Evaporative dry eye occurs when the lipid layer that coats the tear film is of poor quality, quantity, or both, allowing the aqueous layer of tear film to evaporate quickly. Evaporative dry eye is closely associated with meibomian gland dysfunction (MGD), obstructive meibomian gland dysfunction (o-MGD), blepharitis, posterior blepharitis, anterior blepharitis, and allergies.
Systemic conditions such as Hashimoto’s hypothyroidism can lead to evaporative dry eye because the thyroid can effect meibum production. Demodicosis (infestation by demodex mites) may also be a contributing factor.
Acne treatment with retinoids such as isotretinoin, can lead to atrophy of the meibomian glands, reduced meibum production and more viscous meibum, leading to evaporative dry eye.
Untreated, evaporative dry eye can lead to more serious problems such as symptomatic conjunctivochalasis or even blindness.
Behaviors to watch for:
The slightest wind is bothersome or excruciatingly painful to the eyes
Difficulty or no reading
Keeping eyes closed for long periods and even all day
Difficulty or no driving
Frequent use of eye drops, more than once every 2 hours
Not participating in normal daily activities
Thoughts of suicide
Thinking about enucleation, removing the eyes
The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007)
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