The Eye Works Optometry

1328 Pearl Street Napa, CA 94559
(707) 254-2020 | Fax: (707) 254-2036
New Patients Call: (707) 693-4434
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Open Saturday!

Dry Eye

What is dry eye?

In a healthy eye, tears are responsible for the perfectly smooth ocular surface which allows clear vision. Tears also clean and lubricate the eye. Every time we blink, a fresh layer of tears, called the Tear film, spreads over the eye. The Tear film is important for keeping the eye moist and comfortable. Sometimes, the eye may stop producing enough tears or tears evaporate too quickly. This common and often chronic condition is referred to as dry eye syndrome.

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    • Life style – staring at computer screens, televisions, or electronic readers for long periods of time, exposure to air conditioning, wind, smoke, and dry climates
    • Age – dry eye syndrome often gets worse as we age
    • Gender – women are more likely to develop dry eyes
    • Other factors – long term use of contact lenses, refractive eye surgery, some medications, medical conditions, such as, rheumatoid arthritis, diabetes, thyroid problems and inflammation of the eyelids.

    The Tear Film

    The tear film is structured with 3 components that work together: a complex mucus component, a watery portion (Aqueous) and a complex oil outer layer (Lipid). The oil component (Lipid) is important for reducing evaporation of tears and also provides structure to the tear film. Lipid is produced by the meibomian glands and is injected unto the tears with each blink. Meibomian gland dysfunction (MGD) can create a deficiency in the lipid component of the tears, which leads to evaporative dry eye.

    The watery component produced by the lacrimal glands (aqueous) is also important. A lack of aqueous production can result in another type of dry eye called aqueous deficient dry eye. Aqueous deficient dry eye can be associated with disorders such as rheumatoid arthritis and lupus.


    The OCULUS Keratograph® 5M is an advanced diagnostic device that is used for evaluating the Dry Eye Syndrome and measuring the quality and quantity of the tear film. Keratograph® 5M has a high-resolution color camera and is equipped with intelligent software to analyze the collected data and document the findings. It can also compare the results and show the success of the dry eye treatment. With help of the Keratograph® 5M your doctor can find the root cause of your dry eye syndrome and can suggest the best treatment plan.


    The Keratograph® 5M examination

    There is an advanced technology called the OCULUS Keratograph® 5M. It helps Ophthalmologist and Optometrists in accurately diagnosing the Dry Eye Syndrome and documenting the findings. If treatment is necessary, the Keratograph® 5M can compare the before and after treatment results to evaluate the success of the treatment.

    Quality and quantity of the tear film

    To measure the quality and stability of the tear film, the OCULUS Keratograph® 5M measures the tear film break up time non-invasively. This test takes less than 30 seconds and does not require touching the eye. To evaluate the quantity of the tear film, the Keratograph® 5M takes a picture of the lower eyelid to measure the tear meniscus height.

    Lipid Layer

    The Keratograph® 5M can document a movie of the oily layer of the tear film. A healthy and thick lipid layer is colorful and protects the tears from fast evaporation. If there is not enough lipid, the tear film becomes unstable, the moisture dissipates quickly and both vision and comfort can be compromised.


    Located in both upper and lower lids, the meibomian glands produce complex oils that stabilize the tear film and prevent tear evaporation. If the meibomian glands do not function properly dry eye usually occurs. Your doctor can utilize the advanced features of the Keratograph® 5M to directly assess the health of your meibomian glands.

    Dr Craig Sultan at The Eye Works Optometry works with all ages of patients, including younger patients, to reduce the risk and incidence of dry eye development through cutting edge technology / pretesting each patient as well as sound nutritional and protective means. If you should develop dry eye, I test for small changes in the above symptoms with the Keratograph 5M. A treatment plan can be developed by Dr. Sultan upon review of testing results.

    You may schedule an appointment here or call us at 707 254 2020. We are open six days a week, Monday, Wednesday, Thursday and Friday 9am to 6pm, Tuesday 10am to 6pmand Saturday from 9am to 4pm.