Dry Eye and Other Ocular Surface Disorders

Dry eye is commonly used to describe any one of a variety of conditions causing chronic redness, irritation and excessive tearing. All of these conditions result in an insufficient or inadequate tear film. It is the normal tear film that protects the eye from exposure, infection and inflammation. When the tear film does not function properly, permanent damage can occur. In addition to insufficient volume of tears, other conditions such as meibomitis, blepharitis, exposure or allergy can result in a “dry eye” syndrome.

Makeup of Tears
In general, our tears are made up of three layers. The layer that coats the eye itself is largely composed of mucin. The outer, surface layer is made up of an oily substance secreted by the meibomian glands of the eyelids, whereas the middle layer is comprised of aqueous (the watery component of the tear). If any of these layers are insufficient, the tear film will be inadequate.

Aqueous Insufficiency
In this, the most common cause of dry eye, the eyes fail to produce sufficient quantities of the watery component of the tear film. This is generally referred to as aqueous insufficiency. It tends to occur with advancing age, certain medications and some autoimmune conditions such as rheumatoid arthritis. Treatments generally consist of artificial tear supplements and sometimes the use of cyclosporine (Restasis) eye drops. We will occasionally either temporarily or permanently occlude the punctum of the upper and/or lower eyelids to prevent the patient’s tears from draining away too quickly.

Meibomian Gland Dysfunction
Also a very common cause of dry eye, this occurs when the oil glands of the upper and lower eyelids fail to produce an adequate coating of the eye. Since it is the oil coating that prevents the tears from evaporating too quickly, meibomian gland dysfunction can be a cause of severe dry eye.

Diagnosistic Advances
At the Indiana Eye Clinic, we take a very scientific approach to the diagnosis and treatment of ocular surface disease. We now have the ability to establish a baseline “concentration” or osmolarity of our patient’s tear film using a few microliters of the patient’s own tears. This allows us to recommend a course of therapy based upon scientific and measurable parameters. We can also now test for common ocular allergens that play a role in ocular surface disease. Combining these and other ocular surface studies allows us to prepare a customized treatment plan for each patient.

Treatment Options
Treatments may include lid cleansing, meibomian gland massage, nutritional supplements, Restasis, oral and topical anti-inflammatory agents, artificial tear supplements, punctal occlusion and specially compounded hormone based eye drops.

Our Mission
Our mission is to utilize the most advanced technology and latest therapeutic innovations to help us diagnose and treat your ocular surface disease. Based on sophisticated analysis of your tear film osmolarity and allergy status, we will create a customized treatment plan to combat your dry eye symptoms.

What You Need to Know
The diagnosis and treatment of ocular surface disease has evolved tremendously over the past decade. Advances in our diagnostic capabilities and the use of new treatment modalities have allowed us to greatly improve our ability to treat patients with dry eye disease. We are very excited about these recent advances in the treatment of ocular surface disease and look forward to sharing their benefits with you. Our patient coordinators will be happy to answer any questions you might have and assist in arranging a consultation.

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