Dry eye, or dry eye disease (DED), is caused by a reduction in the eye's ability to produce or maintain normal tears. There are two main types of dry eye disease, aqueous deficient and the most common form, evaporative. Aqueous-deficient dry eye develops when the eyes do not produce enough of the watery component of the tears and evaporative dry eye is caused by a deficiency in the outermost oily layer of the tears. Meibomian gland dysfunction (MGD) is the leading cause of dry eye disease. The meibomian glands produce an oily substance called meibum that aids in preventing evaporation of the water in the tears by forming a layer over the top. When the meibum isn’t present or of good quality, it is not able to protect the surface of the eye and tears will evaporate more than usual, resulting in a dry, gritty, or scratchy feeling. Approximately 86% of people with dry eye disease have excessive tear evaporation due to MGD.
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