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Winter can make dry eye flare—here’s what to do

Evan Olson, MD

Dry eye is one of the most common eye problems, affecting 30 percent of people who are over 50. Below, Dr. Evan Olson, a comprehensive ophthalmologist at Vancouver Clinic, answers the most common questions about this condition. Dr. Olson is a specialist in cataract surgery and sees patients at the clinic’s Salmon Creek location.

Q: What is dry eye?                                                               

Dr. Olson: Dry eye is a disease that disrupts the healthy tear film in the eye. When the tear film is unbalanced, it often results in significant pain and blurry vision. About 7 to 10 percent of the general population have dry eye, however it’s more common in older adults. Post-menopausal females are more likely to be diagnosed with it than anyone else.

Q: What season is the hardest for people with dry eye?

Dr. Olson: Allergies often irritate eyes in the spring. While antihistamines can help, they can also dry the eyes out further. Patients tend to complain less about dry-eye symptoms in the summer than they do at any other time of year. In the fall, allergens and colder, drier air begin to worsen dry eyes.

The winter tends to be the worst for dry-eye sufferers as the outside air cools down and the humidity indoors drops to a year-long low due to indoor heating. Upper respiratory infections also peak in the winter, and many decongestants decrease tear production. With symptoms at their worst during the winter months, it’s a great time for patients to talk with their eye doctor.

Q: What are the symptoms of dry eye?

Dr. Olson: Symptoms include eye pain; intermittent blurry vision; a scratchy, stinging, or burning sensation; difficulty wearing contacts; light sensitivity; and tired or strained eyes. Although it seems counterintuitive, one of the most common complaints is watery eyes. In patients who don’t have a healthy oil later, tears evaporate rapidly. The lacrimal gland tries to compensate, resulting in an overproduction of the watery portion of the tears.

Q: How is it treated?

Dr. Olson: There are an increasing number of treatment options for dry eye. I encourage my patients to:

  • Avoid dehydration by drinking plenty of water
  • Consider purchasing a humidifier to increase indoor humidity
  • Take a fish oil or omega-3 supplement
  • Limit medications that contribute to dry eye
  • Avoid exposure to smoke and other irritants.

It’s also important to give eyes a break from prolonged reading and computer, phone, and TV use. A practical rule of thumb is to follow the 20-20-20 rule. Every 20 minutes, look at something 20 feet away for 20 seconds. Many people do not blink often enough, so blinking repeatedly for a few seconds every so often can help. Periodic warm compresses and eyelid scrubs can provide relief to some patients.

Over-the-counter artificial tears—preservative free are best—may be sufficient for mild cases. For patients who experience eye pain, blurriness, or tearing immediately upon waking, it is wise use a lubricating ointment before bed and artificial tears right after waking up.

When these measures aren’t enough, I will sometimes recommend prescription solutions. Some patients benefit from a punctal plug—a tiny, safe medical device that is inserted into the tear duct to help prevent liquid from draining from the surface of the eye. This can be easily inserted in the clinic in less than a minute.

If you suspect you have dry eye, talk to your eye doctor to get an accurate diagnosis. Your physician can then determine which treatments are right for you.