Dry Eye Disease
What is Dry Eye Disease?
Dry eye disease (DED) is a multifactorial, often chronic and progressive, inflammatory disease of the tear film and ocular surface that can lead to eye discomfort, visual disturbance, tear film instability, and potential ocular surface damage, if not treated timely and appropriately. The most important ocular structures involved in dry eye patients include the meibomian glands, cornea, conjunctiva, and the tear film. The tear film consists of 3 layers -- the mucin layer, the aqueous layer, and the lipid layer. Majority of the patients suffer from a lack of the outermost layer of the tear film, called the lipid (oily) layer, which is caused by a blockage of the meibomian glands, causing the tears to evaporate quicker than normal. This is known as Meibomian Gland Dysfunction (MGD), which is the most common type of dry eye disease.
Dry eye is a condition that is associated with many risk factors, such as:
- digital device use
- ocular surgery
- contact lens wear
Various medications (such as antihistamines, decongestants, and antidepressants) as well as certain systemic conditions (such as Sjogren’s, Lupus, Rheumatoid Arthritis, Thyroid Disease, and Diabetes) can also play a role in developing dry eye disease.
Patients suffering from dry eyes can experience symptoms ranging from:
- foreign body sensation
- light sensitivity
- blurry vision
- fluctuating vision
- tired or red eyes
- overall eye discomfort
- eye fatigue
Some of the most common daily tasks affected include watching tv, computer work, and driving at night. Contact lens intolerance is a key finding in patients who have dry eye disease.
There are a variety of treatment options available for patients suffering from dry eye disease. The severity of the patient’s signs and symptoms often dictates the type of therapy that is recommended. Some of the different therapeutic approaches include artificial tears, ointments, and nutritional supplements, such as omega vitamins. When patients have more severe dry eye disease, prescription drops, such as topical anti-inflammatories, Xiidra, or Restasis, are usually started. Oral antibiotics are sometimes instituted for improved relief. Several other options include lid hygiene, heat masks, punctal plugs, autologous serum tear drops, amniotic membrane tissue, such as Prokera, and scleral lenses. Thermal and laser treatments are also available, via LipiFlow and BBL or IPL, respectively.
Importance of Diagnosing and Treating Dry Eye Disease
If you are experiencing dry eye disease, it is crucial to have it treated for several reasons. One of which is to prevent eye infections, ulcers, or corneal scarring. The other benefit is to improve contact lens wear for longer and more comfortable hours. Also, it is crucial to have a healthy ocular surface prior to any eye surgeries, such as LASIK, PRK, or cataract, to maximize the best surgical outcomes.