DRY EYE SYNDROME Dry eye disease, or keratoconjunctivitis sicca, is among the most frequently established diagnoses in ophthalmology; in India, one in four patients consulting an ophthalmologist complains of the symptoms of dry eye. Although epidemiological studies investigating the prevalence of dry eye disease are rare, published studies indicate that up to 20% of adults aged 45 years or more experience dry eye symptoms. Recent studies have shown that immunologic changes play a role in the pathogenesis of dry eye, not only in Sjögren’s syndrome, but also in postinfectious and age-related conditions. Despite increasing understanding of the pathogenic factors involved in dry eye disease, there has been a lack of consensus on diagnostic criteria, classification of disease states, and the aims and interpretation of specific diagnostic tests. There is a need, therefore, for standardization of disease terminology and diagnostic tests in order to improve the usefulness of epidemiological and clinical investigation of this important ocular disorder.
Dry eye disease (DED) is one of the most frequently encountered ocular morbidities. Twenty-five percent of patients who visit ophthalmic clinics report symptoms of dry eye, making it a growing public health problem and one of the most common conditions seen by eye care practitioners. Historically, the term “Keratoconjunctivitis sicca” can be attributed to the Swedish ophthalmologist Henrik SC Sjögren. He was the first to refer to the triad of Keratoconjunctivitis sicca, dry mouth, and joint pain, which occurs mainly in women (90% of the cases) , and in 1950 Andrew De Roetth introduced the term “dry eye”. For many decades, DED was thought to be limited to dryness of the eyes due to reduction of the aqueous phase of the tear film.
In 2007, the International Dry Eye Workshop (DEWS) revised the original definition and classification scheme of DED and developed a new definition, as well as a three-part classification of DED based on etiology, mechanism, and severity of the disease. The new definition of dry eye is “Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface.”
Additionally, DED can be categorized as episodic or chronic. Episodic dry eye occurs when environmental or visual tasks with reduced blinking overwhelm the stability of the tear and produce symptomatic dry eye. Chronic dry eye, although aggravated by the same environmental conditions, persists continuously with symptoms and possible damage to the ocular surface. Because the tear film in dry eye patients is unstable and incapable of maintaining the protective qualities that are necessary for its structure and function, patients experience the discomfort symptoms associated with dry eye, which are burning, stinging, grittiness, foreign body sensation, tearing, ocular fatigue, and dryness. Patients may complain of symptoms of dry eye in the presence or absence of signs of the disease. Additionally, dry eye may be diagnosed based only on the signs observed by a healthcare professional in the absence of symptoms/complaints by the patients.
Dry eye disease is seen with increased prevalence in patients with autoimmune diseases, which affect approximately 8% of the population, of whom 78% are women Dry eye disease also affects postmenopausal women and the elderly The prevalence of DED is estimated to be 7.4% to 33.7% depending on which study is cited, how the disease is diagnosed, and which population is surveyed.
Dry eye syndrome, or dry eye disease, is a common condition that occurs when the eyes don’t make enough tears, or the tears evaporate too quickly. This leads to the eyes drying out and becoming red, swollen and irritated. Dry eye syndrome is also known as keratoconjunctivitis sicca, or simply “dry eyes”.
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Over the last 3 years, Optho Remedies has focused on dry eye syndrome and believes there is a market opportunity for a range of high quality, innovative and competitively priced ocular lubricants. Optho Remedies has identified dry eye syndrome as a significant area of patient need. It is a condition that increases with age, with the over 60s most likely to suffer, but it is also influenced by lifestyle and environmental factors. As many as 50% of us may suffer from dry eye at some point.
It has been defined as a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tears film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface (DEWs Report, 2007). In other words, dry eye is caused when there is too little water, oil or mucus in the tear film.
The tear film consists of three layers:
The condition ranges from mild cases (which often go untreated and are caused by environmental factors) to more severe disorders of the lachrymal tear film which can result in chronic eye disease. Initial symptoms can often be relieved with preservative-free artificial tears.
Types of Dry Eye Syndrome
1) Aqueous tear-deficient dry eye is a disorder in which the lacrimal glands fail to produce enough of the watery component of tears to maintain a healthy eye surface.
2) Evaporative dry eye may result from inflammation of the meibomian glands, also located in the eyelids. These glands make the lipid or oily part of tears that slows evaporation and keeps the tears stable.
Dry eye can be associated with:
Cosmetic surgery, if the eyelids are opened too widely.
SYMPTOMS OF DRY EYES The symptoms of dry eye syndrome are mild for most people, although more severe cases can be painful and lead to complications.
Symptoms usually affect both eyes and often include:
Feelings of dryness, grittiness or soreness that gets worse throughout the day.
Some people may also have episodes of watering eyes, which can occur if the eye tries to relieve the irritation by producing more tear.
Dry eye can be a temporary or chronic condition:
Can self-care treatments and remedies help alleviate dry eyes?
Treatment / Medication Though dry eyes cannot be cured, there are a number of steps that can be taken to treat them. You should discuss treatment options with an eye care specialist. Treatments for dry eyes may include: