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Dryness of eyes occurs when there is a change in the tear film which keeps the eye moist and lubricated. Our tear film consists of three layers: outer oily layer, middle watery layer and the inner mucous layer. Each eye has a lacrimal gland which produces the watery layer of the tear film. Whenever we blink, our eyelids spread a thin film of fluid over the eye. Our eyelids contain multiple tiny glands which secrete oil. It covers the outer layer of tear film, preventing evaporation of watery layer. The part of the eye called conjunctiva covers the front and underside of our lids produces mucous which allows watery tears to spread over the surface of the eye.

Symptoms of Dry eye include irritation of eye, stinging, foreign body sensation, grittiness, tearing, redness, discomfort, difficulty in looking at light, blurring of vision, itching and difficulty in opening the eye.

Causes of dry eye include decreased production of tears due to the diseases affecting the lacrimal gland, eyelids or conjunctiva. Certain systemic conditions, side effects of systemic medications, auto immune disorders, allergic eye conditions, injury ,contact lens wear, pregnancy also causes dry eye.

Diagnosis of dry eyes includes comprehensive clinical examination, surface staining, estimating the volume of tears, examining the quality of tears, investigating the stability of production of tears and ocular surface examination. Tear samples could be assessed for markers of dry eye. SBM device is an excellent method of screening and diagnosing dry eye disease.

Treatment options: Patients with dry eye symptoms often have many contributory factors. It is imperative to treat any causative factors that are amenable to treatment. One of the popular ways to treat dry eye is through artificial tears. Eye drops can be dispensed as disposable unims. Gels and Ointment are also used along with lubricants. Tear replacement / Artificial tears is frequently unsuccessful when used as the sole treatment if additional causative factors are not addressed. Anti-inflammatory eye drops, Omega 3 supplements and warm compressors are helpful.

Approximately 50% of Dry Eye Disease (DED) is caused by Meibomian gland dysfunction. IPL ( Intensed Pulse Light) treatment for dry eye is an effective way to treat meibomian gland dysfunction, improves tear quality and thus improving patient related symptoms.

The current management options for DED include treatments for:  tear insufficiency, eyelid abnormalities, anti-inflammatory medications, dietary modifications, environmental considerations, surgical approach and complementary therapies.

Mrs. Anantha Lakshmi
Senior Optometrist
Rajan Eye Care Hospital

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