Dry Eye Basics
Dry eye disease is a catch all based diagnosis for people who suffer from a non-allergy related ocular surface disorder. It is estimated to affect between 5 and 25% of the population, with it being more common in women than men. The phrase “ocular surface disorder” means that something is creating a problem with the surface of the cornea (the clear tissue over the iris) and/or the conjunctiva (the clear tissue that covers the eyeball and under the eyelids). Chronic redness, tearing, grittiness, light sensitivity, intermittent visual blur, and burning are all symptoms of dry eye. The problem is that these symptoms can be caused by numerous underlying issues, and correctly diagnosing these issues can be challenging because of their complex nature.
Dry Eye is Tricky
Sometimes, patient symptoms can be much worse than what we see happening on the eye. And on the other hand, some patients eyes look terrible, but they have no symptoms whatsoever. So in other words, the symptoms don’t match the severity of the condition, and this can cause doctors to under-prescribe for those who look normal but feel awful and for those who look bad, but feel normal. And with good reason, because prescription eye drops are very expensive. But the good thing is that these symptoms can, in most cases, be temporarily resolved. However, in this case, addressing the symptoms does not address the underlying cause of the disease.
Treat the Cause
In order to be treated properly, the causative factor must be unveiled. Is it caused by inflammation, is there a true deficiency in the production of tears, or is it a combination of both? Is the inflammation caused by an eyelid disorder, or is there an underlying systemic autoimmune disorder? Is the eyelid disorder from an underlying skin disorder, from bacterial overload, or from an infestation of mites in the lash follicles? Hopefully you see where I am going with this.
The great thing about dry eye is that there are some really good new diagnostic tests now that help us find out whether we are dealing with inflammation, tear deficiency, or a combination of the two. And by having these tests available, we can more accurately pinpoint what conditions need to change. This leads to better prescribing of in-office procedures, pharmaceuticals, nutraceuticals, and at-home care.
Over the next several blogs I will be talking about dry eye a lot. It has the capability to impact the quality of life of those it affects. It is a complex disease, so it deserves plenty of discussion.
All the best!
Mike Morabito, O.D.
To read additional parts of this series, click the link(s) below: