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Symptoms & Types of Dry Eye

Symptoms of dry eye can be multitude with a breakdown typical of the three types of ocular surface disease:

Aqueous Deficiency (“Dry Eye”) – Dehydrated

  • Tearing is the most common symptom (salivation analogy when you are thirsty)
  • Blurred Vision/Fluctuation in vision (typical with prolonged computer use)
  • Dry, gritty feeling (worsens as day progresses)
  • Redness (exacerbated by use of OTC vasoconstrictors which decrease blood flow to the eye)
  • Sand-like sensation of a foreign object in the eye

Posterior Blepharitis/Lid Margin Disease/Meibomian Gland Dysfunction (MGD)/Evaporative Dry Eye

  • Oil layer is poor or deficient
  • Burning is the most common symptom
  • Stinging, tearing, blurred or fluctuation in vision especially with near vision tasks is common

Ocular Allergy

  • Itching, Itching, Itching is the most common symptom
  • Redness
  • Swelling of the white of the eye (chemosis)
  • Nasal/Throat congestion

To avoid confusion, there are two forms of blepharitis – anterior and posterior. Posterior mentioned above affects the meibomian oil glands in the posterior margin of the eyelid causing inflammation or redness to eyelid margin, hordeolum or stye (acute stage), and/or chalazion (chronic stage). Anterior blepharitis causes dandruff like scurf or matter along the actual eyelashes with associated inflammation and/or redness to the same eyelid margin and can lead to loss of lashes (madarosis). Both types of blepharitis are chronic with intermittent bouts of flare ups causing many of the dry eye symptoms discussed above. Posterior blepharitis or MGD is typically progressive where the meibomian glands will atrophy or drop out without treatment in the earlier stages causing chronic scarring and eyelid margin defects, including loss of lashes. Certain eyelid cancers can also cause similar eyelid defects so being examined by Dr. Jackson or his associates is critical as soon as any eyelid anomalies occur.

Side view of an eye with tear film anatomy.

  • Lipid (oil) layer – lubricates and prevents evaporation.
  • Aqueous (water) layer – nourishes and protects the cornea.
  • Mucin layer – adheres tears to the eye.
  • Meibomian glands – create the lipid (oil) layer of the tear film, a blockage can lead to evaporative dry eye.