Many people have dealt with minor episodes of dry eyes, while for some this condition is chronic and frustrating to deal with.
Dry eye disease (DED) means just what it sounds like, but it can range from mild to extremely severe in its symptoms and has several underlying causes with a huge range of treatments.
At its core, it is due to an inadequacy of the quantity or quality of tear film fluids that need to cover all surfaces of the eye. Read on to learn about symptoms, signs, and management for dry eyes.
DED can present in a variety of different ways but some symptoms include eye irritation, discomfort, gritty feeling, burning sensation, or the feeling of something stuck in the eye.
This may be accompanied by blurry or fluctuating vision, light sensitivity, and an inability to tolerate contact lens wear.
Paradoxically, you might also experience excessive eye watering if the eyes are dry, because the eye overreacts to dryness and rapidly produces a lot of watery tears that have nowhere else to go. This is especially true if you live in a dry or windy climate.
Finally, you may experience no symptoms at all, even if our optometrist notices objective signs of dryness in your eye examination. This disconnect between appearance and symptoms is common in DED as well.
A primary cause of DED is an increase in salt concentration of the tear film, leading to damage to the front surface of the eye from inflammation. This increase in salt concentration can be caused by either too little secretion of water onto the surface of the eye or from evaporation of the tears from the front surface that is too quick.
The resulting inflammation on the eye surface decreases the amount of tear production even more, resulting in a vicious cycle. Nutrients in the tears necessary for eye health, like mucous, ions, minerals, sugars, etc. are also reduced in this case. Our optometrist will perform a variety of tests to pinpoint what the main cause of your dry eye is.
Aqueous deficient dry eye, just as it sounds, is when there is not enough water in the tear film due to decreased production. This leads to increased salt concentration in the tears and resulting inflammation.
The main methods of treatment for this DED type include immunomodulator medications, humidifiers, nighttime eye ointments, and artificial tears. Enhanced methods like specialized contact lenses and surgical procedures might also be options.
Evaporative dry eye is mainly due to the blockage or destruction of the oil secreting glands in the eyelids. These glands are located in the upper and lower eyelids and can die off with age, disease, blockage, or injury and do not regrow.
These glands secrete oils onto the eye with each blink to prevent excessive tear evaporation. The lack of a good oil component in the tears causes the tear film to evaporate too quickly.
Treatment for this type of dry eye disease would include warm compresses to make the glands secrete their oils, eyelid massage to express the secretions, and omega-3 fatty acid supplementation to improve the consistency of the oils and reduce inflammation in these glands.
One can also have mixed dry eye, a combination of the above two types, and thus treatment would include a combination of both of these DED subsets. Most individuals will have a combination of both, at varying levels, and thus treatment will include a wide set of daily practices to help maintain the ocular surface.