Dry eyes

DESCRIPTION

Definition of Dry eye
 
Dry eye (Xeropthalmia) is a condition in which the eye fails to make enough tears to coat it, which exposes the cornea and conjunctiva (outer coverings of the eye) to evaporation and subsequent damage.
Also known by names such as Xerosis, Keratitis sicca, Keratoconjunctivitis sicca.
 
Causes and Risk Factors of Dry eye  
 
Dry eye may result due to deficiency of either mucus or aqueous component, or both.Causes of decreased mucus production due to degeneration of conjunctival/corneal epithelium are,
1. Vitamin A deficiency
2. Burns
3. Infections like trachoma, diphtheria
4. Eye lid abnormalities – ectropion, proptosis
 
Causes of decreased tear production by lacrimal gland are, 
1. Sjogren Syndrome
2. Rheumatoid arthritis
3. Systemic Lupus Erythematous
 
Investigations
 
1. Staining with dye e.g. rose Bengal dye, to look for damaged epithelium
2. Slit lamp examination of the film of tears (a dye such as fluorescein may be placed in the eye to make the tear film more visible)
3. Schirmer's test measures the rate of tear production using a calibrated paper wick placed on the edge of the eyelid
4. Tear Lysoszyme ratio
 
Treatments of Dry eye 
 
a) Use of dark glasses outdoors
b) Hot compresses or eyelash cleaning
c) Vitamin A supplements in deficiency cases or application of topical trans- retinoic acid
d) Artificial tear drops
e) Permanent blockage of the puncta of the eye, delaying the tear drainage with the help of silicone plugs or cauterization.
f) Lateral tarsorrhaphy for the eyelid can also be done to reduce evaporation of tears
g) Medications such as Restasis, topical corticosteroids, and oral tetracycline and doxycycline
 
Complications and When Should You See a Doctor
 
a) Ulceration or infection of cornea
b) Loss of vision

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