Dry Eye Education

Dry Eye is most often defined based on the quantity or quality of your tears. Millions suffer from Dry Eye, a chronic disease that can worsen over time.
There are two forms of Dry Eye – Evaporative Dry Eye and Aqueous Dry Eye. 9 out of 10 individuals (86%) suffer from the evaporative form of Dry Eye. LipiFlow® is a revolutionary treatment that directly treats the cause of your Evaporative Dry Eye.

Do You Have Dry Eye?

Every time you blink, tears spread across the front surface of the eye. Your eyes depend on a flow of tears to provide constant moisture and lubrication to maintain eye health and comfort. When the volume or consistency of the tear system becomes imbalanced, you might experience dry eyes.

When tears do not adequately lubricate the eye, a person may endure.

  • Sensitivity to light
  • Blurred vision
  • A burning sensation
  • Discomfort in windy or dry conditions
  • A gritty sensation
  • Redness

Although symptoms often start as minor inconveniences, the effects of dry eye are progressive and can worsen over time, potentially leading to severe discomfort or blurred vision.

Not Enough Tears?

Tears are necessary for your overall eye health.

Dry Eye occurs when the eyes do not produce sufficient tears or the tears evaporate too quickly. Without proper treatment, inadequate tear production can make daily activities frustrating, affecting your personal and professional life, from reading or watching TV, to driving or working on the computer.

The most common form of Dry Eye is the Evaporative form, which affects 9 out of 10 dry eye cases (86%). This form results from a shortage of oil on the surface of your tears caused by a blockage in your eyelid (Meibomian) glands, leading tears to evaporate faster than normal. This lack of oil production is often referred to as Meibomian Gland Dysfunction (MGD).

Testing For Dry Eye

There are two distinct types of dry eye. The first occurs when the eyes do not produce enough tears. The second occurs when tears evaporate too quickly. Improved technology over the last few years now allows us to detect causes and differentiate between the two types of dry eye.

Tear Break-up Time

Tear breakup time (TBUT) is a clinical test used to assess for evaporative dry eye disease.  To measure TBUT, fluorescein is instilled into the patient’s tear film and the patient is asked not to blink while the tear film is observed under a broad beam of cobalt blue illumination.  The TBUT is recorded as the number of seconds that elapse between the last blink and the appearance of the first dry spot in the tear film.  A TBUT under 10 seconds is considered abnormal.

A normal tear film will be seen with the dye spread evenly over the entire ocular surface and will last more than ten seconds.

An abnormal TBUT will show an uneven coverage of the dye as the tears evaporate from the ocular surface.  Abnormal TBUT is considered less than 10 seconds.  Extreme dry eyes will result in a TBUT of less than 3 seconds.

Tear Osmolarity Testing

The TearLab Osmolarity System* is intended to measure the osmolarity of human tears to aid in the diagnosis of dry eye disease in patients suspected of having dry eye disease, in conjunction with other methods of clinical evaluation.

Meibomian Gland Evaluation

The LipiView® interferometer is the first device of its kind that enables eye doctors to assess your tear film by capturing images that measure the thickness of the lipid (oil) component. This process is non-invasive and takes about five minutes.

Next is a closer look at what’s happening at the gland level. With the use of the Meibomian Gland EvaluatorTM your doctor can examine the quantity and quality of lipids (oils) being released from your glands.

Treatment of Dry Eye


The only FDA-Approved treatment for the most common cause of Dry Eye.

Other Treatments for Dry Eye

There is significant research in the treatment of dry eye but dry eye is generally controlled rather than cured. This means ongoing care is required.

Artificial Tears

Artificial tears, or lubricating eye drops, have been the mainstay of dry eye treatments. Artificial tears re-instill important components of the tear film and are an effective treatment for temporary relief of dry eye.   Unfortunately their effect is often short lived and may require multiple drops during the day.  Avoid using some over-the-counter eye drops that “take the red out”.  These drops often contain harsh preservatives that can cause further dryness of your eyes. Our current recommendations for artificial tears are Systane and Similasan.  We also recommend non-preserved tears as they are much easier on the eye.


New medications such as Restasis show promise in increasing tear production. Nutritional supplements might also help. Essential fatty acids and flax seed oil have been shown to increase tear quality and to reduce dry eye symptoms.

Punctal Plugs

Temporary or permanent silicone plugs in the tear ducts are an effective treatment option. They attempt to hold more of your natural tear longer on your eye. The plugs can be inserted painlessly in the eye doctor’s office and are normally not felt once inserted.


Sometimes the cause of dry eye is a medication. In this case it’s a good idea to work with your physician to see if other medications can be substituted.

Blink Training

In patients with evaporative dry eye, blinking exercises can help decrease partial blinking and improve meibomian gland function and symptoms.