Dry Eye

Millions of people are affected by Dry Eyes.  

Dry eye is a common condition in which the eyes are insufficiently lubricated, leading to redness and pain. The eyes can become dry and irritated because there is an insufficient amount of tears being produced, or because there is an imbalance in the makeup of the tears themselves. Tears are necessary to maintain a healthy ocular surface and provide sharp vision. The tears drain through ducts in the inner corners of eyelids and flow to the back of the nose.

Tear film has three layers: Lipid layer (outermost layer), Aqueous Layer in the middle, and Mucin Layer (innermost layer).

Alleviating the symptoms of dry eye is important. Left untreated, they have the potential to damage vision due to inflammation and scarring.

Dry eye may be due to Meibomian gland dysfunction which leads to reduced oil in the oily layer of the natural tear film leading to evaporative loss as it is not able to protect the aqueous or water layer of the eye. (Meibomian glands are present in the eyelids). 

The Lacrimal Glands contribute to the aqueous layer of the tear film, required for maintaining a healthy ocular surface.

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Causes of Dry Eye

People of all ages may be affected by dry eyes. It can result from certain medications, medical conditions or injuries. Dry eye tends to affect women more than men because of the hormonal changes that take place during pregnancy and menopause. Oral contraceptives can also affect the consistency of tears. Other causes of dry eye include the following:

  • Oral medications including: Antihistamines, decongestants, blood pressure medications, antidepressants.
  • Rheumatoid arthritis, diabetes, Sjögren's syndrome, and thyroid disease
  • Environmental conditions such as smoke, wind or excessive sun
  • Long-term contact lens use
  • Eye injury
  • Eye or eyelid surgery
  • Inflammation of the eye (conjunctivitis or keratitis), blepharitis

Any of these factors, alone or in combination, can affect the frequency or consistency of tears, either of which can lead to dry eye.

Symptoms of Dry Eye

The symptoms of dry eye typically occur in both eyes, and include the following:

  • Stinging, burning or scratchiness
  • Eye fatigue
  • Sensitivity to light
  • Difficulty wearing contact lenses
  • Excessive tearing
  • Blurry vision

Dry eye can damage eye tissues, leaving tiny abrasions on the surface that can impair vision. There are, however, many treatments for relieving dry-eye symptoms, restoring eye health, and protecting vision.

Treatment of Dry Eye

Treatment for dry eye depends on its cause and severity, as well as the patient's overall health and personal preference.

Nonsurgical treatments, which include the following, are often effective:

  • Deliberately blinking/ increasing rate of blinking
  • Increasing humidity levels at home and at work
  • Using artificial tears or a lubricating ointment
  • Avoiding environmental irritants
  • Eliminating medications that may be responsible
  • Adding Omega-3 fatty acids to the diet or taking them as supplements
  • Insertion of punctal plugs to limit tear drainage
  • Punctal cautery to permanently close the drainage holes
  • Treatment of an underlying disease

If an eyelid condition is causing dry eye, eyelid surgery may be recommended.

If dry eye is left untreated, it can lead to complications that include pain, corneal ulcers/scars or vision loss.

Artificial tears and ointments over the counter to provide lubrication to the ocular surface are temporary measures to provide relief.

Serum Tears from a patient's own blood containing proteins and growth factors to improve the health of the ocular surface.

Prescription eye drops are also available to address the causes of dry eye such as inflammation and improve tear film quality.

LipiFlow Treatments

Lipiscan is a high definition imaging that helps to identify structural changes to the meibomian glands and allows capturing and storing the images of these glands which are vital to the health of the ocular surface.

LipiFlow is a treatment available for evaporative dry eyes due to meibomian gland disease with deficient lipid production.

The LipiFlow system applies local pulsed heat to the eyelids for patients with Meibomian Gland Dysfunction using a sterile single-use device called an Activator.  It helps improve and relieve the blockage of the meibomian glands which contribute to the lipid layer of the tear film.

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Preventing Dry Eye

There are steps that can be taken to prevent dry-eye symptoms. Simple lifestyle modifications such as wearing protective glasses on windy days and giving the eyes a break during reading or other tasks that require intense focus can effectively reduce the frequency and severity of symptoms. 

Humidifiers may be used to increase humidity to the living environment at home and at work.

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