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Advancing Care - August 2022

advancing care



Don’t get blindsided by dry eye syndrome  

You’ve likely seen the commercials and you may have experienced the symptoms yourself: The gritty, itching, burning, achy symptoms of dry eye syndrome are real, and so is the battle. Have you tried virtually every over-the-counter product available? It may be time for a new plan of attack for chronic dry eye. 

Dry eye, also known as dysfunctional tear syndrome, tends to develop with advancing age. Between 10-30 percent of people over 50 are affected with it. The most common symptoms of dry eye are irritation, redness and burning — the sensation that something is scratching or that something is stuck in your eye. Excessive tearing, in response to the lack of lubrication, can also be a sign of dry eye, as can discomfort wearing contact lenses. 

“Dry eye is a very common disorder that can be debilitating,” said Brian M DeBroff, MD, an ophthalmologist at Yale New Haven Hospital and director of cataract and intraocular implant surgery for Yale Medicine Ophthalmology.  

What causes dry eye?

A host of things can cause dry eye, including diseases such as hypertension and diabetes; immune disorders, such as rheumatoid arthritis and lupus; and medications such as antihistamines, beta-blockers, diuretics, anti-Parkinson’s drugs and chemotherapy. 

“Dry eye can also be seasonal,” Dr. DeBroff said. “During the winter when the heat is on, the humidity levels are much lower and the air is much drier. If people have very dry heat in their house and don’t have a humidifier, oftentimes, their eyes can dry out quite quickly.” 

And for some working in front of a computer screen (or using other electronic devices) for long periods of time can also contribute to the symptoms. 

Treating dry eye

Treatment for dry eye depends on what’s causing it. There are two main types of dry eye: One is called aqueous tear-deficiency, in which tears are not sufficiently produced to lubricate the eyes; the more common form is an evaporative type in which tears are produced but evaporate too quickly. 

“If you are producing tears but they are evaporating too quickly, I would recommend warm compresses and Omega-3 fatty acid supplements,” said Vicente Diaz, MD, an ophthalmologist at YNHH. “If you are not producing enough tears, you start with artificial tears that provide lubrication.” 

Dr. Diaz recommends starting with an over-the-counter product. However, if you are using the artificial tears three to four times a day and you are still symptomatic, talk to your eye doctor about a prescription-strength medication option. If dry weather or indoor conditions are causing dry eye, using a humidifier — especially while running central heating or air conditioning — may help. 

The future looks bright

If the at-home remedies don’t work, more invasive treatments may be necessary because severe dry eye can cause damage to the cornea (the transparent “window” at the front of the eye). Surgical options are uncommon, however.

“Most of the time, we can control dry eye syndrome with medications,” Dr. DeBroff said, noting that less than 1 percent of patients require surgery.

Dry eye is usually easily diagnosed by its symptoms, and the cause can usually be determined during a thorough eye exam by an ophthalmologist, without the need for invasive tests. 

Learn more about Ophthalmology at Yale New Haven Hospital. 

Taking your vitamins? Make sure to tell your doctor. 

You exercise regularly and eat healthy foods. And to boost your immune system, you take a multivitamin every day. It can only help, right?  Well, perhaps. 

A recent study published in The New England Journal of Medicine found that adverse effects of supplements were responsible for an average of about 23,000 emergency department visits per year.  

Still, American consumers spend billions of dollars on vitamins, herbs, minerals and supplements. National health surveys show that more than half of all American adults take some kind of vitamin or dietary supplement, a percentage that increases with age. 

Many people don’t realize that taking some over-the-counter supplements alongside prescription drugs and other medicines can have dangerous and even life-threatening effects, according to Brittany Langdon, PharmD, a pharmacist and manager of the Apothecary and Wellness Center at Yale New Haven Hospital. That’s why it’s important to talk to your physician about everything you are taking.

“A number of supplements can enhance, diminish or negate a prescription drug in ways that can be consequential and unpredictable,” she said. “Many supplements can contain ineffective or harmful ingredients, especially if combined with prescription drugs.” 

According to Langdon, supplements and vitamins can change the “ADME" of your prescription medications. ADME stands for absorption, distribution, metabolism and excretion of drugs. Depending on the person and the drug they are taking, interactions can be serious. Vitamins and supplements can cause harmful reactions, or they may reduce the effectiveness of prescription meds. 

For example, warfarin is a drug often prescribed to treat or prevent blood clots in veins or arteries. Gingko biloba (an herb) and vitamin E supplements can thin your blood – so taking them with warfarin potentially increases your risk for internal bleeding or stroke. Vitamin C is often consumed as a supplement to ward off the common cold —but high-dose vitamin C supplements may reduce the effectiveness of some types of cancer chemotherapy and interfere with statin medications. 

Langdon says that many people also think that because a vitamin or supplement is advertised as “natural” it means the product is “safe.” This can be a dangerous assumption.  

“Vitamins and supplements are regulated as foods, not drugs. This means the Food and Drug Administration does not evaluate the quality of the supplement or assess its effect on the body before the product hits the shelves,” she said. “Some supplements can have a range of ingredients instead of exactly the amounts listed on the labels – which is why, even though supplements are ‘natural,’ they can sometimes be unsafe.”

To help avoid any health hazards that can arise from mixing supplements and medications, Langdon recommends that you: 

  • Talk to your doctor before starting any new over-the-counter medication or supplement. “If you feel you need something else in your diet, your doctor can make sure there aren’t any underlying conditions that may be the reason you feel the need to supplement,” she said.
  • Update your medication information. Bring a list of everything you take — over-the-counter medicines (pain pills, allergy relief, etc.), herbals, minerals, vitamins, dietary supplements and prescription drugs — to your next doctor’s appointment.
  • Keep track of the dosages and how many times a day you take them.

Also, if you’re planning a surgery, don’t be surprised if your doctor asks you to stop taking dietary supplements two or three weeks before the procedure to avoid changes in heart rate, blood pressure or bleeding risk.

Free wallet medication cards available

When your doctor asks about your medications, do you remember everything you are taking? It is important that your healthcare providers have complete information about your medical history and all of the medications you are taking. Having your medication list in one place helps your physicians, pharmacists and healthcare staff take better care of you.

Yale New Haven Health offers a free wallet medication card to help you and your family members keep an accurate record of your medicines. Keep the card in your wallet, so it will be handy in case of an emergency. Bring it to all doctor visits, when you go for any medical tests and all hospital visits. Be sure to keep it up-to-date; add new items and cross out any medications when you stop taking them. 

To receive a free wallet medication card, email [email protected] with your name and address. Supplies are limited. Please allow three to four weeks for delivery. 

A Spanish language version of the wallet card is available upon request.

What would you like to know about advancing your care? 

Want to learn more about a particular health topic or service? Questions about classes and events at YNHH? We want to hear from you! Tell us what you like about Advancing Care or how we can improve. Send an email and let us know how Advancing Care can be your go-to health news source.

Take a walk and chat with YNHH doctors

Take a walk and chat with local doctors as part of Yale New Haven Health’s Get Healthy Walk ‘N Talk with a Doc. Walks are each Saturday through September from 9 - 10:30 am along the Farmington Canal Greenway Trail in New Haven. Walks begin at the entrance on the corner of Shelton Avenue and Starr Street and last approximately one hour. Parking is available at New Freedom Missionary Baptist Church, 280 Starr St., New Haven. Please arrive by 8:45 am on each walk day. For more information, email Andy Orefice or call 203-688-5671. 

MyChart: Your medical information in one place

MyChart gives Yale New Haven Health System patients secure, online, 24/7 access to portions of your electronic medical record (EMR). There you can see your medical history, most laboratory and test results, appointment information, medications, allergies, immunizations and other health information. You can schedule appointments with your doctor, request or renew prescriptions, pay your bill, and send and receive secure, confidential electronic messages with your doctor’s office. Sign up by using the activation code on the after-visit summary from your doctor, request a MyChart Activation Code at your next appointment or visit MyChart and click or tap “New User?”

Find a Doc at YNHH

Are you looking for a physician? Call 888-700-6543 or visit our website’s Find a Doctor feature for information on physician specialties, office hours and locations as well as insurance plans accepted. Many of our physician practices offer telehealth video visits for your convenience. 

Billing questions?

Yale New Haven Hospital offers financial counseling to patients and families. Spanish-speaking counselors are also available. To make an appointment with a financial counselor, call 855-547-4584.