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Dry as a Desert - A Series About Dry Eyes

Dry Eyes

Welcome to part 1 of the dry eye series where we explain everything from what dry eye is, symptoms associated with this condition, types of dry eye, and treatments available.

This is a big topic in the eye field. First and foremost, most everyone is going to be diagnosed with dry eye at some point in time. Our lifestyles in the modern day do not lend us a lot of opportunities to properly rest and relax our eyes. We have constant digital device use, swinging temperatures, contact lens wear, and more to point to for why so many people have dry eyes! This article is going to touch on the basics to get you started, stay tuned for a deep dive on this topic further into this series ;)

So What is dry eye?

Dry eye, aka keratoconjunctivitis sicca, is a condition brought on by a reduced or poorly functioning tear film within the eye. There are 3 kinds of dry eye - evaporative, aqueous deficient (low liquid), and inflammatory. The most common that we see clinically is evaporative. To explain this further I’ll first talk about the anatomy of our eyes.

Our tear film consists of 3 components, the mucous layer, watery layer, and oily layer. The mucous layer comes from the goblet cells we house within our conjunctiva. The watery layer is produced by our lacrimal glands, and the oily layer comes from our meibomian glands within the upper and lower lids of our eyes.

Profile view about anatomy of the ocular tear film and components contributing to the tear layer

Back to the 3 types of dry eye:

Evaporative dry eye is typically due to the lack of oil production from, or sometimes clogging of, our Meibomian glands. We excrete oils from these glands every time we blink! So you can imagine how when using digital devices, and stareng all day at a screen, we can essentially stall reinforcement of our oily layer due to the simple lack of blinking.

  • Aqueous deficient dry eye comes from an insufficient amount of aqueous production from our lacrimal glands. Certain medications we take can also lead to this deficiency.

  • Inflammatory dry eye is typically born from systemic issues, either systemic microvascular or autoimmune conditions. We can also have local inflammation such as blepharitis (lid inflammation) which can also cause dry eye.

What does it feel like?

Symptoms for dry eye can range, common symptoms include the following:

  • Redness

  • Itching

  • Excessive tearing

  • Sharp and random pain

  • Intolerance to moving air (AC/fan)

  • Contact lens intolerance

  • Light/glare sensitivity

  • Foreign body sensation

How do we treat it?

That’s a bit more complicated. The type of dry eye you have will determine the type of treatment you might need. Often for evaporative dry eyes, the treatment requires that we get those pores (meibomian glands) functioning again! In this case, you will usually be prescribed at-home warm compress therapy, and specialized artificial tears during the day to supplement the tears you’re losing. For aqueous deficient, artificial tears work yes, but it’s often just a bandaid. If you’re not producing enough tears, a medicated therapy may be required to increase tear production.

There are also new and innovative treatments more available to us now and for longer lasting treatment times. These include: Intense Pulse Light therapy, Radio Frequency, In-office heated lid treatments, Lid and lash cleansing with ZEST protocol, and more. Specialty lenses are also a great option! You don’t have to give up on contact lens wear because you can’t tolerate traditional soft lenses, ask Dr. Gohel if you’re curious.

All in all, your annual eye exam can lead to a lot more benefits for your eyes than just visual improvement. Your ocular health assessment is such an important part of your exam, and you may have conditions like dry eye that need further intervention as highlighted in this article.

We’ll be exploring these topics in further depth as we move along in this series, thanks for checking in, stay tuned :)

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