At CARE Clinic, the optometrist first assesses the factors contributing to your dry eyes — such as weakened eyelid glands, blepharitis, or eye surface sensitivity — then discusses treatment options tailored to your needs: OptiLight IPL, iLux, or ZEST.
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"The cause of dry eye varies from person to person. Tears may be insufficient, evaporate too quickly, become unstable, or may be disrupted by the eyelids, certain medications, hormonal changes, contact lens wear, or a systemic disease."
A dry eye may burn, sting, tear, or appear blurry at times. When these symptoms occur—upon waking, using a screen, in the evening, or with wind—can be as revealing as the symptom itself.
"Two dry eyes may appear similar, but the cause varies: insufficient tears, rapid evaporation, irritated eyelids, or inflammation of the eye surface."
THE CARE EXPERIENCE
The optometrist examines tear coverage, measures the time it takes for tears to break up between blinks, and identifies dry areas.
The optometrist checks if the eyelids, their glands, blink frequency, contact lens wear, certain medications, or systemic conditions contribute to the symptoms.
Start with a routine tailored to your profile, then discuss in-clinic treatments (IPL, iLux, ZEST, photobiomodulation) if the signs and severity justify it.
Symptômes
Symptoms vary from day to day. The timing of their appearance — upon waking, at the end of the day, in front of a screen — often guides the evaluation.
01
A feeling of warmth, stinging, or irritation appears when the eye's surface becomes less stable, especially at the end of the day or in front of a screen.
02
The sensation of having a grain of sand in the eye often indicates irritation of the ocular surface or the edge of the eyelids.
03
Blurred vision that clears after blinking suggests tear film instability.
A dry eye can paradoxically water: the irritated surface triggers reflex tears that are more abundant but less stable.
Diffuse redness often accompanies irritation. Redness affecting only one eye or that is painful warrants a prompt evaluation.
When looking at a screen, the blink rate decreases, which accelerates tear evaporation and increases eye strain.
Contact lenses can become less comfortable when tears lack stability.
Winter heating, air conditioning, wind, and smoke accelerate tear evaporation.
"
Two dry eyes may look similar, but the cause can differ: insufficient tears, rapid evaporation, or irritated eyelids.
Dr. Francesca Olinga, optometrist
Overview
Dry eye primarily arises from three mechanisms: rapid evaporation, a lack of tears, or a combination of both. Identifying the dominant mechanism guides examination and treatment.
To remember
Eyelid glands: the most common cause, but not the only one
The glands located along the eyelid edges produce a thin layer of oil that prevents tears from evaporating. When these glands are not functioning well, tears evaporate quickly between blinks.
01
Evaporative dryness
Tears evaporate too quickly, usually because the eyelid glands produce less oil.
Signs
•
Rapid tear evaporation
•
Burning sensation at day's end
•
Fluctuating vision with screens
02
AQUEOUS DRYNESS
The amount of tears is insufficient, especially during menopause, chronic inflammation, or Sjögren's syndrome.
Signs
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Sandy sensation
•
Insufficient tears on testing
•
Persistent dryness in both eyes
03
Mixed dryness
Multiple mechanisms often coexist (rapid evaporation and lack of tears). A single treatment is not always sufficient.
Signs
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Symptoms that vary throughout the day
•
Partial response to lubricants
•
Multiple factors at play
04
Dryness associated with a condition
Ocular rosacea, blepharitis, Sjögren’s syndrome, medications, post-LASIK, or conjunctivochalasis can contribute to dry eye.
Signs
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Irritated eyelid margins
•
Systemic illness or medication
•
Symptoms outside of the eyes
Tears
01
The tear film covering the eye is distributed less evenly and breaks up more quickly between blinks.
02
The ocular surface becomes more exposed to the air, triggering burning, redness, stinging, or tearing.
03
Persistent irritation fuels inflammation, which makes symptoms more frequent and harder to alleviate without appropriate treatment.
Causes
The glands in the eyelids produce a thin layer of oil that slows down tear evaporation. If this oil is insufficient or of lower quality, tears can evaporate quickly between blinks.
The edges of the eyelids can become irritated or inflamed, particularly due to blepharitis or ocular rosacea. In some patients, certain medications, hormonal changes, wearing contact lenses, dry air, or systemic diseases (such as Sjögren's syndrome or rheumatoid arthritis) can further contribute to dry eye.
Perspective
Dry eye often occurs in episodes. Some periods are temporary; others recur frequently when the eyelid glands function less effectively, or with blepharitis, ocular rosacea, or systemic conditions.
Some episodes are temporary, such as after a long screen session, exposure to wind, or being in a heated environment. Other situations may persist when the eyelid glands are functioning poorly, such as in blepharitis, ocular rosacea, or systemic conditions.
Clinical follow-ups help validate which treatments are truly effective, adjust those that are insufficient, and discuss other options if dry eye remains active.
Dry eyes are common and often benign, but certain signs — pain, decreased vision, sensitivity to light — warrant a quick evaluation.
A sudden loss of vision or very blurry vision that doesn't clear up with blinking warrants a prompt evaluation.
Urgent
Significant eye pain or eyes particularly sensitive to light warrant a prompt evaluation.
Urgent
Intense or marked redness in a single eye warrants a rapid evaluation.
Urgent
Immediately remove contact lenses and seek immediate medical attention if the eye becomes red and painful.
Immediat
Abundant purulent discharge or a very swollen eyelid requires prompt evaluation.
Urgent
During the evaluation, the optometrist assesses whether dryness primarily stems from tears (insufficient volume), eyelids (blepharitis, poorly functioning eyelid glands), rapid evaporation, or a compromised eye surface. Treatment follows this analysis.
Some treatments target tears (lubricants, punctal plugs). Others target the eyelids and their glands (ZEST, iLux), or associated inflammation (IPL OptiLight, photobiomodulation). Observed signs at the examination and your symptoms guide the next steps.
Schedule an assessment
An optometrist and founder of the CARE Clinic, Dr. Francesca Olinga understands dry eye because she has experienced it. Experienced in the management of complex cases (neuropathic pain, demodex, chalazions), she uses innovation and attentive listening to guide you toward improved eye comfort.
Optometrist with over 30 years of experience and speaker for eye care professionals. Dr. Nguyen has experience in improving visual quality affected by dry eye. She supports her patients in reconciling their aesthetic goals (makeup, cosmetics) and optimal eye comfort.
An optometrist and member of theOOQ, Dr. Daniel Nguyen splits his practice between eye exams in an optometry clinic and advanced management of dry eye conditions at the CARE Clinic. This dual practice provides him with a comprehensive view of his patients' visual health, from routine screenings to cutting-edge therapeutic protocols. dry eye Biography of Karine Charbonneau
