Two ophthalmologists on Sunday advised people to get a doctor’s diagnosis before buying artificial tears, as most over-the-counter artificial tears are water-based and have limited efficacy for people with lipid-deficient dry eyes.
The prevalence of the dry eye syndrome (DES) is higher among people of Asian descent than some other groups, Tri-Service General Hospital ophthalmologist Tai Ming-cheng (戴明正) said, adding the prevalence in Taiwan is 7.85 percent
While the risk of dry eyes increases with age, women and people with immune-related diseases, such as diabetes or sicca syndrome, have a higher risk, Tai said.
Photo: Lin Chih-yi, Taipei Times
The incidence of diabetes is highest among people aged 60 to 79 in Taiwan, he said.
About one-third of patients visited ophthalmology clinics for dry eye symptoms that ranged from mild to severe, Tai said.
DES has become more prevalent, as modern life involves frequent and lengthy use of screens such as computers or mobile phones, he said.
However, people have generally become more aware of eye care and learned to see a doctor for diagnosis when they have eye problems, Tai said.
Increasing rates of DES diagnoses in Taiwan reflects intensified use of digital devices as well as heightened awareness of self-care, he added.
The issue with dry eyes is not about the lack of tears, but about the collapse of tear film homeostasis, Tai said.
The tear film consists of the lipid layer, the aqueous layer and the mucin layer, which are all indispensable, he said.
Dry eyes caused by insufficient lipid secretion and rapid tear evaporation are categorized as the lipid-deficient type, while those caused by insufficient tear secretion are aqueous-deficient, Tai said, adding that dry eyes with both secretion problems are considered the “mixed” type.
About 37.1 percent of dry eye patients are aqueous-deficient and 38.5 percent are mixed, while 18.3 percent are lipid-deficient, he said, adding that different types of dry eyes must be treated with different approaches.
Eye drops containing preservatives can irritate the corneas or cause redness and stinging for people who have to use artificial tears for extended periods of time, Tai said.
Using regular eye drops could lead to blurred vision and inconvenience for people wearing contacts or dealing with other eye conditions such as glaucoma that require multiple medications, he said.
Such issues might reduce people’s adherence to use instructions from medication, he added.
Linkou Chang Gung Memorial Hospital ophthalmologist Chen Hung-chi (陳宏吉) said most over-the-counter artificial tears are water-based and are not helpful for lipid-deficient dry eyes.
People should seek an ophthalmologist’s diagnosis of what their eye issue is before buying artificial tears or other medicines, he said.
Nasal sprays for treating dry eyes have become available, Chen said, adding that people can discuss with doctors to find out the most suitable treatment for themselves.
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