Dry Eye Disease and Blepharitis

Image Description: A woman wearing glasses rubs her eye with her hand, with her eyes closed

Written for Blind Low Vision NZ by Yeji Kim, Optometrist, Specsavers Rangiora, Canterbury.

On the face of it, dry eye disease sounds like quite a self-explanatory condition. Many people associate dry eyes with the feeling of red, gritty or burning eyes. However, dry eye disease can cause other unexpected symptoms such as intermittent blurry vision, light sensitivity, or even excessively watery eyes. Chronic dry eye disease can also cause damage to the sensitive outermost tissue of the eye, known as the cornea.

Patients who experience dry eye disease often put up with mild symptoms, but persistent symptoms over many years can negatively impact quality of life.

How does dry eye disease occur?

A key component of your eye is the very thin liquid layer on the surface of the eyeball, known as the tear film. The tear film acts as a hydrating barrier for the eye and contributes to maintaining clear vision. When the tear film is unstable or of poor quality, dry eye symptoms may emerge. Many factors can affect the tear film, such as medications, health conditions, environmental factors, and visual demands. A common condition is blepharitis, which can contribute to dry eye symptoms as well. To learn more, you can read the PDF Epidemiology and risk factors of dry eye disease: considerations for clinical management.

What is blepharitis?

Blepharitis is a chronic inflammation of the eyelids. It is often more common as we get older but can happen to people of all ages and backgrounds.

Blepharitis is classed into two subtypes:

• Anterior blepharitis comes from an overgrowth of bacteria along the base of the eyelashes, which can cause crustiness and gritty sensations in the eye as well.
• Posterior blepharitis is where the oily glands along the edge of the eyelids become blocked and stop producing quality oil, which is a crucial component of the tear film. This common condition is also known as Meibomian Gland Dysfunction (MGD).

The role of your optometrist

Optometrists are able to diagnose dry eye disease and blepharitis during a routine eye examination with the use of a slit lamp microscope to assess different structures of the eye. This gives us enough information to create a tailored treatment plan. We can target the specific causes of your dry eye disease, or the subtype of blepharitis present on your eyelids.

As there are so many variables that contribute to dry eye disease, treatment will often need to cover multiple factors. For example:

• Making changes to your environment by reducing direct exposure to air conditioning.
• Taking regular breaks from concentrated tasks to improve the frequency of blinking.
• Supplementing the tear film with regular lubricating eyedrops. Your optometrist will be able to recommend the most helpful lubricating drops for your tear film following an examination.
• Routine care at home with eyelid cleansing products or warm compresses.

If there is a diagnosis of blepharitis, treatment options may include:

• Prescribed oral medication or prescription eyedrops.
• Treatments such as Intense Pulsed Light therapy (IPL) or Low Level Light Therapy. (LLLT) are becoming available at most optometrist practices. These dry eye treatments are safe and painless and provide long-lasting improvements and relief.

About the author:

Raised in Auckland, Yeji Kim graduated from the University of Auckland with a Bachelor of Optometry. Following this, she works as an optometrist at Specsavers Rangiora in North Canterbury.

Image Description: A shoulder-length shot of Yeji Kim, an optometrist at Specsavers Rangiora in Canterbury, with black hair, smiling at the camera.

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