According to the National Institutes of Health (NHI), the prevalence of dry eye disease around the world varies from 5% to 34%. Dry eye disease is defined as a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface.
Dry eye disease can influence the ocular surface (cornea, conjunctiva and accessory lacrimal glands), meibomian glands (which produce the outer lipid film of the tear film) and the lacrimal gland.
How do tears work?
When you blink, tears spread over the eye. This keeps the eye’s surface smooth and clear. Tears are important for good vision.
Tears are made up of three layers:
- An oily layer
- A watery layer
- A mucus layer
Each layer of your tears serves a purpose.
The oily layer is the outside of the tears. It makes the tear surface smooth and keeps tears from evaporating too quickly. This layer comes from the meibomian glands in the eyelids.
The watery layer is the middle of the tears. It makes up most of what we see as tears. This layer cleans the eye, washing away particles that do not belong in the eye. This layer comes from the lacrimal glands in the eyelids.
The mucus layer is the inner layer of the tears. This helps spread the watery layer over the eye’s surface, keeping it moist. Without mucus, tears would not stick to the eye. Mucus is made in the conjuctiva. This is the clear tissue that covers the white of your eye and inside your eyelids.
Normally, our eyes constantly make tears to stay moist. If our eyes are irritated, or we cry, our eyes make a lot of tears. But, sometimes the eyes don’t make enough tears or something disturbs one or more layers of the tears. In those cases, we end up with dry eyes.
What are the main causes of dry eye disease?
People tend to make fewer tears as they get older due to hormonal changes. Both men and women can get dry eye. However, it is more common in women—especially those who have gone through menopause.
Here are some other causes of dry eye.
- Certain diseases, such as rheutmatoid arthritis, Sjögren’s syndrome, thyroid disease, and lupus
- Blepharitis (when eyelids are swollen or red)
- Entropion (when eyelids turn in); ectropion (eyelids turn outward)
- Being in smoke, wind or a very dry climate
- Looking at a computer screen for a long time, reading and other activities that reduce blinking
- Using contact lenses for a long time
- Having refractive eye surgery, such as LASIK
- Taking certain medicines, such as:
- Diuretics (water pills) for high blood pressure
- Beta-blockers, for heart problems or high blood pressure
- Allergy and cold medicines (antihistamines)
- Sleeping pills
- Anxiety and antidepressant medicines
- Heartburn medicines
It is important to tell your optometrist about all the prescription and non-prescription medicines you take during your consultation.
Common symptoms of dry eye disease
- You feel like your eyes are stinging and burning.
- Blurred vision, especially when reading
- There is a scratchy or gritty feeling like something is in your eye.
- There are strings of mucus in or around your eyes.
- Your eyes are red or irritated. This is especially true when you are in the wind or near cigarette smoke.
- It is uncomfortable to wear contact lenses.
- You have lots of tears in your eyes.
Having a lot of tears in your eyes with dry eye might sound odd. But your eyes make more tears when they are irritated by dry eye.
How is dry eye disease diagnosed?
Your optometrist will begin with an eye examination. They will look at your eyelids and the surface of the eye. They will also evaluate how you blink.
There are many different tests that help diagnose dry eyes. Your optometrist will do a test that measures the quality or the thickness of your tears. They will also measure how quickly you produce tears as well as how quickly the tear film starts to break up.
Treatment of dry eye disease
It is important to know that dry eye is a chronic disease, that treatment is long-term and may be slow to take effect. By diagnosing the cause of your dry eyes, your optometrist will decide on a specific treatment plan. The avoidance of aggravating factors such as cigarette smoke, dry heating air, air conditioning, and others is a fundamental part of treatment.
- Artificial tears
Artificial tears are the mainstay of therapy for all severity grades of dry eye disease. Artificial tears increase tear film stability, reduce ocular surface stress and improve the optical quality of the ocular surface.
- Anti-inflammatory treatment
Even with only moderately severe dry eye, there is an inflammatory reaction of the ocular surface. To break the vicious circle of surface damage and inflammation, anti-inflammatory treatment may be required. - Heat compression
The heat from the compress helps to melt and loosen the oil buildup in the meibomian glands, allowing it to flow more freely and lubricate the eye surface, alleviating dryness. After removing the heat compression, blink your eyes a few times by squeezing them tight and opening them to express the oil from the meibomian glands. - Blephasteam treatment in the optometric practice
A Blephasteam is a medical device used to treat dry eyes by delivering warm, moist heat to the eyelids, which helps to unblock the meibomian glands responsible for producing the oily layer of tears, thus improving tear quality and alleviating dry eye symptoms; essentially, it's a pair of goggles that create a humid environment to melt and express clogged oils from the glands, providing relief for dry eye conditions like Meibomian Gland Dysfunction.
After the session with the Blephasteam, the optometrist will do expressions on the lower and upper lid to remove all oil buildup from the meibomian glands.
At Spectacle Warehouse we offer all of the above treatment options for dry eye disease. Contact us today to make an appointment for the evaluation of your dry eye. We will perform all the necessary test to determine a specific treatment plan for you.