Redness, irritation, itching, dryness, grittiness, excess tearing, blurry vision, and pain can all be symptoms of ocular surface disease, also known as dry eye disease.  The ocular surface plays an important role in protecting the more delicate parts of our eyes, but when the ocular surface is not healthy, quality of daily life can be affected.  While the common thread is always increased inflammation, there are multiple factors that can lead to ocular surface disease:
 

1. Lack of tear production:  the bulk of your tear film is made of aqueous, which can be depleted if the lacrimal gland is not functioning properly.
2. Poor oil release / production:  oil produced by glands near your eyelashes can become clogged or inflamed, leading to increased tear evaporation and styes.
3. Systemic conditions:  systemic inflammatory disorders, such as Sjogrens, metabolic disease, rosacea, and other autoimmune conditions increase inflammation on the ocular surface.
4. Lifestyle:  poor diet, stress, lack of sleep, and smoking can exacerbate ocular surface disease by increasing oxidative stress on the surface of the eye.
5. Bacteria:  bacteria or mites on eyelash follicles release toxins onto the eyelid and into the tear film, causing inflammation.
6. Environmental:  poor air quality and extended screen time increase evaporation, leading to dryness from exposure.  We also blink less frequently and incompletely while on digital devices.
7. Lid anatomy:  incomplete eyelid closure while sleeping can lead to surface dryness upon waking.  Loose, droopy lids can also cause misdirection of tears, leading to poor tear coverage of the ocular surface.
8. Allergy:  seasonal and environmental allergies can be present without other systemic evidence of allergies.

The first step in treating ocular surface disease is identifying the major underlying factors for each individual.  While most doctors screen for ocular surface disease at annual comprehensive exams, a more detailed exam is usually recommended to layout a targeted approach.  This detailed ocular surface exam involves a very in-depth conversation with the doctor as well as specific diagnostic tests to evaluate each component of the ocular surface and tear film.  Once the offending factors are identified, a treatment plan can be put in place.  Ocular surface disease is often a chronic condition that has to be treated and managed as an ongoing condition.  While some treatments are in-office short-term solutions, many options rely on patients to adopt new at-home habits.  To learn more about ocular surface disease and new treatment options, ask our scheduling coordinators to schedule your ocular surface disease evaluation.