Eye problems, such as diabetic retinopathy and macular edema, are well-known complications of diabetes. Fortunately, these conditions can be treated and even prevented if caught early (which is why getting an annual dilated eye exam is so important for people who have diabetes).
What is dry eye?
Another eye problem that’s more common in people who have diabetes is dry eye. According to the National Eye Institute, dry eye is a condition in which the eye does not produce tears properly. It can also involve tears not having the right consistency or evaporating too quickly. Tears are necessary to help maintain moisture on the surface of the eye and for clear vision. In many cases the surface of the eye becomes inflamed; if not treated, pain, ulcers, scars, and possibly loss of some vision can occur. Between 10% and 30% of the population suffer from dry eye. One study showed that people who have diabetes have a 50% chance of getting dry eye.
What causes dry eye?
There are a lot of causes of dry eye, including:
Age: The older we get, the drier the eyes can get. Most people over the age of 65 have some degree of dry eye.
Gender: Women are more likely to have dry eye than men, thanks to hormonal changes.
Medications: Blood pressure medications, birth control pills, antihistamines, decongestants, and antidepressants can reduce tear production.
Medical conditions: Having diabetes, rheumatoid arthritis, lupus, and thyroid problems, along with certain eye problems, raise the risk of dry eye. Research shows that dry eye in people with diabetes is typically linked with a type of neuropathy called autonomic neuropathy; this neuropathy can affect the nerves that control tear production.
Environment: Dry, windy, or smoky climates increase dry eye risk. Staring at a computer screen all day also increases the likelihood.
Refractive surgery: Procedures such as LASIK, LASEK, and PRK can decrease tear production and lead to dry eye.
Contact lens–wearers are also more likely to have dry eye, although contact lenses don’t cause the condition.
How do you know if you have dry eye?
Any of the following symptoms could signal dry eye:
• Stinging or burning sensation in the eye
• Feeling like you have something gritty in your eye
• Stringy mucus in or around your eyes
• Pain in the eyes
• Eye redness
• Eye fatigue
• Blurry vision
• Heavy eyelids
• Excess tears following periods of very dry eyes
• Inability to wear contact lenses
Of course, these symptoms can be linked with other eye conditions, too. That’s why it’s important to see an eye care specialist if you have any of these. He or she can rule out other possible causes of dry eye, as well.
How is dry eye treated?
Dry eye can be treated in a number of ways, although it can’t be cured. You may need to try one or more of these. It’s important to realize that dry eye can be an ongoing condition. Here are the treatment options:
• Cyclosporine (brand name Restasis) is a prescription drug that can help with dry eye; it may take up to three to six months for it to fully work, however.
• Eye drops and ointments: Artificial tears (eye drops) are available over the counter that can help the condition. Choose preservative-free eye drops to prevent further irritation. Restasis is the only prescription eye drop that can help increase tear production. You need to continue to use eye drops even when your eyes feel fine. You might use an ointment at night if your eyes dry out when you sleep.
• Punctal plugs: Your eye doctor may recommend plugging the drainage holes at the inner corners of your eyelids with punctal plugs. These are made of materials such as silicone or collagen and may be temporary or permanent.
• Punctal cautery: This is a surgical procedure that permanently closes the drainage holes.
• LipiFlow: LipiFow is a technology that applies heat and pressure on the eyelids to unclog blocked glands.
• Applying warm compresses on the eyes
• Cleaning the eyelids to remove debris and oil and to help the glands in your eyelids function properly.
• Massaging the eyelids
• Blinking regularly when at the computer and when reading
• Wearing sunglasses when outdoors
• Increasing the humidity at home and at work
• Keeping your blood sugars in your target range as often as possible
• Omega-3 fatty acids: Studies show that increasing your intake of omega-3 fatty acids can help with dry eye management. The best sources of omega-3s are fatty fish (salmon, tuna, mackerel, herring). Or speak with your doctor or dietitian about taking an omega-3 fatty acid supplement in the form of fish oil or flaxseed oil.
• Fluids: To prevent dehydration, drink plenty (roughly 8–10 glasses each day) of non-caloric fluids during the day, such as water, seltzer water, or unsweetened ice tea.
• Eat a nutritious diet: While more research is needed, there may be some basis for increasing your intake of potassium, vitamin A, zinc, and B vitamins to help with eye health. Do this by eating a variety of fruits, vegetables, whole grains, nuts, and seeds.
Dry eye is an uncomfortable, chronic condition that can affect the quality of your life if it’s not treated. However, there are treatments available. Be patient and work with your eye care specialist to find the approach that works best for you.
Although complications might some day be a part of Amy Mercer’s plotline with Type 1 diabetes, they will not be the conclusion. Bookmark DiabetesSelfManagement.com and tune in tomorrow to read more.
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Amy Campbell: Amy Campbell is the author of Staying Healthy with Diabetes: Nutrition and Meal Planning and a frequent contributor to Diabetes Self-Management and Diabetes & You. She has co-authored several books, including the The Joslin Guide to Diabetes and the American Diabetes Association’s 16 Myths of a “Diabetic Diet,” for which she received a Will Solimene Award of Excellence in Medical Communication and a National Health Information Award in 2000. Amy also developed menus for Fit Not Fat at Forty Plus and co-authored Eat Carbs, Lose Weight with fitness expert Denise Austin. Amy earned a bachelor’s degree in nutrition from Simmons College and a master’s degree in nutrition education from Boston University. In addition to being a Registered Dietitian, she is a Certified Diabetes Educator and a member of the American Dietetic Association, the American Diabetes Association, and the American Association of Diabetes Educators. Amy was formerly a Diabetes and Nutrition Educator at Joslin Diabetes Center, where she was responsible for the development, implementation, and evaluation of disease management programs, including clinical guideline and educational material development, and the development, testing, and implementation of disease management applications. She is currently the Director of Clinical Education Content Development and Training at Good Measures. Amy has developed and conducted training sessions for various disease and case management programs and is a frequent presenter at disease management events.
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