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Dry Eye Syndrome/Ocular Surface Disease

What is  dry eye syndrome?

Dry eye syndrome (also known as Keratitis sicca) is one of the most common problems affecting the general population, causing problems that range in severity from mildly irritating to debilitating. Dry eye syndrome is a general term that describes changes to the front surface of the eye in response to a breakdown of the tear film that coats the ocular surface.  This disturbance can lead to a multitude of symptoms, including burning, stinging, itching, tearing, foreign-body sensation, discharge, frequent blinking, mattering or caking of the eyelashes, redness, light-sensitivity, eye pain, and eye fatigue.  Dry eye syndrome is often referred to as tear film dysfunction.

The condition is more common in women and men, and in middle-age and elderly people. The insufficient tear production may be traced to conditions that result in decreased corneal sensation or damage to the tear glands. These may include long-term contact lens wear and Sjogren’s syndrome, a chronic inflammatory disease in which many of the body’s normally moist membranes (such as those in the mouth and nose) lack sufficient moisture. An individual with dry eye syndrome/tear film dysfunction may have more than one condition causing the symptoms.

How is dry eye diagnosed?

Many people with dry eye syndrome/tear film dysfunction have subtle signs  that are not obvious on a general screening eye exam. For this reason, if the condition is suspected by you or your primary care doctor, a thorough evaluation will frequently be necessary. Depending on your signs, symptoms, history and any comorbidities, your doctor may order tests ranging from Shirmer tear test to blood tests to check for systemic disease. 

What is the treatment for dry eye?

Most cases of dry eye can be treated by using artificial tear drops several times daily. Additional treatment options may involve:

  • A non-medicated lubricating ointment placed in the eyes at bedtime to relieve the dryness normally felt upon wakening.
  • Tear-conserving interventions such as punctal plugs to reduce tear drainage and treatments to the ocular surface to prevent evaporative tear loss. Warm compresses, eyelid scrubs, and oral flaxseed (2000 mg/day) oil with fish oil supplements have also been found to be useful in alleviating symptoms and decreasing the frequency of topical agents.
  • Prescription medicines to encourage tear-production such as Restasisâ and Xiidraâ may also be used by your doctor.
  • Topical ophthalmic steroids are helpful in controlling the acute inflammatory aspect of the disease. 

Most people with dry eye syndrome who keep up their regimens as prescribed by their eye doctor are able to control their symptoms, and function with minimal difficulty. Because of the complexities of dry eye syndrome, however, most people are never permanently “cured.”  

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