People living with macular degeneration who have had eye injections are at an increased risk of developing dry eye symptoms. Learn how to protect your vision and manage dry eye after anti-VEGF treatment.
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Do you ever feel like you have sand in your eyes? Does your vision seem blurry or watery? If so, you may be suffering from dry eye disease, a common condition that occurs when the eyes are not able to produce enough tears to lubricate the eyes or when the tears evaporate too quickly.Â
It is estimated that between 16 million and 49 million Americans suffer from dry eye, which is between 5-15% of the population. And, dry eye is a common problem among macular degeneration patients who have had intravitreal eye injections.Â
What Is Dry Eye and Why Is It Important to Treat?
Symptoms of dry eye can include feeling uncomfortable, itching or stinging, redness in the eyes, feeling as if there is sand or a foreign body in your eyes, and even excessive tearing. Dry eye may be more likely to occur in certain situations, such as being in an air-conditioned room, wearing a mask, or using screens for an extended period of time.Â
In general, when it comes to the causes of dry eye, there can be multiple potential reasons. Decreased tear production can be due to aging, health conditions such as allergic eye disease, post-eye surgery such as intravitreal injections or cataract surgery, and medications such as antihistamines and antidepressants.Â
On the other hand, increased tear evaporation can be caused by not blinking enough while reading or driving, allergies to preservatives in eye drops, environmental conditions like wind or air conditioning, and health conditions.Â
If left untreated, severe dry eye can lead to inflammation or infection of the eyes and damage to the corneal surface, leading to corneal ulcers and vision loss.Â
What Causes Dry Eye after Anti-VEGF Treatment?
The use of intravitreal anti-vascular endothelial growth factor (VEGF) agents to treat wet macular degeneration and other retinal vascular conditions is becoming increasingly common. Millions of intravitreal injections are given each year. Many people living with wet macular degeneration were not only able to preserve their vision, but they also had improved vision.Â
Intravitreal injection is also commonly referred to as an eye injection
Like any treatment, therapeutic efficacy comes with adverse events. A serious risk of chronic anti-VEGF treatment is the possibility of ocular infection during treatments, such as endophthalmitis.Â
To prevent this, antibacterial and disinfecting agents are used by your eye doctor before treatment. However, these agents may sensitize the ocular surface and induce dry eye. It was found that eyes that have had a pre-operative topical application of povidone-iodine for anti-VEGF injection were associated with insufficient production of tear film oil (meibum), higher symptoms score for dry eye, and less stable tear film.
Dry eye is a common complaint in patients receiving repeated intravitreal injections, especially those with preexisting conditions such as long-standing diabetes or extensive retinal surgery. This suggests that their preexisting conditions worsened their dry eye symptoms due to the intravitreal procedure.
Managing Dry Eye after Anti-VEGF Treatment: What You Need to Know
If you're undergoing an intravitreal procedure for macular degeneration, it's common to experience dry eye as a side effect. To keep your vision healthy, it's essential to manage the condition.
Your doctor may prescribe lubricative eye drops to alleviate symptoms and discomfort post-treatment. Since people respond differently to different eye drops, you may need to try a few before you find the best one for you.Â
Eye drops come in two categories: non-prescription and prescription. Over-the-counter non-prescription eye drops, commonly referred to as artificial tears or lubricating eye drops, generally cost less and are usually effective enough to treat most symptoms.Â
They are available with preservatives or preservative-free. Because preservatives may irritate your eyes, especially if the dry eye is caused by antibacterial and disinfecting agents, preservative-free eye drops may be more appropriate.Â
If you have a more complex condition or if you need something stronger, your eye doctor may prescribe a prescription-only drug.Â
Lubricating eye gels and ointments, usually prescription-only, are more viscous than eye drops and may come as a dissolvable insert that you place between your eyelid and eyeball. While eye gels are more effective at treating severe dry eye symptoms, they take longer to become effective. As it is quite thick, it can temporarily cause blurry vision.
For the more severe conditions, there are also prescription eye drops that can bring down inflammation and help your eyes make more tears.Â
Your doctor may also suggest other treatments to address other potential causes of your dry eye, such as thermal pulsation, antibiotic treatment, or even a meibomian gland probing procedure.
In addition to applying dry eye medication as your eye doctor’s recommendation, you can prevent or manage dry eye after anti-VEGF treatment with the following tips.Â
- Blink often: To help clear debris and lubricate the ocular surface, make a conscious effort to blink more often throughout the day.Â
- Protect your eyes: Wear wraparound sunglasses or goggles when you're outside to shield your eyes from wind, sun, and other elements.Â
- Avoid wind, air conditioning, or smoking: These can all contribute to dryness and eye irritation.Â
- Use a humidifier: Keeping the air in your home moist can help reduce eye irritation.Â
- Be mindful of makeup: Powder or glitter in eye makeup can be a source of irritation. Opt for non-irritating formulas if you choose to wear makeup.Â
- Avoid wearing contact lenses after your injection: Wearing contact lenses is known to lead to dry eyes.Â
- Limit screen time and take breaks: Staring at screens for too long without breaks can lead to dryness, so make sure to take regular breaks and blink frequently.Â
- Stay hydrated: Drinking plenty of water helps keep your body functioning properly and reduces the risk of dry eye.Â
- Get enough sleep: Aim for 7 to 8 hours of sleep per night to give both your body and eyes time to rest.Â
- Talk to your doctor: Your doctor can help switch the anesthetic or saline solution used in your injection procedure, prescribe treatments, and take other steps depending on the severity of your dry eye symptoms.Â
It's important to remember that you can manage dry eye after anti-VEGF treatment with the right combination of treatments and preventative measures. With good care, you can keep your vision healthy and clear!
Key Takeaways
Dry eye is a common condition that can affect wet macular degeneration patients who have had intravitreal eye injections. If left untreated, it can lead to inflammation and infection of the eyes, damage to the cornea, and vision loss.Â
You can manage dry eye and keep your vision healthy. Talk to your doctor if you are experiencing dry eye symptoms.Â
Don't let dry eye be an obstacle to keeping your retina dry.Â
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