Dry eye and Optometry

The Optometrist's Role in Dry Eye Management

Dry eye is one of the most common eye conditions, affecting more than 30% of the population in Mexico. Optometrists play a fundamental role in its detection, diagnosis, and management, working in collaboration with ophthalmologists to offer comprehensive treatment.

What is Dry Eye?

It is an imbalance in the tear film resulting from:

✔ Deficit tear production (hypostrecretion).

✔ Excessive evaporation (meibomian gland dysfunction).

✔ External factors (screens, pollution, poorly fitting contact lenses).

Common symptoms:

Grit or foreign body sensation.

Redness and eye fatigue.

Fluctuating vision.

Contact lens intolerance.

Optometrist's Work in Dry Eye

1 Diagnosis

Performs specific tests to assess:

Tear quality: Tear break-up time (TBUT).

Tear volume: Schirmer test.

Meibomian gland status: Meibography (in specialized clinics).

Ocular surface evaluation: Slit lamp and stains (fluorescein, rose Bengal).

2 Treatment

A. First-Line Therapy

Preservative-free artificial tears (e.g., sodium hyaluronate, carbomer).

Eyelid hygiene (warm compresses, massages, special wipes).

Environmental modification (humidifiers, resting from screens).

B. Advanced Therapy

Special contact lenses:

Scleral: Create a humid chamber over the cornea.

Hybrid: Combine comfort and protection.

Punctal plugging (in severe cases, with collagen or silicone plugs).

Referral to an ophthalmologist for treatments such as:

Intense pulsed light (IPL).

Autologous serum.

3. Patient Education

Teach complete blinking techniques (for screen users).

Recommend omega-3 supplements (to improve tear quality).

Explain how to properly clean the eyelids.

60% of contact lens wearers suffer from dry eye (DEE).

80% of cases are due to excessive evaporation (meibomian gland dysfunction).

Only 20% of patients receive a timely diagnosis.

When to Refer to an Ophthalmologist?

The optometrist should refer a patient to a specialist if they detect:

Corneal ulcers.

Sjögren's syndrome (autoimmune disease).

Failure of conventional treatments.

Tips for Patients with Dry Eyes

✔ Blink 15-20 times per minute when using screens.

✔ Wear glasses with UV protection and anti-pollution.

✔ Avoid direct air conditioning in your eyes.

✔ Remove eye makeup every night.