Dry eye and the desert

Season and changing weather is here. This means more outdoor activities, golfing an tennis. Here are a few tips to keep your ocular surface healthy, functioning and decrease potential problems.

1) Lid Hygiene - your eyelids contain the meibomion oil glands. They secrete the middle oil layer of the tear film (there are 3 layers). Anything affecting them can cause secondary dry eye. Some of the common conditions causing their dysfunction are ocular rosacea, blepharitis and makeup inspissation, atopic and contact dermatitis and Demodex (dust mites). It is crucial to maintain lid hygiene, to keep these glands working properly. Otherwise, they can become blocked and not function properly. Some may get blocked and then when body temperature heats up, may spontaneously secrete/dump their contents into the tear film- effectively causing a slurry (or what can look like an oil slick) causing vision to blur. Warm compresses 3-4 times a week for 5 minutes (Bruder lid compress, eye packs or rice compresses) can help to liquefy the secretions and allow the gland to work properly. This should be followed with proper lid hygiene/washing the lids- either Avenova lid cleansing system (a unique antibacteraial product that also kills dust mites and quiets ocular rosacea, dermatitis and lid inflammation) or Systane lid wipes. Even if you don't have the time (or desire to use the compresses)- cleaning the lids 3-4 times a week with a product like Avenova can make a huge difference. These products (especially the Avenova, prescription only-available at Dr. Martin's office) help to pull debris off the lid margin that would otherwise clog the gland orifice. Some patients have rosacea, and the rosacea can cause dysfunction of these oil glands, necessitating oral and topical medication to control inflammatory and changed in lid structure that can scar the lid. For those patients that wear make-up, make sure to remove your makeup with a water based make up remover (not oil, Vaseline, baby oil or cold creams). Using regular mascara and not water-proof make up is also helpful in keeping bacteria colonization down.

2) Dry eyes - With the higher temperatures the air conditioners, fans and sand/dust contact increases. Also due to the California drought- there is more debris in the air. Pollution and fans/air conditioners can dry out the eyes. Wind with sand can contain pollen as well as iron (this can actually rust on the eye if it becomes trapped). Proper eyewear protection, sunglasses and safety eye glasses, should be part of your outdoor clothing routine. Sunglasses will cut down on exposure, tear evaporation and protect from blowing debris. It will also help to decrease UV damage that can cause pterygiums or pingueculas (tiny flesh-like growths on the white part of the eye near the cornea). Sunglasses and hats also protect against damaging UV rays that can cause Basal cell and squamous cell carcinoma. The use of artificial tears-Oasis preservative free (prescription only, available at Dr. Martin's office), Systane, Refresh or Genteal (there are many types of tears-try the products for a day or two and see which product works best for you. Do not use Visine!) will help decrease pollen/allergen exposure and lubricate the eyes. Living in the desert, they become a staple to one's daily regimen. Tears can be used 2-4 times a day. If needed more often, we suggest preservative free tears, such as Oasis (which can be used every 30 minutes) or using a thicker tear (such as a gel or lubricating ointment). In addition, avoiding medications that dry out secretions (diuretics, alcohol, antihistamines, narcotics, etc) or using tears more often when taking these medications. If you must take an antihistamine, monteleukast (Singulair) is the desired medication as this does not dry out the ocular surface. One can also supplement their diet with Flaxseed, fish , Omega 3 and GLA supplements as well as cyanocobalamin (B vitamin).

3) Pools - in general chlorine is not harmful to the eyes. Depending on concentrations, it can cause some irritation and redness, although this is usually temporary. Using artificial tears to rinse the eyes before and after swimming can help decrease contact and irritation.