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The different types of dry eye

Dry eye is a problem that affects many people. People who suffer from dry eyes either do not produce enough tears or have tears that evaporate too quickly from the surface of the eyes to keep them moist. Do you have this issue?

To better understand what is happening to your eyes, here is a little more information about how they function:

Our tears are composed of 3 main layers:

  • Lipidic layer: meibum produced by the Meibomian glands of the eyelids while blinking
  • Watery layer: produced by lacrimal glands
  • Mucin layer: produced by mucus cells of the conjunctiva and links the cornea and the rest of the tear film

It is important to know the different types of dry eye conditions when it comes to finding out why people suffer from dry eyes. Dryness can be divided into 3 types: aqueous deficiency, evaporative and mixed.

Aqueous deficiency is characterized by decreased tear production by the lacrimal glands. It can be the result of age or SJögren's syndrome, an autoimmune disease affecting the function of various glands in the body, including the lacrimal gland. It can also be secondary to comorbidity that desensitizes the cornea, including diabetes, stroke, viral infections of the cornea, chronic ocular inflammation, and eye surgeries such as LASIK or cataract surgery.

Evaporative dryness is related to the decrease or poor quality of the meibum so that the tear film will evaporate faster than normal. The most common form of this condition is meibomian gland dysfunction (MGD).

The mixed type means that both the evaporative form and the lack of tears are involved.

The evaporative form is involved in about 85% of the causes of dry eye. There will be a change in the quantity or quality of Meibum produced or a deterioration of the glands. In most cases, there will be a combination of several causes. The most common type of DGM is obstructive: the gland's opening becomes blocked, and less meibum (lipid) reaches the eye's surface. It may happen that the glands atrophy as a result of this blockage which lasts over time. 

Main risk factors for meibomian gland dysfunction (MGD)

- Age

- Ethnicity (more frequent in Asians)

- Make-up

- Contact lens wear

- Various medical conditions such as ocular allergies, ocular rosacea, autoimmune disease, inflammation of the cornea or eyelids or bacterial infection

Aggravating factors for DGM

- Computer use over a long period during the day. Because of the decrease in blinking frequency, meibum is not released from the glands.

- Dry environment

Are you looking for a solution to this problem? Different treatments are possible to relieve your eyes! Here are some of the most frequently suggested treatments for DGM:

- Good eyelid hygiene

- Warm compresses and massages on the eyelids

- IPL or IRPL

- Anti-inflammatory drops

- Omega-3 supplements

- Lipiflow, Ilux

Meibomian gland dysfunction can cause a lot of discomfort for patients, so it is important to manage it at the first sign. Speak to your IRIS optometrist.

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