Dry Eye Disease Is More Than "Dry Eyes": Experts Explain the 2 Types

Dry eye is a multifactorial disease characterized by a loss of homeostasis of the tear film layer, which can present itself in different ways. Dry Eye Awareness Month is dedicated to bringing attention to people who may have the disease without realizing it because they aren’t familiar with associated symptoms.

Misunderstanding Dry Eye Disease Symptoms

Dry eye disease is often misunderstood, as patients tend to assume it only implies lack of water covering the eyes, which is an oversimplification, explained Nicole Bajic, MD, assistant professor at Cleveland Clinic Lerner College of Medicine and ophthalmologist at Cleveland Clinic Cole Eye Institute.

She explained that the tear film layer is complex, made up of a combination of aqueous, a watery component, and oil from the oil glands that line the eyelid. Blinking deposits a small amount of oil into the tear film to ensure the aqueous doesn’t evaporate quickly. Additionally, small cells in the conjunctiva, which is a clear, thin skin covering the white part of the eyeball, create mucus.

“You need a perfect combination of all 3 to have a good quality tear film,” Bajic said.

Additionally, Adam Baird, OD, FAAO, optometrist at Vanderbilt University Medical Center, explained that there are 2 different forms.

“The aqueous deficient form of dry eye, which is when the eyes don't produce enough tears, but there's also the evaporative form of dry eye, which is where the tears evaporate too quickly,” he said. Baird added that patients can have a blend of the 2 different forms, which all significantly impact patients’ vision.

Preventing Long-Term Dry Eye Condition

Dry Eye Awareness Month is a very important campaign that helps people recognize symptoms of dry eye disease and become more likely to seek care for it.

“We are able to catch things at an earlier stage…before they become so severe that it's impacting their vision more severely or causing more serious complications that can lead to permanent vision loss,” said Shahzad Mian, MD, chair of the Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, and director of W.K. Kellogg Eye Center.

Awareness campaigns help highlight options for care. With dry eyes being underrecognized and undertreated, it continues to be a common condition that can affect people’s daily lives.