What is Dry Eye Disease?
Causes, Symptoms & Treatment in Decatur, GA
Dry eye disease is a common, often chronic condition that affects millions—especially here in Atlanta and Decatur. If your eyes feel gritty, sting, tear excessively, or are sensitive to light, you may be experiencing signs of dry eye. At Intown Dry Eye Care, we diagnose and treat the root causes of dry eye, including Meibomian Gland Dysfunction (MGD), with advanced, in-office therapies like Lumenis OptiLight IPL and meibography-guided care.
Burning, gritty, or scratchy sensations in your eyes
Red or irritated eyes
Excessive tearing
Sensitivity to light
Blurred vision
Eye fatigue/tired eyes and headaches
Frequent blinking to clear your vision
Difficulty wearing contact lenses
Stringy mucus around your eyes
Crusting along your eyelids
Symptoms of Dry Eye
What Causes Dry Eye?
Water
Lacrimal Gland: If your tear-producing gland is not functioning properly, your body may not be making enough tears.
Oil
Meibomian Glands: The oily layer of your tear film prevents your tears from evaporating between blinks. In most cases of Dry Eye Disease (86%), these oil glands are clogged.
Lid Function
Blink: A healthy blink is responsible for both the even spread of tear film across the surface of your eyes and for pushing oil out of the Meibomian Glands to prevent tear evaporation. If your blink is incomplete or too infrequent, your eyes will feel dry and burn.
Lid Closure & Seal: An incomplete lid seal during sleep can dry out the front surface of your eyes (cornea and conjunctiva), significantly increasing the dryness of your eyes.
Allergy
You may be experiencing an allergic component to your dry eye symptoms. These ocular sensitivities can cause your eyes to itch and tear.
Systemic
Health Conditions: Certain conditions can contribute to dry eye. These include Rosacea, Rheumatoid Arthritis, Lupus, Sjogren's Syndrome, Sarcoidosis, Diabetes, Thyroid disorders, and others.
Hormonal Changes: Mostly affecting women, hormonal changes that contribute to dry eye are those that occur during/after menopause and during pregnancy.
Nutritional Deficiencies: A lack of vitamins A and D, as well as omega-3 fatty acids, can play a role in dry eye development.
Aging: As we age, tear production naturally decreases.
Medications: Various medications, including those for allergies, colds, depression, high blood pressure, birth control, and Parkinson's disease, may lead to dry eyes.
Bacteria/Mites
Our eyelid margins and eyelash follicles can harbor bacteria and mites. These can all release toxins and contribute to inflammation and irritation.
Environmental
Screen Time: Staring at screens for extended periods can contribute to dry eyes, as it leads to reduced blinking.
Environmental Factors: Dry air, wind, and low humidity can cause your tears to evaporate more quickly.
Contact Lens Wear: Soft contact lenses can limit eye lubrication, and improper cleaning or extended wear can exacerbate dryness.
Irritants: Prolonged exposure to smoke, dust, or chemicals can trigger or worsen dry eye symptoms.
Eye Surgeries: Procedures like LASIK or cataract surgery can result in dry eye symptoms.
Understanding your Tear Film
Your tear film is the protective layer that covers the surface of your eyes, keeping them hydrated and comfortable while safeguarding them from foreign particles. The tear film is made up of three distinct layers, each playing a vital role in delivering nutrients, flushing away debris, and protecting against bacteria.
Mucus layer: This is the innermost layer, responsible for anchoring the rest of the tear film to the surface of your eye.
Aqueous layer: Produced by your lacrimal glands, this middle layer of your tears is the water component. This layer keeps your eyes hydrated and nourished, while washing away particles and bacteria.
Oil layer: Produced by your meibomian glands, this outer layer helps seal in the moisture from the other layers and prevents evaporation of your tear film
When any one of these layers is compromised, it can lead to discomfort and dryness in the eyes.
What is Dry Eye Disease?
The clinical definition of dry eye disease (DED) is “a multifactorial condition of the ocular surface characterized by a disruption in the tear film homeostasis, leading to symptoms of irritation and visual disturbances, often caused by inadequate tear production or excessive tear evaporation, and accompanied by inflammation and damage to the corneal surface.”
But what does this mean? Dry Eye Disease is a medical condition that occurs when there is a disruption with one or more of the three components of your tear film.
Meibomian Gland Dysfunction
The most common cause of Dry Eye Disease, responsible for 86% of the Dry Eye seen in the US, is Meibomian Gland Dysfunction (MGD).
Meibomian glands are oil-producing glands located along the edges of your eyelids. These glands release oil that forms the outer layer of the tear film, helping to prevent tears from evaporating too quickly. MGD occurs when these glands become blocked, disrupting the flow of oil.
When the meibomian glands are functioning properly, the oil they produce is similar in consistency to olive oil. However, when the glands become inflamed, the oil thickens to a toothpaste-like consistency, causing the glands to become clogged.
When your meibomian glands aren’t producing enough oil to provide the outer layer of your tear film, your tears evaporate too quickly. In response, your lacrimal glands overproduce watery tears to compensate. Unfortunately, these tears aren’t able to properly coat and protect your eyes in the way the oily layer would. This can lead to the common symptom of constantly tearing eyes.
In the early stages, MGD may not cause noticeable symptoms. As the condition progresses, it can lead to Dry Eye symptoms and/or inflammation of the eyelids. If MGD remains unaddressed, blocked glands can eventually become stagnant and atrophied.
How Is MGD Diagnosed?
During your initial Comprehensive Dry Eye Evaluation, Dr. Udell will assess your Meibomian glands via meibography, a specialized imaging technique that allows infrared visualization of the Meibomian glands beneath the eyelid surface. Additionally, Meibomian gland expression may be conducted to evaluate the quality of the oils produced by the glands, helping to determine your stage of Meibomian Gland Dysfunction.
Dry Eye Care
Treatments to get your eyes feeling better
You wouldn’t neglect other eye conditions like age-related macular degeneration or glaucoma. Your Dry Eye Disease deserves the same level of attention and treatment.