Supporting patients with dry eye
Independent optometrist and faculty member of the Johnson & Johnson Institute, Amanda Davidson, discusses her experiences of treating dry eye, its prevalence and how the company is innovating in the field
In your experience, is there a lack of understanding around dry eye among patients?
Dry eye is a largely overlooked and under-treated disease that affects more than 340 million people worldwide, according to data obtained Johnson & Johnson.
Patients are generally unaware of the chronic nature of dry eye and the management options that are available to them. Many patients put up with minor symptoms as they don’t feel like they are severe enough to seek advice for. I have certainly treated patients who have said things like, “I don’t have dry eyes, just aching eyes,” without knowing the latter can actually be a symptom of dry eye.
Dry eye can often also be confused with other conditions, particularly hay fever or allergies. This is a problem as early diagnosis is important for maintaining a good quality of life and can prevent more serious, long-term problems, such as pain and corneal scars, which can occur if dry eye goes untreated.
How do patients usually describe their symptoms?
Symptoms and descriptions vary greatly between patients, but the terms most frequently reported by patients to their healthcare practitioners include scratchy, gritty, tired, heavy, dry, burning, sandy and sore. Eye care practitioners should also be listening out for patients reporting symptoms of blurred vision, especially when concentrating or looking at a screen, or indeed complaints of glare, as these can also be symptoms of a potentially unstable tear film. Many patients are also surprised to learn that intermittently watery eyes can also be a symptom of dry eye.
How common is dry eye and how does it affect patients?
The TFOS DEWS II report suggests that up to half of the adult population is affected by dry eye symptoms. As we head into the summer months, this figure can rise even higher. We know that exposure to sunlight, spending more time outdoors, swimming in the sea and dehydration can increase the prevalence of dry eye symptoms.
Researchers at Aston University have found that incidences of dry eye in children are also on the rise. This has been linked to screen time, which is listed by DEWS II as a consistently recognised risk factor for dry eye.
For some patients, dry eye is a minor irritation but for others it can have a huge impact on quality of life. In fact, some patients put it on par with having angina. Patients with dry eye are three times more likely to report problems with common activities, such as reading, computer use and watching TV. Dry eye has also been linked to poor visual performance when driving.
Is dry eye a widely undiagnosed condition?
I definitely think that there are many people who are living with undiagnosed dry eye, especially at the mild-to-moderate end of the scale. Many of my patients assume that the symptoms are a result of ageing and that they are just something they need to put up with. Others don’t feel that the symptoms are serious enough to seek advice for.
Dry eye can often also be confused with other conditions – particularly hay fever or allergies
An independent consumer study obtained by Johnson & Johnson Vision revealed that almost half of those experiencing eye irritations do not use any eye drops. Among the reasons for not treating are difficulty using eye drops, lack of product knowledge and belief that their symptoms are not serious enough.
How is Johnson & Johnson Vision educating optometrists to open up conversations around dry eye with patients?
As a whole, the industry is working together to raise the profile of dry eye and stressing the importance of early intervention to prevent long term problems. Johnson & Johnson Vision is no exception to this. It has a dedicated team of professional affairs consultants who proactively visit practices around the country to talk to eye care practitioners about dry eye, increasing the awareness of the condition and highlighting the benefits of early intervention for our patients.
I would encourage eye care practitioners to specifically ask patients about the symptoms of dry eye
Additionally, Johnson & Johnson Vision provides education that is open to all eye care practitioners, either through regional events and roadshows, digital learning on their professional website or as a comprehensive two-day course dedicated to the diagnosis and management of dry eye. Even in the very early stages of careers, Johnson & Johnson Vision is involved in providing dedicated training around dry eye to undergraduate optometry students and pre-reg optometrists through digital learning.
How is Johnson & Johnson Vision innovating in the dry eye market?
We are very lucky to have within our portfolio, products that have been developed specifically with meibomian gland structure and function in mind. The recent acquisitions of AMO and Tear Science, mean that Johnson & Johnson Vision is able to support eye care practitioners with investigations of the ocular surface through the use of LipiView and treatment of dry eye through the use of revolutionary LipiFlow technologies, as well as providing a range of ocular lubricants to offer patients symptomatic relief for the mild to moderate cases of dry eye that we regularly see in our clinics.
Image credit: Getty/AndreyPopov