Dry Eye Clinic

What You Need to Know About
Dry Eye Disease

The Prism Eye Institute Dry Eye Clinic is an internationally recognized center for Dry Eye and Ocular Surface Disease and the largest provider in Canada for dry eye care.

Dry eye disease is a common, largely undiagnosed condition that affects around twenty-five percent of Canadians. It can cause uncomfortable symptoms like:

Burning & stinging eyes
Scratchy & red eyes
Irritation & foreign body syndrome
Visual disturbances

The Prism Eye Institute’s dry eye clinic is designed to give you a comprehensive and collaborative approach to managing your dry eyes.

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What Is Dry Eye Disease?

Simply put, dry eye disease occurs when there’s a problem with your tear film.

Your tear film is the thin layer of moisture that sits on the surface of your eye to hydrate, protect, and nourish your corneas—the clear dome over your eyes—and helps you see clearly.

How the Tear Film Works

The tear film is composed of basal tears and is essential for healthy, comfortable eyes. It’s spread across the surface of your eyes every time you blink.

The tear film is made of three distinct layers, each with a role in keeping your eyes healthy and your vision clear. Dry eye disease occurs when there’s a disruption to any of these layers, which interferes with the proper lubrication of your eyes, leading to discomfort and irritation.

Oily Layer

The oily outer layer (lipid) prevents the tear film from evaporating too quickly and creates a smooth surface to help you see. The oily layer is produced by the meibomian glands that line your eyelids.

Watery Layer

The watery middle layer (aqueous) is composed mainly of water and proteins and keeps your eyes hydrated, repels bacteria, and protects the cornea. It’s primarily created by the lacrimal gland.

Mucous Layer

The inner mucous layer (mucin) keeps the tear film adhered to the surface of the eye. It’s produced by the epithelial cells in your conjunctiva—the membrane that lines the insides of your eyelids and part of the eye.

What Causes Dry Eye Disease?

Dry eye disease is a complex condition caused by several factors that impact the quality or quantity of your tears.

Some patients develop dry eyes because there’s an imbalance in the composition of their tears, causing them to evaporate too quickly. Others develop dry eyes because they don’t produce enough tears to keep their eyes comfortably lubricated.

Increased Tear Evaporation

When the outer oily layer of your tear film is compromised, your tear film may evaporate too quickly, resulting in evaporative dry eye disease. This type of dry eye disease is primarily caused by meibomian gland dysfunction (MGD). MGD is a group of disorders that cause the meibomian glands to become inflamed, damaged, or blocked.

Several factors can contribute to MGD, including blepharitis, vitamin A deficiency, environmental conditions, eyelid disorders, and simply blinking less often.

Evaporative dry eye disease accounts for 85% of dry eye cases.

Decreased Tear Production

When you don’t produce enough of the watery layer of the tear film, you can develop aqueous deficient dry eye disease, a chronic inflammation of the eye’s surface.

Aqueous deficiency can occur because of age, medications with ocular side effects, temporary nerve damage caused by laser eye surgery, and corneal nerve sensitivity caused by long-term contact lens use. It’s also strongly tied to autoimmune diseases like Sjögren’s Syndrome, rheumatoid arthritis, and lupus.

How Is Dry Eye Disease Diagnosed?

Your dry eye specialist will use innovative technology to determine the exact cause(s) of your tear and ocular surface dysfunction. We will objectively measure your symptoms, tears, ocular tissues and function of all the systems involved. This information is used to provide you with a customized treatment plan which will be provided to you at the end of your thorough consultation.

A dry eye evaluation involves:

A comprehensive eye exam
The measurement of your tear volume
An assessment of your tear quality
A tear analysis measuring tear osmolarity

Osmolarity Testing

Osmolarity is the measurement of how much salt is in your tears. High tear osmolarity is the hallmark of dry eye disease.

We take a direct sample to measure the composition and saltiness of your tears, which tells us how severe your condition is or how effective your treatment is.

Lipiscan

Lipiscan is a quick diagnostic scan that takes a high-definition image of your meibomian glands. Dysfunctional meibomian glands appear in these images as a shortening or complete loss of the glands.

HD Analyzer

The HD Analyzer provides an objective and noninvasive analysis of the tear film over a twenty-second interval. This allows us to evaluate how successful a patient’s blink is at restoring tear function.

InflammaDry

InflammaDry provides a quick, in-office measurement of an inflammatory marker consistently present in those with dry eye disease.

Prism Dry Eye Clinic’s Treatment Options

We offer a variety of innovative and effective treatment methods to help you find relief. For more general information on dry eye diagnosis and treatment, visit here.

Intense Pulsed Light (IPL)

Intense pulsed light (IPL) is a noninvasive therapy that uses light on the skin around the eyes and face to reduce inflammation of the meibomian glands and improve tear film stability.

Transcutaneous Radio Frequency (RF)

Radiofrequency (RF) treatment for dry eye involves the use of energy waves to stimulate the production of natural oils in the meibomian glands.

LipiFlow® Thermal Pulsation

LipiFlow® is a non-surgical, FDA-approved treatment for dry eye that uses thermal pulsation to remove blockages in the meibomian glands and improve oil flow.

Microblepharoexfoliation (MBE)

Microblepharoexfoliation (MBE) is a gentle, non-invasive procedure using Zocular® eyelid system treatment solution (ZEST), which removes debris and exfoliates the eyelid margin to treat blepharitis.

Low-Level Light Therapy (LLLT)

Low-level light therapy (LLLT) uses specific wavelengths of light to stimulate cellular processes and reduce inflammation, offering relief to dry eye patients.

Amniotic Membrane Graft (AM)

An Amniotic membrane graft (AM) is a regenerative non-surgical therapy that uses human placental tissue to reduce inflammation and promote healing of the ocular surface in dry eye patients.

Intraductal Probing (IDP)

Intraductal probing is a minimally invasive procedure that uses specialized instruments to clear blockages and restore function to the meibomian glands, improving dry eye symptoms.

Blood-Derived Eye Drops

Blood-derived eye drops contain autologous serum or plasma, which can help promote healing and reduce inflammation on the ocular surface for dry eye patients.

Can Dry Eye Disease Cause Vision Loss?

Fortunately, dry eye disease itself isn’t sight-threatening. But if left untreated, your symptoms can worsen, and the condition can increase your risk of eye infections and complications and impact your quality of life.

While it’s a chronic condition with no cure, several treatment options exist to address the root cause of dry eye symptoms and restore the functionality of your tear film.

If you have dry eyes, it’s important you follow up with your eye doctor for a comprehensive eye exam and proper diagnosis so you can receive personalized treatment that gets to the root of your condition.

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