Conditions associated with dry eye disease

One of the most common ocular conditions is the dry eye syndrome. It is recognized both in the individuals who may be well and in patients treated for other illnesses. Diagnosis is based on an interview, eye and general examinations, and diagnostic tests. Over recent years, our knowledge of the dry eye disease (DED) has grown tremendously. Optometrists need to be aware of the connections between systemic conditions and DED as the prevalence of associated systemic conditions grows.

More than 30 million people are suffering from dry eye syndrome (DES), but actually less than 1 million are receiving treatment. It can sometimes be difficult to identify the exact cause of dry eyes because the condition is often multifactorial, with several contributing factors leading to intermittent blurriness, vision fluctuations, and stinging or watery eyes. Aging contributes to the use of optical devices, menopause, indoor and outdoor settings, regular travel, smoking that aids in the routine of improper eye care, health conditions, medication, and eyelid problems can causes symptoms of dry eyes.

Research suggests that more than 50 percent of diabetes mellitus (DM) patients have dry eyes, and important associations exist between DED and length of diabetes and retinopathy for diabetics. Polyuria and polydipsia are known symptoms of DM, and common dry eye symptoms such as burning, foreign body and gritty sensations and sore eyes are often reported by patients. Persons with such symptoms should go to clinics / offices of optometry, and see optometrists to provide them the best management choices. A closer review is required of patients who are believed to have DED and who have minor symptoms.

Theories for why dry eye is so prevalent in diabetes patients range from autonomic dysfunction to aldose reductase activity in the sorbitol pathway. Rheumatoid arthritis (RA) patients also show signs and symptoms of dry-eye disease. Most patients suffering from systemic lupus erythematosus (SLE) and thyroid eye disease were also diagnosed with dry eye. Dry eye disease is known to be multifactorial with inflammation being a key factor contributing to the vicious cycle of dry eyes. Most commonly, evaporative dry eyes cause tear hyperosmolarity that destroys the cells of the ocular surface.

This damage causes an inflammatory response that contributes to chronic tear secretion dysfunction and further increases tear osmolality. In contrast, the aqueous deficient dry eye involves inflammation that attacks and damages the lacrimal glands causing production of tears to decrease. Many patients with dry eyes respond well to basic treatments, such as anti-inflammatory drugs, antibiotics and artificial tears. Some cases of Eye surface disorders, however, do not respond well to these traditional therapies.

Because most unresponsive Ocular Surface Disorder cases are caused by a chronic underlying condition and the eyepiece surface will not recover completely until that systemic condition is managed. Diabetes causes metabolic, neuropathic, and vascular tissue damage that leads to inflammatory process and lacrimal and ocular surface functional degeneration. Antioxidants (nutritional supplements), anti-inflammatory agents (topical corticosteroids and immunomodulatory drugs) and/or anabolic agents should be prescribed which mimic insulin-related effects.

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