Sunday, January 15, 2006

keratoconjunctivitis sicca (dry eyes)

Decreased tear production occurs as a part of the aging process. This diminished tear secretion is caused by an atrophy of the lacrimal gland. Absence of tears can cause keratinization (loss of moisture and thickening) of the corneal and conjunctival epithelium and can result in blindness. Decreased tear secretion occurs predominantly in keratoconjunctivitis sicca, and may occur in amyotrophic sclerosis (disease affecting nerve impulses in the connective tissue), Sjogren syndrome (connective tissue disease characterized by dry eyes, dry mouth, and arthritis), and some bulbar palsies.
Symptoms of dry eyes include a foreign body sensation, burning, itching, and excessive tearing. Each of these symptoms are worsened by a hot dry atmosphere and tobacco smoke. These symptoms may be aggravated by reading or infrequent or incomplete blinking. A propensity for dry eyes may be aggravated by keratitis, dellen, and pterygium.
Treatment for dry eye is often unsatisfactory. People experiment until they find a method of relief. Artificial tears and long-acting lacrimal inserts are commercially available. Hot soaks applied to the eyelids several times a day may be useful. Avoidance of dry atmospheres and direct wind, which may encourage tear evaporation, is helpful. People with dry eyes should avoid riding with the car windows down and having air-conditioner vents and fans directed on them. Humidifiers may also be helpful, especially in the winter when the humidity is low. If all of these fail, punctal occlusion, either temporary or permanent, can be used to diminish the symptoms.
It is important that dry eyes not be overlooked because untreated dry eyes may develop into irreversible corneal changes. The treatment for more extensive corneal changes may include surgery.
Newell, F. W. Ophthalmology Principles and Concepts, 6th ed. St. Louis: C. V. Mosby Co., 1986.

1 Comments:

MedRounds Publications said...

For more information, visit Dr. Ben Glasgow's Dry Eye blog.

8:17 AM  

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