What is Dry Eye Disease? 

With each blink of the eyelids, tears spread across the front surface of the eye providing lubrication, keeping the surface of the eyes smooth and clear, washing away foreign matter in the eye and reducing the risk of eye infection. To drain, tears in the eyes flow into small drainage ducts in the inner corners of the eyelids, which empty into the back of the nose. Dry eyes can occur when tear production and drainage is not in balance.

Diagnosis

Tests and procedures that may be used to determine the cause of your dry eyes include:

  • A comprehensive eye exam. An eye exam that includes a complete history of your overall health and your eye health can help us diagnose the cause of your dry eyes.
  • A comprehensive ocular surface analysis which we should include:
    • Measuring the volume of your tears. We use non-invasive methods which have been shown to be more accurate.
    • Determining the quality and stability of your tear film. Other tests use special dyes in eyedrops to determine the surface condition of your eyes. Your doctor looks for staining patterns on the corneas and measures how long it takes before your tears evaporate.
    • Determining your level of ocular inflammation. Dry eye disease is an inflammatory condition and managing your long term ocular health depends on improving the quality and quantity of your tears as well as managing the resultant inflammatory changes.

Causes

There are many, often interrelated causes of dry eye, including:

  • Age. Dry eyes are a part of the natural ageing process. The majority of people over age 65 experience symptoms of dry eyes at some stage.
  • Gender. Women are more likely to develop dry eyes, often due to hormonal changes caused by pregnancy, the use of oral contraceptives and menopause.
  • Medical conditions. Local inflammation of the eyelids (blepharitis) or inflammation of the ocular surface can cause dry eyes to develop.  People with rheumatoid arthritis, diabetes, rosacea, thyroid problems and many other health conditions are also likely to have symptoms of dry eyes.
  • Medications. many medicines, including antihistamines, decongestants, blood pressure medications and antidepressants, can reduce tear production.
  • Environmental conditions. Exposure to smoke, wind and dry climates and air conditioning can increase tear evaporation causing dry eye symptoms. Failure to blink regularly, including staring at a computer screen for long periods of time, can also contribute to drying of the eyes.
  • Other factors. Long-term use of contact lenses can be a factor in the development of dry eyes. Refractive eye surgeries, such as LASIK, can decrease tear production and contribute to dry eyes.

Management 

The primary approaches used to manage and treat dry eyes are to improve the quality and quantity of tears and treating the inflammation of the eyelids or eye surface that contributes to the dry eyes.

  • Increasing tear volume. Mild cases of dry eyes can often be managed using over-the-counter artificial tear solutions. These can be used as often as needed to supplement natural tear production. Preservative-free artificial tear solutions are recommended because they contain fewer additives, which can further irritate the eyes.
    People with dry eyes that don’t respond to artificial tears alone will need to take additional steps to treat their dry eyes. Tear supplements may need to be highly specific depending upon the specific condition of your eye. There are even some that are made from your blood plasma that are used in severe cases.
  • Conserving tears. Keeping natural tears in the eyes longer can reduce the symptoms of dry eyes significantly. This can be done by blocking the tear ducts and reducing tear drainage, or trying to manipulate the humidity of the environment around the eye, including wearing goggles  The tear ducts can be blocked temporarily or permanently if needed. Or a surgical procedure can even permanently close the tear ducts in . In either case, the goal is to keep the available tears in the eye longer to reduce problems related to dry eyes.
  • Increasing the quality of your tears. These may include:
    • Taking an omega-3 fatty acid nutritional supplement may help.
    • Regular heat treatment with warm compresses.
    • Some people benefit from IPL treatment to improve the functioning of the tear oil glands.
  • Treating the contributing eyelid or ocular surface inflammation. Your optometrist might recommend prescription eye drops or ointments, warm compresses and lid massage, or eyelid cleaners to help decrease inflammation around the surface of the eyes.

Book an appointment now for a comprehensive ocular surface health analysis.

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