My fighters often complain that their eyes are watering or feeling gravelly and red. For people with Parkinson’s, dry eye can be a common problem for a number of reasons. Today we are only going to talk about meibomian gland disease (MGD) caused by Parkinson’s disease.
Remember, I don’t give bad news without a treatment or action to take, so read on..
People may not understand why their eyes feel dry. It may lead them to think that they’re not producing enough tears, and then become dependent on eye drops. The leading cause of dry eye is MGD. MGD occurs when there is compromised function or structure of the meibomian glands (basically they become plugged). These glands are located in the eyelids and they produce a protective oily layer over your eye. This oil helps protect the eye surface from disease and prevents the tears from evaporating when your eyes are open and blinking. At night, this oil creates a water-tight seal, so your eyes don’t dry out. Without these oils, your eyes are susceptible to drying elements like air conditioning, fans, dry climates, computer use, reading and other daily activities that may harm our eyes. If you don’t get your eyes “unplugged” and working, they can actually atrophy and not produce the oils at all.
What causes MGD and why are people with Parkinson’s susceptible to it?
The most common reasons are age (the number of oil glands decrease as we age) and improper blinking.
Other reasons include:
- Wearing contact lenses
- High cholesterol and triglycerides
- Allergic conjunctivitis and other eye diseases
- Inflamed or damaged eyelid or cornea
- Bacterial infection
- Autoimmune diseases like rosacea, lupus, rheumatoid arthritis, and Sjögren’s syndrome
- Some medications including estrogen replacement therapy and others
It’s important to have regular eye exams and ask your eye doctor to properly examine your meibomian glands through gland expression, even if you aren’t experiencing dry eye yet. This is a separate test than the usual exam.
The basic treatment for mild dry eye is pretty simple:
- Warm compresses – 10 minutes each night at bedtime to melt clogged oil, followed by gland expression (ask a doctor for instructions).
- Lid hygiene – Use specialized washes for your eyelids to prevent bacteria from forming on dry eyes. Some doctors still prescribe baby shampoo for this, but specialists tell me that this is out dated information and can actually cause drying and irritation.
- Quality artificial tear drops
- Nutritional Suppliants – Omega-3 and flax seeds oils are helpful.
- Blinking exercises!!
Did you know it’s common for people with PD to only partially blink or blink infrequently compared with people who do not have PD? This is also true for people without PD who use computers and other devices (including the T.V.) which effects both the blink rate (how frequently we blink) and blink completeness (whether the eyelids close completely during a blink).
Bring on the exercise!!
- Hold your fingers at the corners of your eyes and blink. If you feel any movement under your fingers, you are using your defense muscles that run along the side of your head. Your blinking muscles are above the eyelids.
- It is very important to do the squeeze step to stretch the blinking muscle so you can make complete contact between the upper and lower lids. When you are doing the exercises correctly you should feel no movement under your fingers except when you squeeze.
Open – Pause – Pause
Close – Pause – Pause
Squeeze – Pause – Pause
Open
Repeat these steps 5x, and do this several times throughout the day. If you’re working on computer or watching TV you should do this exercise every 20 minutes.
** If your dry eye is more symptomatic more therapeutic management is recommended. See your eye doctor.
References:
www.webmd.com/eye-health/meibomian-gland-dysfunction#1
Med Sci Monit. 2014; 20: 2243–2249. Published online 2014 Nov 11. doi: 10.12659/MSM.890861 PMCID: PMC4238794 PMID: 25387009Ophthalmological Features of Parkinson Disease Barbara Nowacka,1,A,B,C,D,E,F,G Wojciech Lubiński,1,A,B,D,E,F,G Krystyna Honczarenko,2,A,BAndrzej Potemkowski,3,A,B and Krzysztof Safranow4,C,D