Dry eye occurs when there is inadequate tear production or function, resulting in an unstable tear film and ocular surface disorder. Tears are produced by the lacrimal glands and spread across the eye in three layers - lipid from the meibomian glands, aqueous from the lacrimal gland, and mucus from goblet cells. Keratoconjunctivitis sicca (KCS) is a condition where aqueous tear production is insufficient to maintain the tear film, which can be caused by problems with the lacrimal glands alone or as part of Sjogren's syndrome. Treatment focuses on replacing tears and lubricating the eyes.

1. Dry Eye

2. Dry Eye
Occurs when
Inadequate tear production
Inadequate function
Results in Unstable Tear Film and
Ocular Surface Disorder.

3. Tear Production
Secreted by the
lacrimal glands
Spreads over the
ocular surface
Drained the lacrimal
canaliculi into the
nasolacrimal duct

4. Tear Film
 Lipid Layer
(meibomian glands)
 Aqueous Layer
(lacrimal gland)
 Mucus Layer
(goblet cells)

5. Functions
Anterior corneal surface smooth & regular
for refraction
Prevents the drying of cornea & maintain
the transparency of cornea
Supply oxygen
Medium for removal of debris & noxious
irritants
Lubricates the cornea eye lid interface

6. KERATOCONJUNCTIVITIS SICCA
Aqueous tear production is
insufficient to maintain normal
tear film

7. Causes
Pure KCS
Lacrimal Glands alone are involved
Primary Sjogren syndrome
KCS associated with dry mouth

8. Secondary Sjogren syndrome
oTrauma
oInfection
oInflammation
oHypersensitivity
oAutoimmune
oTumours

9. Clinical Features
Irritation
Burning
FB sensation
Mucus discharge
Blurring of vision
Pain

10. Work Up
History
Examination
Decrease marginal tear strip
Mucus strands & debris in
the Conjuctiva
Punctate epithelial erosion
corneal filaments

11. Investigations
Tear Film
breakup time
Rose bengal
staing
Shimmer test

12. Treatment
 Tear substitutes
 Mucolytic agents
 Topical retinoides

13. “I did then what I knew how to
do.Now that I know better I do
better”