Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, blurred vision, fluctuating vision, and tear film instability with potential damage to the ocular surface. It is accompanied by increased concentration of salts in the tear film and inflammation of the ocular surface.
A thin film of tears coats the eye and serves to lubricate the eye, reduce friction between the eyelid and the ocular surface, protect the eye from infection, sweep away foreign matter, and provide a smooth refractive surface to give clear vision. The tear film consists of three layers: mucin, aqueous, and lipid. The mucin layer consists of long chain polysaccharides produced by cells on the eye. The mucin layer is responsible for holding tears onto the surface of the eye. The aqueous layer is produced by the lacrimal gland. It is the watery layer to our tears. The lipid layer is the outermost layer and is produced by the meibomian glands of the eyelids. The lipid layer stabilizes the tear film and reduces the evaporation of the tears.
Dry eye disease can be classified into two types, aqueous deficient dry eye and evaporative dry eye. Aqueous deficient dry eye results from an insufficient aqueous layer of the tears. It is due to dysfunction of the lacrimal gland; this can be caused by certain medications, inflammatory disease, or certain auto-immune diseases such as Sjogren’s, rheumatoid arthritis, and systemic lupus erythematosus. Evaporative dry eye disease is caused by blockage and dropout of the meibomian glands, this can be due to bacterial biofilms and exotoxins, inflammation, or a diet lacking essential fatty acids. Rosacea is a chronic inflammatory disease that is also known to cause meibomian gland dysfunction and evaporative dry eye.
Treatment is tailored specifically to the type of dry eye disease and its severity. We have special equipment to diagnose and treat dry eye. Treatment might be simple at-home therapy such as artificial tears or warm compress masks. We also have a BlephEx instrument to remove harmful bacteria and build along the eyelids. Our latest addition is the LipiFlow device for removing blockages from meiboiman glands and restoring meibomian gland function.