DRY EYE

What is DRY EYE?
Dry eye is a condition in which a person does not have enough quality tears to lubricate and nourish the eye.Tears are necessary to maintain clarity of the cornea and nourishes the front surface of the eye to ensure clear vision.
Any anormaly in the integrity of the eyes tear film,the production or drainage can result in dry eye.This condition is often chronic and mostly affects the older adults.

The  lower and the upper eyelids mechanically spread over the ocular surface through neuronally controlled blinking mechanism to wet the corner and other ocular surfaces and exits through the nasolacrimal drainage system.then into the nose.
Tears provide lubrication,nourish ocular surface to reduce the risk of infections,wash away foreign substances that accidentally fall on the eye,keeps ocular surface smooth to allow clear vision.
What is the differences between dry eye and dry eye syndrome (keratoconjunctivitis sicca )
dry eye is the general condition in which a person does not have enough quality tear to lubricate and nourish the eye.
Dry eye syndrome (keratoconjunctivitis sicca) is when the water layer of the tear film is inadequate.this is the most common form of dry eye.

What Causes Dry Eye?
AGE:
Dry eyes are part of the natural ageing process.Geriatric clinicians reports its normal for  90% of people older than 65 to experience  some symptoms of dry eye.
Gender:
Women are more likely to experience dry eye/dry eye syndrome due to some hormonal changes during pregnancy, the use of oral contraceptives and menopause.
Medication:
Certain meditations such as antihistamines,blood pressure medications,decongestants,and antidepressants can cause reduced tear production.
Medical conditions :
People with medical conditions such as primary Sjogren syndrome (xeropthalmia),secondary Sjogren syndrome such as rheumatoid arthritis,systemic lupus erythematosus,systemic sclerosis,dermatomyositis,thyroid disease and many more.
Conditions due lacrimal gland inflammation (blepharitis,thyroid eye disease and sarcoidosis )
Absence of lacrimal gland following surgical removal,obstruction of the pores of the lacrimal gland,neurological lesions (Riley-Day syndrome ) and the inward(entropion) or outwards ( ectropion) turning of the eye lids.
Environmental conditions 
Evaporative keratoconjunctivitis sicca (DES) is most common due to tear oil difficiency.the tear evaporates faster than normal in hot,dry,windy Environments and sometimes smoke exacerbates the symptoms.A prolonged staring on computer screen with reduced blinking can cause dry eye.
Others :
Long term contact lenses use,irregularities on the ocular surface due to trauma,and refractive surgeries such as LASIK can cause dry eyes.

SIGNS AND SYMPTOMS OF DRY EYE
Foreign body sensation
Eye irritation
Watery eyes
Photophobia
Burning sensation
Stringy mucus discharge
Transient blurring of vision
Surprisingly person rarely complain that their eyes are dry but watery.This sounds paradoxical!!.
REASONS why the eyes profusely tear/water in dry eye is because:The corner is the most sensitive tissue of the body (eye) with majority nerve endings.,therefore,As in dry eye condition,any small change in the tear film integrity that nourishes the cornea will physiologically trigger the brain to automatically trigger a reflex tearing mechanism to wash away and protect the cornea from drying (damage ).

Note: Dry eye predisposes the eye to bacterial keratitis/sterile ulceration which may lead to corneal perforation and later loss of vision.

 HOW TO TREAT DRY EYE
The main aims of treatment of KCS are to relieve discomfort,provide smooth optical surface and prevent corneal damage.
1.Adding tears
A visit to your ophthalmologist /optometrist for comprehensive examination (tear break-up time,rose bengal test,Schirmer test ) for diagnosis on possible dry eye conditions may cause the need for tear substitutes.example;Eye Drops:
Hypromellose (tears naturale),cool eyes,polyvinyl alcohol(hypotears),sodium hyaluronate(VISMED).,sodium chloride (normosol) and Povidone(Oculet)
 Gels; Viscotears ,Gel tears and many more.   Ointment;lubritears,Lacrilube, only used at bedtime.
2.conserving tears
Room humidifiers,moist chamber googles,UV protective sunglasses,temporary occlusion of the puncta using collagen plugs into the Canaliculi and using Artificial tear supplements.
3.Increasing tear film production
Treatment of underlying anormalies that affects the lacrimal glands and it's adnexae (meibomiam gland topical application of tear supplements improves tear film production in quantity and quality.
4.A Small Lateral tarsorrhaphy :this dercreases the surface area of the interplpebral fissure allowing reduced air cornea contact thereby reducing tear evaporation
5.Other options:
Oral cholinergic agents like Pilcarpine (salagan ) are very effective in the relief of xerostomia and about 40% of patients also obtain relief. 

Comments

Post a Comment

Popular posts from this blog

Image
WATERING EYE Tears are secreted by the main and accessory lacrimal glands and pass laterally accross the ocular surface then evacuated through the canaliculus into the lacrimal sac,nasolacrimal duct and finally into the nose through the valve of Hasner. A variable amount of the tear film is lost through evaporation depending on the ambient temperature,humidity,and the rate of blinks per minute. An inefficiency in any may result in either dry eyes or watering eyes.its worth to know that any abnormal anatomy of the eye or morbidity may also result in watering eyes. General signs and symptoms note: signs are cause specific and may include multiple features of the underlining anormaly profuse tearing pain,rednes,swelling and epihora at the medial canthus in cases of dacrocystitis painless swelling in the inner canthus(mucocele)  accumulation of sulphur granules in the canthus incomplete blinks and reduced blinking rate redness of the eye congestion and redness of
Read more
Image
EYECARE EVERYWHERE  World Sight Day-2018 As eyecare professionals I will take this opportunity to congratulate all cadres in the eyecare team for making this vision possible. We owe it to God not men to give the best eyecare service to all men irrespective of who they are or where they live . The ancient Roman words best explains it; Oculus populis, Oculus dei. This means the eyes of men are the eyes of God. As Doctors let’s do well to serve God through men. God bless all Doctors around the world as we celebrate today the impact you are all making to make the world a better place. God bless you. I am Dr. Joel Kyeremeh,O.D Let’s join hands as we work together to achieve Millennium Development Goal 6 : universal health for all. With this the true equity in healthcare will be accomplished. This is a call to responsibility nonetheless there are still more people who still do not have access to medical care . 
Read more

Stye and Chalezion

Image
what is the difference :  STYE and CHALEZION  Stye (external hordeolum) is an acute suppurative inflammation of gland of Zeis or Moll. Chalezion (internal hordeolum/meibomian cyst) is a chronic non infective granulomatous inflamation of the meibomian gland. STYE: Causes Of Stye: Habitual rubbing of the eyes/lids Common Chronic blepharitic patients Most recurrent among patients with diabetes mellitus High alcohol intake increases the risk of Stye onset Symptoms of Stye : Acute eyelids pain Swelling of the lids Mild watering (tearing) Localized hard,red tender lid margins(cellulitis ) Ocular Discomfort with light (photophobia ) Abscess formation with visible pus beneath eyelid hair follicles Treatment of Stye: 1.Hot compresses 2-3 times a day are very useful in cellulitis stage. Note: when pus point is formed it may be evacuated by epilating (removing ) the involved hair surgery is rarely performed for Stye. 2.Antebiotic eye drops(doxicyclin/ciprofloxacin) 3-4
Read more