Dry Eye Disease
Dry eye disease occurs when the tear film and ocular surface lose their normal balance, leading to symptoms such as dryness, irritation, or fluctuating vision. This can result from a combination of factors, including unstable tears, increased evaporation, inflammation, or changes in nerve function. If you have experienced symptoms such as redness, burning, watery eyes, fluctuating vision, or sharp, stabbing discomfort, you may be experiencing dry eye disease.
What is Dry Eye Disease?
Dry eye disease is a multifactorial, symptomatic disease of the ocular surface characterized by a loss of homeostasis of the tear film and/or ocular surface. It is accompanied by symptoms such as dryness, irritation, or fluctuating vision, and involves contributing factors including tear film instability, hyperosmolarity, inflammation, and neurosensory abnormalities. This updated definition reflects the latest understanding from the TFOS DEWS III report. Traditionally, dry eye disease has been categorized into two main types: aqueous-deficient dry eye and evaporative dry eye, which often coexist. Aqueous-deficient dry eye occurs when the lacrimal glands do not produce enough of the watery (aqueous) component of tears. Evaporative dry eye is caused by increased tear evaporation, most commonly due to dysfunction of the meibomian glands, which are responsible for producing the oil layer of the tear film. More recent understanding recognizes that dry eye disease is often driven by a combination of underlying factors rather than a single type. These may include meibomian gland dysfunction, inflammation, tear instability, and changes in nerve function. As a result, modern management focuses on identifying and treating the specific contributors affecting each individual.
How is dry eye diagnosed?
Prior to your examination you will be asked to fill out an intake form that asks specific questions about overall health, medications, allergies and symptoms including those most commonly associated with Dry eye disease. You will have the opportunity to complete a Dry Eye Questionnaire. This information helps our team tailor testing to your specific concerns and needs. In addition to your routine health assessment, the Optometrist may perform various diagnostic tests like meibography, tear film break up time and analysis, corneal and conjunctival staining patterns, and possibly further investigation of MMP-9 markers and/or osmolarity testing. The Optometrist is able to combine the signs and symptoms from your assessment to diagnosis the type of dry eye you are suffering from and develop a custom management plan based on your health needs.
What causes dry eye and what are the symptoms?
Dry eye disease is a multifactorial condition of the ocular surface influenced by a range of factors that can disrupt the normal balance of the tear film. These include aging, hormonal changes, environmental exposures (such as air pollution, wind, and low humidity), screen use and reduced blinking, and underlying changes in tear stability, inflammation, or nerve function. Dry eye is also associated with systemic health conditions such as rheumatoid arthritis, thyroid disease, and Parkinson’s disease, and can be influenced by certain medications including oral contraceptives, antidepressants, antihistamines, and thyroid medications. Genetics and family history may also play a role. Common signs and symptoms of dry eye include redness, stinging, burning, grittiness, scratchiness, or a sensation of something in the eye. Some individuals may also experience excessive tearing (watery eyes), which is a reflex response to irritation and tear film instability rather than a sign of adequate lubrication.
Will dry eye harm my eyes? Can dry eye be cured?
If left untreated, dry eye disease can significantly impact quality of life and, in more severe cases, can lead to damage of the ocular surface. Chronic dryness may contribute to inflammation and injury of the cornea, potentially affecting vision. Dry eye can also make contact lens wear more difficult due to increased irritation and a higher risk of complications. If your symptoms worsen or are not improving with treatment, it is important to follow up with your optometrist. Dry eye disease is often a chronic condition that requires ongoing management. Treatment is aimed at improving the health and stability of the tear film and ocular surface, while relieving symptoms. Current approaches focus on identifying and addressing the underlying causes (or “drivers”) of dry eye, such as tear instability, inflammation, meibomian gland dysfunction, or changes in nerve function. Treatment plans are individualized based on each patient’s specific needs and contributing factors. At-home care remains an important part of management and may include lubricating eye drops, warm compresses, eyelid hygiene, and, in some cases, dietary supplements. In addition, prescription therapies may be recommended to reduce inflammation or support natural tear production, depending on the underlying contributors to the disease. Lifestyle and environmental modifications are also key components of care. Reducing screen time, taking regular breaks during prolonged near work, improving indoor humidity, protecting the eyes from wind and dry environments, staying well hydrated, and getting adequate sleep can all help improve symptoms. Managing underlying systemic conditions, reviewing medications, and optimizing overall health may also play a role in improving dry eye symptoms over time. In-office treatments may be recommended based on the specific drivers of dry eye. These can include intense pulsed light (IPL) and radiofrequency (RF), which are commonly used to improve meibomian gland function and reduce inflammation. Additional therapies, such as Jett Plasma, may also be used to support eyelid and ocular surface health by improving tissue function and addressing contributing factors to dry eye.
Dry Eye Explained
The two main types of Dry Eye Disease can occur independently or co-exist. The signs and symptoms of both affect the entire ocular surface, including the tear film, cornea, conjunctiva, eyelids, lacrimal and meibomian glands. Effective management involves identifying the specific type and tailoring treatment to alleviate symptoms and preserve ocular health.
Tears have three layers.
An outer lipid layer produced by the meibomian glands to prevent the tear film from evaporating.
A middle aqueous layer produced by the lacrimal glands that helps hydrate the eye, repel bacteria, protect the cornea and bring important electrolytes to the surface of the eye. This watery layer also helps smooth the surface of the eye and allows it to refract light so you can see clearly.
An inner mucin layer that helps the tear film spread evenly across the surface of the eye. This layer is produced by conjunctival goblet cells, specialized epithelial cells that secrete mucus onto the surface of the eyes.
Dry eye can be broken into three main components.
Typically, dry eye disese is caused by a combination of these factors, and treatment is tailored to address the underlying causes for each individual.
1. Not enough tears.
The eye isn't producing enough of the watery component of tears. Treatment options include lubricating eye drops, prescription medications to support tear production, and maintaining good hydration.
2. Tears are evaporating too quickly.
Often cause by Meiobomian Gland Dysfunction (MGD), where the oil layer of the tear film is poor, leading to faster evaporation of tears. Treatment options include warm compresses, eyelid hygiene, lipid-based eye drops, and in-office treatments such as IPL, RF, or JETT.
3. Inflammation or irritation.
The surface of the eye becomes inflamed, which can worsen symptoms and make dry eye difficult to manage. Treatments include anti-inflammatory eye drops, targeted therapies, and addressing underlying contributing factors.
At Home Products
Like the condition itself the management for dry eye symptoms is also multifactorial. Modern treatment focuses on identifying and addressing the specific underlying causes of dry eye for each individual. This often involves a combination of in-office treatments and consistent at-home care, working together to improve tear stability, reduce inflammation, and support overall ocular surface health. With the right approach, patients can experience meaningful improvements in comfort, vision, and quality of life.
At Revelstoke Optometry Centre, we take pride in offering carefully selected, evidence-based treatment options. Each product in our selection has been chosen based on clinical research and our doctors' experience to ensure both safety and effectiveness. Click the shop button to browse our recommended products, or visit us in-office to learn more. Click on each product photo to be explore supporting research and clinical studies.
Thealoz Duo
A preservative-free artificial tear with a unique combination of trehalose and hylauronic acid that is clinically proven to stabilize tear film, reduce inflammatory markers and restore normal osmotic balance. Thealoz Duo significantly alleviates symtpoms and restores the ecosystem of the eye. Suitable for contact lens wearers.
Thealoz Duo Gel
Clinically proven, Thealoz Duo Gel builds on the benefits of Thealoz Duo, adding carbomer, a polymer that enables longer-acting dispersion of the therapeutic ingredients. Thealoz Duo Gel combines trehalose, hylauronic acid, and carbomer gel that delivers long-lasting relief, day and night, for those with persistent dry eye symptoms or undergoing ocular surgery. While compatible with all types of contact lenses, lenses must be removed before using the gel and should not be reinserted until 30 minutes after use.
Blephaclean
A daily lid hygiene wipe with clinically proven antimicrobial cleansing properties and symptom relief. It is the only medical grade gauze lid wipe on the market. Free of preservatives, perfume, and parabens.
Blephagel Duo
A soothing and cooling gel for daily lid hygiene of sensitive eyelids and eyelashes. Blephagel Duo is a gentle hypoallergenic gel providing a calming sensation. Each pack contains 100 gauze pads and an easy-to-use tube providing a calibrated dose for each use. No need for rinsing. Can be used with eyelash extensions.
Blepha Eyebag
Reusable antimicrobial warming eye mask, specifically designed to provide rapid relief and long-lasting ocular comfort. The Blepha Eyebag is safe and well tolerated in the treatment of meibomian gland dysfunction, blepharitis, styes and chalazions. Ideal for use both before and after lid cleansing. It is handmade with natural components and is free from additives and plastics. It has a silk and cotton surface and is filled with untreated linseed. The Eyebag is safely decontaminated each time it is heated by microwave immediately before use.
Blephaderm
A preservative-free, soothing eyelid and eye contour cream for repairing, hydrating, and protecting the delicate eyelid skin that supports ocular health. Formulated with trehalose to provide bioprotection and regenerate the skin moisture barrier, hyaluronic acid to provide hydration and comfort, and Ophiopogon Japonicus to target itchy, inflamed skin, soothe and repair dry skin, and support the eyelid microbiota.
Zaspray
A unique, preservative-free liposomal spray, combining hyaluronic acid and the proprietary PER-LIP complex (consisting of liposomes and perilla seed extract) to hydrate, lubricate, and alleviate discomfort in irritated, itchy, red eyes. Ideal for those who struggle with eye drops, Zaspray delivers a fine mist in a precise measured dose to hydrate the eye and its surroundings. Not suitable for use with fake eylashes or contact lenses.
ZocuWipes
Harnessing the power of an innovative botanical formulation, each ZocuWipe towelette incorporates an activated okra complex made of polysaccharides to effectively cleanse the eyelids of dirt, debris, bacteria, and oil that contribute to dry eye symptoms. Each box contains 30 towelettes for 1 month of treatment.
ZocuFoam
ZocuFoam is a gentle and nourishing formulation enriched with the goodness of okra packaged in a foam bottle used to rinse away oil and debris for overall freshness. Feel the power of Zocular's patented Zokrex system with activated okra complex to relieve irritated, scratchy eyes or facial blemishes. Apply once or twice daily. Each bottle of ZocuFoam Cleanser and Moisturizer lasts 2-3 months.
ZocuShield
ZocuShield is an innovative gel containing activated Okra polysaccharide complex that penetrates through the biofilm to cleanse and nourish the eyelids.
I-DROP MGD
I-DROP MGD is a preservative-free, eye drop that helps relieve symptoms associated with evaporative dry eye. It is an advanced eye drop for hydrating and lubricating the cornea. The formulation contains 0.20% viscoadaptive hyaluronan, as well as superior osmoprotectants and bioprotectants that stabilize and enhance the lipid layer (oily layer) while reducing evaporation of the tear film. It is a long-lasting artificial tear that re-coats the surface of the eye with every blink, resulting in a lower therapy cost to the patient with fewer daily applications. I-DROP MGD is available in a multi-dose bottle with a sophisticated one-way valve and air-return system that delivers one sterile-dosed drop at a time.
I-DROP PUR GEL
I-DROP PUR GEL is a preservative-free, eye drop that is recommended for patients diagnosed with moderate to severe chronic dry eye syndrome who are looking for the ultimate relief and comfort for their dry eyes. The viscoadaptive property of I-DROP PUR GEL contains 0.30% HA with added glycerin. This formulation allows the drops to move back and forth across the surface of the eye with every blink, thus allowing for a longer residence time. It offers a higher hydration capability and stabilizes the lipid layer (oily layer) of the tear film, resulting in superior comfort to the patient. The sophisticated one-way valve dispenses one sterile, dosed drop at a time (no wasted product) and eliminates any chance of the product re-entering the bottle.
I-DEFENCE
I-DEFENCE is a long-lasting, lubricating ointment that delivers superior moisturizing and protection of the ocular surface. Containing 0.40% sodium hyaluronate, I-DEFENCE’s formulation is extremely effective at providing maximum, long-lasting relief of dry eye symptoms and is well tolerated by the patient. The unique viscous properties of I-DEFENCE enable a prolonged contact-time with the ocular surface. This hydrating ointment provides soothing relief of dry eye symptoms, such as soreness, irritation or a gritty sensation on the eyes and acts as a barrier against moisture loss. It is ideal for patients that suffer from nocturnal lagophthalmos. Not suitable for use with contact lenses.
I-RELIEF Mask
A hot and cold therapy eye mask with temperature retaining Thermabeads for lasting hot or cold therapy to provide relief from symptoms associated with Dry Eye Disease, Blepharitis, MGD, styes, chalazia, headaches and sinus pressure, swelling and puffiness.
OcuSci Mask
A dry eye compress mask with an antimicrobial, machine-washable cover to provide moist heat and cold therapy for relief of dry, itchy eyes. Can be heated in the microwave or oven!
BIHOCL
BIHOCL Hypochlorous spray is a versatile, all-natural, and highly-effective electrically charged solution that mimics the essence of human healing, as based on the science of Hypochlorous Acid (HOCl) – an organic and naturally occurring product of our internal defense system. This alcohol-free and preservative-free topical skin and facial spray is a perfect cosmetic solution to soothe your skin throughout the day. It removes bacteria from eyelids and lashes, reduces inflammation in the eyes, and helps to restore overall comfort and support your skin’s natural defense against irritation, inflammation, and post-procedure sensitivities. BIHOCL O.D. is a safe and powerfully effective antimicrobial solution for specialized eye care and daily ocular health. It’s an effective complement to existing treatment protocols for dry eye disease, blepharitis, MGD, and similar conditions, and can be used daily to set the foundation or optimal daily eyegiene.
De3 Omega
DE3 Omega Benefits is a custom formulation for occasional eye dryness, to provide the body with the essential nutrients it needs to produce a soothing, healthy tear film. Omega-3 deficient glands may become inflamed and clogged which accelerates tear evaporation and dryness due to missing oil. Studies show that long-term consumption of 2240mg of EPA & DHA in the re-esterified triglyceride form (rTg) may help to maintain a healthy tear film and assist in overall eye comfort. Bottles come in 3 different serving sizes: 90 capsules, 180 capsules, 270 capsules.
Oe Liquid Omega
Oe Omega Benefits is a custom formulation for occasional eye dryness, to provide the body with the essential nutrients it needs to produce a soothing, healthy tear film. Each bottle has 40 servings = 40 days.
Understanding Eye Drops
Hydrating drops add moisture to the eyes and can help when you are not producing enough tears. These types of drops contain ingredients tht improve lubrication and comfort.
Aqueous (Hydrating) Drops
Lipid-based drops can help prevent tears from evaporating too quickly by supporting the oil layer of the tear film which is important for patients with miebomian gland dysfunction.
Lipid-Based Drops
Tear-stabilizing drops improve how long tears sty on the eye and help to create a more stable, long-lasting tear film.
Tear-Stabilizing Drops
Preservative-free eye drops are gentler on the eyes and recommended for patients who use eye drops frequently. Preservative-free is also recommended to avoid irritation.
Preservative-Free Options
Why PRN Omega-3s?
PRN is one of the few omega-3 formulations studied specifically in dry eye patients, showing measurable improvements in both signs and symptoms, including tear osmalarity, tear break-up time, inflammation markers, and symptom scores. PRN omega-3s support multiple underlying causes of dry eye as they reduce inflammatory pathways, improve tear quality, and support healthier oil production.
High quality, highly absorbable formulation
Compared to typical over-the-counter fish oil supplements, PRN Omega-3's use a re-esterified triglyceride (rTG) form, which is more efficiently absorbed—up to three times better than standard omega-3 forms. They also provide a high concentration of EPA and DHA and are ultra-purified to remove mercury, PCBs, and other contaminants.
Many over-the-counter omega-3 supplements contain lower doses and are less bioavailable, meaning they are not absorbed as effectively. Because the clinical benefits of omega-3s depend on both dosage and absorption, formulation quality plays a key role in their effectiveness.
Consistent dosing used in research
PRN Omega-3 formulations are designed to reflect the dosing used in clinical trials when taken consistently over 8–12+ weeks. This is important, as current research emphasizes the use of evidence-based, reproducible treatments. Many generic omega-3 supplements do not reach therapeutic dosing levels, which may limit their effectiveness.
Cornerstone of modern dry eye treatment
Omega-3 supplements are a key component of modern dry eye management, helping to support the tear film from the inside out. They are typically used alongside artificial tears, eyelid hygiene, and in-office treatments as part of a comprehensive, multi-modal approach.
DE3 OMEGA FAQ's
How does DE3 compare to store bought fish oil?
DE 3 contains 2240mg of EPA and DHA in an ultra-purified triglyceride (rTG) form, which is a similar form to a piece of fish, but without the impurities. Triglyceride formulations are dietary forms of Omega 3's and are readily absorbed. Ethyl ester based forms of Omega 3 are more economic and readily available however the absorption rate is around 30% in comparison to triglyceride formulations which are between 90-95%. Ethyl ester based Omega 3s contain preservatives that cause atrial fibrillation and increased risk of bleeding- they are NOT safe to use if you are on blood thinners. In comparison, triglyceride based Omega 3s do not have this risk, The recommended dose of DE3 Omega 3 allows for the blood index level to reach around 8% which is the required amount for therapeutic effects.
Can I get a sufficient amount of Omega-3s from just eating fish?
The American Heart Association and the American Cardiology Association recommend 2-3 grams of omega-3s daily (EPA+DHA). To get this amount of Omega 3s (generally equal to 3 soft gels of PRN Omega 3s daily) from eating fish, you would have to consume the equivalent of 37 cans of tuna per week! Eating this much fish could result in an increased risk for mercury poisoning. Other fish that can be purchased in stores are mostly farm-raised which have little Omega-3s, or wild-caught, which are optimal but have an increased risk of being contaminated with harmful PCBs, dioxins, mercury, etc.
Why not flaxseed oil?
Flaxseed contains the plant source of Omega-3s, also known as alpha-linolenic acid (ALA). This form is less easy to absorb and less effective in the body. ALAs act as Omega 6s which are pro-inflammatory and can exacerbate dry eye symptoms. ALAs have also been shown to increase the incidence of Macular Degeneration. Marine-based Omega-3s have been shown to be more absorbable which may provide systemic benefits.
View clinical study here.
Check out Dr. Bill Harris' publications for OmegaQuant and more studies from the Fatty Acid Research Institute
90 Day Relief Challenge
... or your money back guaranteed!
*The 90-Day Challenge guarantees relief from the patient's dry eye symptoms. Any discontinuation of use for reasons other than lack of dry eye relief in 90 days will not be eligible for a refund. If the patient is unable to take the product as recommended for any reason, Labtician will not refund the cost of the product. To take the challenge, buy a 90-Day supply of softgels or liquid omega from your Optometrist. In order to qualify for the guarantee, the patient MUST take 3 softgels or 1 teaspoon daily as recommended for the 90-Day period. If at the end of the 90-Day period the patient does not experience relief from their Dry Eye symptoms as determined by their doctor, Labtician will reimburse the cost of the 90-Day supply.
In Office Procedures
Modern treatment of dry eye disease focuses on identifying and addressing the underlying causes of dry eye, such as meibomian gland dysfunction, inflammation, and tear instability, using a personalized approach. In many cases, a combination of at-home management and in-office treatments, provides the most effective and lasting results. Advanced technologies, including Radiofrequency (RF) and Intense Pulsed Light (IPL), are designed to target key contributors to dry eye by improving meibomian gland function and reducing inflammation. These non-invasive treatments can significantly improve tear quality and eye comfort.
At Revelstoke Optometry Centre, we offer in-office treatments using the Lumecca (IPL) and Forma (RF) handpieces from InMode. We also provide non-ablative treatments with the Jett Plasma Pen, which can support eyelid health and help manage dry eye associated with meibomian gland dysfunction and blepharitis. When combined with consistent at-home care, the treatments work to improve tear stability, reduce inflammation, address gland blockages, and support the long-term health of the ocular surface, helping patients achieve lasting relief from dry eye symptoms.
Dry Eye Testing
At Revelstoke Optometry Centre, our doctors use a state of the art dry eye diagnostic system to support accurate diagnoses, earlier intervention, and customized treatment. A personal evaluation report is generated after your Optometrist evaluates your tear breakup time, tear meniscus height, meibomian gland function, lipid layer thickness, eyelid margin, and more.
InMode
Introducing the Lumecca-I and
Forma-I handpieces for the Envision by InMode!
Envision is an advanced in-office workstation equipped with multiple modalities, the Lumecca and Forma handpieces, to perform safe and effective, nonsurgical, office-based procedures to improve Meibomian Gland Dysfunction and reduce dry eye symptoms.
In - Office Treatments
Lumecca-I ensures precise, targeted, spot-size Intense Pulsed Light (IPL) procedures to treat inflammatory conditions in smaller zones. This technology was developed with an advanced Xenon flash lamp and is optimized for light and dark skin tones.
Lumecca-I
Forma-I is the only RF device with a Health Canada indication for treatment of Meibomian Gland Dysfunction (MGD). It is intended for use in the periorbital area and eyelids, and relieves inflammation of meibomian glands and eye irritation.
Forma-I
ENVISION
Forma-I is radiofrequency energy (RF) or heat that is applied to the upper and lower eyelids to melt hardened oils in the meibomian glands to allow for removal of blockages, improving of the tear film and gland function. Not only can we treat the ocular area with our Forma-I technology, we can also treat the entire face and neck to give an overall lift and glow.
Forma-I RF
Lumecca-I is intense pulsed light (IPL) used to target the blood vessels around the eyes causing inflammation and irritation. This light therapy helps to liquify blockages in the meibomian glands, and reduce bacteria present on the skin. It also reduces and can remove pigmented lesions like age and sun spots.
Lumecca-I IPL
Jett Plasma Pen
Advanced in-office treatment used to help manage conditions such as Meibomian Gland Dysfunction and blepharitis.
The Jett Plasma Pen provides non-ablative treatments, meaning it works beneath the surface of the skin without harming the outer layer. The pen uses DC micro charges and pulsed DC microcurrents, which are very small, controlled electrical pulses that encourage healthy cell activity. These pulses help improve cell regeneration, loosen blocked oils (meibum) in the meibomian glands, increase hydration and nutrient delivery, and reduce inflammation, supporting overall eye health.
Jett Plasma Medical Pen is Health Canada Aprproved and is backed by years of research and development, as well as numerous clinical studies, ensuring both safety and efficacy for patients.
Four Sessions
A typical course of Jett therapy for blepharitis or Dry Eye Disease is four sessions. Patients experience progressive relief with consistent outcomes over a short treatment plan.
Stye Resolution
Jett treatments can significantly shorten the healing time for styes, with many patients seeing noticeable improvement after just one or two treatments.
