Ocular Surface Disease (OSD), also known as Dry Eye Disease (DED), refers to a range of conditions affecting the eye’s surface and tear film, leading to symptoms like irritation, dryness, and discomfort. It is increasingly common and can significantly impact someone’s quality of life. Understanding its causes, treatment options, and preventive strategies can help manage the condition and may improve eye health.
What Is Ocular Surface Disease?
The ocular surface includes the cornea, conjunctiva, and tear film, which work together to keep the eye lubricated, protected, and functioning properly. A disruption in the tear film or inflammation of the ocular surface can lead to Ocular Surface Disease. The most common form of OSD is Dry Eye Disease, though other conditions can also affect the eye’s surface.
The tear film has three main layers:
- The oily layer (lipid layer) – Prevents tear evaporation.
- The watery layer (aqueous layer) – Provides moisture and nutrients.
- The mucin layer – Helps the tear film adhere to the eye’s surface.
When these layers are imbalanced—either due to insufficient tear production or excessive evaporation—the eye becomes insufficiently lubricated, leading to dryness and discomfort.
Common Causes Of Ocular Surface Disease
Several factors contribute to Ocular Surface Disease:
Age & Hormonal Changes
As people age, tear production often decreases, which can contribute to Dry Eye Disease. Hormonal shifts, such as those occurring during menopause, pregnancy, or from birth control use, can also reduce tear production and increase the risk of OSD.
Environmental Factors
Dry air, wind, and exposure to air conditioning or heating can lead to faster tear evaporation. Living in low-humidity areas or working in climate-controlled environments can exacerbate symptoms of OSD.
Medications
Certain medications, including antihistamines, decongestants, antidepressants, and medications for high blood pressure, can reduce tear production and contribute to OSD. Drugs used for chemotherapy or acne treatment can have similar effects.
Underlying Health Conditions
Autoimmune diseases like rheumatoid arthritis, lupus, and Sjögren’s syndrome can cause inflammation and dryness of the eyes. Other conditions, such as diabetes or thyroid disorders, can affect the tear film and contribute to OSD.
Contact Lens Use
While contact lenses correct vision, they can reduce oxygen flow to the cornea, contributing to dryness and irritation. Improper lens care or prolonged wear can make the eyes more susceptible to OSD.
Eye Surgery
Refractive surgeries like LASIK can sometimes lead to OSD. These procedures may affect the nerves responsible for tear production, leading to dryness or discomfort post-surgery.
Symptoms Of Ocular Surface Disease
Symptoms of OSD can range from mild to severe and may include:
- Dryness or gritty feeling in the eyes
- Redness or irritation
- Blurred vision that improves with blinking
- Sensitivity to light (photophobia)
- Eye fatigue, especially after prolonged focus (e.g., reading, computer use)
- Sensation of something in the eye (foreign body sensation)
If left untreated, OSD can lead to complications such as corneal damage or scarring, which may impact vision.
Treatment Options For Ocular Surface Disease
Treatment for Ocular Surface Disease depends on the severity and underlying causes of the condition. Common treatment approaches include lifestyle changes, medications, and in-office treatments.
Artificial Tears & Lubricating Drops
For mild cases, over-the-counter artificial tears or lubricating eye drops can offer temporary relief by supplementing the natural tear film and reducing dryness. It may take some experimentation to find the right type of drops that work for you.
Prescription Medications
For more severe OSD, prescription medications like cyclosporine A (Restasis) or corticosteroid eye drops may be necessary. Punctal plugs—tiny devices inserted into tear ducts to block drainage—can also help retain moisture on the ocular surface.
Lifestyle Modifications
Simple lifestyle changes can significantly help manage OSD. These include:
- Taking regular breaks from screen time (e.g., the 20-20-20 rule—every 20 minutes, look at something 20 feet away for 20 seconds).
- Using a humidifier in dry environments.
- Wearing protective eyewear in windy or dusty conditions.
Warm Compresses & Lid Hygiene
Maintaining eyelid hygiene and using warm compresses can improve the function of the meibomian glands, which secrete the oily layer of the tear film. This treatment is particularly helpful for meibomian gland dysfunction, a leading cause of evaporative dry eye disease.
Surgical Or In-office Treatments
For persistent cases, treatments such as LipiFlow (thermal pulsation) or intense pulsed light therapy (IPL) may be recommended to clear blocked meibomian glands and restore proper tear production. Punctal plugs can also be inserted surgically to help retain moisture on the ocular surface.
Preventing Ocular Surface Disease
While Ocular Surface Disease cannot always be prevented, several steps can reduce the risk:
- Stay hydrated to support healthy tear production.
- Blink regularly to spread the tear film evenly across the eye.
- Wear protective eyewear in harsh environmental conditions (e.g., wind, dust).
- Avoid smoking and minimize exposure to secondhand smoke, which can dry out the eyes.
- Consume a diet rich in omega-3 fatty acids, which may help with tear production.
Managing & Treating Ocular Surface Disease
Ocular Surface Disease is a common condition that can cause significant discomfort and interfere with daily activities. By understanding its causes, symptoms, and treatment options, you can take steps to manage the condition and improve your eye health. A combination of lifestyle changes, medical treatments, and care from West Valley Dry Eye Optometrists can help give you relief and protect your long term eye health.
Contact our team as West Valley Dry Eye to schedule an appointment for any eye conditions you may be experiencing.