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What is Ocular Surface Disease?
Ocular Surface Disease (OSD) is the most common eye problem in the United States.  The natural tears that your eyes produce are composed of three layers:
  • the outer oily layer
  • the middle watery layer
  • the inner mucus layer
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Ocular surface disease, also known as dry eye disease, is a condition where a person cannot produce enough tears or there is an imbalance with the layers of the tears, leading to ocular surface inflammation.  Good quality tears are necessary for maintaining the health of the front surface of the eye and for providing clear and comfortable vision.

What Causes Ocular Surface Disease?
OSD is most often a result of aging but can also result from:  ethnicity, general health problems (allergies, high cholesterol, endocrine disorders, pregnancy, menopause, rosacea, psoriasis, rheumatoid arthritis, Sjogren’s Syndrome), medications (oral contraceptives, retinoic acid, hormone replacement therapy, antidepressants, antihistamines, androgen medications), environmental factors, contact lens over wear, abnormal blinking, make-up, and others that your eyecare practitioner may discuss with you.

What are Symptoms of Ocular Surface Disease?
OSD is a common and often chronic problem.  OSD can make it more difficult to perform some activities, such as using a computer or reading for an extended period, and it can decrease tolerance for dry environments.  OSD can produce a wide range of symptoms including, but not limited to:
  • Dryness
  • Gritty sensation
  • Redness
  • Irritation
  • Fatigue
  • Burning
  • Stinging
  • Watering
  • Light sensitivity
  • Itching
  • Discomfort with contact lenses
  • Blurry or fluctuating vision
If left untreated, excessive inflammation can damage the ocular surface tissue and decrease vision.   We may perform additional ocular surface testing with diagnostic instruments to determine how to tailor your management.  We may also request that you return for additional testing and follow-up examinations.

Management of Ocular Surface Disease
Management will vary depending on the type of ocular surface disease you have. Recommended management may include:
​- Artificial Tears – Instill one drop ___ time(s) per day in both eyes
  • Preservative-free
  • Refresh Optive / Advanced / Optive Mega 3 PF / Celluvisc / Repair
  • Systane Balance / Complete / Ultra / PF
  • TheraTears
  • Oasis Tears
- Gels and Ointments – Instill ¼ “ strip into lower lid sac ___ time(s) per day in both eyes
  • TheraTears Gel
  • Refresh PM Ointment
  • ​Systane Gel / Nighttime
- Bruder Heat Mask – Apply to closed lids ____ time(s) per day to both eyes
- Prescription ophthalmic steroids – Instill one drop ___ time(s) per day in both eyes
  • Lotemax / FML / Tobradex
- Prescription Ophthalmic Restasis / Cequa / Xiidra – Instill one drop 2 times per day in both eyes
- Lid Cleanser – Apply to closed lids ___ time(s) per day to both eyes
  • Hypochlorous acid solution / Tea Tree Foam Cleanser (EyeEco)
  • OCuSoft Lid Scrub Plus Foam or Wipes
  • Cliradex
- Oral doxycycline or azithromycin – take ___ capsule(s) by mouth for ___day(s) with food
- Omega-3 Supplements
- Humidifier
- Blink Exercises