Dr Carlos Verges
In the last issue of April we talked about dry eye in women, hormonal changes after menopause as the first cause of dry eye and the importance of ophthalmological reviews to stop their advance and symptomatology. In this issue we continue with the topic of dry eye and its association with allergy problems, so frequent in the spring time.
Dry eye and ocular allergies are different entities but relate to each other.
During the spring months many patients who consult us for eye irritation are thinking of an allergic problem and may be is true in some cases but in many others it is an association between different factors affecting the ocular surface.
The presence of pollen in the atmosphere, especially on windy days, associated with pollution of cities like Barcelona, is a terrible association for the eyes and the respiratory tract. Pollution acts as an enhancer of pollen, triggering an inflammatory reaction on the mucous membranes, such as the ocular conjunctiva.
Pollution enhances pollen allergic reaction, irritating the eyes and respiratory tract.
With this state of conjunctival irritation, the associated pollution and pollen creates a status of inflammation in the eyes and cause decompensation of other disorders such as dry eye. Where there was already a certain degree of dry eye, is common in the spring time worsens, patients feel discomfort when blinking, burning sensation and even tearing, something that confuses them even more because it is not common in these patients with dry eye.
Dry eye is a disorder of the ocular surface caused by a decrease in tear production (usually of hormonal origin) or poor tear quality with excessive tear evaporation (usually by altering the meibomian glands of the eyelids). In either case breakage of the tear film that protects the ocular surface is produced, being exposed the cornea and conjunctiva to the action of air, causing it desiccation.
Dry eye occurs when the air directly contact with the ocular surface for premature rupture of the tear film, causing tissue inflammation.
The air dry the ocular surface and triggers inflammation that will be responsible for the discomfort that often experience patients with dry eye, as grittiness, burning, heaviness of eyelids and difficulties to spend much time staring, reading or in front of a computer screen .
The discomfort can be very variable, from a feeling of dryness accentuated indoors with heated or air conditioners, to situations where it is impossible to keep their eyes open and be able to live a normal life.
All these problems can be increased in the spring, to be associated with the inflammatory reaction that cause pollen particles and pollution when contact with the eye. In patients with dry eye tear film rupture occurs and the cornea and conjunctiva will be exposed to these pollution-pollen particles floating in the atmosphere, initiating the inflammatory effect that is associated with those person suffering dry eye.
The eye protection (glasses) and use of preservative-free artificial tears are the most recommended prevention.
The best way to prevent decompensation of dry eye in spring is to protect the eyes with sunglasses side shields, use helmet to let motorcycle, avoid closed or poorly ventilated areas as air conditioners powerful that are beginning to be seen in this May.
We recommend artificial tears to lubricate and cleanse the eye surface, dragging the allergenic particles deposited in the eye. Be especially careful with artificial tears, not all are equal and it is preferable the mono-dose and preservative-free.
Supplements of omega-3 associated with a balanced diet have shown high efficacy in controlling the symptoms of dry eye and ocular allergy.
Another effective measure is to increase the omega 3 in the diet, highly recommended in dry eye and irritation especially when associated to allergic sensitization. Oily fish, olive oil, among others, are rich in omega 3 and, for those who do not like this type of food, we recommend the supplements found in pharmacies and specialty stores, capsules with high concentration (1000 mg / day) and high purity.
As always, we recommend that in cases of symptomatic dry eye or prone to allergic reactions patients, come to the ophthalmologist in the spring time to start prophylactic treatment to prevent ocular surface decompensation and worsen discomfort.