What is Dry Eye Disease?

Dry eye disease (DED) is a condition affecting millions of people worldwide. It occurs when your eyes do not produce enough quality tears, or when the tears evaporate too quickly. Tears are not just plain saltwater; they are complex fluids composed of thousands of molecules organised into two dynamic layers:

• The Oily Layer: This  is crucial for preventing tear evaporation and stabilising the tear film. It is produced by the Meibomian glands located in the upper and lower eyelids.
• The Watery Layer: This inner layer lubricates the eyes, provides essential nutrients, and helps defend against infection.

When the balance between tear production and evaporation is disrupted, it can lead to an array of symptoms, including increased tear saltiness, inflammation, and potential damage to the ocular surface.

The Vicious Cycle

In dry eye disease, if the oily layer is too thin, the watery layer is exposed and evaporates quickly between blinks. To compensate, your eyes may produce more watery tears, which can lead to a feeling of wateriness without providing relief. However, if the watery layer is deficient, there are not enough tears to lubricate the eye during blinking. This leads to discomfort, friction, and potential surface damage from dryness.

What Causes This?

Several factors contribute to the onset of dry eye disease:

1. Meibomian Gland Dysfunction (MGD)

MGD is characterized by problems with the quality or quantity of oils produced by the Meibomian glands. When these glands do not function properly, the oily layer of the tear film is compromised, leading to increased evaporation and dry eye symptoms.

2. Aqueous Deficiency

A deficiency in the watery layer can occur for various reasons, including certain medical conditions or medications that reduce tear production. This lack of sufficient lubrication can cause discomfort and increase the risk of ocular surface damage.

3. Environmental Factors

Exposure to dry, windy, or air-conditioned environments can make symptoms worse by increasing tear evaporation. Prolonged screen time and reduced blink rates during focused tasks can also contribute to the onset of dry eye disease.

Symptoms 

The symptoms can vary widely but often include:

• Itching and Burning: A common sensation that indicates irritation.
• Grittiness or a Foreign Body Sensation: Feels like something is in the eye.
• Stinging or Discomfort: Can vary in intensity.
• Redness and Pain: May indicate inflammation.
• Wateriness: This can actually signify dryness.
• Discharge: Mucous discharge may occur in some cases.
• Light Sensitivity: Increased sensitivity to light can be troublesome.
• Tired Eyes: A feeling of fatigue in the eyes.
• Blurred or Fluctuating Vision: May occur intermittently, especially after long periods of reading or screen time.
• Puffy Eyelids and Eyelash Scales: These can be visible signs of inflammation
  and irritation.

Symptoms may worsen in the morning when waking or later in the day, particularly after extended use of digital devices, driving, or wearing contact lenses.

Diagnosing The Condition

Diagnosis typically involves a comprehensive eye examination, where your tear production and overall eye health will be assessed. Various tests may be used to evaluate tear film and the condition of the ocular surface.

Risk Factors 

Several risk factors can increase the likelihood of developing dry eye disease, including:

• Age: Tear production tends to decrease with age.
• Gender: Women, especially after menopause, are at a higher risk.
• Medications: Certain medications, including antihistamines and antidepressants, can
  reduce tear production.
• Underlying Health Conditions: Conditions such as autoimmune diseases can also contribute to dry eyes.

Treatment Options 

Managing dry eye disease is highly individualised, focusing on the specific underlying cause. 

Treatment options may include:

• Lid Hygiene: Regular cleaning of the eyelids can help manage Meibomian
  Gland Dysfunction.
• Ocular Lubricants: Artificial tears can provide temporary relief from dryness.
• Intense Pulsed Light (IPL) Therapy: This treatment can improve gland function
  and reduce inflammation.
• Tixel Treatments: A thermal procedure that stimulates the meibomian glands.
• Punctal Plugs: Small devices inserted into the tear ducts to reduce tear
  drainage and maintain moisture.

Preventing Dry Eye Disease

Preventing dry eye disease involves adopting a few proactive lifestyle habits to maintain tear health and reduce strain on the eyes.

• Blink regularly – Especially during extended screen use, to keep the eyes moist and prevent tear evaporation.
• Take frequent breaks from digital devices – Follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds.
• Use humidifiers to add moisture to the air – particularly in dry or windy environments.
• Maintaining proper lid hygiene – use a warm compress to clean the eyelids and improve gland function.
• Managing any underlying conditions – such as allergies or Meibomian Gland Dysfunction, also plays a key role.
• Staying hydrated and eating a balanced diet rich in omega-3 fatty acids –
  found in fish and flaxseeds, these can support healthy tear production.
  Find out more about our recommended omega 3 eye nutrients here.