Ocular Surface Disease (Dry Eye)

Ocular surface disease is a condition of the tear film, eyelids, and surface of the eye that leads to many challenges with our vision as well as the comfort of our eyes.

What Is Dry Eye?

Have you experienced intermittent blurry vision? Do your eyes feel gritty, scratchy, tired, burn or become painful? Do your eyes or eyelids look red or irritated? Do you experience frequent tearing? These symptoms may be indicative of ocular surface disease, commonly called dry eye syndrome. Ocular surface disease is a condition of the tear film, eyelids, and surface of the eye that leads to many challenges with our vision as well as the comfort of our eyes.

Though often overlooked, our tears and ocular surface play a crucial role in preserving our vision and comfort. Ocular surface disease is increasingly common and may require more attention than one might think. Below you will learn a little bit more about some causes of ocular surface disease and what your eyecare professional may consider as they evaluate your eyes.

At Glacier Eye, we want to help you enjoy excellent vision and enjoy your life. Ocular surface disease does not have to stand in the way! Do not hesitate to contact our clinic and schedule an evaluation today.

Our eyes are constantly producing tears to lubricate the eye, fight disease, provide nutrients, and maintain good vision. Tears are actually made of multiple substances, including an oil called meibum that comes from glands in our eyelids known as meibomian glands.

Meibum is essential to a healthy tear film as it prevents evaporation of tears. If tears evaporate the tear film becomes more concentrated, which generates inflammation. A variety of factors, including environmental, dietary, and our general health, play a role in the function of our meibomian glands. Dysfunction of these glands is very common and is a major contributor to ocular surface disease. Treatment of dry eye often includes efforts to improve meibomian gland health, which helps restore the natural tear film.

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Blepharitis refers to an inflammatory condition on the eyelids and eyelashes. This condition may occur due to rosacea, allergies, native bacterial or mite overgrowth, and other diseases. Symptoms include redness of the eyelids, crusting or “dandruff-like” material on the eyelashes, blurry vision, burning or irritation of the eyes. Inflammation of the eyelids promotes meibomian gland dysfunction and inflammation on the surface of the eye, which leads to a poor tear film.

Treatment of blepharitis depends in large part on the cause, so it is important to be evaluated by an eyecare professional. As mentioned above, we all have bacteria and mites that grow on our skin. Often, an imbalance of these along our eyelids drives the inflammatory reaction. See the following section for additional details.

Demodex are among the microbiome that is native to our skin. These mites live in the eyelid meibomian glands. Overgrowth of these organisms can cause many of the symptoms mentioned previously, including redness, blurry vision, irritation, and redness of the eyes.

Demodex is very treatable and doing so can increase ocular comfort as well as vision. Some therapy includes use of eyelid hygiene products, particularly those containing tea tree oils, and washing bed sheets in hot water. However, other efforts may be needed to help improve your condition. If you are experiencing some of these symptoms, call us today!

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Significant research is being performed to better understand ocular surface disease, or dry eye syndrome, as there are still more questions than answers. What we now understand is that it is not merely a lack of tears or poor quality tear film, alone. Rather, there is a cyclical process in which the tear film becomes over concentrated leading to inflammation on the surface of the eye. The inflammation further breaks down the tear film and damages cells on the ocular surface. This feeds the cycle by generating additional inflammation and tear film disruption.

Sometimes lifestyle changes and increased lubrication can break this cycle. However, other times the inflammatory signals need to be stopped in order to allow the ocular surface to heal itself and reestablish a healthy tear film. At Glacier Eye Clinic we test for inflammation in order to determine what therapies are best for you.


Therapy for ocular surface disease is multimodal and different for every patient. A thorough evaluation of the eyelids, meibomian glands, tear film, and ocular surface in addition to an understanding of patient symptoms are essential in determining both the cause and possible treatments needed to improve the condition. Also, medical history including medical conditions and medications taken help guide the decision making process for dry eye therapy.

It is important to understand that ocular surface disease is typically chronic and usually requires some ongoing maintenance. However, symptoms can be controlled and you can get back to enjoying your lifestyle. Oftentimes, it requires dedication, patience, and some trial and error to stabilize the condition, however, enjoying good vision and comfortable eyes is possible.

Our doctors at Glacier Eye Clinic will work with you to understand your symptoms, your circumstances, and your visual needs. Together, we will work toward improving your vision and your quality of life.

Additional information about ocular surface disease can be found on the American Academy of Ophthalmology website.