Different Types of Dry Eye Explained

Dry eye is more than just a lack of tears. Tears have different layers, each with a role. If any layer fails, dry eye can develop. Knowing your type helps you find relief.

What Is Dry Eye?

Dry eye happens when your tear film is not working properly. Your tear film has three layers. The outer layer is oily, helping tears evaporate more slowly. The middle layer is watery and provides moisture. The inner layer is mucus-like and helps tears stick to the surface of your eye.

All three layers need to be healthy and balanced. If this balance is off, you may feel burning, stinging, grittiness, blurry vision, or watery eyes. Watery eyes can actually signal dry eye. Your eyes may overproduce water to compensate. Without oil to hold it, that water just runs off, offering no relief.

The Two Main Types of Dry Eye

·      Aqueous-Deficient Dry Eye

With this type, your eyes simply do not produce enough of the watery layer. The lacrimal glands, located just above your eyes, produce this watery layer. When production slows, your eyes do not get the moisture they need.

This form of dry eye is often linked to aging, certain medications, or medical conditions like Sjogren’s disease, rheumatoid arthritis, or lupus. It can also occur after eye surgeries such as LASIK.

·      Evaporative Dry Eye

This type is actually more common. It happens when your tears evaporate too quickly. The problem usually lies in the meibomian glands, which are tiny oil glands along the edges of your eyelids. These glands produce the oily outer layer of your tear film. That oil acts like a lid, keeping the watery layer underneath from evaporating.

When these glands get clogged or stop working well, the oil layer is missing or of poor quality. Without that protection, your tears evaporate too fast. This can happen from not blinking enough, especially during long hours on screens. It can also be caused by eyelid inflammation (blepharitis) or by skin conditions such as rosacea.

Mixed Dry Eye

Many people have both types at once. They do not produce enough tears, and the tears they do make evaporate too quickly. This is called mixed dry eye. It is not a separate type; it is simply a combination of the two. Treating it usually means addressing both problems.

How Do You Know Which Type You Have?

You cannot determine this on your own. An eye doctor can run simple tests to identify what is happening.

A Schirmer’s test checks the amount of tears your eyes produce over a few minutes. A tiny strip of paper is placed along your lower eyelid for a few minutes. If the paper does not get very wet, it suggests your eyes are not making enough tears. That points to aqueous-deficient dry eye.

The tear breakup time test checks how stable your tears are. The doctor puts a dye in your eye and watches how long it takes for dry spots to appear. If your tears break up too quickly, it suggests evaporative dry eye.

Your doctor may also examine your meibomian glands or take images of them to see if they are clogged or damaged.

To find out what kind of dry eye you have and discuss treatment options, call DeCesare Eye Associates at (401) 331-4475 to schedule your appointment at our Providence office.

https://my.clevelandclinic.org/health/diseases/24479-dry-eye

https://www.healthline.com/health/types-of-dry-eye