KERATITIS SICCA AND DRY EYE SYNDROME
Section snippets
TEAR FILM
Tear film is a complex layer of liquid that provides a first-line defense against toxic and microbial agents for the ocular surface. It contains immunoglobins, lysozymes, and vitamin A, which combat allergens and foreign bodies.15, 26 It also provides nutrition to the cornea, flushes debris from the cornea, and supplies needed lubrication to the surface of the cornea. Perhaps most importantly, it provides and maintains an optically uniform surface and forms the first and most powerful
ETIOLOGY OF DES
A defect in any of the three layers of the tear film or in the blinking mechanism can lead to signs and symptoms of dry eyes. Aqueous tear deficiencies occur commonly in conditions such as rheumatoid arthritis and sarcoidosis, but can also be seen in more rare conditions, such as alacrima and familial dysautonomia. Causes of dry eyes are listed in Table 1.12, 15 Meibomian gland dysfunction is seen in rosacea and chronic blepharitis. Meibomian gland inflammation causes either complete
SYSTEMIC DISEASES
Dryness may result from systemic diseases. Included in this list are the autoimmune disorders, Sjögren's, systemic lupus erythematosus (SLE), and rheumatoid arthritis, and the infiltrative disorders, lymphoma and amyloidosis, tumors, radiation, and chemotherapy.13, 31, 32 It is important to determine if dryness is a local entity or a part of a systemic disease process. Local problems can be treated with conservative measures, such as artificial tears, but KCS secondary to the autoimmune
Symptoms
Foreign-body sensation is a universal complaint. It is often described as a feeling of sand in the eyes. This foreign-body sensation is caused by the mechanical interaction of the palpebral conjunctiva and the rough, irregular, dry corneal and conjunctival surface. Other symptoms include tearing, pain, photophobia, and redness. A decrease in the vision is also noted. This is caused by a change in the refractile surface of the cornea due to its desiccation and an irregular tear film on its
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Safety and efficacy of cyclosporine 0.05% drops versus unpreserved artificial tears in dry-eye patients having laser in situ keratomileusis
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2002, Journal of Toxicology - Cutaneous and Ocular ToxicologyOcular discomfort and conjunctival alterations in operating room workers. A single-institution pilot study
2001, International Archives of Occupational and Environmental Health
Address reprint requests to William H. Constad, MD, 600 Pavonia Avenue, 6th Floor, Jersey City, NJ 07306
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From the Department of Ophthalmology, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New Jersey