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Dry Eyes

What is Dry Eye Syndrome?

Dry Eye Syndrome (or Ocular Surface Disease) is a condition caused by the reduction in quality and quantity of tears as a result of inflammation. Sometimes people don’t produce enough tears or the right quality of tears to keep their eyes healthy and comfortable. Minnesota Eye Consultants is proud to be an Accredited Dry Eye Center, utilizing the latest diagnostic and treatment technology.

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What are the Symptoms of Dry Eye?

Some common Dry Eye symptoms include pain from eye irritation, a sandy or gritty sensation, decreased tolerance to contact lenses and sensitivity to light. In early stages, the symptoms may seem to appear and disappear, but generally, worsen as the day progresses.

What Causes Dry Eye?

There are many factors that can lead to your Dry Eye. As you age, you may secrete fewer tears, leading to increased dryness. Hormones likely play a role as well, as dry eyes are more common in women than men, especially post-menopausal women. Systemic diseases, like Sjogren’s Syndrome, Rheumatoid Arthritis, Lupus and Riley-Day Syndrome, and diseases of the eye that affect the eyelids, the eye’s surface or the cornea, can also cause or aggravate dry eyes. Similarly, conditions that affect the eye’s ability to close or blink completely also dry out the surface of the eye.

Some patients experience dryness after refractive surgery. There is a decrease in tear production following LASIK and Phototherapeutic Refractive Surgery (PRK) that can persist for 3-6 months. This can be significant enough that it requires frequent administration of artificial tear substitutes.

Environmental factors, such as a dry, windy climate, or smoke and air conditioning, may speed up tear evaporation as well.

The Tear Film

To better understand your Dry Eye, it’s best to start with the basics of how the tear film functions. The tear film protects the eye by cleansing and flushing harmful chemicals and environmental contaminants from the surface. This anti-infectious film, which covers the surface of the eye, consists of three layers: an oily layer, a watery layer, and a mucus layer.

Chart showing tear film.

The outer, or oily lipid layer, is very thin and oily. This layer of oil, which floats on the surface of the tear film, is secreted by the meibomian glands located just behind the lashes in the lids. The main purpose of the outer layer is to smooth the tear surface and prevent tear evaporation.

The middle, or aqueous (water) layer, is secreted by the lacrimal glands and accounts for most of what we think of as our “tears”. This layer provides the surface of the eye with oxygen and various nutrients and washes away foreign particles or irritants.

The inner, or mucin (mucus) layer, is produced by the conjunctiva. This layer coats the eye’s surface with a substance called mucin, which enables tears to “stick” to the surface of the eye. This mucus layer also allows the watery layer to spread evenly over the surface of the eye, helping to keep the eye moist.

The eyelids are also important in maintaining a healthy tear film. Eyelids, which open and close normally, spread tears over the surface of the eye (the epithelium). This does not occur in patients with abnormal lid position, poor lid closure, or an incomplete blink.

Ideally, the eye is continuously bathing itself in tears. By producing tears at a slow and steady rate, the eye stays moist and comfortable. Tears can be produced in two different ways; at a slow and steady pace to keep the eye healthy and lubricated, and as a response to an emotion or eye irritation. It may sound strange, but excessive tearing is actually a symptom of Dry Eye/Ocular Surface Disease. If there’s a disruption in the healthy tear film, the eye may become irritated, causing an excessive amount of tears to help comfort the eye. So, oddly enough, patients who report having watery eyes may actually have Dry Eye/Ocular Surface Disease.

What is Blepharitis?

Blepharitis is a common yet chronic condition where the eyelids become inflamed and irritated near the base of the eyelashes. This can occur due to systemic or skin conditions, bacteria or other pathogenic organisms.

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Common symptoms include red, watery eyes, mattering or mucus discharge upon awakening from sleep, irritation and itching of the lid margins, foreign body sensation and stinging, blurred or decreased vision, and pain or discomfort.

Anterior Blepharitis affects the outside of the eyelid at the base of the lashes, and Posterior Blepharitis results mostly from the clogging of the meibomian glands (referred to as Meibomian Gland Dysfunction). Blepharitis involving the meibomian glands decreases the production of the oily tear film layer, leading to Dry Eye.

Meibomian Gland Dysfunction

Meibomian glands secrete an important protective oil that helps shield the surface of the eye and prevent the tear film from evaporating. When meibomian glands become clogged, the tear film evaporates more rapidly and as a result, patients may suffer from a variety of symptoms (listed above in the Blepharitis paragraph).

When these gland blockages occur and are left untreated, the meibomian glands can shrink, deteriorate and even disappear entirely. Your physician will evaluate both the function and structure of your meibomian glands to properly assess the overall health of the eyelid.

The innovative LipiView Interferometer at Minnesota Eye Consultants can take digital images of the meibomian gland structures and has the capability of measuring your oily protective layer.

Treatment Options for Dry Eye

Dry Eye is typically treated with at-home dry eye care, artificial tears and/or prescription drops or ointments. If your Dry Eye is more advanced, your physician may recommend Punctal Plugs or Punctal Occlusion, LipiFlow, Intense Pulsed Light Therapy (IPL), BlephEx or Demodex to help improve symptoms.

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Find more information on the in-office treatments offered at Minnesota Eye Consultants.

Patient Testimonials

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Our Dry Eye Specialists

Ahmad M. Fahmy, O.D., FAAO, Dipl., ABO

Ahmad M. Fahmy, O.D., FAAO, Dipl., ABO

Specializes in: Dry Eye & Primary Eye Care
Practices at: Bloomington, Minnetonka

Mark R. Buboltz, O.D., FAAO

Mark R. Buboltz, O.D., FAAO

Specializes in: Dry Eye, Primary Eye Care & Specialty Contact Lenses
Practices at: Bloomington, Woodbury

Johnna D. Hobbs, O.D.

Johnna D. Hobbs, O.D.

Specializes in: Dry Eye & Primary Eye Care
Practices at: Bloomington,

Cristelle E. Boots, OD

Cristelle E. Boots, OD

Specializes in: Primary Eye Care & Dry Eye
Practices at: Blaine, Woodbury

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