﻿Now, if you ever look much into dry eyes,
you will no doubt have stumbled upon the condition known as Sjogrens syndrome.
In this video, we'll have a look at the causes of dry
eyes and also the significance of the sjogrens syndrome as concluded
by the leading research study on dry eye disease,
and finally, why this is important for treating dry eyes successfully.
Hey, what's happening? I'm Martin Oguzie and this is Martin's Eye Tips.
Thank you for watching and on this channel, all about helping you to see
better, see more comfortably and also to be less anxious about your eyes.
If that sounds remotely interesting to you, then please go ahead and subscribe
to the channel, hit that notification bell as well,
so you get reminded every time I upload
a new video. Dry eye research, such as the work by Schiffman et al. 2003,
suggests that the long term impact of even moderate dry eyes can result in worse quality
of life for individuals than someone suffering from a condition such as angina.
And with that in mind, let's discuss the causes by dissecting
the key summary of the leading study on dry eyes,
which is the Dry Eye Workshop Study II or the DEWS II study as is also known.
I'll leave a four links to the DEWS
organization website in the description box below if you want to check that out
and if you're interested in finding out more about the report.
Also, do check out the first video in this three part series.
For more information on what dry eyes is and if you haven't yet watched that,
then go watch that first and then come back to this video.
Now, let's begin with the latest definition by the DEWS study.
So dry eye is a multi-factorial disease of the tears and surface of the eye
that results in symptoms of discomfort, visual disturbance and tear instability.
It is accompanied by an increased
osmolarity of the tear film and inflammation of the eye surface.
So there are obviously some big words in there.
I know, but the key ones to how we go
about soothing our eyes and making it more comfortable are tear instability
osmolarity an inflammation of the eye surface.
Also, as the definition suggests,
dry eye is caused by a multitude or lots of factors.
But they all produce the well documented
symptoms that include burning, itching of the eyes, redness, pain,
tired eyes and, strangely enough, even watery eyes.
Now, the following image is a quick overview of the classes of dry eye
and the basic causes as outlined by the DEWS to study.
Now, as we have a look at the flow chart
here, there are two main types of dry eyes.
One where your eye does not produce enough tears,
and this is called Aqueous Deficiency Dry Eyes,
and then the other where your tears
evaporate away too quickly and we call this Evaporative Dry Eyes.
The vast majority of dry eyes is due
to evaporative type with the aqueous deficiency type leading
to more serious symptoms and often a more challenging discomfort to treat and manage.
The causes of evaporative type fall into two classes.
First of all, we have external factors which are things in your environment,
environmental factors that reduce or impact the quality of your tears
and include things like contact lens wear and also Lasik.
Then you have eye related problems
and these are factors which are caused by abnormal functioning of your eyes,
which then affect the quality of your tears, of which Melbomian
Gland Dysfunction is one of the most common causes.
The causes of Aqueous Deficiency type are classified in two ways also.
First of all, it is due to Sjogrens Syndrome and then
secondly is everything else that is Non-Sjogrens Syndrome related but causes a lack
of tear production and the same serious long term dry eyes.
I think this is a good time to briefly
talk about Sjogrens Syndrome because it's clearly important enough and common enough
to have a category all of its own in the DEWS II research.
So Sjogrens Syndrome is caused
by the immune system, which is the body's defense against
infection, damaging healthy parts of the body through
incorrectly activating an ongoing inflammatory
response in the area where no infection actually exists.
So this is known as an autoimmune
condition, and there are many autoimmune conditions that range from
rheumatoid arthritis to a psoriasis and Crohn's disease.
However, Sjogren's Syndrome usually affects
areas of the body that produce fluids such as your tears and your salivary glands.
But other parts of the body, such as the nerves and the joints,
can also be affected by Sjogren's Syndrome as well.
Coming back to those big words from earlier on.
So tear instability,
osmolarity and inflammation of the eye surface,
here's how they all fit in. The firstly, with tear instability,
it's worth knowing that your tears are made up of three distinct fluid layers
that are released by different glands and pores to form the mixture that
is our tears. First of all, we have an oil layer at the front
that stops the watery layer evaporating too quickly,
and then secondly, in the middle we have
the watery middle lamb, which provides moisture to the eye that is needed,
and then thirdly, we have the mucus layer
at the bottom, which holds all the layers together and evenly spread over the eye.
So starting with inflammation of the eyes surface, inflammation is a process
by which the body's white blood cells and substances that they release protect
us from infection by foreign organisms such as bacteria and viruses.
The inflammation is great for a very short
term protection, but if it continues for some time,
it can cause serious issues and damage to otherwise healthy tissue. On the eye
it's a key problem that can either
cause dry eyes or it can also be the result of ongoing
dry eye, depending on the path in the above classification and flow chart
that is taken. As part of an inflammatory process.
We get heat produced as well as other
signs like redness and dilated blood vessels and swelling.
Tear instability comes about when the tear film
doesn't stay evenly spread over the surface of the eye.
And this can happen because the mucus
production from the mucous glands is low or the surface of the eye is slightly
damaged and the mucus can't evenly spread or anchor onto the surface of the earth.
The result is soreness and the triggering
of inflammation and the symptoms of dry eye. Osmolarity;
this is basically how concentrated your tear is.
For example, the more evaporation of the watery layer
that occurs, then the greater the osmolarity and the dry eyes as well.
The result is soreness
and the triggering of information and symptoms of dry eyes.
So why is this all important?
Well, all of the ways that we go about treating dry eyes and managing dry eyes
should involve addressing one or all of the problems are related to tear instability,
tear osmolarity and also inflammation of the eyes surface.
Now, having said that, one last point that I think is helpful
to touch on is the severity of dry eye symptoms.
And there is actually an official grading
scale of your symptoms, which can be useful as a point to the kind
of solution that might best suit your dry eyes.
And here's a simple example.
There are many cases where the symptoms or the visible signs of a condition
are not a good indication of the severity of the condition.
However, in the case of dry eyes, the DEWS study has concluded that dry eye
symptoms are a very good indicator of how severe your condition is.
And this is important for several reasons.
For one, it means that we can get a very good indication of how well your dry eye
is being managed by how severe the symptoms are.
The reason that symptoms are such a good indicator is because inflammation is
the biggest cause of dry eye discomfort and the problems associated with dry eyes.
So by dealing with the inflammation,
we can manage and even cure dry eye symptoms.
In the next video in this three part series,
I'll be talking about the dry eye treatments.
So don't miss that, if you find this video helpful.
I'd love to get you to subscribe
on the channel, so please hit that subscribe button,
hit that notification bell as well so you get reminded when the next video is released.
Let me know in the comments section as well,
what's been your experience with dry eyes?
Have you found it manageable?
Have you had a cure for your dry eyes?
Is it something that you've been
struggling with for a long time without a solution.
Let me know. I'd love to get your feedback on that as
well and check out the description as well I leave some links to the DEWS
report website so you can have a look at that, I think is really useful
and valuable information for people who have dry eyes. Until the next time
I look forward to seeing you in the next video.
Take care.