The clinic has a full selection of eye drops and contact lens rewetting drops for dry eye needs. Contact lenses designed for dry eye are also available. For more severe dryness, drainage areas of the eye may be plugged to decrease tear outflow.
Mucin layer – This is the most posterior layer of the tear film lying adjacent to the corneal and conjunctival surface. This layer serves as a wetting agent allowing the aqueous (tears) to spread evenly over the front of the eye.
Aqueous layer – This is the largest portion of the tear film lying between the mucin and lipid layers. It serves as the fluid hydrating portion of the tears.
Lipid layer – This is the most anterior (external) layer of the tear film. It prevents evaporation of the aqueous layer.
Decreased aqueous production– This may be caused by lacrimal gland dysfunction, systemic disease, medications, or trauma.
Evaporation of tears – Evaporation causes decreased tear volume.
Eyelid anomalies
Ectropion – The lower lid turns away from the eye which may increase evaporation of the tears.
Entropion – The lid and lashes turn toward the eye which may affect the tear film.
Exopthalmos – The eye bulges forward abnormally causing the eyelids to spread apart.
Lagopthalmos – With this condition it is difficult to completely close the eyelids.
Lipid deficiency – Decreased lipid layer causes increased evaporation of the aqueous layer
Blepharitis – This eyelid inflammation often has dandruff-like skin cells t rapped on the eyelashes.
Meibomianitis – This is meibomian gland inflammation.
Inspissated meibomian glands – Meibomian gland secretion hardens leaving a cap over the gland orifice.
Mucin deficiency – Loss of this layer decreases tear film stability leading to evaporation of the aqueous layer.
Reduced blink reflex – Loss of corneal sensitivity leads to decreased blink reflex and less reflex tearing.
Causes of decreased corneal sensitivity
Post refractive surgery – Creation of the corneal flap may decrease the function of the nerves in that area reducing corneal sensation and the blink reflex. This tear film status should return to normal approximately six to nine months after the surgery.
Contact lens wear - This may decrease corneal sensitivity. Excessive wear of contact lenses may compromise the corneal surface and lead to abnormal wetting of the surface.
Systemic disorders – These may affect corneal sensitivity.
Uneven distribution of tears – Can lead to exposure of the cornea and conjunctiva.
Low viscosity artificial tears – These drops are added to increase the aqueous portion of the tear film. Preservatives are added to multi-dose (larger) bottles to maintain sterility. Sterile, non-preserved, single-dose containers are also available. Multi-dose bottles can also be made with preservatives that dissipate when in the eye yet still maintain sterility in the bottle.
High viscosity artificial tears - These solutions have an increased concentration of viscosity agents.
High viscosity ointment – These ointments provide a coating over the eye that will not evaporate or drain from the eye as quickly as artificial tears.
Contact lens rewetting drops – These solutions are formulated to apply to the eye while wearing soft or hard contacts.