What is Dry Eye?

Dry eye is a condition in which there is an imbalance between tear production and tear drainage.
A person must produce enough tears of good quality to keep the front surface of the eye
lubricated, smooth, and clear.
Lacrimal gland

Meibomian glands Tears are made of three layers:

Lacrimal duct
- oily layer from meibomian glands
located in your eyelids
- watery layer from lacrimal glands
- mucus layer from the conjunctiva, the
clear white covering of your eye

Tear drainage When you blink, a tear film made of

Flow of tears in the nose these layers spreads over the eye

In dry eye, your eyes don’t make enough tears or one or more of the layers of the tear film are
not of good enough quality.

Who gets Dry eye?

Age: Most people over the age of 65 experience some dry eye symptoms
Gender: Women are more likely to develop dry eye due to hormonal changes such as due
to pregnancy, the use of oral contraceptives, and menopause.
Medications: Certain medications like antihistamines, decongestants, blood pressure
medications, antidepressants, can reduce tear production.
Medical conditions: Conditions such as rheumatoid arthritis, diabetes, thyroid problems
increase your likelihood of having dry eye. Inflammation of your eyelids
(“blepharitis”), or inflammation of any part of your eye can affect the quality of
your tears and dry your eyes.
Environmental & other: Exposure to smoke, wind, and dry air can cause early tear
evaporation. Looking at screens makes you blink less and dries your eyes.
Additionally, long-term use of contact lenses or eye surgery such as LASIK can
decrease tear production.
 What are the symptoms of Dry Eye?

Stinging,
Redness scratching, or To diagnose dry eye, your family
burning sensation doctor will ask you about risk
factors and symptoms.

If further information is needed you

Light sensitivity Watery eyes
can be referred to an optometrist or
ophthalmologist, who can further
evaluate your eyelids, eyes, and tear
film.
Stringy mucus near
Blurry vision
the eye

How is Dry Eye treated?

The first step includes addressing the underlying cause and preventing new episodes of dry eye,
and so understanding your symptoms, lifestyle, habits, and any environmental triggers is
essential. Treatment options:
• Preservative-free artificial tears 2 – 4x a day
• Prescription drops can be trialed if over the counter artificial tears do not provide enough
relief: Restasis (cyclosporine ophthalmic emulsion) 0.05%, Xiidra (lifitegrast ophthalmic
solution) and Cequa (cyclosporine ophthalmic solution) 0.09% are the three non-steroidal
anti-inflammatory drops for dry eye approved in Canada. These are to be used for short-
term relief.
• Punctal plugs are tiny silicone plugs that are placed in the eye’s tear duct to slow down
tear drainage. These are most effective for individuals that do not produce enough tears.
Most people do not feel the plugs.
• Eyelid cleaning with diluted baby shampoo or over-the-counter cleansers and application
of warm compresses over the eyes twice a day for 5 minutes at a time will help reduce the
inflammation of the meibomian glands – the glands that produce the oily layer of the tear
film. This will allow for better quality tear film and less dry eye.
References:
1. https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/dry-eye?sso=y
2. https://www.aao.org/eye-health/diseases/what-is-dry-eye
3. https://www.reviewofophthalmology.com/article/approaches-and-methods-for-treating-dry-eye-2021