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What is Dry Eye?

Dry Eye is a long-term chronic disease that causes discomfort and may compromise vision if left untreated. There are two forms of Dry Eye:  Evaporative Dry Eye and Aqueous Deficient Dry Eye. The condition occurs when the eyes do not produce enough tears or the appropriate quality of tears to keep the eyes lubricated, healthy and comfortable. The eyes produce tears either at a slow, steady pace or they produce large quantities of tears due to irritation or crying. Excessive tearing from Dry Eye may sound counter intuitive, but it is the eye’s response to discomfort. If the tears do not keep the eye wet enough, the eye becomes irritated and prompts the gland to make more tears.

Blinking produces a film of tears that covers the eye, making its surface smooth and clear. Good vision is not possible without this tear film. The tear film consists of three layers:

  • Lipid (oil) layer - lubricates and prevents evaporation
  • Aqueous (water) layer -nourishes and protects the cornea
  • Mucin layer - adheres to the eye

Aqueous Deficient Dry Eye occurs when the lacrimal glands do not create a sufficient amount of aqueous (water) to keep the eyes moist. Traditional treatments such as topical eye drops may help alleviate symptoms from this form of Dry Eye.

Evaporative Dry Eye is caused by blockage in the Meibomian glands that create the lipid (oil) layer of the tear film and are located in the eyelids. This condition of obstructed glands is known as Meibomian Gland Dysfunction (MGD). When the glands aren’t working properly, they do not produce enough tear film oil and the tears, which lubricate and keep the eyes comfortable, evaporate too quickly.  An insufficient oil layer can cause tears to evaporate four to six times faster. Although there are many treatment options available, traditional methods have proven ineffective for some. Fortunately, Chesapeake Eye Care and Laser Center now offers LipiFlow®, the most revolutionary Dry Eye treatment available. This amazing breakthrough technology helps unblock the glands, improving oil secretions and providing symptom relief. 

What causes Evaporative Dry Eye?

  • Age, contact lens use and hygiene, cosmetic use, and illnesses, particularly diabetes, may cause or exacerbate Evaporative Dry Eye.
  • Hormonal changes in women during menopause, particularly decreasing levels of estrogen, can cause thickening of the oils secreted by the Meibomian glands, which in turn can result in blockages.
  • Decreased estrogen levels may enhance conditions under which staphylococcal bacteria can proliferate in Meibomian glands.  This results in a decreased oil secretion rate.

Who’s affected?

Over 100 million people worldwide suffer from Dry Eye disease. Men and women at any age can be affected; however, Dry Eye increases with age and often affects women after menopause.

What are the symptoms?

  • Dryness
  • Itching
  • Burning
  • Stinging
  • Tearing
  • Redness
  • Sensation of something in your eye
  • Sensitivity to light

Why is it important to treat Dry Eye?

If left untreated, Dry Eye can result in visual deterioration. Dry Eye is a real physical condition that requires treatment to stop the cycle of deterioration and worsening symptoms. It is a chronic disease that must be properly diagnosed and managed. Without proper treatment, Dry Eye deterioration may result in:

  • Increased tear evaporation
  • Unstable tear film
  • Damage to the eye’s surface (cornea)
  • Higher levels of discomfort
  • Inflammation and cell damage
  • Fluctuation and decrease in vision

Additional Treatments for Dry Eye

Punctal Plugs
Punctal Plugs are an adjunct in Dry Eye treatment. Punctal Plugs preserve a patient's own tears by reducing the drainage of tears through the nasolacrimal duct. They are available in both temporary and permanent forms.

Eye Drops
Many forms of eye medications are available to include artificial tears, allergy eye drops, Restasis®, and Xiidra®. These medications work by various mechanisms to add to the tear volume, allow the tears to better coat the eye or block cells which compromise the ocular surface.

PROKERA® biologic corneal bandage devices are used by eye doctors around the world to heal and treat eye diseases such as, keratitis, common Dry Eye, recurrent corneal erosions, filamentary keratitis, persistent epithelial defects, neurotrophic corneas, herpetic ulcers, and many other ocular surface diseases.

Are Dry Eye symptoms affecting you?

If you experience any Dry Eye symptoms on a regular basis or if simple activities like reading, using a computer, watching television, driving or even wearing contact lenses become difficult, please give us a call at 1-877-DR4-2020 to schedule an evaluation or email us to request an appointment.

Erin Benjamin, M.D.
Erin Benjamin, M.D.