CAUSES OF DRY EYE DISEASE


Despite the multifactorial nature of dry eye disease (DED), evidence has clearly shown tear evaporation is a leading cause of the disease1,2

percent of DED cases
have excessive tear evaporation due to MGD as the root cause.1
Venn diagram showing percentage breakdown of DED etiology
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When a patient reports they don’t have any symptoms, I tell them that I also care about their anatomy, and their meibomian glands are essential to maintaining their visual quality.3

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—Preeya K. Gupta, MD

Reduced blink rate, increased screen time, and lid laxity can lead to tear evaporation, but the main contributor is MGD4,5

MGD is characterized by:

changes in meibum composition
Changes in meibum
composition5
reduced meibum secretion
Reduced meibum secretion6
breakdown of the tear film lipid layer
Breakdown of the tear
film lipid layer2,5

Evaporation drives the persistent cycle of DED2

Tear evaporation triggers a cycle of ocular surface damage, inflammation, and worsening of DED symptoms.2,7
Illustrated cycle of evaporation in DED Illustrated cycle of evaporation in DED
The continuation of this cycle can contribute to the loss of ocular surface homeostasis.8

*Desiccation is the drying of the ocular surface due to tear evaporation exceeding tear production.5

Treating the underlying source of DED signs and symptoms could help break the cycle and restore ocular surface homeostasis

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The Missing Piece of the Therapeutic Equation: Excessive Tear Evaporation in DED

Review an expert perspective written by ophthalmologist Darrell E. White, MD, the founder of SkyVision Centers.

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NEW

Evaporation in Dry Eye Disease: Delving Into the Core Mechanism

Review an expert perspective on the mechanisms of DED written by optometrist Paul Karpecki, OD, FAAO, chief clinical editor for Review of Optometry.


If evaporation is not addressed, signs and symptoms of DED may chronically persist.9

signs and symptoms of DED may chronically persist

Review select literature expanding on the mechanism of DED

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Revisiting the vicious circle of dry eye disease: a focus on the pathophysiology of meibomian gland dysfunction

Baudouin C, et al. Br J Ophthalmol. 2016
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The International Workshop on Meibomian Gland Dysfunction: executive summary

Nichols KK, et al. Invest Ophthalmol
Vis Sci.
2011
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New

The interventional MGD consensus statement: detecting, diagnosing, and dealing with MGD

Devries D, et al. Cataract & Refractive Surgery Today. 2022
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New

Meibomian gland disease: the role of gland dysfunction in dry eye disease

Chhadva P, et al. Ophthalmology. 2017
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New

TFOS DEWS II pathophysiology report

Bron AJ, et al. Ocul Surf. 2017