Summary about Disease
Dry eye syndrome (DES), also known as keratoconjunctivitis sicca (KCS), is a common condition that occurs when the eyes don't produce enough tears or the tears evaporate too quickly. This leads to discomfort, visual disturbances, and potential damage to the eye surface. It can significantly impact quality of life.
Symptoms
Common symptoms include:
A gritty, sandy, or burning sensation in the eyes
Blurred vision, especially when reading or after prolonged screen use
Excessive tearing (the eyes may overproduce tears in response to the dryness)
Redness of the eyes
Sensitivity to light
Eye fatigue
Stringy mucus in or around the eyes
Difficulty wearing contact lenses
Causes
Dry eye can be caused by a variety of factors, including:
Decreased Tear Production:
Aging
Certain medical conditions (e.g., Sjogren's syndrome, rheumatoid arthritis, lupus)
Certain medications (e.g., antihistamines, decongestants, antidepressants, hormone replacement therapy)
Laser eye surgery (temporary in most cases)
Hormonal changes (e.g., menopause)
Increased Tear Evaporation:
Blepharitis (inflammation of the eyelids)
Meibomian gland dysfunction (MGD)
Infrequent blinking (often due to prolonged screen use)
Wind, smoke, or dry air
Eyelid problems (e.g., ectropion, entropion)
Tear composition Imbalance:
Problems with any of the tear layers (oil, water, mucus)
Medicine Used
Treatments focus on relieving symptoms and managing the underlying cause. Common medications include:
Artificial Tears: Over-the-counter lubricating eye drops are the first line of treatment.
Prescription Eye Drops:
Cyclosporine (Restasis) and Lifitegrast (Xiidra): These help reduce inflammation and increase tear production.
Corticosteroid eye drops: Used for short-term relief of inflammation.
Punctal Plugs: These tiny devices are inserted into the tear ducts to block drainage and keep tears on the eye's surface longer.
Ointments: Lubricating ointments can be used at night to provide longer-lasting relief.
Other: Topical antibiotics (for blepharitis), secretagogues (medications that stimulate tear production)
Is Communicable
No, dry eye syndrome is not communicable. It is not caused by an infection and cannot be spread from person to person.
Precautions
Use artificial tears regularly, even when your eyes feel fine.
Blink frequently, especially when using screens.
Take breaks from screen use. Follow the 20-20-20 rule (every 20 minutes, look at something 20 feet away for 20 seconds).
Use a humidifier to increase air moisture.
Avoid smoke, wind, and dry environments.
Wear wraparound sunglasses outdoors.
Maintain good eyelid hygiene (warm compresses and gentle cleaning).
Stay hydrated.
Ensure proper contact lens fit and care.
Consider an omega-3 fatty acid supplement (after consulting with a doctor).
How long does an outbreak last?
Dry eye syndrome is often a chronic condition. It can fluctuate in severity, with periods of worsening symptoms and periods of relative calm. There isn't a defined "outbreak" length. Without management, symptoms will persist. Consistent management strategies can alleviate symptoms long-term, but the underlying condition may still be present.
How is it diagnosed?
Diagnosis typically involves a comprehensive eye exam, which may include:
Review of medical history and symptoms: The doctor will ask about your symptoms, medical conditions, and medications.
Slit-lamp examination: This allows the doctor to examine the front of the eye, including the cornea, conjunctiva, and eyelids.
Tear volume tests:
Schirmer test: Measures the amount of tear production using filter paper strips placed under the lower eyelids.
Phenol red thread test: Similar to the Schirmer test but uses a shorter thread with a pH-sensitive dye.
Tear quality tests:
Tear breakup time (TBUT): Measures how quickly tears evaporate from the eye surface.
Osmolarity test: Measures the salt concentration of tears.
Meibography: Imaging of the meibomian glands to assess their structure and function.
Timeline of Symptoms
The timeline of dry eye symptoms can vary greatly depending on the cause and severity:
Early Stages: Occasional mild dryness, grittiness, or burning, especially after prolonged screen use or exposure to dry environments. Symptoms may be relieved by blinking or artificial tears.
Intermediate Stages: More frequent and persistent symptoms, including blurred vision, redness, and sensitivity to light. Over-the-counter treatments may provide only temporary relief.
Advanced Stages: Severe and constant discomfort, significant blurred vision, and potential damage to the cornea. Prescription medications and other interventions may be necessary to manage symptoms and prevent complications.
Important Considerations
Dry eye is a chronic condition that often requires ongoing management.
Proper diagnosis and treatment are essential to prevent complications such as corneal damage.
Lifestyle modifications and good eye hygiene can help manage symptoms.
Consult with an eye care professional for personalized recommendations.
If you wear contact lenses, discuss the best type and care regimen with your eye doctor.
Certain medical conditions and medications can worsen dry eye.
Self-treating with inappropriate eye drops can worsen symptoms in the long term. Consult a doctor.