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  • Writer's pictureMr Ahmad Elsahn

Types of Dry Eye Disease: Symptoms and Causes

Updated: May 20

Dry eye disease is a multifaceted condition that arises from various factors affecting the tear film and ocular surface. It's essential to recognize the different types of dry eye disease and their underlying causes to tailor effective treatments. One prominent subtype is evaporative dry eye disease, often linked to meibomian gland dysfunction (MGD).

Man with glasses in pain

What is dry eye?

Dry eye is a condition characterised by disruptions to the tear film, which consists of three layers that cover and protect the surface of your eyes. A smooth and stable tear film is crucial for clear and comfortable vision. When the tear film is compromised, it can lead to uncomfortable symptoms such as burning, itching, excessive tearing, or blurred vision.

Types of Dry Eye Disease

Aqueous-Deficient Dry Eye

Aqueous-deficient dry eye occurs when the lacrimal glands, responsible for producing tears, inadequately produce the watery component of tears known as the aqueous layer.

This condition can be triggered by various factors, including autoimmune diseases, hormonal fluctuations, specific medications, and the natural aging process.

  • Causes: Insufficient production of aqueous tears by the lacrimal glands.

  • Contributing Factors: Aging, autoimmune diseases (e.g., Sjögren's syndrome), hormonal changes, medications, and systemic conditions.

Evaporative Dry Eye Disease

Evaporative dry eye arises when there is a deficiency or poor quality of the oily layer of tears, which plays a crucial role in preventing their evaporation.

This condition often stems from dysfunction of the meibomian gland, responsible for producing the oily component of tears, located within the eyelid. Additionally, factors such as inflammation of the eyelids and environmental influences, including low humidity levels or extended exposure to computer screens, can contribute to the development of evaporative dry eye.

  • Causes: Excessive evaporation of tears due to poor lipid (oil) layer in the tear film.

  • Contributing Factors:

Mixed Dry Eye

A combination of aqueous tear deficiency and tear instability contributes to dry eye symptoms. In this scenario, tear production is insufficient, leading to a lack of watery tears, while the tear film becomes unstable. These conditions collectively result in discomfort and dryness in the eyes.

  • Causes: A combination of both aqueous-deficient and evaporative mechanisms.

  • Contributing Factors: Individuals with mixed dry eye experience a blend of insufficient tear production and accelerated tear evaporation. Aging, hormonal changes, and certain medications can amplify these effects.

Inflammatory Dry Eye

  • Causes: Inflammation of the ocular surface, disrupting the balance of tear components.

  • Contributing Factors: Autoimmune diseases (e.g., rheumatoid arthritis), ocular surface inflammation, and systemic inflammatory conditions can trigger inflammatory dry eye.

What Type of Dry Eye Disease is Most Common?

The most common form of dry eye is evaporative dry eye.

Common Symptoms of Dry Eye Disease

Regardless of the type, dry eye disease manifests through a range of symptoms, including:

  • Irritation

  • Redness

  • Foreign body sensation

  • Blurred vision

  • Light sensitivity

Diagnosis and Treatment

Accurate diagnosis is crucial for effective management. Eye care professionals often conduct a comprehensive eye exam, including assessing tear production, evaluating the quantity and quality of tears, blinking patterns and examining the ocular surface.

While dry eye doesn't have a cure, various treatments can alleviate discomfort and manage symptoms effectively.

Treatment approaches may include:

  • Artificial Tears: Lubricating eye drops to alleviate symptoms.

  • Prescription Medications: Anti-inflammatory medications or medications that stimulate tear production.

  • Lifestyle Modifications: Adjustments in environmental conditions and habits to reduce exacerbating factors.

  • Outpatient Procedures: Advanced treatments such as Intense Regulated Pulsed Light (IRPL) or Activa for MGD management.

What Medical Conditions Can Cause Dry Eye?

Various medical conditions can contribute to the development of dry eye, including:

  • Diabetes: Elevated blood sugar levels in diabetes can damage nerves and blood vessels in the eyes, leading to dry eye symptoms. Research indicates that approximately 54% of individuals with diabetes experience dry eye.

  • Sjogren’s syndrome: This autoimmune disorder causes inflammation in the body's moisture-producing glands, including the tear glands, resulting in dry eye.

  • Rheumatoid arthritis (RA): RA, another autoimmune disorder, can induce inflammation in different parts of the body, including the tear glands, leading to dry eye.

  • Lupus: Lupus, also an autoimmune disorder, can cause dry eye symptoms due to inflammation.

  • Thyroid disorders: Both overactive (hyperthyroidism) and underactive (hypothyroidism) thyroid glands can contribute to dry eye symptoms.

  • Rosacea: This chronic inflammatory condition can affect the eyes and lead to dry eye symptoms.

  • Allergies: Seasonal or year-round allergies can trigger eye inflammation, resulting in dry eye symptoms.

  • Vitamin A deficiency: Inadequate intake of vitamin A can impair tear production, leading to dry eye.

  • LASIK surgery: Dry eyes are a common side effect of LASIK surgery, often occurring as a temporary condition following the procedure.

Understanding the types and causes of dry eye disease is crucial for tailoring effective interventions. Whether it's addressing aqueous-deficient mechanisms, managing evaporative dry eye due to MGD, or dealing with a combination of factors, personalized care is key. Regular eye exams and open communication with your eye care professional are fundamental steps in managing and finding relief for dry eye disease.

Dry Eye Disease Treatment at Eyepros

We offer a free no-obligation consultation to discuss your needs and what options would be most suitable for you. We have treatment centres based around the Midlands, including Nottingham, Birmingham and Derby. Get in touch to book your consultation.

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About The Author

Mr Ahmad Elsahn

Mr Ahmad Elsahn

Mr Ahmad Elsahn is a highly accomplished Consultant Ophthalmologist specialising in cataract surgery, minimally invasive glaucoma surgery and laser eye surgery, with over two decades of experience.

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