Dry eye disease can be divided into two major categories: patients with Poor Tear Production and Evaporative dry eye. The tears of our eyes are a complex composition of oils, mucin and liquids. In order for our tears to adequately lubricate the structures of our eye’s they need to have the correct saltiness (osmolarity), liquid, mucin and oily component. If any of these are not in the correct proportion, we may experience symptoms of dry eye disease.
Symptoms Of Dry Eyes
Symptoms of dry eyes are below:
- Contact lens discomfort
- Fluctuating vision
- Soreness or irritation
- Burning or watering
- Eye fatigue
- Light sensitivity
Dry Eye Causes
There can be a variety of causes of Dry Eye including;
- Computer or Digital Device Use
- Climate and Environmental Factors
- Contact Lens Wear
- Eye Injuries/Surgeries
- Eyelid Conditions
- Eye Diseases affecting the Meibomian Glands
- Hormonal Changes
- Low Blink Rate
Poor Tear Production
Patients who have been diagnosed with poor tear production can be treated in a variety of ways. For patients with relatively mild dry eyes, the use of artificial tears can often relieve their symptoms.
There are a variety of artificial tears that your doctor can prescribe, all of them are over-the-counter.
These can be used as infrequently as once or twice a day to as frequently as every half-hour and more often. For patients who are allergic to the preservatives in some artificial tears and for those who will be using it frequently, your doctor may prescribe preservative free artificial tears.
In addition to doing the above, your doctor may suggest occluding the tear drainage canals, punctum, in order to allow the tears you produce to linger on your eye longer instead of being drained away. There are several techniques used to occlude the punctum: some temporary and some permanent. What is best for you should be discussed with your doctor.
For those patients who have moderate to severe dry eyes associated with poor tear production there is medication that can be used, such as Restasis, that has been shown to help restore tear production. In addition some patients have found relief in the use of autologous serum tears. Ask your doctor which treatment or combination of treatments is right for you.
Evaporative Dry Eye
Approximately 85% of patients with dry eyes, have some evaporative component. Patients with evaporative dry eye disease often have adequate tear production.
However the layer of oil that sits atop of the liquid layer may be lacking or disrupted. It is this fine layer of oil that prevents the liquid component of your tears from evaporating.
Several causes that may contribute to evaporative eye disease are an incomplete blink, and eyelid or eyelash infection, meibomian gland dysfunction to name a few.
Your doctor may suggest lid exercises that re-train your lids to close completely, allowing the oily layer of the tears to be distributed equally throughout your eye. If there is an infection, antibiotics and or steroids, anti-inflammatory medication, may be prescribed.
Often non ethyl ester formulated omega-3 supplements will be dispensed that can also offer relief. For moderate to severe dry eye patients who have the evaporative form of dry eye an FDA approved therapy called LipiFlow may offer long-term relief.
Each case of dry eye is unique. Successful alleviation of symptoms can be achieved through a number of treatment options. After a thorough exam, our doctors will choose the treatment options that are best for your specific needs. Treating other medical conditions such as eye lid disease, are often necessary to alleviate the symptoms associated with dry eyes.