Dry Eye Syndrome

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Dry eye syndrome is also known as keratoconjunctivitis sicca (KCS). It is an eye disease which results due to reduction in tear production or increased evaporation of the tear film. The disease often results in severe damage to the ocular surface, thereby affecting the normal visibility significantly.

Dry eye syndrome is broadly classified into two types:

  • KCS associated with Sjögren syndrome
  • KCS not associated with Sjögren syndrome

Sjögren syndrome is an exocrine gland dysfunction, which is characterized by lymphocytic infiltration of the gland. This results in the development of soccer complex, which is often characterized as dry eye syndrome.

Dry eye syndrome is more prominent in individuals with vitamin A deficiency and autoimmune diseases. Additionally, the condition affects elderly people more as compared to youngs adults or children. Dry eye syndrome affects males and females to a similar proportion; however, no clinical evidence is available to support the prevalence.

Dry eye syndrome is more common in elderly. However, factors such as physical stress, vitamin A deficiency, diseases, etc. tend to induce the development of the syndrome.

Some of the factors linked with the development of the dry eye syndrome are:

Inadequate Tear Production
Lacrimal hyposecretion leads to evaporation of tears. This causes dryness of the layer covering the cornea and the conjunctiva.

Various diseases such as xerophthalmia, sensory denervation, rheumatoid arthritis, Sjögren’s syndrome, and autoimmune diseases are associated with the development of the syndrome.

Physical Factors
These include:

  • Excessive exposure to dry atmosphere (ACs, wind)
  • Bright sunlight
  • Active smoking
  • Chemicals
  • Burns
  • Drugs/medications

Administration of various drugs is known to worsen the condition. Additionally, the drugs intensify symptoms and interfere with the treatment strategies of the syndrome. Drugs include antihistamines, sedatives, contraceptives, atropine, and antihypertensives.

Symptoms Of Dry Eye Syndrome
Symptoms may vary from person to person, and depends upon the age of the patient. Some of the most common symptoms are:

  • Dryness in the layer covering the conjunctive
  • Burning sensation or itching
  • Inflammation or redness of the eye, particularly around the iris and corners
  • Reduction in blinking
  • Increased sensitivity to light, sun, or bright lamp
  • Uneasiness while reading
  • Increased urge to scratch the eye

Treatment Strategies
Dry eye syndrome, if left untreated, can lead to blindness or partial loss of vision. Thus, it is necessary to diagnose the condition early to prevent further damage. Some of the common treatment strategies are:

These include anti-inflammatory agents that are particularly used to reduce the swelling and irritation in the eye. These include corticosteroids, omega-3 fatty acids, topical cyclosporins, topical tetracyclines, and immunosuppressants.

Synthetic lubricants and aqueous materials are commonly used in mild cases; however, for severe condition, medications or even surgery is required.

Artificial Eyewears
Various synthetic moisture chambers are employed to retain moisture in the eyes. These help in improving the hydration of the eyes, thereby preventing further damage.

Surgical Intervention
Different surgical strategies are used depending upon the severity of the syndrome. Few of the most common strategies are:

These are used to enhance the visibility of patient and retain the moisture inside the eye. These plugs are loaded with fluorescein that enhances the reading capability, tolerability to sunlight, and improved vision in low light. They include hydrogel plugs, absorbable plugs, and thermoplastic plugs.

Amniotic Membrane Transplantation
It is used to replace the damage aqueous layer surrounding the conjunctiva with the amniotic membrane. However, the method is quite rare.

Some of the common complications associated the syndrome are:

Corneal Inflammation
In severe cases, the persistent inflammation often damages the corneal surface. The condition is called as keratitis. The resulting damage leads to infection and ulceration of the cornea.

Long-term cases are often reported with the symptoms of conjunctivitis. This occurs due to the inflammation of conjunctiva. This results due to continued dryness, irritation, and potential infection. Red eyes, burning and itching, and sticky eyelids are some of the common symptoms of conjunctivitis.

Dry eye syndrome is an ocular disorder, which results from dryness in the eye. The condition is characterized by dryness of the layer covering the conjunctiva and cornea, severe burning, inflammation, and scratching. Treatment strategies include surgical intervention, medications, and synthetic eyewear that prevent further damage to the eyes. If left untreated, it can lead to conjunctivitis or keratitis.

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