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Dry Eye

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What is Dry Eye?

Dry eye disease is a common condition that affects a large majority of the population and occurs when your tears aren't able to provide adequate lubrication for your eyes. Tears can be inadequate and unstable for many reasons. There are multiple forms of dry eye which affect the eyes in different ways. 

 

  • Aqueous Deficient Dry Eye: The eyes do not produce enough of the aqueous layer or watery layer of the tear film. 

 

  • Evaporative Dry Eye is when portions of the tear film evaporate quickly and do not provide an adequate tear film. 

 

  • Inflammatory Dry Eye occurs when inflammation around the lids and lashes leads to a reduction of the oily layer of the tear film. 

 

  • In some cases some patients will have a combination of more than one type of dry eye.

What Causes Dry Eyes?

  • Allergies

  • Autoimmune conditions such as Hyper or Hypothyroidism, Rheumatoid Arthritis, Psoriatic arthritis, Crohn's disease and much more. 

  • Daily Environment (dusty, windy, hot/dry) such as working in a construction site, kitchen, or hospital etc. 

  • Decreased hormones associated with aging

  • Pregnancy and associated hormonal changes

  • Eyelid inflammation (blepharitis and meibomian gland dysfunction) 

  • Medication/supplement use including, such as OTC cold medicines, anti-histamines, beta-blockers, pain relievers, sleeping pills, diuretics, hormonal replacement, and oral contraceptives

  • Sjogren's syndrome (dry mucous membranes throughout body)

  • Eye surgery, post refractive surgery (LASIK or PRK)

  • Contact lens use and contact lens overwear. 

  • Neurologic conditions including: stroke, Bell's palsy, Parkinson's, trigeminal nerve dysfunction

  • Exposure keratitis, eyelids do not close completely during sleep (lagophthalmos)

  • Diabetes

  • Infectious Keratitis, including Herpes Simplex and Herpes Zoster Keratitis

  • Neurotrophic Keratitis

Dry Eye Symptoms

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Meibomian Gland Dysfunction and Blepharitis

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A huge part of a dry eye exam is evaluating the lids and lashes. These two areas give us great cues into the quality of someone's dry eye. Also, the lids essentially house the eye, so if the eye is dry we can expect that the lids and lashes will show signs of dryness too. Meibomian gland dysfunction and blepharitis are eye conditions that overlap. Both affect the eyelid, but while blepharitis affects the front of the eyelid, meibomian gland dysfunction affects the back.

Meibomian gland dysfunction (MGD) is a condition that affects the few dozen tiny glands in our eyelids that help make up the oil layer of our tears. The oily layer of our tear film is key to preventing dry eye, as it helps lubricate and hydrate the front surface of our tear film. The oily layer also slows down the evaporative process of our tears. With MGD the glands around our eyelids become clogged and no longer release the oils that our tear film and eye requires to stay hydrated. 

Typical findings with Blepharitis include flaky lashes and swollen lids. Blepharitis typically occurs as a result of a blockage in the oil glands at the base of the eyelashes, sometimes as a result of a demodex mite infestation. Demodex mites are part of the normal adult human facial skin flora. This is a totally normal part of bacteria that resides on the glands of our skin. In some cases some patients have more demodex than others causing inflammation of the lids and lashes.

Treatments For Dry Eyes

Although there is current no way to fully cure dry eye, there are multiple ways to relieve symptoms. The main goal is to help imrove tear production and to cut down eye inflammation. Currenlty there  are many different types of medicated drops that help improve tear prodcution. There is even a nasal spray that helps eyes produce more tears. With that there are also multiple in office procedures that help stimulate glands around the eye lids to release more tears or improve the quality of tears. Within the past few years there has a been a vast improvement in what your eye doctor can provide you to help to relieve your symptoms of dry eye. Schedule an Dry Eye Evaluation today to see how Everyone Eyecare can help you. 

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