Summary DED and eyelid therapy notes

DED and eyelid therapy




Outer lipid layer- secreted by meibomian glands and prevents tear evaporation
Aqueous layer- secreted by lacrimal glands, supplies oxygen to the corneal epithelium and
contains antibacterial enzymes. Washes away debris
Mucin layer- secreted by goblet cells, allows wetting of corneal surface.

Risk factors:
 Female
 Age
 Smoking
 Caffeine
 Diabetes
 Topical meds
 Systemic meds
 Acne
 Arthritis

Aqueous deficient dry eye
 Failure of tear production by lacrimal gland.
 Reduction in volume of tears which causes hyperosmolarity of the tears and induces
an inflammatory response.
 Sjogrens: autoimmune condition which involves damage to secretory glands
 Non sjögrens: Lacrimal gland obstriction, trauma.
Evaporative dry eye:
 Increased evaporation of tears from the ocular surface when the lacrimal gland is
functioning normally.
 Can be intrinsic (abnormality of ocular structures)- MGD, proptosis, low blink rare
 or extrinsic (external)- CL wear, allergy, systemic drugs, vitamin A deficiency,
environment,
 Oily layer isn’t good so doesn’t protect watery layer which vanished quickly, brain
thinks we need more tears so produces too much water.

important questions to ask:
 How long for?- if sudden onset unlikely dry eye
 Binocular? If unilateral unlikely to be dry eye