DRY EYE SYNDROME

1. DRY EYE SYNDROME
AYIENWI FRUBIH WILSON

2. CONTENT
1 Overview
2 Semiology
3 Causes
4 Evaluation and Diagnostic testing for dry eye
disease
5 Management
6 Prognosis / Follow up

3. Overview
• Dry eye syndrome is a general term that
describes the state of the front of the eye in
response to a breakdown in the natural layer
of tears that coats the front of the eye, called
the tear film.

6. SIGNS AND SYMPTOMS
• Burning
• Stinging
• Itching
• Tearing
• Sandy or gritty feeling
• Scratchy or foreign-body
sensation
• Discharge
• Frequent blinking
• Mattering or caking of
the eyelashes (usually
worse upon waking)
• Redness
• Blurry or fluctuating
vision (made worse
when reading, computer,
watching television,
driving, or playing video
games)
• Light-sensitivity
• Eye pain and/or
headache
• Heavey eye lids
• Eye fatigue

7. causes
• Allergies
• Decreased hormones
associated with aging
• Pregnancy and associated
hormonal changes
• Thyroid eye conditions
• Eyelid inflammation
(blepharitis)
• Medication/supplement
use including, but not
limited to: psychiatric
medicines, OTC cold
medicines, anti-
histamines, beta-blockers,
pain relievers, sleeping
pills, diuretics, hormonal
replacement, and oral
contraceptives
• Sjogren's syndrome (dry
mucus membranes
throughout body)
• Other autoimmune
disorders including Lupus
and/or Rheumatoid
Arthritis
• Chemical exposures /
injuries to the eyes
• Eye surgery
• Infrequent blinking,
associated with staring at
computer or video
screens (which is
becoming a more
frequent contributor), and
Parkinson's
• Environmental (dusty,
windy, hot/dry)
• Contact lens use
• Neurologic conditions
including: stroke, Bell's
palsy, Parkinson's,
trigeminal nerve
dysfunction
• Exposure keratitis, in
which the eyelids do not
close completely during
sleep (i.e. lagophthalmos)
• Post refractive surgery
(LASIK or PRK)- while
typically transient can
become a chronic issue in
some
• Inflammatory eye
conditions, including
Herpes virus infections
and uveitis / iritis
• Diabetes
• Vitamin A deficiency (rare
in US except in certain
diseases such as Crohn's)

8. Evaluation and Diagnostic testing for
dry eye disease
• Corneal sensation: reduced sensation may be
present in severe and chronic dry eye
disease . Sensory denervation may cause dry eye
by reducing the afferent signaling of tear
production, reducing the blink rate.
• Tear break up time (TBUT)
• Ocular surface staining (Fluorescein sodium to
identify desquamated areas on conj)
• Rose Bengal: stains devitalized epithelial cells that
lack a healthy mucin coating.

9. Cont…
• Lissamine green: detects sick epithelial cells as
well as deficientcy in mucin production.
• Schirmer test:
– The Schirmer I & II test is performed without
anesthesia and, thus, measures basic and reflex
tearing.
– Schirmer test with anaesthesia: the basic secretion
test
Tear meniscus height (meniscometry)

13. Management
Depending on the causes, there are numerous treatments for dry eye
syndrome / tear film dysfunction, but the more common treatment
modalities include:
• Artificial tears
• Tear conserving interventions such as punctal plugs or nighttime
masks/goggles
• Warm compresses
• Eyelash and eyelid scrubs
• Topical ophthalmic steroids are helpful in controlling the inflammatory
aspect of the disease in short bursts.
• Oral flaxseed oil or fish oil supplements 2000mg/day has also been found
to be useful in alleviating symptoms and decreasing the frequency of
topical agents anecdotally.
• Autologous serum tears, compounded artificial tears with mixed with the
patient's serum, can be particularly helpful in recalcitrant cases.

14. Prognosis / Follow up
• Most people with dry eye syndrome who keep
up with their regimen as prescribed by their
eye doctor are able to have their symptoms
controlled, allowing them to function either
symptom-free or with minimal difficulty.

15. THANK YOU