Home Health Disease & Ailments Dry Eye Syndrome (Keratoconjunctivitis Sicca): Symptoms, Causes, Diagnosis & Treatment

Dry Eye Syndrome (Keratoconjunctivitis Sicca): Symptoms, Causes, Diagnosis & Treatment

Dry eye syndrome, also known as keratoconjunctivitis sicca, is a condition of having dry eyes. Dry eye is a common condition that occurs when the tears aren’t able to provide adequate lubrication for the eyes. Symptoms include irritation, redness, discharge, and easily fatigued eyes. Blurred vision may also occur. Scarring of the cornea may occur in some cases, without treatment of dry eyes.

If you have dry eyes, your eyes may sting or burn and you may experience it in certain situations like when on an airplane, in an air-conditioned room or after looking at a computer screen for a long time. Dry eyes can result from the use of contact lenses, Meibomian gland dysfunction, allergies, pregnancy, vitamin A deficiency, LASIK surgery and from the intake of certain medications such as antihistamines, blood pressure medication, hormone replacement therapy, and antidepressants.

Artificial tears are the usual first line of treatment for dry eyes. Dry eye syndrome is a common eye disease and affects about 5–34% of people to some degree. It affects up to 70% among older people.

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How Does Dry Eye Syndrome Affect Your Body?

The eyes produce tears all the time. Healthy eyes are covered with a fluid, known as a tear film and is designed to remain stable between each blink. This tear film prevents the eyes from becoming dry and enables clear vision. If the tear glands produce fewer tears, the tear film can become unstable and break down quickly, creating dry spots on the surface of the eyes. Tears are made of a mixture containing water, fatty oils, protein, electrolytes, and substances to fight off bacteria, and growth factors which help keep the surface of the eyes smooth and clear to see properly. Disturbance in any of these levels can cause tears to evaporate quickly.

What Are The Causes of Dry Eye Syndrome?

  • Decreased tear production – Keratoconjunctivitis Sicca is caused due to decreased tear production, caused by a number of factors.
  • Medicines – Antihistamines, decongestants, hormone replacement therapy, antidepressants, drugs for high blood pressure, acne, birth control, Parkinson’s disease, diabetes, thyroid disorders, rheumatoid arthritis, vitamin A deficiency and others can cause dry eyes.
  • Laser eye surgery – This surgery may cause dry eyes and is usually temporary.
  • Tear gland damage – Damage of tear gland from inflammation or radiation, causes dry eyes.
  • Increased tear evaporation – This can happen from wind, smoke or dry air, blinking less often while reading, driving or working at a computer.
  • Eyelid problems – Out-turning of the lids (ectropion) and in-turning of the lids (entropion) can cause dry eyes.
  • Imbalance in tear composition – The oil film produced by small glands on the edge of the eyelids (Meibomian glands) might become clogged, which can cause dry eyes.

What Are The Risk Factors of Dry Eye Syndrome?

  • Age – Tear production tends to diminish as one gets older. It is more common in people over 50.
  • Sex – Lack of tears is more common in women, especially because of hormonal changes due to pregnancy, using birth control pills or menopause.
  • Diet – A diet low in vitamin A, which is found in liver, carrots, and broccoli, or low in omega-3 fatty acids, which are found in fish, walnuts and vegetable oils can cause dry eyes.
  • Wearing contact lenses – Improper contact lenses can damage the eye and usually causes Keratoconjunctivitis Sicca.
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What Are The Symptoms of Dry Eye Syndrome?

Symptoms of Keratoconjunctivitis Sicca, which usually affect both eyes, may include:

  • Stinging, burning or scratchy sensation in the eyes
  • Stringy mucus in or around the eyes
  • Sensitivity to light
  • Eye redness
  • A sensation of having something in the eyes
  • Difficulty in wearing contact lenses
  • A difficulty with night-time driving
  • Watery eyes, which is a response to the irritation of dry eyes given by the body
  • Blurred vision

How is Dry Eye Syndrome Diagnosed?

  • Eye exam – This includes a complete history of your overall health and your eye health, and can help your doctor diagnose the cause of your dry eyes.
  • Measuring the volume of tears – Schirmer test is done to measure tear production which is done by placing blotting strips of paper under the lower eyelids.
  • Determining the quality of tears – A special dye is used in eye drops to determine the surface condition of eyes. The doctor looks for staining patterns on the corneas and measures how long it takes before the tears evaporate.
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How To Prevent And Control Dry Eye Syndrome?

  • Avoid direct air blowing in your eyes.
  • Add moisture to the air; during winters, a humidifier can add moisture to dry indoor air.
  • Wear protective sunglasses while going outside.
  • Blink your eyes frequently when doing tasks which require concentration like reading or using a computer.
  • The air at high altitudes, in desert areas, and in airplanes can be extremely dry; therefore frequently close your eyes for a few minutes in between, to minimize evaporation of tears.
  • Position your computer screen below eye level to help slow the evaporation of tears in between eye blinks.
  • Stop smoking and avoid visiting areas where there is smoke.
  • Use artificial tears regularly to keep the eyes well-lubricated.

Treatment of Dry Eye Syndrome – Allopathic Treatment

  • Lacrimal plugs – This involves plugging the tear drainage holes. Lacrimal plugs can be inserted painlessly by an eye doctor.
  • Punctal cautery – This is a surgery for severe cases of Keratoconjunctivitis Sicca that permanently closes the drainage holes. This surgery helps in keeping the small amount of tears on the eye for a longer period of time.

Medications:

  • Antibiotics – These are usually taken orally, though some are used as eye drops or ointments.
  • Corticosteroids – These are powerful anti-inflammatory medications that can be given as eye drops or ointments in severe cases of Keratoconjunctivitis Sicca.
  • Cholinergic (pilocarpine, cevimeline) – These are tear-stimulating drugs which help increase tear production.
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Treatment of Dry Eye Syndrome – Homeopathic Treatment

  • Fatty acids – Omega-3 fatty acids supplements may help relieve dry eye.
  • Acupuncture – Dry eye symptoms improve after acupuncture therapy.

Dry Eye Syndrome – Lifestyle Tips

  • Clean your eyelids to maintain hygiene
  • Use artificial tears or other eye drops to get relief
  • Practice blinking exercises

What Are The Recommended Exercises For a Person With Dry Eye Syndrome?

Blinking exercises for 30 to 40 minutes help to relax eyesight. These include:

  • Looking at a distant object for 10 to 15 seconds
  • Rolling eyes clockwise and counter-clockwise
  • Palming

Dry Eye Syndrome & Pregnancy- Things to Know

  • The chances of having dry eyes are increased during times of hormonal shifts like pregnancy. Levels of male androgen hormone decrease during these hormonal changes and affect tear and lipid production.
  • The change in lipid production during pregnancy may indicate Keratoconjunctivitis Sicca, which is caused when the tear film is not getting sufficient lipid for its strength.
  • Dry eyes can be experienced usually during the first trimester which may or may not extend till the third trimester.
  • Keratoconjunctivitis Sicca may be accompanied with irritation, itchiness, sensitivity to light or pain while wearing contact lenses.
  • For relief, artificial tears or warm compression on eyes can prove to be good and comforting.
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Common Complications Related to Dry Eye Syndrome

  • Eye infections – Without adequate tears, increased risk of eye infections may occur.
  • Damage to the surface of eyes – If left untreated, dry eyes may lead to eye inflammation, abrasion of the corneal surface, corneal ulcer, and vision problems.

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