Types of Dry Eye Disease You Need to Know
Dry eye disease (DED) is a complex condition that impacts millions of people worldwide. It occurs when the eyes are unable to produce sufficient tears or when the quality of tears is inadequate to maintain a healthy ocular surface. While often dismissed as a minor irritation, untreated dry eye disease can lead to significant discomfort and, in severe cases, damage to the ocular surface. At the Miami Contact Lens Institute, our team believes that it’s imperative that our patients have a comprehensive understanding of not only the different types of dry eye disease that exist, but also the treatment options that are available to them.
What Are the Different Types of Dry Eye Disease?
Dry eye disease is something that can have a serious impact on your overall quality of life. Although there are countless people who may try to work through the effects of dry eye on a day-to-day basis, the reality is that if you are suffering from this condition, there are treatment options that are available to you that can help you to have a better quality of life. However, before determining which treatment option is best for you, your eye doctor will need to identify the type of dry eye disease that you have.
There are two primary types of dry eye disease: aqueous-deficient dry eye and evaporative dry eye.
Aqueous-Deficient Dry Eye
Aqueous-deficient dry eye occurs when the lacrimal glands fail to produce enough tear fluid to keep the eyes properly lubricated. This type is often associated with autoimmune diseases like Sjögren’s syndrome, where the immune system attacks the glands responsible for tear production. Other factors, such as aging, hormonal changes, or damage to the lacrimal glands from radiation therapy, can also contribute to this condition. People with aqueous-deficient dry eye often experience a feeling of dryness, irritation, and a gritty sensation in their eyes.
Evaporative Dry Eye
Evaporative dry eye, on the other hand, occurs when tears evaporate too quickly due to a problem with the quality or stability of the tear film. This type is commonly linked to meibomian gland dysfunction (MGD), a condition in which the glands in the eyelids fail to secrete enough oil to form a protective layer over the tear film. Without this layer, tears evaporate rapidly, leaving the eyes dry and irritated. Factors such as prolonged screen use, exposure to windy or dry environments, and certain medical conditions like rosacea can exacerbate evaporative dry eye.
It’s important to note, however, that there are other variations of dry eye disease that can be more nuanced at times. Examples include:
Mixed Dry Eye Disease
In some cases, individuals may experience a combination of both aqueous-deficient and evaporative dry eye, known as mixed dry eye disease. This type requires a comprehensive treatment approach that addresses both tear production and tear film stability.
Beyond the two main types, there are other factors that can contribute to dry eye symptoms. These include allergic conjunctivitis, certain medications (such as antihistamines or antidepressants), and prolonged contact lens use. Environmental factors like air pollution or reduced blinking during screen time can also worsen symptoms, regardless of the underlying type of dry eye.
Neuropathic Dry Eye
Neuropathic dry eye arises from disruptions in the complex interplay of the nervous system. Unlike typical dry eye conditions, the symptoms of neuropathic dry eye are not always tied to tear production or tear film quality. Instead, they often stem from nerve damage, which may result from injuries, surgeries, or chronic conditions. Over time, these disturbances can lead to persistent symptoms that are challenging to address with standard dry eye treatments. Many individuals with neuropathic dry eye find that conventional approaches provide only minimal relief, highlighting the need for specialized care.
Neurotrophic Keratitis
Neurotrophic keratitis, also known as neurotrophic keratopathy, is a rare condition that affects the cornea, the clear, outer layer of the eye. This condition occurs when the trigeminal nerve, responsible for providing sensory input to the cornea, is damaged or impaired. Without proper sensory feedback, the cornea struggles to maintain its health and protective mechanisms, such as tear production and blinking. Neurotrophic keratitis can lead to decreased corneal sensitivity, making the eye more vulnerable to injury and infection. Early diagnosis and treatment are crucial to preserving corneal integrity and preventing further complications.
Iatrogenic Dry Eye
Iatrogenic dry eye is a form of dry eye caused or worsened by medical interventions. Certain medications, such as antihistamines, decongestants, or chemotherapy drugs, can reduce tear production or alter the tear film, leading to dryness and discomfort. Additionally, some medical procedures, including laser eye surgeries like LASIK, can disrupt the normal functioning of the tear-producing glands or nerves in the eye, exacerbating dry eye symptoms. Patients experiencing iatrogenic dry eye often require tailored treatments and close monitoring to manage their symptoms effectively.
What Types of Dry Eye Treatment Options Are Available at Miami Contact Lens Institute?
At Miami Contact Lens Institute, a range of advanced treatments is available to address the underlying causes of dry eye and provide lasting relief. By offering cutting-edge solutions we ensure personalized care for each patient.
TearCare®
TearCare is an innovative treatment designed for patients with meibomian gland dysfunction (MGD), a leading cause of evaporative dry eye. This system uses wearable devices that gently apply heat to the eyelids, loosening blockages in the meibomian glands. After the glands are warmed, your eye doctor performs a targeted expression to clear the blockages, restoring proper oil flow to the tear film. TearCare is a comfortable and effective way to improve tear stability and reduce symptoms.
LipiFlow®
LipiFlow is another advanced option for treating MGD. This FDA-approved thermal pulsation system combines gentle heat with automated massage to unclog and activate the meibomian glands. By improving the quality of the tear film’s lipid layer, LipiFlow reduces tear evaporation and provides relief from dryness, irritation, and fluctuating vision. The procedure is quick, safe, and often delivers long-lasting results.
Scleral Lenses
For patients with severe or chronic dry eye, scleral lenses offer a transformative solution. These custom-designed lenses create a fluid reservoir that continuously hydrates and protects the cornea. By shielding the eye from external irritants and maintaining a moist environment, scleral lenses provide significant relief for even the most advanced cases of dry eye. The team at Miami Contact Lens Institute specializes in fitting these lenses to ensure maximum comfort and effectiveness.
Prokera®
Prokera is a corneal bandage made from amniotic membrane tissue, used to promote healing in patients with severe or persistent dry eye. It contains natural anti-inflammatory and healing properties that help repair damage to the ocular surface caused by chronic dryness or inflammation. Prokera is especially beneficial for patients with advanced dry eye disease or those who have not responded to other treatments. The device is placed on the eye during an in-office procedure and delivers targeted healing to restore eye health.
At Miami Contact Lens Institute, the focus is on providing cutting-edge treatments personalized to each patient’s unique condition. Whether your dry eye is caused by meibomian gland dysfunction, tear film instability, or surface damage, our office offers solutions to restore comfort and improve eye health. If you’re seeking relief from dry eye, scheduling a consultation is the first step toward finding the right treatment for your needs.