What is dry eye?

The dry eye disease or the dry eye syndrome is a broad term used to refer to a collection of symptoms that affect the normal functioning of eyes. The symptoms can include irritation, itching, redness, grittiness (particle in the eye feeling etc). The symptoms can be caused by various factors such as Meibomium Gland Dysfunction, Acqueous deficiency, SJS disease, Schjoreign’s syndrome etc. As a dry eye sufferer one of the most important steps is to understand the mechanism in work behind the symptoms and investigate towards underlying causes. The following chart can help addressing the symptoms in a structured manner :

 

Diagnosed with MGD. Know what to do here.

 

So you’ve taken the first big step to address your dry eyes. Identifying that you have MGD is an important step in your dry eye journey. MGD stands for Meibomian Gland Dysfunction. Meibomian Gland is an important gland contained within our eyelids which have an important function in maintaining our tearfilm. Our tearfilm has three parts – aqueous, mucin and meibum. The meibum or the lipid part is generated by the Meibomian gland.

              This meibum plays an important part in maintaining our tearfilm and preventing it from breaking or vaporizing. This tear film is responsible to lubricate, hydrate and keep the eye surfaces in functional condition. The absence of this film is what causes the Dry eye symptoms. Therefore, once identified once should focus on understanding the state of this film. There are many tests which can help us understand the condition of this film. We’ll be considering the most common ones. These are TBUT, NIBUT, LLT, Gland loss %. Let’s see these one by one :

1. TBUT- Tear break up Time. It gives us a general idea as to how stable is patients tearfilm. The higher the value the healthier the eyes. NIBUT is a TBUT test carried out with a non-invasive instrument.
2. LLT – Lipid layer thickness. This is an indication of how much meibum is present on the eye surface and eyelids. The higher the value the better it is.
3. Gland loss% - Some MGD patients have glands which have disappeared or dropped out. The percentage of these dead glands gives a good indication to the severity of the problem. The less this percentage the better it is for the patients.

There are more tests available than the above mentioned, if you want to know more about them then please contact your doctor. We believe that the above three tests establish a fair picture for a newly diagnosed dry eye person. Please note that there are cases when the symptoms do not correlate with the test readings. In such a case please investigate with help of your healthcare professional.

 

Treatment

 

There are two parts to the dry eye treatment:

1. Addressing the underlying cause

This requires one to go through their medical history and identify key events that may have contributed to their present condition. Often it is a major surgery, serious disease, significant lifestyle changes or long-term use of prescription medicines. One has to work with their healthcare professional and chart out a path to address the root cause of the dry eye issues and prevent them from relapsing

2. Controlling the symptoms

Most patients consult a healthcare professional only when their symptoms start affecting their quality of life. Managing symptoms is therefore a very important aspect of this disease. It may need significant hit and trial before one identifies what works well for oneself. Once some clarity has been achieved with respect to methods and therapies to address symptoms then one should establish routines and make suitable lifestyle changes to keep these issues in check.

The above guidelines will put you on the right path to overcome this disease. One has to remember that recovery may be a slow process and it may take some time for significant improvement to be visible.