Home Health News Is this underdiagnosed disease making you miserable? Phoenix eye doc says it’s possible | Arizona News

Is this underdiagnosed disease making you miserable? Phoenix eye doc says it’s possible | Arizona News

27 min read

Eye exam

PHOENIX (3TV/CBS 5) – When your eyes are crimson and watery and are so irritated and gritty that you wish to claw them out of your face, you most likely blame allergic reactions, proper? I do know I do. But our eye issues may stem from one thing altogether completely different. Something that has nothing to do with the pollen depend. Something your common eye drops will not repair and may even make worse. I’m speaking about dry eye disease. I do know what you’re considering. “Dry eyes. Big deal.” It is an enormous deal. A really huge deal. It’s such an enormous deal that one Arizona optometrist has devoted his observe to it. “That’s literally all I do,” mentioned Dr. Arthur Epstein of the Dry Eye Center of Arizona. We’ll get again to him in a minute. 

“Mildly annoying to completely disabling and life-altering”

Dry eye disease is a progressive situation that may change into terribly painful and wreak havoc in your life. Vicki Robinson is aware of this first-hand. She mentioned it acquired so dangerous that her coworkers had been involved that she may need pink eye, which is contagious. She mentioned the whites of her eyes had been noticeably crimson, and she or he was utilizing eye drops a number of instances a day to attempt to get some reduction. “I was convinced I must have had a bacterial infection,” she recalled. 

Vicki Robinson

Vicki Robinson lived with dry eye disease for greater than yr earlier than getting a correct prognosis and remedy.

That in thoughts, she threw away all of her eye make-up – all the things – and changed it. Eye make-up is usually a breeding floor for micro organism. About the identical time, her eye physician put her on steroid drops. “And that was like the worst thing I could have done,” she mentioned. “So, things just kept getting worse.”

Robinson mentioned she heard individuals in her workplace thought she had been crying. Quite a bit. In an actual property workplace filled with males, the notion of an emotional lady could be dangerous for enterprise. “You do not want to be a female that people are thinking, ‘Oh, she’s having a bad day tough [or] negotiation, so she’s in her office crying. … That’s not the image I wish to project.”

It could be a few yr earlier than Robinson discovered her option to Epstein and the Dry Eye Center of Arizona. A yr of colleagues and mates considering she had a contagious disease, was crying on a regular basis, or worse, had developed a ingesting drawback. A yr of crimson, gritty, irritated eyes and blurry imaginative and prescient. A yr by which she grew more and more uncomfortable as her undiagnosed disease progressed and pissed off along with her physician’s obvious incapability to assist.

Pervasive, advanced, and troublesome to diagnose

According to Epstein, dry eye disease impacts between 15 million and 30 million individuals in U.S., and he believes that quantity is “grossly underestimated.” What’s extra, it’s gotten worse lately, partially due to advances in know-how. Epstein believes it started with the invention of the printing press and has progressed with the arrival and eventual ubiquity of computer systems after which cell units.

Looking at smartphone

Once upon a time, after we had been hunters and gatherers, we regarded into the space, anticipating each prey and predators, blinking within the relentless daylight. Today, our focus is usually mere inches in entrance of our faces, trying into mild that’s something however pure for hours at a time in any respect hours of the day and night time. You already know that harsh blue mild from electronics just isn’t our pal.

Because man’s ingenuity modified the best way we stay, it additionally modified how our our bodies function – in this the case of dry eye disease, we’re speaking about blinking. “The blink drives a lot of these incredibly complex systems that maintain normal [eye] function and normal ocular surface health,” Epstein explains. So, principally, as we acquired extra technologically superior, our eyes did not. They weren’t made to deal that with the best way we operate at the moment. The approach we use our eyes means we’re blinking much less, and that’s an issue. “An inhibited blink … really [has] have impacted the way the eyes function and have resulted in dry eye disease because the [eye] system is, you know, is unable to function properly in the existing environment.”

When dry eye disease, which principally didn’t exist two generations in the past, first confirmed up, it affected largely postmenopausal women. Epstein says the typical age of his sufferers has dropped from the mid-to-high 60s to the mid-to-high 40s, and he is seeing extra males.

Not so simple as it sounds

The identify dry eye disease is deceptively easy. It sounds prefer it must be simple to repair. It’s not.

When your eyes are dry and irritated, crimson and gritty, or it seems like you have one thing in your eye like a grain of sand or an eyelash, your first intuition might be to seek out some synthetic tears or soothing eye drops. If your dry eyes are as a consequence of allergic reactions, these can do the trick. But with dry eye disease, any reduction you get is fleeting at finest. At worst, these drops can exacerbate the issue.

“It’s not as simple as going to the local pharmacy or supermarket and buying some artificial tears,” Epstein mentioned. “It’s actually a crippling, disabling, all-consuming disorder that literally takes over and turns lives upside down. It goes from a minor annoyance to a significant issue to a complete disaster for some patients.”

There’s no treatment for dry eye disease, however there are remedies that may make a world a distinction. But let’s again up a minute and canopy the fundamentals of dry eye disease.

Brief biology lesson (It’s painless. I promise.)

Dr. Arthur Epstein

Dr. Arthur Epstein of the Dry Eye Center of Arizona

To say Epstein is obsessed with his job is an understatement. There is a purpose he’s No. 1 on Newseek’s 2021 list of America’s Best Eye Doctors. (His associate, Dr. Shannon Steinhauser, is within the prime 10.) Passionate may be a greater description of Epstein, and his ardour is contagious. Eye biology may sound like a dry matter, however he makes it fascinating and simple to know. An hourlong dialog with him felt extra like 10 minutes.

One of an important issues to know is that your eyes make two sorts of tears. At least, they’re purported to. Most of us are conversant in the watery tears that come from our lacrimal glands, also referred to as tear ducts. Those tears cleanse and defend your eyes. “[Watery tears are] essentially a built-in emergency eyewash station, which is brilliant,” Epstein defined. You get one thing in your eyes, and the tears wash it away.

Now you may suppose dry eye disease is the results of an issue with these glands. That appears logical, however it’s not fairly proper. With dry eye disease, the difficulty is often with the meibomian glands, which run by the higher and decrease lids of your eyes. These glands produce an oily secretion to lubricate your eyes and stop the tears out of your lacrimal glands from evaporating. This oily movie covers your eye, not solely focusing mild exactly, which is how you see, but in addition defending delicate eye tissue from the tough atmosphere.

When your meibomian glands are usually not working correctly, the result’s dry eye disease. “Dry eye isn’t a disease of a lack of tears, it’s actually a disease of the lack of function of the tears,” Epstein mentioned.

“This was so interesting to me,” Robinson mentioned. “We always think there’s just these tear ducts and that’s what produces the tears. You know, the waterfall tears that we get when we cry. But there’s also tear ducts in the glands of your eyes and mine were completely blocked.”

Symptoms could be chalked as much as different circumstances

Many of the indicators of dry eye disease can simply be attributed to different circumstances. That’s one purpose it’s so troublesome to diagnose and is usually missed. The signs are numerous, however fall into three important classes, based on Epstein.

Most frequent signs

  • Grittiness
  • Dryness
  • Irritation
  • Sense of heaviness
  • General discomfort

“Each blink can be painful,” Epstein mentioned. “It could be quite, quite uncomfortable.”

Another symptom is blurry imaginative and prescient that no prescription reliably fixes. The situation there includes these oily tears which might be supposed assist your eyes focus. When these tears are usually not present, your eyes don’t focus correctly and your visions goes wonky.

The third important symptom is the one which’s most seen to others – redness. It’s aesthetic, however continuously crimson eyes can lead individuals to incorrect conclusions about you, as Robinson discovered the onerous approach.

Epstein mentioned signs of dry eye disease are typically like most issues within the body – “bilateral, but asymmetrical.” Both eyes are affected to completely different levels.

If left untreated, dry eye disease can result in abrasions in your eye, which is a a lot larger drawback.

Let’s speak remedy

We’ve already talked about synthetic tears and why they received’t repair dry eye disease. Many sufferers, earlier than they went to Epstein, had been instructed that irritation was in charge for his or her signs. They had been prescribed anti-inflammatories that did nothing for them as a result of irritation was not the difficulty. Antibiotics don’t work both as a result of there isn’t a an infection.

There are quite a lot of remedies Epstein makes use of to assist ease the signs of his sufferers, however probably the most promising is light-based remedy. “That has been just an astounding breakthrough; it’s literally transformed our practice,” Epstein mentioned. “We can recover damage, in many cases, in gland tissue and in gland function.” The mild remedy helps regenerate tissues. The know-how is similar that’s been utilized in beauty pores and skin remedies to minimize the visibility of wrinkles and age spots. “From the eye point of view, it’s transformative,” Epstein mentioned. “It literally can turn the glands back on and stabilize the tears in ways that we couldn’t even dream of before.”

The vitality ranges of the remedy for the eyes are a lot decrease than what’s utilized in beauty procedures. Epstein says it’s painless. Robinson vouched for the that. But it’s not a one and performed remedy. The commonest course of remedy with the Lumenis OptiLight, which is authorized by the Food and Drug Administration for treating dry eye disease, is 4 periods about three weeks aside. “Patients like it,” Epstein mentioned. “They come out feeling better rather quickly.”

Robinson did. “After the second session, I [had] marked, noticeable improvement.” She mentioned she’s “100% improved” after the OptiLight remedies.


An OptiLight remedy session is a comparatively fast in-office process.

The remedy is an easy in-office process. “It might be a little bit uncomfortable, but you can bear anything for just a few minutes,” Robinson defined. “You can just feel it’s more like a warm sensation. You see a flash even though your eyes are closed and covered. You get that sense of a flash of light off in the distance, and then you feel the heat.” It comes all the way down to how delicate your pores and skin is, however for most individuals, there’s little — if any — restoration time and no lingering ache or tenderness. “There was absolutely no downtime, no discomfort, no swelling, no nothing,” Robinson mentioned. She did her periods within the morning after which went to work within the afternoon.

Epstein says a few of his sufferers have reported “collateral aesthetic benefits” like fewer wrinkles round their eyes. Robinson mentioned her eyelashes have change into thicker. She mentioned they had been sparse and never rising effectively earlier than her remedies.

The “catch” with the OptiLight, for lack of a greater phrase, is that it’s not coated by insurance coverage. “It was absolutely worth the cost,” Robinson mentioned. “I would recommend it.”

Taking time with every affected person

Every affected person is exclusive. There’s no one-size-fits-all strategy to coping with dry eye disease. That’s one thing Epstein retains in thoughts when any individual entrusts their eyes to him. And it’s one thing Robinson appreciated. “He would make you think that you’re the only patient he’s going to see that day,” she mentioned. “He takes so much time. And this is one of the things that I think is key and made a difference in my outcome.”

Man with eye pain

Epstein says the typical age of his sufferers has dropped from the mid-to-high 60s to the mid-to-high 40s, and he is seeing extra males.

Robinson mentioned Epstein asked her questions on her signs and what she had been doing to deal with them, and he listened to her solutions. “The fact that he paid attention to all this and took the care and the time to explain why he was recommending things in the sequence that he was recommending and why he was recommending them for my particular case, made all the difference,” she defined. “It’s his mannerisms and his approach made a difference. He educates you.”

Epstein’s aim is to not promote you on OptiLight. If there are different choices, he would be the first to share them. His solely aim is an effective final result of each affected person, together with understanding their situation.

“He’s so enthusiastic and passionate about what he does,” Robinson mentioned. “It comes shining through. And he is a wealth of knowledge; he is so much fun to talk to.”

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