Dry Eyes

One of the certainties of life is that change is constant. There is seldom a month goes by without some innovation that improves the quality of our lives. That is particularly true in health care, whether it is a change in technique to investigate a problem or a new method of treatment. In some cases it can be the realisation something most health care practitioners thought of as trivial actually can have a major detrimental effect on our quality of life.

One example in eye-care is the realisation a tiny mite called Demodex is the culprit causing the majority of dry eye problems. Dry eyes have for many years been relegated to the list of trivial problems that we are all expected to simply live with and get on with our lives regardless of the discomfort we are suffering. In general eye care professionals, both ophthalmologists and optometrists, have ignored the substantial body of research over the last few years which have looked at quality of life measures. This is particularly true with patients with dry eyes. I can understand this as patients with very obvi- ous clinical signs of dry eye disease can have minimal symptoms and vice versa.

One of the things health professionals are guilty of is not listening to our patients. Only last month I talked about a new “Realistic Medicine” initiative where we should all take more time to talk to our patients and actually listen to what they are telling us. Often the clues are in simple throw away lines from our patients.

Frequently I deal with dry eye patients whose symptoms appear grossly disproportionate to the signs. Treatments range from masking the problem with eye drops to treating the underlying cause of the problem. The improvement in quality of life measures can be dramatic.