July 29, 2013
2 min read

BLOG: Who has dry eye?

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Read more dry eye blog posts from Darrell E. White, MD

Now that you’ve decided you want to treat dry eye, you probably are wondering what you’ve gotten yourself into.

The first thing to figure out is who has dry eye. It turns out that almost anyone can have what we know as dry eye, but there is one very common type of patient with whom you always need to be on the lookout for dry eye in all its forms.

Years ago, as it was preparing to launch Restasis (cyclosporine ophthalmic emulsion 0.05%, Allergan), Allergan did some research on dry eye patients and discovered that there is a dry eye archetype: a woman between the ages of 35 and 55 is the most likely to present to your office with new symptoms of dryness. In our practice, this certainly is true, so much so that the entire staff is always a little surprised when a woman in this age group doesn’t have dry eye.

While anyone can certainly have classic dry eye, we are always very alert when a young or mid-life woman has symptoms that we associate with dryness. A classic story is relatively new difficulty wearing contact lenses in a long-time wearer. Other common symptoms include tearing, foreign body sensation, fluctuation vision or fatigue and, of course, my all-time favorite: dryness.

Being alert to groups or categories of people who tend to have dryness can help you to avoid missing the diagnosis. A patient’s medical history will uncover collagen-vascular diseases such as lupus and rheumatoid arthritis, and of course a diagnosis of Sj ögren’s syndrome is always an alert. We are all aware that certain classes of medications such as antihistamines, birth control pills and diuretics can cause dryness. Where you live makes a big difference, too. People who would otherwise be symptom-free may very well show up at your office door if you practice in Park City, Utah, rather than Kalamazoo, Mich.

Once you have decided that your practice will actively care for the dry eye patient, everyone in the practice is now a part of the dry eye team. The process of diagnosis begins when a patient calls the office, and every person who has contact with that patient has an important role to play in making the diagnosis. Noting common but important details such as gender and age, other medical problems and medications can tip you off to who might have dry eye before the patient even sits down at the slit lamp.

Let’s talk next week about common symptoms of dry eye and how they can help to direct your evaluation. I’ll see you then.