Levels of dry eye

Who is affected by dry eye?

Dry eye is a chronic disease that affects hundreds of millions of people worldwide. Left untreated, it can damage the cornea and the conjunctiva and considerably reduce quality of life for those who suffer from it. This is why early detection is so important, as is the right treatment for each case.

Although anyone can have dry eye, certain risk factors can increase your chances of suffering from this disease.

Category

Risk factor

Personal

Gender (it affects women more than men).

Age.

Asian ethnicity.

Contact lens use.

Diet low in Omega-3 fatty acids.

Conditions

Dry or windy environments.

Air conditioning.

Reading for long periods.

Driving for long periods.

Exposure to tobacco smoke.

Prolonged exposure to screens (computers, tablets, mobile phones).

Chronic diseases

Diabetes type II

Glaucoma

Hepatitis C

Parkinson’s disease

Allergies (perennial and seasonal)

Rosacea

Thyroid disorders

Autoimmune diseases

Rheumatoid arthritis

Diabetes type I

Psoriasis

Lupus

Sarcoidosis

Sjögren syndrome

Medication

Anticholinergics

Antipsychotics

Antivirals

Beta-blockers

Diuretics

Oestrogens

Glaucoma medications

Oral contraceptives

Opioids

Surgical procedures

Lasik procedures

Eye surgery

Dry eye in its mildest form is increasingly common, caused by adverse environmental circumstances or by excessive reading on digital screens. This form affects people of all ages, including children, who sometimes show symptoms of the disease but not the signs associated with it.

Medical history: the first filter for detecting cases of dry eye

One of the simplest tools that a visual health professional can use to determine if a person has dry eye is to talk about the symptoms. To convert this conversation into data, the OSDI test can be used. This is a questionnaire to be filled in by the person affected, which gives an initial idea of the severity of the case.

The professional should then perform other tests to assess any signs of the disease and determine its type and level.

There are different types and levels of dry eye, requiring different treatments

Two types of dry eye can be distinguished: one that affects the quantity or quality of the tear film’s aqueous layer (aqueous tear deficiency - ATD), and one that is related to alterations in the tear’s lipid layer (evaporative dry eye - EDE). As the disease progresses, the two types combine.

Dry eye disease can be classified as mild-to-medium, moderate or severe, depending on the intensity and persistence of the symptoms and signs that appear during clinical examination.

Although treatment should be personalised for each patient, there are certain basic recommendations for each stage. Initial options focus on changing certain habits (reducing reading time and taking breaks during reading, for example), improving environmental conditions (use of humidifiers, etc.), modifying the diet (inclusion of Omega 3-rich foods), eliminating certain treatments that may lead to dry eye, and adopting certain hygiene practices that may mitigate symptoms.

In addition to these recommendations, there are products that can relieve symptoms during the early stages of the disease, such as lubricating drops and gels. In fact, the use of artificial tears, whatever their type, is recommended for all levels of dry eye.

In the second stage, other treatments may be introduced, such as the use of special glasses with a moisture chamber, or pulsed light or thermal pulsation therapy to treat the meibomian glands. Also recommended at this stage are topical antibiotics.

In the third stage, autologous serum may be added plus therapy with scleral contact lenses. If these do not work, the fourth group of measures includes treatment options such as the application of long-acting topical corticosteroids and surgical occlusion.

Acuaiss: drops for mild cases, and gel for more severe cases

Acuaiss Gotas are artificial tears with two humectants, hyaluronic acid and hydroxyethylcellulose. The molecules bind together to form a protective mesh, called a dual polymer, which gives double comfort.

Acuaiss Gotas comes as drops, in a bottle or in a single-dose format (without preservatives), and Acuaiss Dual Gel comes as a gel, also in a bottle or in single-dose format (without preservatives).

Acuaiss Gotas to relieve mild dry eye

Acuaiss Gotas is an artificial tear containing two humectants: 0.13% hyaluronic acid, and 0.10% hydroxyethylcellulose.

It provides immediate freshness and relief in cases of irritation caused by mild dry eye.

It is indicated for:

● Dry eye caused by extensive use of digital devices (computers and mobile phones).

● Dry eye caused by adverse environmental circumstances (heating, air conditioning, pollution, etc.).

● Eye irritation caused by allergies or from exposure to swimming-pool chlorine.

● Users of soft and rigid contact lenses who want greater comfort when wearing their lenses and for handling their lenses more easily.

● People who have undergone surgery (in this case, the preservative-free, single-dose format is recommended.

Acuaiss Dual Gel to relieve moderate-to-severe dry eye

Acuaiss Dual Gel is a new artificial tear in gel form with a liquid base and a viscous texture. It contains two humectants: high-concentration hyaluronic acid (0.30%), and hydroxyethylcellulose (0.10%).

It provides intense, lasting hydration without blurred vision, in spite of the high concentration of its ingredients.

It relieves the acute symptoms of moderate-to-severe dry eye: intense, persistent irritation, itchy or stinging eyes, watery eyes (epiphora), sensation of foreign body or sand in the eye, blurred vision and photophobia.

It is indicated for:

● Acute symptoms of dry eye and persistent irritation, such as itchy eyes, sensation of a foreign body in the eye, irritation and feeling of tired and watery eyes, which require extra hydration during the day and a humectant gel at night.

● Lagophthalmos (people who do not close their eyes completely when asleep)

● Contact lens users who, after many years of use, still feel discomfort when wearing lenses. The gel can also be used to facilitate lens insertion and extraction.

● Ortho-K lens users. In this case, the single-dose format is recommended for the gel consistency, the 0.30% hyaluronic acid content and the absence of preservatives.

● Post-operative ophthalmic treatments which require intense, lasting hydration (preservative-free single-dose format).

● Cases in which dry eye is a side-effect of a medical treatment or is related to hormonal imbalance, such as during the menopause.

Sources

● Craig JP, Nelson JD, Azar DT, Belmonte C, Bron AJ, Chauhan SK, de Paiva CS, Gomes JAP, Hammitt KM, Jones L, Nichols JJ, Nichols KK, Novack GD, Stapleton FJ, Willcox MDP, Wolffsohn JS, Sullivan DA. TFOS DEWS II Report Executive Summary. Ocul Surf. 2017 Oct;15(4):802-812. doi: 10.1016/j.jtos.2017.08.003. Epub 2017 Aug 8. PMID: 28797892.


● Craig JP, Nichols KK, Akpek EK, Caffery B, Dua HS, Joo CK, Liu Z, Nelson JD, Nichols JJ, Tsubota K, Stapleton F. TFOS DEWS II Definition and Classification Report. Ocul Surf. 2017 Jul;15(3):276-283. doi: 10.1016/j.jtos.2017.05.008. Epub 2017 Jul 20. PMID: 28736335.


● Jones L, Downie LE, Korb D, Benitez-Del-Castillo JM, Dana R, Deng SX, Dong PN, Geerling G, Hida RY, Liu Y, Seo KY, Tauber J, Wakamatsu TH, Xu J, Wolffsohn JS, Craig JP. TFOS DEWS II Management and Therapy Report. Ocul Surf. 2017 Jul;15(3):575-628. doi: 10.1016/j.jtos.2017.05.006. Epub 2017 Jul 20. PMID: 28736343.


● Li N, Deng X, Gao Y, Zhang S, He M, Zhao D. Establishment of the mild, moderate and severe dry eye models using three methods in rabbits. BMC Ophthalmol. 2013 Oct 5;13:50. doi: 10.1186/1471-2415-13-50. PMID: 24093832; PMCID: PMC3852057.


● Rouen PA, White ML. Dry Eye Disease: Prevalence, Assessment, and Management. Home Healthc Now. 2018 Mar/Apr;36(2):74-83. doi: 10.1097/NHH.0000000000000652. PMID: 29498987.


● Staff. (2021, Dic 22): Screen Exposure in Kids Could Cause OSD Symptoms Without Signs, Review of Optometry.