Update in office management
Dry Eye Syndrome: An Update in Office Management

https://doi.org/10.1016/j.amjmed.2011.01.030Get rights and content

Abstract

Dry eye syndrome is a multifactorial disease of the ocular surface and tear film that results in ocular discomfort, visual disturbances, and tear instability, with potential damage to the cornea and conjunctiva. Risk factors for dry eye syndrome include age (>50 years old), female sex, environments with low humidity, systemic medications, and autoimmune disorders. There are several treatment options that range from artificial tears to anti-inflammatory and immunosuppressant agents. Treatment of this highly prevalent condition can drastically improve the quality of life of individuals and prevent damage to the ocular surface.

Section snippets

History and Physical Examination

Patients with dry eye syndrome commonly present with ocular pain, foreign body sensation, and redness. It is necessary to take a thorough social and medical history to help identify any factors contributing to their symptoms. A social history helps identify any environmental factors, such as low humidity, that can worsen a low aqueous tear production state. Several systemic medications also can cause dry eyes (Table). Finally, a review of systemic symptoms positive for joint pains, dry mouth,

Diagnostic Modalities

Diagnostic tests supplement the physical examination and include tear break-up time, rose bengal, lissamine green, or fluorescein stains, and a Schirmer test.

The tear break-up time test consists of placing fluorescein dye onto the eye. Once the dye is evenly distributed on the ocular surface, the time is measured until there is a dry spot appearing in the fluorescein-stained tear film. A time <5 seconds (normal >10 seconds) will signify an unstable tear film with increased tear evaporation.

Rose

Management

Dry eye syndrome is a chronic condition, and treatment is directed at minimizing the symptoms and improving the quality of life for the individuals. One of the first treatment options involves making simple environmental modifications to reduce evaporation of the tear film. These measures include increasing ambient humidity with humidifiers, avoiding air currents, and taking frequent breaks from visually demanding tasks. Additionally, changes in systemic medications that may be causing dry eye

Conclusion

Dry eye syndrome is a disorder of the tear film, leading to excess dryness of the cornea and conjunctiva that leads to ocular discomfort, blurred vision, and damage to the ocular surface. It is diagnosed by obtaining a thorough history, including a review of symptoms, medications, social history, and a comprehensive eye examination with diagnostic testing. There are several treatment options that range from artificial tears to autologous blood serum drops. The best treatment option for each

References (12)

There are more references available in the full text version of this article.

Cited by (0)

Funding: None.

Conflict of Interest: None.

Authorship: All authors listed had access to the data and a role in writing the manuscript.

View full text