Acute Red Eyes
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Dry Eye Disease

Published on
December 4, 2023
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Dry eye disease describes a spectrum of conditions that feature ineffective lubrication of the eye. Symptoms range from discomfort through to disabling pain, redness and fluctuating vision and can impact on many visual activities.

The underlying causes of dry eyes are complex and numerous and need a thorough examination for your optometrist to determine the cause and most appropriate treatment. At our Adelaide and Henley Beach practices our therapeutic optometrists are equipped with the technology to appropriately diagnose and treat dry eye disease.

What causes dry eye disease?

The tear film is made up of three elements: the mucin (mucous) layer, the watery aqueous layer and the oily lipid layer.1 Specialised cells (such as goblet cells) embedded throughout the surface of the eye create the mucin component. The lacrimal gland under the bony aspect of the eyebrow secretes the watery aqueous component. The meibomian glands in the upper and lower eyelids secrete oil to make up the lipid component.

In most dry eye cases, the watery aqueous component is produced at normal quantities but evaporates too quickly. This is called evaporative dry eye. There are three main causes: blepharitis, meibomian gland dysfunction and environmental factors.1

1) Blepharitis is inflammation of the eyelid margins. This is a chronic condition that arises from overpopulation of bacteria or mites (demodex) on the eyelid or within the eyelash follicles. 2) Meibomian gland dysfunction (MGD) occurs when the oil-producing glands stop making enough lipid. Since this layer keeps tears from evaporating, newly produced tears quickly disappear. 3) Environmental factors such as air-conditioning, humidity, extended screen time or wind can result in excessive tear evapration.

Severe cases of dry eye are due to low production of aqueous tears, referred to as aqueous deficient dry eye. This is less common than evaporative dry eye, and may be due to autoimmune disease, dehydration, poor sleep, medication or prior eye surgery.1

How can dry eye disease be treated?

Dry eye disease treatment is tailored depending on the cause (blepharitis, MGD, environmental or aqueous deficient). It is also tiered, in that mild treatments are used first followed by more intense methods if other therapies fail. See our complete list of dry eye treatments here. Most of these treatments for mild dry eye disease can be completed at home, but we also have a host of more intense therapies that can be complete in-office. See the list of treatments our optometrists can perform at Innovative Eye Care here.

References

1) Clayton JA. Dry Eye. N Engl J Med. 2018 Jun7;378(23):2212-2223. doi: 10.1056/NEJMra1407936.

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