Dry eye 06/01/2013

Dry eye syndrome is the name given to a varied group of conditions characterised by symptoms of eye irritation and associated with a reduction in diminished tear production or an abnormally fast evaporation of tear film. The prevalence of dry eye syndrome increases with age and affects approximately 30% of the adult population. It is a chronic and very frequent pathology.

Symptoms

When its surface is not hydrated sufficiently, the eye may become irritated: dryness, discomfort, a stinging sensation on the eye surface, decreased vision and, in some cases, damage to the cornea and conjuntiva.

Causes

Dry eye syndrome occurs when the lacrimal gland does not secrete enough tears to keep the eye properly lubricated or when there is an abnormally fast evaporation of the tear film.

Meibomian gland dysfunction is one of the most common causes of evaporative dry eye. The Meibomian glands are located on the rim of the eyelids.  They secrete a lipid substance composed of elements such as phospholipids, triglycerides and free sterols, which lubricate the eye surface and also delay tear evaporation.

The role of these dozens of glands can be adversely affected by age, the menopause, the prolonged use of contact lenses or aqueous deficiency. It is also affected by the administration of certain antiandrogen, antidepressant or retinoid drugs, among others.

The normal secretion of the Meibomian glands depends on genetic and hormonal factors.

Treatment

A proper anamnesis, ophthalmological exploration and specific ophthalmological examinations determine the best treatment in each case. It is important to identify the cause and treat it early in order to prevent eye damage.

In mild cases of dry eye syndrome, it is important to clean the lacrimal glands regularly with a tissue. Artificial tears and lubricating ointments help to control dryness and irritation.

In moderate cases of dry eye syndrome, artificial tears need to be applied more frequently. If this proves to be inadequate or impractical, consideration should be given to closing the lacrimal points with lacrimal plugs. 0.05% cyclosporine is effective in patients with chronic dry eye syndrome and with diminished tearing secondary to eye inflammation.

In severe cases of dry eye syndrome, more specific additional treatments are required: acetylcysteine, autologous serum, wet chamber or lateral tarsorrhaphy.

In cases of coexisting connective tissue disorders (such as Sjörgren’s syndrome), the condition is addressed in conjunction with an internist physician and a rheumatology physician.

When the patient presents Meibomian gland dysfunction, we proceed to unclog them and repermeabilise them through glandular massage.  This enables us to restore their correct secretion. This is a safe, fast and effective procedure.

More information:

Specialised Dry Eye Unit