About Eye Diseases 
Dry Eye Syndrome
Tears are essential in providing clear vision as well as
comfort for our eyes. The tear film that coats the front
surface of the eyes consists of lipid, water and mucous
layers, and it helps to maintain a healthy ocular surface
and protect the cornea from damage and infection.
Lipid secreted by the meibomian glands prevents
evaporation of the tear film from the ocular surface.
The water layer, containing a complex mixture of
electrolytes, antibodies, nutrients and other substances,
is produced by lacrimal glands and conjunctival-cells
and serves the purpose of lubrication. Mucus produced
by conjunctival goblet cells provide an even and smooth
tear film over the eyes to minimise friction during
blinking. Tears drain out from the eyes through the tear
ducts subsequently.
Change in the quality or quantity of tears compromises the ocular lubricity and results in dry eye syndrome. There are two common types of dry eye, aqueousdeficient and evaporative dry eye. Aqueous-deficient dry eye is characterised by decreased secretion of tears from the lacrimal glands and conjunctiva. Evaporative dry eye results from excessive evaporation of tear fluid from the ocular surface. It is mostly caused by meibomian gland dysfunction which affects the normal secretion of lipid. The usual patterns of dry eye are mixed aqueous-deficient/ evaporative forms. A special form of dry eye condition due to autoimmune disease can result in dry eye, also known as Keratoconjunctivitis Sicca, which may have systemic involvement.
Common Symptoms
Dry eye can be associated with a host of irritative symptoms. Damage to the ocular surface can be manifestation of severe dry eye. Common symptoms of dry eye include:
Common Causes
The cause of dry eye is multifactorial, and the common causes include:
Diagnostics
If you are having eye discomfort and symptoms of dry eye, it is important that you discuss your condition with an ophthalmologist. A comprehensive eye examination is needed to evaluate the quality and quantity of tears produced by the eyes. Testing may include:
Treatment of Dry Eye Syndrome
The best treatment option will be tailored to the pattern and severity of dry eye by the ophthalmologist. Treatment strategies are fundamentally aimed to increase the fluid quantity on the ocular surface, augment the lubricity of tears and decrease tear evaporation.
Change in the quality or quantity of tears compromises the ocular lubricity and results in dry eye syndrome. There are two common types of dry eye, aqueousdeficient and evaporative dry eye. Aqueous-deficient dry eye is characterised by decreased secretion of tears from the lacrimal glands and conjunctiva. Evaporative dry eye results from excessive evaporation of tear fluid from the ocular surface. It is mostly caused by meibomian gland dysfunction which affects the normal secretion of lipid. The usual patterns of dry eye are mixed aqueous-deficient/ evaporative forms. A special form of dry eye condition due to autoimmune disease can result in dry eye, also known as Keratoconjunctivitis Sicca, which may have systemic involvement.
Common Symptoms
Dry eye can be associated with a host of irritative symptoms. Damage to the ocular surface can be manifestation of severe dry eye. Common symptoms of dry eye include:
- Dryness
- Redness
- Burning sensation
- Itchiness
- Foreign body sensation
- Photophobia
- Blurry vision
- Excessive tearing
- Sharp or dull pain
Common Causes
The cause of dry eye is multifactorial, and the common causes include:
- Ageing
- Lifestyle-related (e.g. prolonged reading, computer use)
- Environmental triggers (dusty, windy or dry climates; use of dehumidifier, air-conditioning or heaters)
- Extended use of contact lenses
- Meibomian gland dysfunction/ Blepharitis
- Hormonal changes (menopausal/ postmenopausal women)
- After corneal surgery
- Use of eye medications with preservatives
- Some medications effects
- Vitamin A deficiencies
- Anatomical abnormalities of eyelids or facial nerve disorders
- Autoimmune diseases: Sjogren syndrome, rheumatic arthritis, systemic lupus erythematosus
- Medical diseases: thyroid diseases, diabetes
- Lacrimal glands disease
Diagnostics
If you are having eye discomfort and symptoms of dry eye, it is important that you discuss your condition with an ophthalmologist. A comprehensive eye examination is needed to evaluate the quality and quantity of tears produced by the eyes. Testing may include:
- Taking history to note if any health condition which may contribute to factors of dry eye
- Examination of the eyelids and cornea
- Fluorescein staining test to examine the tear film stability and tear break up time
- Tear test to measure the tear secretion
Treatment of Dry Eye Syndrome
The best treatment option will be tailored to the pattern and severity of dry eye by the ophthalmologist. Treatment strategies are fundamentally aimed to increase the fluid quantity on the ocular surface, augment the lubricity of tears and decrease tear evaporation.
- Reduce reading time and use of computer and ensure adequate rest
- Use of eye lubricants: artificial tears, gel and ointment
- Avoid environmental triggers
- Eyelids warm compress and eyelids hygiene
- Intake of oral supplements, e.g. flaxseed oil, Omega-3 fatty acids, etc
- Use of Cyclosporine eyedrops/ topical steroid eye drops
- Punctum plugs insertion
- Maintain a balanced diet
- Other therapies: punctal occlusion surgery, use of autologous autoserum eye drops, wear scleral lens or protective eyewear for severe case
