North Toronto Eye Care
An Accredited Dry Eye Center
Dry Eye Disease is largely under diagnosed condition that occurs when the eyes do not make enough tears or the tears evaporate too quickly. It’s generally not sight threatening but if left untreated, the symptoms – itching, discomfort and irritation – become worse and can increase the risk of infection and other visual problems. It is important for patients with this condition to take special care of their eyes in order to alleviate symptoms and prevent complications. The diagnosis of Dry Eye is often missed because allergy, eyestrain and fatigue have similar symptoms. Your NTEC Eye doctor in Toronto will determine if you have dry eyes, and provide a customized treatment tailored specifically for you. It is important that Dry Eye is managed correctly in order to prevent possible associated infections and/or visual disturbances that can occur if left untreated. Your doctor can diagnose dry eye after a thorough evaluation of your eyes and tear production with a Schirmer tear test and Tearlab Osmolarity testing.
Understanding your Tear Film
Our eyes need a constant layer of tears – called the tear film – to maintain and protect the sensitive surface tissues. Dry eye syndrome occurs when there is a lack of adequate tears. For some people, the cause of dry eyes is an imbalance in the composition of their tears. Other people don’t produce enough tears to keep their eyes comfortably lubricated.
Tears are comprised of three layers
1) Lipid (oil) layer: Outermost Layer which lubricates the eyes and helps prevent tears from evaporating when the eyes are open.
2) Aqueous (water) layer: Middle Layer that is composed of water and nutrients that lubricate and nourish the cornea.
3) Mucin layer: Innermost Layer that coats the surface of the cornea and makes the tears adhere to, and spread evenly over the surface.
Changes or disruption to any one or more of the three tear film layers may interfere with the process of routine lubrication of the eye surface, resulting in Dry Eye Disease.
What should I do if I have Dry Eye symptoms?
Only a doctor can determine if you have Dry Eye Disease – and NTEC doctors offer enhanced testing to provide an important diagnostic and predictive value. Test results are used to design a treatment approach tailored to your specific condition.
- A COMPREHENSIVE eye exam
- Measurement of the VOLUME of your tears
- Assessment of the QUALITY of your tears
- Tear Analysis measuring your TEAR OSMOLARITY
NTEC provides the latest tear analyzer that tests TEAR OSMOLARITY. This non-invasive test determines the salt and enzyme concentration of your tear film. In fact, some doctors refer to it as the “thermometer of the eye” as it reflects the inflammation caused by elevated salt content.
The American Academy of Ophthalmology (AAO) Preferred Practice Pattern for Dry Eye Syndrome specifically recommends tear osmolarity testing for the diagnosis and management of dry eye syndrome. Note that the TearLab tear osmolarity test is identified as “a more sensitive method of diagnosing and grading the severity of dry eye compared to corneal and conjunctival staining, tear break-up time, Schirmer test and meibomian gland grading”.
Although not covered by Ontario Health Insurance Plan, it provides an important predictive value in determining the severity of an individual’s dry eye, and a meaningful measure of the health and stability of the protective tear film that covers the surface of your eyes.
Why do Eyes become dry?
There are two main reasons why eyes become dry:
Aqueous Deficient Dry Eye
Aqueous Deficient Dry Eye occurs when the production of tears by the lacrimal gland is not adequate, or when changes to the tear producing glands produce lower quality tears. A deficit in tear production may be the result of other underlying medical conditions such as rheumatoid arthritis, lupus, or Sjogren’s Syndrome. Aqueous Deficiency Dry Eye can also be indicative of a temporary or permanent damage to the lacrimal glands caused by trauma, local or central nerve damage or from chemotherapy and radiation treatments.
Evaporative Dry Eye
Most patients suffer from Evaporative Dry Eye – a condition where the tears produced are of poor quality and evaporate too quickly due to a lipid or mucous deficiency of the tear film. Your North Toronto Eye Care doctor will examine your eye using a slit lamp in order to see blocked/inflamed gland openings and/or frothy tears characteristic of evaporative dry eye. The consistency and quality of your tears will also be assessed.