Keratoconjunctivitis Sicca
(Dry Eye Syndrome)

Overview

Keratoconjunctivitis Sicca (Dry Eyes) is a very common condition. It is one of the most common conditions of the eyes. It occurs when there is a defect in your tear film so that it does not adequately coat the eye. This can occur from decreased tear production, poor quality of the tear film, or poor oil film (from the lids). There are three layers to the tear film. The outermost layer is the oil layer and comes from the oil glands of the eyelids. The middle layer is the aqueous layer, which comes from the lacrimal gland and is made up of water and other important substances.

The innermost layer is the mucin layer and comes from specialized cells in the conjunctiva. If any of these layers are abnormal, you will have Dry Eye Syndrome. Symptoms include, but are not limited to irritation, tearing, itching, foreign body sensation, and blurred vision. It is initially treated with frequent use of lubricating tear drops. If symptoms occur at night or upon awakening, lubricating ointment can also be used. Both the lubricating ointment and tear drops are over the counter and can be bought without a prescription. We also carry them in the office.
In addition to lubricating the eye, tears are also produced as a reflex response to outside stimulus such as an injury or emotion. However, reflex tears do little to soothe a dry eye, which is why someone with watery eyes may still complain of irritation.

Dry eye syndrome has many causes. One of the most common reasons for dryness is simply the normal aging process. Many other factors, such as hot, dry or windy climates, heat and air-conditioning, smog and cigarette smoke also cause dry eyes. Certain medications, thyroid disease, and diseases such as arthritis can also cause dryness. Women frequently experience problems with dry eyes as they enter menopause because of hormonal changes. Contact lens wearers may also suffer from dryness because the contacts absorb the tear film. Many people also find their eyes become irritated when reading, concentrating, or working on a computer. Stopping periodically to rest and blink keeps the eyes more comfortable.

Signs and Symptoms

• Irritation
• Itching
• Burning
• Foreign body sensation
• Dry Feeling
• Tearing
• Blurred vision that improves with blinking
• Increased irritation when reading, concentrating
  or working on the computer

Detection and Diagnosis

Keratoconjunctivitis Sicca is detected during a slit lamp examination. Specialized drops are used to allow us to see the quality and evaporation rate of the tear film. We can also measure the production of the aqueous or water part of the tears.

Treatment

Artificial Tears: This can be used throughout the day, anytime your eyes feel irritated. We suggest using them every hour for a few days and then use them anytime your eyes do not feel comfortable. Use a brand of tears that is only moisturizing with no allergy or red-out. Examples include: Systane, Refresh, Tears Naturale II. If you are sensitive to the preservative, they also come without preservatives. Examples include: Refresh PF, Tears Naturale PF.

Lubricating ointment: Use about ½ inch just before bedtime inside the lower lid. It will blur the vision for a few minutes. If the vision is still blurred in the morning, rinse it out with tear drops and use less the next night. Look for a brand without Lanolin if you are sensitive to wool. Examples include: Refresh PM, Lacrilube, Tears Renewed.

If symptoms persist with the treatments above contact the office
for additional treatment including punctual plugs and/or prescription treatments including Restasis. If you have questions
please call us at 847-328-2300 or 800-653-EYES.

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