Dry Eye Syndrome

Dry eye syndrome is the most common reason for a visit to an eye doctor

It is a multifactorial disease of the ocular surface that results in a wide range of symptoms, including discomfort, visual disturbance, tear film instability and potential damage to the ocular surface. There is increased osmolarity of the tear film and quite often a chronic inflammation of the ocular surface.

Dry eye syndrome is a malfunction of patient¨s Lacrimal Functional Unit, which comprises the lacrimal glands and ocular surface. The ocular surface consists of cornea, conjunctiva and meibomian glands and eyelids, together with nerves that link them.

The reasons of dry eye syndrome are

  • Decreased tear production in some patients
  • Increased tear evaporation
  • Incorrect quality of tears in most of the patients

Dry eye is a general term referring to abnormalities of the tear layer which normally coats the surfaces of the eyes. In most cases the main reason is not the amount of tears, but the inadequate quality of tears caused by the improper functioning of the lipid secreting meibomian glands that provide clear vision and protect sensitive surface tissues.

Symptoms of dry eyes

Patients will present some of the following symptoms:
  • Tired eyes when reading, watching TV, computer work
  • Foreign body sensation
  • Sore eyes
  • Gritty eyes
  • Fluctuating vision
  • Eyelids stick shut at night
  • Burning eyes
  • Contact lens intolerance
  • Excessive mucus discharge
  • Watery or running eyes
  • Irritation by smoke
  • Increased sensitivity to light (photophobia)
  • Blurred vision

Grading of dry eyes

The mildest form of dry eyes can be managed with artificial tear supplements, warm lid therapy and environmental changes. The majority of people suffer from dry eyes from time to time.

The next level,is moderate dry eye symptoms; these affect vision more and also have an impact on life quality because of more severe symptoms like chronic pain, light sensitivity and eye sensitivity

The severe dry eye might lead to damage of the outer ocular surface like conjunctiva and especially the cornea, leading to ulceration of the cornea, a possible infection and severe impairment of daily life, including visual impairment.

Causes of dry eyes

The major risk factors are increased age and being female, but dry eye syndrome is a very common symptom and condition affecting almost everybody to some extent during life.

Dry eye syndrome has a wide variety of causes:

  • Meibomian Gland Dysfunction (MGD)
  • Blepharitis- either anterior or posterior
  • Ocular surface disease/allergic conjunctivitis
  • Systemic diseases like Sjögrens syndrome, Rheumatoid Arthritis, SLE,
  • Thyroid disease
  • Eye conditions like ocular rosacea and corneal dystrophies
  • Rosacea, atopia
  • Eyelid conditions
  • Eye injuries and burns
  • Idiopathic reasons
  • Blink disorders

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