Blink, Blink: Unpacking the Mystery of Dry Eye

Blink, Blink: Unpacking the Mystery of Dry Eye

Many people don’t know what dry eye is. Simply put, dry eye is NOT (just) eyes that are dry. This is a symptom of many eye related issues. And, the implications of our collective lack of knowledge are significant. Peeq Pro was started because ocular surface disease, specifically dry eye, is exploding. 

What is dry eye?

What is Dry Eye

The formal definition is - "Dry eye is a multifactorial disease of the ocular surface charac­terized by a loss of homeostasis of the tear film, and accompanied by ocular symp­toms, in which tear film instability and hyperosmolarity, ocular surface inflamma­tion and damage, and neurosensory abnormalities play etiological roles." (Source: Tear Film & Ocular Surface Society Dry Eye Workshop II (TFOS DEWS II), published in 2017)

For non-doctors, this means that your tear quality is poor, or you don’t have good tear quantity. And by some measures more than 7/10 American adults have dry eye.

Tears are not only what happens when you cry. Tears also describe the lubricating liquids in your eyes when you blink. Having poor tear quality can mean that your eyes itch, hurt, turn red, etc.  In addition, one key symptom is you may develop a lack of feeling in the nerves in your eyes - and thus, they won’t feel anything, including dryness.

Importantly, dry eye is not an infection or other temporary state. Usually, dry eye requires a permanent change in behavior for the patient. It does not go away. Symptoms may be lessened, but it is the sort of thing that persists.

Dry Eye and Plaque

Dry Eye and Plaque

Many optometrists describe dry eye and the reasons for dry eye as comparable to plaque on teeth and the variety of oral health problems that arise from not brushing and flossing. Essentially, most people do a poor job of washing their eye area. As such, many develop pre-cursors (such as meibomian gland dysfunction) or actual ocular surface diseases. 

Like brushing one’s teeth, washing eyelids is a consistent way that people can combat dry eye. Doing it well is important. But, doing it consistently is essential.

The statistics on prevalence are wildly varied. Some say that dry eye disease (the clinically defined disease above) is in 3% of the U.S. population, others say 40 million people by 2028. Similarly, the range of people with meibomian gland dysfunction (MGD) is between 50-73% of Americans. This is because dry eye disease is only being identified and studied because people are describing “discomfort” in much greater numbers.

This evolution of dry eye appears to be caused by multiple human behaviors causing more eye related strain.

  1. Screen Time. People look at their screens and blink far less frequently. This means that the tears are being secreted far less frequently.
  2. Medicine. Certain medicines, i.e. accutane, and medical procedures, i.e. LASIK, have exacerbated or caused certain ocular surface conditions, including dry eye.
  3. Environment. Sitting in artificial cooling conditions, particularly under a vent, or having poor air quality after a wildfire or similar environmental event has caused many exacerbating situations for people’s eyes.
  4. Makeup. Putting cosmetics on your eye area, and then inadequately washing it off causes damage over time to the glands, lashes, and lids. Rubbing to get makeup off stretches the skin around the eyes and can cause additional damage.

Moreover, our bodies change as we age. Women, particularly going through or after menopause, have less production of tears. This is a natural process within a female’s body. This helps explain why so many women have dry eye - prevalence is about 2/1 female to male.

Compliance for dry eye care

The next step to dry eye is compliance and treatment. For tips on compliance, check out our blog on Proper Eyelid Hygiene

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