Lacrimal Disorders (Dry Eye Syndrome)
- Diseases and abnormalities of tear production and maintenance of tear film
- The most common lacrimal disorder is dry eye syndrome, which is often referred to as dysfunctional tear syndrome.
- Lacrimal duct disorders usually result in overflow tearing.
- System(s) affected: skin/exocrine
Very common throughout the United States; more often seen in arid climates:
- Predominant gender: female > male
- Predominant age: Dry eye symptoms increase with age and are most often seen in the elderly.
Etiology and Pathophysiology
- Tear film is composed of three layers:
- Mucin layer: allows spread of aqueous tears
- Thick aqueous layer: produced by lacrimal gland
- Lipid layer: controls tear evaporation
- Results from poor tear production, rapid tear evaporation, and/or an abnormal concentration of mucin or lipid in tear film
- Most common cause of dry eye symptoms is aqueous tear deficiency.
- Decreased androgens are thought to contribute to a decrease in tear production.
- Exposure to dry environments (e.g., high altitudes)
- Contact lenses wear
- Female gender
- Computer use
- Hormonal diseases
- History of collagen vascular disease such as rheumatoid arthritis, Sjögren syndrome, thyroid disease, rosacea, Bell palsy, eyelid abnormalities
- Medications, including oral contraceptives, diuretics, β-blockers, anticholinergics, antihistamines, and antidepressants
- Vitamin A deficiency
- Eye surgery: blepharoplasty, cataract, laser vision correction
- Use of artificial tears (with preservatives)
- Prevent exposure to eye irritants from pollution, cigarette smoke, and sun exposure.
- Ensure adequate vitamin A intake through diet or as a supplement.
- Patients with prior laser vision correction should wait at least 6 months before undergoing blepharoplasty because of the effects on corneal sensation, tear production, and tear film alteration.
- Increasing awareness of this condition among people residing in dry environments
- Decrease or stop contact lens wear.
Commonly Associated Conditions
- Sjögren syndrome
- Rheumatoid arthritis
- Thyroid disease
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