Dry Eye Disease
What is Dry Eye Disease?
Dry Eye is a common disease affecting vision quality and eye comfort. Symptoms of Dry Eye can vary widely from patient to patient.
People with Dry Eye may experience one or more of the following symptoms:
- Dry, gritty, or itchy sensation
- Stinging
- Irritation
- Light sensitivity
- Visual fluctuation
- Watery eyes
- Stringy mucus near the eye
At our clinic, we use a number of different technologies to determine whether you may be experiencing Dry Eye and to better understand your symptoms. Dry Eye is a serious condition that can dramatically affect your vision and your eye health.
Diagnosis
Dry eyes can be diagnosed through a comprehensive eye examination. Testing with emphasis on the evaluation of the quantity and quality of tears produced by the eyes may include:
- Patient history to determine the patient's symptoms and to note any general health problems, medications or environmental factors that may be contributing to the dry eye problem. External examination of the eye, including lid structure and blink dynamics.
- Evaluation of the eyelids and cornea using bright light and magnification. Measurement of the quantity and quality of tears for any abnormalities.
- Special dyes may be put in the eyes to better observe tear flow and to highlight any changes to the outer surface of the eye caused by insufficient tears.
- Specialized imaging of Meibomian glands and tears with Keratograph. With the information obtained from testing, your doctor can determine if you have dry eyes and advise you on treatment options.
Dry Eye Causes
What Causes Dry Eye?
What causes Dry Eye? Dry eye can be influenced by a number of factors related to environment and health that determine tear quality.
Tears have 3 layers:
- A mucus layer,
- An aqueous (watery) layer, and
- A lipid (oily) layer.
If there’s an imbalance in these layers, your vision and comfort of your eyes may be affected. For example, if not enough lipid layer is being produced, tears may evaporate too quickly and cause symptoms ranging from discomfort to extra tear production and poor quality of vision. Poor tear quality is often caused by Meibomian Gland Dysfunction (MGD), a condition that impacts the production of oils in your tears. The most common form of MGD is obstruction of the oil producing glands in the eyelids. At Eyecare Experts, we will test your tear quality to determine whether MGD is contributing to or causing your dry eye symptoms and create a customized treatment plan to address it.
Craig JP, Nichols KK, Akpek EK, et al. TFOS DEWS II Definition and Classification Report. Ocul Surf. 2017;15(3):276-283. doi:10.1016/j.jtos.2017.05.008
The Tear Film
The Tear Film
An intact tear film ensures that our eyes do not dry out. It consists of several layers, with an oily lipid layer protecting the watery layer beneath it from evaporating. The watery layer contains oxygen and supplies the cornea with essential nutrients. Beneath this, there is a mucous mucin layer by which the tear film adheres to the cornea. The tear film also protects the eye against foreign bodies and bacteria.
The Meibomian glands
Meibomian glands
The meibomian glands are located along the inner edge of the eyelids. They produce the lipids of the oily layer. This is distributed across the ocular surface with every blink of the eye, protecting the tear film from evaporating too quickly. If the functions or structure of the tear film are impaired, this leads to sensations of dryness.
Detecting Dry Eye
Detecting Dry Eye Reliably
There is no single test to reliably diagnose dry eye, as there are always several factors involved, and sufferers may report a variety of symptoms. The key to proper analysis of the various factors involved in eye wetting disorders and determination of their causes lies in a broad-based diagnostic approach. The necessity of this is already evident in view of the variety of risk factors that may trigger dry eye symptoms.
Risk factors for dry eye:
- Meibomian gland dysfunction
- Rosacea
- Diabetes mellitus
- Vitamin A deficiency
- Glaucoma drug therapy
- Corneal surgery
- Environmental factors such as:
- smoke, ozone, dry air, air conditioning, VDU work etc.
- Allergies
