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Dry Eye

Dry eye is a disease of the front of the eye, whereas a disruption in our normal tear production and maintenance occurs. There are two main types of dry eye: aqueous deficient dry eye and evaporative dry eye.

Condition Information

Dry eye is a disease of the front of the eye, whereas a disruption in our normal tear production and maintenance occurs. There are two main types of dry eye: aqueous deficient dry eye and evaporative dry eye.

Dry eye is a disease of the front of the eye, whereas a disruption in our normal tear production and maintenance occurs.1 There are two main types of dry eye: aqueous deficient dry eye and evaporative dry eye.

Aqueous deficient dry eye occurs when too little tears are produced by the lacrimal gland located below our eyebrow.3 When we don’t have adequate aqueous tear production, our ocular surface becomes rough, causing burning, gritty, and scratchy eyes. Wearing contact lenses or having a history of previous eye surgery can contribute to this type of dry eye.4

Evaporative dry eye, also known as meibomian gland dysfunction (MGD), stems from the clogging of the meibomian glands inside of our eyelids. Our meibomian glands secrete meibum, the lipid or oily layer of the tear film. This tear layer helps to keep the other layers of the tear film in place. When our meibomian glands are clogged, our tears can evaporate easily, causing irritation.5

Symptoms of dry eye:

  • Redness
  • Watering
  • Burning
  • Blurry vision
  • Decreased tolerance and discomfort when wearing contact lenses.11

Dry eye can be associated with systemic disease, including diabetes, thyroid issues, arthritis, ulcerative colitis, and Sjӧgren’s syndrome.2 Dry eye can also be caused by certain medications, including antihistamines for allergies, high blood pressure medication, and anti-anxiety or depression medication. Dry eyes can also be caused by extended computer or digital screen work. It is important to take breaks when viewing screens up close for extended periods of time, as we blink less during these periods.11

Comprehensive eye exam: A comprehensive eye exam with a thorough medical history can help determine if systemic disease is contributing to dry eye.

Anterior segment evaluation: Extensive evaluation of the cornea, conjunctiva, eyelids, and tear film (front of the eye) are essential in diagnosing dry eye disease.

Lissamine green stain: Stain that targets devitalized cells while ensuring to leave healthy cells alone.10

Rose bengal stain: Stains dead cells on the ocular surface, excellent for evaluating evaporative dry eye.10

Schirmer test: A paper strip is placed inside the eyelid for a few minutes to determine how much of the paper is wetted by your tears.6

TearLab: A device that determines tear osmolarity, which is the amount of salt in the tears.7

Meibography: Technology to photograph and assess the meibomian glands inside the eyelids.

Dry eye can be treated in several ways and depends on the type of dry eye present. Most commonly, dry eye is treated with artificial tears, which are lubricating eye drops to supplement the tear film. Dry eye can also be treated with warm or hot compresses, in the case of evaporative dry eye. Heated compresses warm up the meibum inside our eyelids and allow for more optimal secretion onto the ocular surface. Punctal plugs can be used to treat dry eye. These plugs are inserted into the punctum (tear duct) of our eyelids blocking tears from draining off the front of our eyes. Steroid drops can be used short term to reduce ocular surface inflammation, but can have lasting side effects.6

Dry eye disease, when severe, can be debilitating to some patients. Treating dry eye requires consistent compliance with treatment regimens, including recommended follow-ups with an eye care practitioner to determine progress and symptom improvement. Co-management with primary care physicians and specialists to determine if a patient’s dry eye is caused by a systemic disease or by a habitual medication is essential is tackling the signs and symptoms.

The content provided on this page is provided for educational purposes only and is not a substitute for professional medical advice and consultation. Please consult your eye care or health care provider if you are seeking medical advice, diagnosis, or treatment. Click here for our full legal disclaimer.

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