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They say that the eyes are the windows to the soul.

But as our lifestyles get increasingly sedentary, we’re cooped up indoors facing a computer or mobile device for the majority of the day. And with the combined effects of ageing, the use of contact lenses and improper eye health care, our peepers suffer the brunt of it and we’re left stricken with issues such as dry eyes, as a recent study by Johnson & Johnson Vision (JJV) concluded.

The online survey, which polled over a thousand Singaporeans, found that 51 per cent of respondents suffer from dry eyes while 40 per cent experienced soreness in the eyes.

In this article, we are zooming specifically into the problem of dry eyes as it is a prevalent condition that afflicts many. In fact, JJV quoted a 2016 study by Market Scope that found that 340 million people suffer from dry eyes globally. We spoke with Dr Lee Hung Ming, an eye doctor and surgeon who has almost thirty years experience and has his own namesake clinic in Gleneagles Hospital, to share with us some facts surrounding ocular health.

Read on to learn more about your eyes and how to identify and solve the issues you might have been struggling with.


Fact 1: There are other symptoms you should look out for

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Dry eyes occurs when your tears aren’t able to provide adequate lubrication for your eyes. Usually, you’ll get a dry, stinging sensation, but that is not the only telltale sign you should take note of. Other symptoms you should look out for include: Grittiness, blurring, redness, irritation, tearing, fatigue, strain and pain. You might also feel some sensitivity to light and a sensation like you have something in your eye.

Dr Lee states that people who suffer from frequent intermittent blurring of vision and or intense pain or discomfort should seek medical attention.


Fact 2: Know the triggers

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Triggers to eye problems are surprisingly easy to spot, but equally easy to ignore due to their prevalence in our lives. Dr Lee delineated three triggers that contribute to eye problems and they all arise from modern lifestyles. They are increased screen time, from reading, computers, mobile and handheld devices, prolonged engagement with near work (basically a short working distance from the activities mentioned earlier) and the presence of air-conditioning. However, there are also other factors that can impact eye health.

Improper lighting conditions, Dr Lee added, where the light is too dim or bright, can also result in eye strain. Older age groups tend to require brighter conditions as compared to their younger counterparts, but in general, the lighting should be diffused and there shouldn’t be a shadow cast on the reading material — the latter a reason why children are advised to not read while lying down. Similarly, there shouldn’t be too much contrast between the lighting and what you’re reading/looking at (e.g. looking at a very bright screen in a dark room).

If you have long-sightedness but eschew wearing glasses, this might trigger dry eyes as you’d need to focus more, straining your peepers. Wear your glasses regularly to mitigate this issue.

Finally, if the area around you is too dry or dusty, it can also irritate the eyes.


Fact 3: Contact lenses are a trigger too

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Can’t do without your contact lenses? Take note: Contact lens wearers have a higher susceptibility to dryness and inflammation. This is because these hydrogel lenses have to absorb water in order to retain their shape, not to mention they are foreign bodies that are forcibly placed onto the eyes. Contact lenses reduce the flow of oxygen to the eyes and can increase the risk of corneal ulcers, eye infections and inflammation. Coloured lenses are even worse because they have less permeability due to the addition of pigments.

According to Dr Lee, there are four rules you should abide by when it comes to contact lenses to ensure optimal eye health:

1. Never sleep with contact lenses as you’re prolonging the reduction of oxygen flow to the cornea.

2. Replace your contact lenses as stipulated by the manufacturer (e.g. monthlies or dailies).

3. Your contact lens cleaning solution should not be expired.

4. Your contact lens casing should be clean. A simple wash with soap and water should suffice.

Bonus point: Your hands should be thoroughly cleansed before touching the contact lenses.


Fact 4: Know what are the non-medical ways to relieve eye problems

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1. Take vision breaks. If you feel eye fatigue or strain, take a break and disengage from whatever you’re doing. You could take it a step further and look at something far off, so that the eyes are worked differently.

2. Cultivate good reading habits. Your reading material should be about 50cm away while screens are to be placed 65cm away. A good chair that promotes proper posture is necessary to prevent slouching while lighting should be well suffused. You shouldn’t be facing windows with strong sunlight too.

3. Use eye drops. Eye drops (more of this later) can help to ease the symptoms.

4. A warm compress. Get a warm towel and place them over the eye lashes for 10 minutes. This can help reduce inflammation.

5. Get humid. Drier conditions such as winter or air-conditioning can dry out the eyes. So, invest in a good humidifier at your workplace or in your house.


Fact 5: Your tears are not just water

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Tears (or tear film) are made up of three layers: A layer of oil secreted from the Meibomian glands, an aqueous layer and a mucous layer. With a function similar to sebum, the oils help to prevent excessive evaporation of the lubricating liquid layer while the mucin coats the cornea and distributes the tear film.

He also added that while the symptom of tearing seems at odds with dry eyes, people who are afflicted with this condition can have qualitative issues, which means that their tears are of poor quality and perhaps lack sufficient oil, have degenerated Meibomian glands or blocked ducts, for example. Less oils would mean that tears would evaporate faster and lead to dry eyes.


Fact 6: Not all eye drops are created equally

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While the problem of dry eyes can seem very easily and effectively solved by eye drops, Dr Lee clarified that it isn’t a mean to an end. Eye drops are only good if you are having quantitive problems with your tears, that is, you don’t produce tears to support the eye, because you’re literally boosting the tear level with eye drops. It’s not particularly useful for those with qualitative issues.

Furthermore, eye drops are not created equally. For example, some might contain more oil in its composition to help sufferers of conditions such as Meibomian gland dysfunction, which JJV describes as “a chronic, progressive and obstructive condition that can affect both the structure and the function of the oil glands in the eyelids”. The oils, as previously mentioned, “are necessary for protecting the tears from pathogens, allergens and evaporation. Without proper functioning Meibomian glands, patients may face eye discomfort, inflammation, fluctuating vision and be at risk for developing dry eye.” So if you’ve been having a dependency on eye drops and they aren’t doing much to relieve of your dry eye issues, it might be time to consult a doctor.

In addition, Dr Lee suggests that when you’re purchasing off-the-counter eye drops, get those that come in a single-use pack. Eye drops that are created to last for a month from opening contain preservatives and these compounds have a potential to cause irritation — thus not providing the relief you’re looking for.

Dr Lee also advises against using eye drops such as Rohto that temporarily reduces eye redness. Rather, find and solve the root cause as these drops constrict the blood vessels (vasoconstriction) but do not treat the underlying medical condition. In addition, these eye drops result in a dependency, where rebound hyperemia can occur (i.e. the redness reappears with a vengeance), when you stop using them.


Fact 7: Changes in your body can affect your eyes too

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While ageing can lead to degeneration of the tear ducts, a fall in hormone levels caused by menopause and andropause can also lead to dry eyes. Taking hormone pills however, said Dr Lee, might not relieve this particular problem. Try using eye drops to alleviate the symptoms, but if they persist, do consult a medical professional who might be able to prescribe a solution.