Dry Eye Syndrome: Keratoconjunctivitis Sicca


 

Dry eye syndrome, also known as keratoconjunctivitis sicca (KCS), is a condition caused by lack of tear production or rapid evaporation or break-up of the tear film. Patients with this condition frequently complain of eye dryness, redness, burning, foreign body sensation, itchiness, light sensitivity, and even decrease in vision in severe cases.

It is unclear why this condition occurs, but it is more common in women than in men and can be associated with rheumatological disease such as Sjögren's syndrome or rheumatoid arthritis. Sometimes patients with severe KCS are referred to a rheumatologist for further work-up. Environmental conditions such as the sun, wind, air conditioning, heaters, smoke, and pollution, as well as certain medication and thyroid eye disease, can contribute to the worsening of symptoms. LASIK surgery may be a factor as the surgery temporarily disrupts the ocular surface and lacrimal gland feedback leading to decrease in tear production. This condition usually clears up by 6 months to a year after the LASIK surgery. It is important to check for inflammation of the eyelid margins, blepharitis, which can exacerbate KCS. In addition, patients who wear soft contact lenses are prone to have worsening symptoms of their dry eyes.

Diagnosis of dry eye syndrome is aided by measurement of tear production called Schirmer's test, Lissamine green staining of conjunctiva, and careful examination of the anterior segment of the eye.

The treatments of dry eye syndrome include tear replacement, closure of the tear outflow duct, or eye medication, which may aid in tear production if used on a long-term basis. In some cases, your ophthalmologist may recommend combining dry eye treatment with blepharitis therapies. The treatment that's right for you will depend on the specific condition your dry eyes.

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