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Dry eye syndrome
Definition
Dry eye syndrome is when the eye is unable to maintain a healthy layer of tears to coat it.
See also:
Alternative Names
Keratitis sicca; Xerophthalmia; Keratoconjunctivitis sicca
Causes, incidence, and risk factors
Dry eye syndrome often occurs in people who are otherwise healthy. It is more common with older age, because you produce fewer tears with age.
In rare cases, it can be associated with rheumatoid arthritis, lupus erythematosus, and other similar diseases. It may also be caused by heat (thermal) or chemical burns.
In areas of the world where malnutrition is common, vitamin A deficiency is a cause. This is rare in the United States.
Symptoms
Signs and tests
Signs include:
- Reduced visual acuity
- Thick cornea
Tests may include:
- Slit lamp (biomicroscope) exam of the film of tears (a dye such as fluorescein may be placed in the eye to make the tear film more visible)
- Schirmer's test -- measures the rate of tear production using a calibrated paper wick placed on the edge of the eyelid
Treatment
Treatments may include:
- Hot compresses or eyelash cleaning
- Lubricating ointments (in more severe cases)
- Medications such as Restasis, topical corticosteroids, and oral tetracycline and doxyccycline
- Tiny plugs placed in the tear drainage ducts to help the tears stay on the surface of the eye
- Wetting drops called artificial tears
Surgery may be used if the eyelids are in an abnormal position.
Support Groups
Expectations (prognosis)
Most patients with dry eye have only discomfort, and no vision loss. With severe cases, the clear window on the front of the eye (cornea) may become damaged or infected.
Complications
Ulcers or infections of the cornea are serious complications.
Calling your health care provider
See your health care provider immediately if you have dry eyes and have:
- A sudden increase in discomfort or redness
- A sudden decrease in vision
Prevention
There is no way to prevent dry eye syndrome. You can prevent complications by using wetting and lubricating drops and ointments.
References
Tu EY, Rheinstrom S. Dry eye. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier; 2008:chap 4.23.
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