Download Dry EyE SynDromE - Dry Eyes Medical

Dry Eye Syndrome
Information about the condition
HEALTHCARE PROFESSIONALS - fact sheet
What is it?
Patients and symptoms
Dry eye syndrome - sometimes called
Dry eye syndrome is a common condition, estimated to
keratoconjunctivitis sicca – is a condition in which
affect up to a third of people at some time in their life. The
the eyes can’t make enough tears, or the tears
condition is most frequently seen in those over 60 years of
evaporate too quickly. This can cause the eyes to
age and is more common in women than men. Patients
become dry, inflamed and uncomfortable.
will present with some or all of the following symptoms:
• Feeling like there is something in their eye Definition
(foreign body sensation)
Dry eyes is a catch-all term referring to abnormalities of
• Scratchy, gritty eyes
the tear layer which normally coats the eye, aiding clear
• Aching or sore eyes
vision and protecting sensitive surface tissues. Other
• Smarting or burning eyes
names for dry eyes include; dry eye syndrome, chronic
• Eyes tire easily, particularly noticeable when dry eye, dry eye disease and keratoconjunctivitis sicca.
reading, watching TV or using a computer
• Contact lens discomfort or intolerance
Pathology
• Excessive mucus discharge
Dry eyes is a multifactorial disease of the tears and • Watery eyes
ocular surface that results in a range of symptoms,
• Eyes easily irritated by smoke
including discomfort, visual disturbance, tear film
• Sensitivity to light (photophobia)
instability and potential damage to the ocular surface. • Fluctuating vision
It is accompanied by increased osmolarity of the tear
• Blurred vision, particularly first thing in the film and inflammation of the ocular surface.
morning and / or late in the day
• Eyelids ‘stick shut’ at night
Dry eye is a disturbance of the lacrimal functional unit,
which comprises the lacrimal glands, ocular surface
(cornea, conjunctiva and meibomian glands) and
eyelids, together with the sensory and motor nerves that link them.
The key features of dry eye are:
• Decreased tear production
• Increased tear evaporation
• Incorrect composition of tears
These result in inadequate lubrication of the eyes.
• Eyelids feel ‘heavy’
Mild dry eye conditions can usually be managed
• Absence / abnormality of lacrimal gland / ductules
satisfactorily with simple lifestyle adjustment and
• Idiopathic reasons
lubricant treatments. Millions of people may suffer • Blink disorders
from time to time and be unaware that they have the condition.
Diagnosis
In addition to observation of symptoms, there are
Moderate dry eye may affect vision more and will
several established tests for dry eye syndrome. probably affect quality of life due to chronic pain, eye
These include:
sensitivity, light sensitivity and restricted activities.
Schirmer’s
Severe dry eye may lead to desiccation of the corneal
A 5mm x 35mm blotting paper strip is used to measure
epithelium, ulceration and perforation of the cornea,
the quantity of tears produced over a 5 minute an increased incidence of infectious disease and,
period. A measurement of less than 6mm indicates potentially, serious visual impairment and blindness.
dry eye syndrome.
Causes
Tear Break-up Time
Dry eye syndrome has a wide range of causes, including:
Fluorescin is instilled into the eye and the patient is
• Systemic diseases (Sjögren’s, RA, lupus, Stevens asked to blink several times and then stop. The time
Johnson, thyroid disease, Bell’s palsy)
between the last blink and the first appearance of a
• Eye conditions (meibomian gland disease, blepharitis, dark spot on the cornea (formation of a dry area) is
ocular rosacea, corneal dystrophies)
then measured. A tear break-up time of less than 10
• Meibomian Gland Dysfunction (MGD)
seconds suggests a dry eye syndrome.
• Elective surgeries (LASIK, PRK, blepharoplasty)
• Eyelid conditions (lagophthalmos, ptosis)
Rose Bengal Test
• Drug side-effects (antihistamines, diuretics, A red dye (Royal Bengal) is instilled into the eye.
beta-blockers)
Aqueous tear deficiency can then be identified via the
• Eye injuries and burns
staining pattern seen using a slit-lamp.
• Chemotherapy and radiation
• Ageing
The Dry Eye Questionnaire developed by McMonnies &
• Menopause
Ho is also an indicator of dry eye syndrome. In general
• Air conditioning, car heaters, air currents
any score over 14.5 indicates the presence of dry eye
• Computer vision syndrome – prolonged use syndrome. Although the questionnaire alone may not
of computers
be a reliable measure of severity, it is widely used as a
• Smoky and dusty environments
clinical evaluation tool.
• Wearing contact lenses
• HRT
For information on treatment options • Vitamin A deficiency
available, please see our fact sheet • Contact lens wear
‘Treatments for dry eye syndrome.’
• Neurological lesions (e.g. Riley-Day syndrome)