...

  16. CHAPTER 12 Twenty Frequently Asked Questions
    (pp. 195-200)

    I am constantly asked questions about dry eye syndrome, not only by my patients but by friends, acquaintances, and even medical colleagues. I can think of no better way to end this book than to answer the twenty most common questions I am asked about dry eye. Here they are.

    1What is dry eye syndrome?

    Dry eye syndrome, or keratoconjunctivitis sicca, is a condition where the cornea and conjunctiva of the eye are excessively dry because of abnormal tears, leading to damage to the eye’s surface. There are two types: aqueous tear deficient dry eye, caused by problems with...

  17. GLOSSARY
    (pp. 201-218)
  18. RESOURCES
    (pp. 219-240)
  19. INDEX
    (pp. 241-250)