Q: I have diabetes and dry eyes. Is there a connection between the two?

A: Recent research has shown that diabetic patients have nearly twice as many dry eye symptoms as the non-diabetic population. Theories on why this is so suggest a possible problem with metabolism of essential fatty acids. Diabetics need to make sure their eye doctor knows of the dry eye symptoms and can subsequently work to eliminate them. There are numerous treatments depending on what type of dry eye is present and the patient’s needs. Untreated, dry eye can have a very significant negative impact on the quality of life.

Q: Is there a cure for dry eyes? Is it safe to wear contacts with dry eyes? Is punctual occlusion for dry eyes reversible?

A: Numerous factors contribute to dry eyes. Low hormone levels, especially testosterone, (women normally have about 11% of the amount a man has) contribute to dry eyes, as well as a deficiency of omega-three fatty acids such as found in flaxseed oil or certain (but not all) fish oils. Correcting either or both of these conditions can “cure” the symptoms in some patients. Talk to your doctor about which forms of flaxseed oil or fish oils are best, since some are ineffective at best. Wearing contact lenses with dry eyes is uncomfortable at best and dangerous in certain cases. It is much easier to get serious eye infections or even corneal abrasions. Concerning punctual occlusion reversibility, it depends on which plugs your doctor uses. Some of the older internal silicone plugs had a tendency to become bound up in fibrotic tissue after placement. Removal in these cases required surgery. Some of the newer types of plugs are reported to be much better in this regard and I have removed them with ease several times. However, one should be aware that fibrosis of an internal plug is always possible. The external type of plugs are much easier to remove but are sometimes less comfortable. Your doctor should discuss all this in detail before you make any decisions.

Q: My eyes frequently burn and feel gritty. My eye doctor told me to put artificial tears in them but it only helps for a few minutes. What should I do?

A: Artificial tears do provide relief for patients with mild dry eye symptoms, but often times more is needed. Certain types of dry eye respond well to omega-3 supplements such as flaxseed oil and some require treatments with sterile ointment at night. Some patients need plugs that are inserted into the tears drains and others do well with the prescription drug Restasis. The treatment that works well for you has to be determined by working with your eye doctor. In our practice we use all these approaches, sometimes in combination, to find the best solution.

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