Should I see an optometrist or ophthalmologist for dry eye syndrome? for dry eye

November 5, 2010 7:59 PM

I think I have Dry Eye Syndrome. Should I see an optometrist or ophthalmologist? Does it even matter? If you have personal recommendations about combatting dry eyes (medical, dietary, etc), I'm also interested in hearing about them.
posted by invisible ink to Health & Fitness (20 answers total)

Response by poster: Forgot to add: I'm a longtime wearer of glasses. I tried contacts several years ago, but they were too uncomfortable due to the dryness and my astigmatism. It was only until very recently that the dryness has become quite uncomfortable (I feel like there's an eyelash in my eye, when obviously there's nothing).
posted by invisible ink at 8:08 PM on November 5, 2010

My eye doctor had me start using eye drops 2-3 times a day - end of problem. My eyes were gritty, sore, felt nasty/allergy-ish. The joys of middle age. I've worn glasses for more than 40 years but think middle age had more to do with it. Heated dry house and pollen made it worse. Worth checking with your regular eyecare person most likely but for me eye drops fixed it. Non-prescription, lubricating ones - I use Systane but don't know if there's anything particularly special - that's what I was given a sample of and it's worked so I kept using it.
posted by leslies at 8:29 PM on November 5, 2010

Best answer: It might vary depending on your location but my optometrist has been excellent in dealing with my (reasonably mild) dry eye syndrome, including prescribing me contacts for astigmatism. Lenses have changed a lot in the past few years and not all optometrists keep up to date in my experience. A big step in fixing my problems was changing my contect lens solution (and using the corresponding rewetting stuff when I wear glasses, so it's probably relevant even without contacts), and again that was due to her being up to date with the latest improvements in this area. I used to get symptoms even when wearing glasses a lot, and now I never do even with contacts in every day.

So I don't think you need an opthamologist to start with at least, but you do need to find a good optometrist. Mine has done some post-grad study along with the usual training and advertises as having an expertise in this area, but word of mouth recommendations can also be effective in finding someone new. Worst comes to worst, just ring up and couple and ask questions. If they care about technological advances in this area they should be keen to talk to you about it. They should also be pretty forward about recommending an opthamologist if that actually is appropriate. Or you could go the other way, ring an opthamologist and ask if you should see them or who they would recommend if not.

If you're intested in trying contacts again don't let your last experience put you off. Things really have changed.
posted by shelleycat at 8:35 PM on November 5, 2010 [1 favorite]

Oh, and by 'rewetting stuff' I'm referring to using eyedrops 2-3 times per day as leslies describes. For me changing to a better brand was necessary to making it work, but it shouldn't be a difficult process.
posted by shelleycat at 8:37 PM on November 5, 2010

Punctal plugs worked for my post-Lasik dry eyes.
posted by TorontoSandy at 8:39 PM on November 5, 2010

Here is WikiPedia's take on this. Look at the references related to fish oil and Omega 3's. There seems to be clinical research that indicates it sometimes helps. Reference 18 seems to indicate it helps in women.
posted by SantosLHalper at 9:04 PM on November 5, 2010

Best answer: Just went to the doctor for this today. Mine are worst in the morning, so I was recommended an OTC product that's like an ointment (vaseline-y) that you put in your eyes/on your eyelids to keep your eyes from drying out while you sleep. Apparently, some people's eyes don't actually close completely while they sleep and things like ceiling fans, heater, and A/C can dry out the surface of the eyes overnight. This may not be the cause of your dry eye, but the ointment is OTC and maybe worth a try?
posted by elpea at 9:27 PM on November 5, 2010

Best answer: I have a recurrent corneal erosion. Basically, pieces of my cornea can come off. If you have ever scratched your cornea, that is what it feels like. Due to this, and the fact that there really isn't any treatment for it, I have had to become something of an expert on avoiding dry eyes, but I am not a doctor.

First, the feeling you are getting of an eyelash could be an inflamed blood vessel. Like any other inflammation, Tylenol can help with that.

Second, rewetting drops work well during the day. Refresh Tears lubricating drops worked well for me. There is also a thicker gel that takes a bit to get used to, but can be much more effective.

Third, if you have problems while you sleep and wake up with irritation, try Muro 128 ointment. Apply it before you close your eyes to go to bed just like you would an antibiotic ointment. It helped me so much.
posted by slavlin at 9:36 PM on November 5, 2010

I have seasonal allergies, astigmatism, and dry eyes. What shelleycat said rings true for me. I didn't know I had additional options in terms of contact lenses until I switched ophthalmologists. My current eye doctor told me there had been significant advancements in soft contacts for astigmatism over the last several years, and if my current brand wasn't working out, I had more alternatives than I used to.

He recommended the combination of a specific brand of contact lenses (the most comfortable I've ever had, Acuvue Oasys) and gave me a prescription for Tears Again. The primary ingredient in Tears Again is flaxseed oil (with primrose oil, safflower oil, and a mess of other things). My new eye doctor told me that he just takes flaxseed oil twice daily and his dry eyes just went away after a few months.

But yes: go see a professional, it certainly won't hurt, and a good one will be able to work with you to find a solution that works for you.
posted by kathryn at 9:51 PM on November 5, 2010

Please be sure to use artificial tears if you start using eyedrops daily. My dad used Visine beyond what the bottle recommends and ended up sterilizing his eye and has a slight but permanent blepharitis (swelling of the eyelid).
posted by IndigoRain at 10:07 PM on November 5, 2010

Like any other inflammation, Tylenol can help with that.

Tylenol's not an anti-inflammatory. I think you're thinking of ibuprofen or possibly aspirin.
posted by shelleycat at 10:53 PM on November 5, 2010 [1 favorite]

Like TorontoSandy, I have punctal plugs. They've been great for me- I had pretty bad dry eyes before, and these have taken care of that with no need for daily eyedrop use.

(My doctor said that in extreme cases, you can actually just get your tear ducts cauterized shut, but it seemed a little extreme to me.)
posted by showbiz_liz at 10:55 PM on November 5, 2010

Unless you know a really killer optometrist-- I've known a few, I'm not down on the profession-- I'd see an ophthalmologist.

I've got chronic blepharitis, and my retinal guy prescribed a combination steroid and antibiotic drop for nightly. It's been pretty awesome, and I wouldn't have known about it otherwise; I'd gone through a bunch of "DO YOUR HOT COMPRESSES AND WASH THE LID MARGIN WITH BABY SHAMPOO" crap without much improvement before that.

I also dig OTC GenTeal eye drops. The gel ones will blur your vision for a few minutes when they go in, but the "moderate" dry eye ones are great for everyday use.
posted by fairytale of los angeles at 12:36 AM on November 6, 2010 [1 favorite]

When I started wearing glasses I started having problems of dry eyes.

Don't remember when and how I realized the cycle of my problem: blinking moisturizes the eye, and when my eyes feel "protected" by the lenses of my glasses I don't to blink, hence the dry eyes. My solution is to alternate periods with and without glasses (which is not too hard for me, since my eyesight isn't that bad).
posted by mirileh at 4:08 AM on November 6, 2010 [1 favorite]

Flaxseed capsules have helped me (recommended by optometrist.)
posted by Carol Anne at 5:14 AM on November 6, 2010 [1 favorite]

Yeah, upping my intake of omega-3's has cut my dry eye suffering by about half. The rest is due to meds I can't go without, unfortunately.
posted by elizardbits at 6:49 AM on November 6, 2010

I'd suggest you bring this up with an opthalmologist or maybe even your regular doctor. There is a chance that the underlying cause of your dry eyes could be something more serious, like the autoimmune disorder Sjögren's syndrome.
posted by Andrhia at 8:03 AM on November 6, 2010

Definitely discuss this with an MD (primary care could be a good start). As Andrhia says, dry eyes can be a symptom of autoimmune disease. Whether or not it is in your case, it's best to know. There's a specific blood test for Sjögren's syndrome--make sure you get that at some point.
posted by Corvid at 11:50 AM on November 6, 2010

I'm just here to second what Carol Anne and elizardbits said about flaxseed oil. I'm not generally into holistic or herbal meds but my opthamologist diagnosed me with both dry eye and blepharitis and recommended flaxseed oil. So I tried it.

Taking three capsules of flaxseed oil/fish oil (I use Theratears which is expensive but good) has definitely reduced my problems to a third of what they once were.

Anecdotally, I ran out of my capsules on vacation once, and figured "a few days off won't hurt." Well it did hurt. Big time, three days later. My eyes were back to their hellish state. I ran out and got the capsules, and 24 hours later my problems were gone.
posted by np312 at 1:29 PM on November 6, 2010

I'm not sure it matters opthamologist or optometrist...I had a great opt as a kid in SF. Now in NOLA I have an opth. Just make sure you find someone who will have the time to listen to your concerns.
posted by radioamy at 6:15 AM on November 7, 2010