I am a 52-year-old woman who suffers from hay fever. I have for years suffered from itchy, burning eyes every spring. I used to wear contact lenses, but I stopped because of this problem. I noticed recently that while my sneezing and runny nose stop when the pollen season ends, my itchy, burning eye condition continues year-round. Is this a lingering effect of the allergy or could it be something else? - M.F., Haifa
Dr. Shahzad Mian, director of refractive surgery at the University of Michigan's Kellogg Eye Center, explains: Up to 20 percent of the population over age 50 may suffer from chronic dry eye syndrome, in which there is a decrease in the amount of lubricating natural tears. You may be one of them. If left untreated, dry eye syndrome can lead to a decrease in vision. Some dry eye patients complain of a chronic sensation of grittiness or the sensation of a foreign body in their eyes, while others complain of burning or itching and sometimes sensitivity to light. The disease tends to occur more in women, especially post-menopausal women. Patients who use contact lenses are also predisposed to it.
In addition to contact lenses, there are several other environmental factors that can trigger symptoms, including looking at a computer screen for a long time or spending time outdoors in dry heat or cold, windy conditions. And some medications also can increase the risk of dry eye disease, such as allergy medications, antidepressants or some very commonly used blood pressure medications.
You should go to your ophthalmologist for an examination. There is a simple, painless test to measure tear production that involves placing filter-paper strips under the lower eyelids to measure the rate of tear production. Several treatments to alleviate the condition are available, including prescription eye drops. Some patients benefit from the insertion of tiny plastic plugs that cover the tear ducts (punctal occlusion) that close the ducts either temporarily or permanently, conserving natural tears and making artificial tears last longer. As dry eye disease is believed to have a strong inflammatory component, a number of new therapies are being developed to reduce inflammation on the surface of the eye and improve tear production. There is some research that suggests that nutritional supplementation with omega-3 and omega-6 fatty acids (in fish oil capsules, salmon, tuna and walnuts, whole-grain breads and most vegetable oils) may be helpful as well. While over-the-counter lubricating eye drops are fine for self-treating mild cases of dry eye disease, those who use them and are not getting relief, or whose quality of life is being hampered, should seek the help of an ophthalmologist for further treatment.
I am a 78-year-old woman who is relatively healthy; I take no medication except one for thyroid balance. I am energetic, go to Tai Chi classes once a week and aquarobics (in the water) twice weekly. My only problem is a genetic illness called CMT (Charcot-Marie-Tooth disease), which means I have poor balance and have to use a walker. All books on exercise stress walking and other movements, which include balance. I find this very frustrating and irritating. There must be many people with a problem similar to mine who would like to exercise and would welcome instruction. - N.K., Givat Ze'ev
Dr. Naama Constantini, a family physician, leading sports medicine expert at Hadassah Optimal of the Hadassah Medical Organization and chairman of the Israel Olympic Committee's Medical Commission, comments:
Walking is easy for most people in general and recommended by many experts. But if you have a balance problem, it is not the only thing that would be beneficial. Anything aerobic - which gets the heart pumping and the lungs working at a faster-than-normal pace - will achieve what walking does. What you're already doing sounds good. Aquatic exercise and tai chi are no less beneficial than walking. You can also try working out on a stationary bicycle, which doesn't require good balance.
Rx For Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx For Readers, the Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to [email protected], giving your initials, age and residence.