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Chronic Dry Eye is a Disease

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Chronic dry eye (CDE) is a disease that causes, overtime, a decrease in the production in the quality and quantity of tears.  

Symptoms of Chronic Dry Eye include:

  • Dryness / Itching
  • Burning / Stinging
  • Watery eyes
  • Light sensitivity
  • Problems wearing contacts
  • Feeling like something is in your eye
  • Blurry vision

CDE is more common in people 50 years of age or older and occur more frequently in women than men.  However, the rise of digital device use in the form of smart phones, tablets, and computers is causing dry eye in young adults.

Blink Rate

When looking at a digital screen, the blink rate decreases by 50%.  In addition, our eyes do not perform a complete blink while looking at digital devices.  There are tiny glands called meibomian glands at the base of our upper and lower eyelids near the eyelashes.  Each time a blink occurs, oil is secreted from the glands.  The oil makes up the top layer of tears and prevents the tears from evaporating.  If an incomplete blink occurs, not enough oil will get onto the front surface of the eye. The tears evaporate at a higher rate leading to dry eye symptoms.


When the meibomian glands are not functioning properly, the oil becomes thick and backs up into the gland.  This causes the gland to atrophy and ultimately disappear. The image below shows the different stages of meibomian gland dysfunction using a special camera called a Meibocan.  80% of dry eyes is caused by meibomian gland dysfunction.  It is important to receive a baseline Meiboscan to determine if you have early signs of meibomian gland dysfunction.  


Blink exercises – every 20 minutes look 20 feet away and perform a hard blink for 10 seconds.  This will help secrete the oil from your glands and prevent them from becoming plugged up.   

Artificial Tears – Using oil-based artificial tears to prevent tear evaporation 2 – 4 times a day.  

Heat mask – a special mask can be prescribed by your eye doctor.  This mask is used 1-2 x a day for 10 minutes at a time to help open the meibomian glands to secrete oil.  

Expression and debridement – performed in-office.  This the process of evacuating plugged glands by mechanically expressing them with special forceps.  After this is done, a special brush is used to clear debris from the lids and clean the meibomian glands.  

If you are someone you know is suffering from dry eye disease, seek help by scheduling a dry eye evaluation at our office today.


Written by Dr. Michael Duong

Dr. Duong received his bachelor’s degree in biology with a minor in chemistry at San Jose State University. He then attended Pennsylvania College of Optometry and received his Doctor of Optometry in 2009.
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