As you know, dry eyes are common among Sjögren’s patients.
[editor's note: This Self-Help booklet was written in first-person by Sjögren’s syndrome patient Dona Frosio]
Living with dry eyes on a daily basis can be a struggle and that is why I wanted to share with you some things I have learned along the way.
drops and treatments
Many brands of eye drops are available, as you can see when you visit any pharmacy or grocery store. I recommend that you check with your eye care provider who can suggest a particular brand for your severity of dry eye. He might also give you samples to try so that you don’t have to waste money purchasing all different types. I warn you that it may take trying several products until you find one that works best for you.
The two basic kinds of drops are bottled drops that contain a preservative and preservative-free drops that come in single dose vials. Additionally, there are drops and gels that have a preservative that disappears when it comes in contact with your eye. Check with your eye care provider about what type is best for you but most patients are told to use preservative-free drops.
Remember that ointments and gels tend to blur your vision and are usually reserved for overnight use. Some people find great success using them before bed and others choose to use regular drops before going to sleep and again if they wake during the night.
Another product on the market is Lacriserts®, small dissolvable cellulose pellets that fit into your lower eyelids. I have found them extremely helpful as they freed me from using drops for most of the day. I encourage you to talk to your eye care provider about them since they require a prescription.
The newest prescription product for dry eyes is Restasis®, cyclosporine eyedrops. Restasis® doesn’t work immediately; it takes time to make a difference. I encourage you to stick to the treatment and work with your eye care provider, as he will monitor its success. The biggest complaint is a burning sensation after application. This usually subsides after using the product for a period of time, so I encourage you to stick it out. I also have heard that keeping Restasis® in the refrigerator can help alleviate some of the burning. This also works with making over-the-counter eye drops feel even more soothing.
Finally, punctal plugs inserted into the tear ducts will keep moisture on your eye by preventing natural and artificial tears from draining down your nose. Most people with plugs love them and, if done properly, the plugs are comfortable.
glasses, goggles, etc.
Most glasses will give some measure of protection from air currents that might irritate your eyes. Frames without separate nose pieces are better for keeping the air away from your eyes when you walk. Wrap-around sunglasses provide outdoor comfort and there are brands that fit against the face with foam such as Onion Goggles (available from stores that carry kitchen items) and Panoptx® windless eyewear, which keep out the wind and debris. Although expensive, they may be just what you need to enjoy being outdoors. Another alternative is safety glasses which I found at Home Depot for less than $10.00. Swim goggles do a good job too although wearing them might not be the fashion statement some of us really like to make.
Moisture chamber glasses are another product that might offer the dry eye sufferer great relief. The glasses are made up by an optician who orders the clear panels from suppliers like EagleVision®. The panels are attached to your regular glasses and trap moisture like goggles. Since the glasses are made individually for each person, they take time and can be costly but those who have used them have found they work well.
Another product that can help protect eyes at night and during the day while napping or resting (since you cannot see through them) is Tranquileyes™, flexible nighttime goggle-like eye shields. Tranquileyes™ have a sponge insert that you can soak in water if you want before you put them on. They were designed to keep the moisture around your eye while you sleep.
Running a humidifier or vaporizer at night can help with not only nighttime eye dryness but also with mouth and nose dryness.
Blepharitis is very common and many people with Sjögren’s experience this condition. Your eye care provider can help you treat this condition and give you some tips as well. And treat it you should.
Blepharitis is a chronic inflammation of the eyelids which causes irritation, itching, and occasionally a red eye. Glands that make tenacious secretions are located along the base of the eyelids. In some patients with dry eyes, the tenacious secretions plug the openings of the gland. This can lead to low grade chronic inflammation and bacterial infection resulting in pain and swelling of the lower eyelids.
Blepharitis is common in patients with dry eyes and may be exacerbated by use of eye drops containing preservatives or extended wear of contact lenses. Also, use of excessive amounts of ocular lubricant can plug the glands and contribute to the problem.
Again, I encourage you to follow your eye care provider’s advice. My ophthalmologist has prescribed a product to treat it and has also suggested using a little baby shampoo and a warm wash cloth on the eyes a few times a day. In addition, there are a few sterile eyelid cleansers and individually packaged eyelid scrubs on the market, so you may want to consider using them as well.
fish oil and other supplements
First and foremost, ALWAYS inform your care provider when adding any over-the-counter items to your diet. This includes vitamins!
Extensive discussion has taken place about adding fish oil and Omega 3’s to the diet. Some research has shown an improvement in the quality of tears that people produce after using these products. You can find products on the market that include these items or you can add them to your diet by buying specific additional supplements. Check near the artificial tears in the store or look for specific products in the vitamin section.