Relieving Eye Dryness
(Question and Answer)
By W. Leroy Griffing, M.D., Chair,
Division of Rheumatology, Mayo Clinic Scottsdale, Scottsdale,
Ariz. (originally published in "Scleroderma Voice,"
2003 #2)
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|
W.
Leroy Griffing, M.D. |
Question:
I recently had an eye infection and was placed on antibiotic
eyedrops. I did not have any improvement and soon found out
that I was reacting to the preservatives in the drops.
An ophthalmologist
informed me that persons with Sjögren's Syndrome should
not use drops that contain preservatives. He has recommended
preservative-free Refresh Plus and Celluvisc and I am amazed
at how much better my eyes feel.
He would like to
use punctal plugs to further improve my dry eye problem. I
am concerned as the temporary plugs are made of collagen and
the permanent plugs are made of silicone.
Would these products
make my scleroderma worse? Should I be concerned about the
use of these plugs?
Answer: Dryness
of the eyes, mouth, skin, and other areas of the body due
to Sjögren's Syndrome commonly occurs with rheumatic
illnesses including scleroderma.
Several artificial
tear and saliva products are available over the counter to
help alleviate eye and mouth symptoms. Many brands of the
artificial tears contain a preservative which itself can be
irritating to the eye, causing discomfort that is easily mistaken
for the symptoms of dryness. Use of preservative-free artificial
tears such as Refresh and several others avoids this potential
problem.
Another way to relieve
eye dryness besides replenishing moisture is to conserve moisture
by plugging the tear ducts. The lower lid of each eye has
a small duct that connects with the inside of the nose, acting
as a drain to take excessive moisture away from the eye.
The opening of this
duct can be plugged temporarily with tiny collagen plugs,
keeping moisture over the eye. People with mildly dry eyes
may find this causes their eyes now to water too much, while
people with excessively dry eyes may not find any benefit.
The collagen plugs
are removable. For people who find the plugs to be "just
right," the collagen plugs are replaced with longer-lasting
silicone plugs. Although these are spoken of as being permanent,
the silicone plugs can be removed later if necessary.
There is no evidence
to suggest that either type of these tear duct plugs is unsafe
for patients with scleroderma or other autoimmune illness. |
