Ophthalmologist (illustrative photo).
(photo credit: INGIMAGE)
I am a 25-year-old man living in Haifa. I suffer from red, itchy and dry eyes in the fall that sometimes make my vision fuzzy. During the rest of the year, I am usually fine. What is the cause?
Prof. Or Kaiserman, head of the cornea and dry-eye clinic at Barzilai Medical Center in Ashkelon, comments: Various phenomena, especially in the fall, cause dryness that affect vision.
Our eyes should always be lubricated by a layer of tears. More than a saline liquid, they contain fats and proteins that together offer protection to the eyeball, especially the smooth surface of the cornea. When there is an inadequate amount of tears, or none at all, the situation can disrupt normal vision.
Dry eye doesn’t mean the body is not producing tears. In most cases, some of the components of tears are missing or the production of tears is reduced. The results are red and itchy eyes; sometimes the lids are stuck together in the morning. Side effects include tiredness, headache and impaired ability to function during the day.
In addition, the use of contact lenses and air conditioners throughout the year and heaters during the fall and winter can also cause dry eye. People who are allergic to trees, bushes and grass may also suffer from it, and in rare cases, it can come from parasites or fungi, especially with the change of the weather from summer to fall.
Over the age of 30, about 30 percent to 40% suffer from dry eye; among the elderly, this rises as high as 90%. As age increases, women suffer more than men – probably due to Sjogren’s syndrome, a chronic, slowly progressing autoimmune disorder that is more common in females than males.
Though dry eye is very common, some people don’t even realize they have it or regard it as normal, so they don’t consult with doctors.
The ophthalmologist should first look for the cause of the problem, as tears are made up of many components.
In most patients, it is due to lack of fats and not the liquid part of tears, so though there is plenty of liquid, dry eye can still be the cause. The eye doctor has to examine the glands that produce the fats to see if they are functioning properly and prescribe the best type of artificial tears.
For a number of years, in accordance with advice from an ophthalmologist, I’ve been taking a multivitamin that has lutein (5 mg.) twice daily for age-related macular degeneration ; I think it has slowed down the AMD quite well. But my pharmacist told me to take only one capsule a day instead of two – meaning I would take only half the amount. I was taking Optimax, but he gave me OptiSafe Max instead. Can anyone out there advise me?
— J.F., Michmoret
Veteran pharmaceutical consultant Howard Rice replies: The proper dosage of OptiSafe is one 5 mg. capsule twice daily. The dosage of OptiSafe Max in your case is one daily, since it has 10 mg. lutein – which is what the physician ordered.
You should also be aware that there are capsules for smokers and nonsmokers; the no-smokers version has the addition of beta carotene, an antioxidant that is not recommended for smokers. I hope you are a nonsmoker.
There is always the question of whether the minerals and vitamins would perhaps work better if they were divided into two doses, taken 12 hours apart. The answer is yes, since most of them gradually leave the body via the kidneys. In the case of a once-only dose, within 12 hours they will have less of an effect during the next 12 hours.
A twice-daily dose preparation reaches its peak and is reduced after a few hours; it then reaches its peak again after the second dose is taken. The ingredients are therefore available to do their job.
Thus, my advice is if possible, take one OptiSafe twice daily as originally prescribed. You should of course regularly check with your physician to ascertain if there is any progression or regression in the AMD, and whether he considers an adjustment to the dose necessary.
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 place of residence.