Dry Eye & Ocular Surface Disease

Dry Eye & Ocular Surface Disease

Dry Eye & Ocular Surface Disease

Dry Eye & Ocular Surface Disease

Have you been told that you have dry eye syndrome or dry eye disease, but you do not experience eye dryness? Our doctors at Grand Eye Care found that many patients diagnosed with dry eye disease are confused when they do not have a symptom of eye dryness. Thankfully, there is updated terminology for disorders of the ocular surface and tear film that describes the symptoms of ocular discomfort, dryness, burning, stinging, grittiness, foreign body sensation, light sensitivity, blurred vision, and fluctuating vision. Let’s take a moment to look at these symptoms patients are experiencing as a result of ocular surface disease (OSD).


  • Ocular surface disease (OSD) describes a group of conditions that affect the front surfaces of the eye known as the conjunctiva and cornea.

  • OSD includes meibomian gland dysfunction, blepharitis, aqueous deficient dry eye disease, demodex, rosacea, allergic conjunctivitis, injury/trauma, long-term eye drop use such as glaucoma eye drops, and immunological conditions like Sjogren’s Syndrome.

  • These conditions affect the quality of the tear film and how it interacts with the front surfaces of the eye.

  • A healthy tear film lubricates and protects the eye as well as helps to provide clear and crisp vision all day long.

  • A poor-quality tear fill causes symptoms of eye discomfort, dryness, burning, stinging, irritation, grittiness, light sensitivity, blurred vision, and fluctuating vision.

  • Finding the cause of the ocular surface disease and treating the specific conditions are the goals of any treatment plan to return your eyes and vision back to normal.


The tear film moisturizes, lubricates, and protects the eye, as well as helps provide crisp and clear vision. It is composed of three layers:

  • Lipid (Oil) Layer – Our eyelids contain glands, the meibomian glands, that secrete oil when we blink. The oil layer lubricates the eye and helps prevent evaporation of the aqueous layer of our tears.

  • Aqueous (Water) Layer – The aqueous layer of the tear film is created by the lacrimal gland and accessory glands. The aqueous layer makes up the majority of the tear film.

  • Mucin (Sticky) Layer – The mucin layer of the tear film is created by goblet cells. Mucin helps the aqueous layer of the tear film stick of the front of the eye.


Meibomian gland dysfunction (MGD) affects the glands of the eyelid that secrete the oil layer of the tear film. In MGD, the meibomian glands stop functioning, become clogged, and are unable to produce a high-quality oil layer which prevents evaporation of the water layer of the tear film. As the glands remain clogged, they begin to deteriorate and stop producing the oil layer.

​​​​​​​Meibography is one great piece of equipment that allows us to actually visualize the health of the eyelid glands. The image below shows how MGD damages the glands over time. As the glands become damaged and disappear, we are unable to bring them back.

How is meibomian gland dysfunction treated?

Because the glands are located within the eyelid, eye drops do not help to treat the meibomian glands. Direct heat applied to the eyelids has continuously been shown to be one of the most effective ways of treating MGD. Utilizing the TempSure Envi radio frequency platform, our doctors are able to successfully target and treat MGD. Interested in learning more about this new, non-invasive and non-surgical treatment for MGD? Schedule a consultation below to experience the relief of your MGD and symptoms with TempSure Envi.

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Blepharitis is a condition that results in chronic inflammation of the eyelids. Blepharitis affects the skin of the eyelid, eyelashes, eyelash follicles, and meibomian glands. Blepharitis can categorized as bacterial, viral, parasitic, and fungal. Blepharitis causes redness, crusting of eyelashes, eyelash dandruff, burning, irritation, blurred vision, and redness.

How is blepharitis treated?

​​​​​​​Blepharitis is difficult to treat due to the various areas of the eyelid that can be affected. In some individuals, prescription ointment and creams can provide relief. Other individuals may be required to utilize eyelid cleansing solutions and cleansing pads. Exfoliation of the eyelids and eyelashes is an effective way to help manage blepharitis when prescription and over-the-counter products cannot provide relief of your symptoms. Interested in learning more about eyelid exfoliation for blepharitis? Schedule a consultation below to see how your eyelids and eyelashes can benefit from exfoliation.

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How Are Dry Eye And Ocular Surface Diseases TREATED?

The overall severity of your ocular surface disease is an important factor that determines the exact treatment selected. Because OSD is caused by numerous eye conditions, it is important to determine the exact conditions present before beginning treatment. Once the specific condition or conditions have been diagnosed, our doctors will provide the appropriate first-line, second-line, and surgical procedures available for each condition.

​​​​​​​Established patients - Remember to refer to the OSD treatment information form that was provided by your doctor to see which treatments are recommended for your eyes.

New patients - Fill out a consultation form below to schedule your ocular surface disease evaluation and begin your customized treatment plan.

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