dry%20eye%20syndrome
DRY EYE SYNDROME

Dry eye syndrome is a clinical condition wherein the patient experiences ocular and conjunctival irritation due to decreased tear production and/or excessive tear evaporation.
It is associated with increased osmolarity of the tear film and inflammation of the ocular surface.

Goal of treatments are to relieve symptoms of patients, to improve visual acuity & quality of life of patients, to restore ocular surface & tear film to normal homeostatic state and to correct the underlying defect.

Lifestyle Modification

  • Lifestyle/environmental modifications are effective for most patients w/ DED
    • Advise patient to reduce or eliminate exacerbating medications (eg antihistamines, antidepressants) & environmental stresses (eg low humidity, air conditioning)
      • Humidified environment decreases tear evaporation
    • Encourage the patient to have regular breaks w/ eye closure when reading or working on a computer
    • Instruct the patient to lower computer screens to below eye level to reduce interpalpebral aperture
    • Advice the patient to keep away from hot, windy, low-humidity, & high altitude places, & to avoid smog, smoke, & vehicle’s exhaust
      • Moisture-retaining glasses may be recommended
    • Educate the patient on correct use of contact lenses
  • For patients w/ chronic blepharitis & meibomian gland dysfunction which may be associated w/ tear dysfunction, eyelid hygiene is an important component of patient’s management
    • Removes irritating debris, increases blood flow, & opens up blocked meibomian glands
    • Warm lid compresses aid in decreasing meibum viscosity & preventing obstruction of ducts
  • Diet influences dry eye symptoms
    • Recommend to increase omega-3 fatty acid in diet (eg fish, fish oil, plants, plant oil) & to decrease omega-6 fatty acid
      • Omega-6 fatty acids are precursors of certain lipid-derived proinflammatory mediators, while omega-3 fatty acids inhibit their synthesis & block production of other inflammatory cytokines
    • Advice the patient to take supplements that contain linoleic acid & gamma-linoleic acid which was shown to improve symptoms & decrease lissamine green staining
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