With so many myths floating around about the cause of dry eye, it’s easy to become overwhelmed with suggestions. From tips ranging from spending less time staring at screens to grabbing an antihistamine due to some mystery allergen. However, new studies are showing that eye dry symptoms could be coming from within your very own body’s immune system.  

A study from the Duke University School of Medicine in Durham, North Carolina reports that the immune system can end up causing a condition named Meibomian Gland Dysfunction, or MGD, where the meibomian glands are stopped from producing oil to moisturize the eyes when the eyelids open. The direct cause is an immune cell called neutrophils. These cells are designed to protect the eye any time it becomes inflamed. When the cells end up gathering around the meibomian glands, it stops the oil production which keeps tears from evaporating. This leads to various eye problems including inflammation, dry eye, and even a buildup of bacteria under the eyelids. Dr. Daniel R. Saban says that the glands aren’t directly blocked by the neutrophils, but that the immune cells have an impact on the glands. “They’re being recruited around the gland and changing the actual glandular cells, which is causing them to malfunction,” Dr. Saban told Medical News Today. “Even under the microscope, you can see that the glandular cells, instead of being plump and round, have changed. They look more like a shriveled raisin than a healthy grape.” 

Scientists say that MGD is the leading cause of dry eye worldwide and that it is considered to be a “major health problem internationally.” Doctors say that dry eye treatment in the United States alone costs about $3.84 billion per year. The team at Duke University School of Medicine are working for possible cures for MGD and suggest that by tracking the neutrophils in the eye, they can develop individual treatment plans to offset the severity of the problem. 

“In addition to providing new treatment strategies, the presence of neutrophils in the eye could provide a biomarker to detect the disease or measure its severity,” Dr. Saban said in a Duke University press release. Dr. Saban also said that they’re working to figure out why the neutrophils are so prevalent in the eye at night, but not during the day. “When you sleep, neutrophils come into your tears,” Saban said. “We don’t know why, but they might be like the garbage truck, coming to collect all the waste while you sleep. Once your eyes open up, however, your tears become clear of these cells. But in these patients, their tears contain plenty of neutrophils even during the day.” 

The doctors noted in their study that the most severe cases of MGD came in patients that also had some other form of inflammation-related disease such as autoimmune disorders. They also noted that not all MGD comes from inflammation and autoimmunity just like all eye inflammations do not cause MGD. Dr. Saban made a point to mention at the end of the study that new treatments could arrive soon for MGD, in line with a current trend from drug manufacturers toward modifying the immune system. 

“New treatments might be presented sooner than expected,” Saban said. “The market is robust right now for new drugs that can modulate the immune system. With the new understanding of how immune cells are involved in this condition, the findings could be translatable with a drug that’s already on the market and repurposed for relieving MGD.” 

Dr. Silverman and the team at EyeCare 20/20 are dedicated to finding the best treatments for any eye condition that you may face. If you’re suffering from dry eye, the team at EyeCare 20/20 are ready to see what is causing your condition and ways that you can find relief. Contact the EyeCare 20/20 team today!

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