Dry Eye
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North Toronto Eye Care: An Accredited Dry Eye Centre
Dry Eye Disease (DED) is a multifactorial under-diagnosed eye condition characterized by loss of homeostasis in the tear film that occurs when the eyes either do not produce enough tears or the tears are of a poor quality and 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 cause reduced vision. 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 DED is often missed because allergy, eyestrain, and fatigue have similar symptoms. Your NTEC Eye doctor 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 along with the appropriate dry eye 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 or an imbalance in the composition of their tears.
Tears are Comprised of Three Layers
Lipid Layer
Outermost oily layer which lubricates the eyes and helps prevent tears from evaporating when the eyes are open.
Aqueous Layer
Middle watery layer that is composed of water and nutrients that lubricate and nourish the cornea.
Mucin Layer
Innermost layer that coats the surface of the cornea and makes the tears adhere to, and spread evenly over the ocular 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.
Two Main Types of Dry Eye
Aqueous Deficient Dry Eye
Aqueous Deficient Dry Eye occurs when the tear secretion by the lacrimal glands is insufficient to maintain a healthy stable tear film. Aqueous Deficient Dry Eye results in a chronic inflammation of the ocular surface and has increasingly strong ties to autoimmune diseases such as Sjogren’s syndrome, rheumatoid arthritis, diabetes, and thyroid disease. This condition is significantly more prevalent in women and only represents about 15% of all dry eye patients.
Evaporative Dry Eye
Evaporative Dry Eye or Meibomian Gland Dysfunction (MGD) occurs when the outer lipid layer of the normal tear film is deficient and as a result, the tears evaporate too quickly. This often occurs when there are recurring blockages of meibomian glands (Chalazion) or when the eyelids are inflamed (Ocular Rosacea or Blepharitis). Evaporative Dry Eye conditions make up 86% of the dry eye population.
Patients can suffer a mixed mechanism of both Aqueous Deficient and Evaporative Dry Eye.
In some instances, dry eye can be related to other conditions and their respective necessary treatment. For example, a link has been found between dry eye, sleep apnea, and the use of a CPAP. Certain medications also contribute to dry eye such as acne medications or antidepressants. It is important to bring your full list of medications with you on the day of your dry eye consultation.
Diagnostic testing will determine the type of DED that you have and will help us to further develop a Personalized Treatment Plan.
- Tear Osmolarity Testing: This in-office test measures the salt content of your tears, providing an accurate assessment of dry eye severity and helping plan the best treatment.
- Inflammadry: This test measures inflammation on the ocular surface, detecting markers elevated in dry eye patients and helping us plan the best treatment.
- Lipiscan: This imaging test evaluates the meibomian glands, providing high-definition images to diagnose gland-based dry eye accurately.
- HD Analyzer: This device measures visual quality and optical scattering caused by dry eye, helping us understand the severity of your condition.
- OPD-Scan III: This comprehensive analysis tool provides an accurate assessment of the corneal surface, helping diagnose dry eye and other conditions.
