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.

Introduction

  • Also known as keratoconjunctivitis sicca (KCS) or dysfunctional tear syndrome
  • Disease of the tears & ocular surface that is secondary to several factors
    • Associated w/ increased osmolarity of the tear film & inflammation of the ocular surface

Pathophysiology

  • Dysfunction in either of the lacrimal glands, ocular surface, eyelids, meibomian glands, or associated sensory or motor nerves may lead to dry eye syndrome (DES) causing changes in the volume, composition, distribution, &/or clearance of the tear film
    • Tear hyperosmolarity may be due to reduced aqueous flow or excessive evaporation of tears
    • Tear film instability may be secondary to hyperosmolarity which results in increased evaporation of tears

Signs and Symptoms

  • Common ocular signs & symptoms experienced by patients that usually worsen later in the day include the following:
    • Blurry vision (may clear temporarily w/ blink)
    • Burning sensation
    • Contact lens intolerance
    • Diurnal fluctuation
    • Eye fatigue
    • Foreign body sensation
    • Increased blinking frequency
    • Irritation
    • Mild itching
    • Mucous discharge
    • Photophobia
    • Redness
    • Stinging
    • Tearing
  • Symptoms may be aggravated by wind, air travel, low humidity, prolonged use of the eyes associated w/ decreased blink rate, or smoky environments
    • Increases evaporation or causes irritation that worsens dry eye syndrome (DES) symptoms

Risk Factors

  • Older age
  • Female
  • Estrogen hormone replacement therapy
  • Androgen & vitamin A deficiencies
  • Antihistamine
  • Decreased intake of omega-3 & 6 fatty acids
  • Connective tissue diseases
  • Hepatitis C infection
  • Radiation therapy
  • Hematopoietic stem cell transplantation
  • Lasik & refractive excimer laser surgeries
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