About Eye - Dry Eye


The tears your eyes are produce are necessary for overall eye health & clear vision. Dry eye is not a disease it means that your eye do not produce enough tears.
Tear film consist of three layer, which from posterior to anterior are mucus layer, aqueous layer, & lipid or oily layer.

  1. mucus layer: It is innermost & thinnest layer of the tear film. It consists of mucin secreted by conjunctiva l goblet cell & glands of manz.

  2. Aqueous layers: the bulk of tear film is produce by this layer which consists of tears secreted by the main& accessory lacrimal glands. The tears mainly comprise of water & small quantities of solutes such as sodium chloride, sugar, urea & proteins. Therefore it is alkaline & saltish in taste.

  3. Lipid or oily layer: This is the outermost layer of the tear film secreted by meibomian, zeis & moll glands. This layer prevents the overflow of tears, retards their evaporation & lubricates the eyelids as they slide over the surface of the globe. It also contains antibacterial substance.

Function of the tear film:

  • It keeps the cornea & conjunctiva moist.
  • Provides Oxygen to the corneal surface.
  • It washes away debris & noxious irritants.
  • It prevents infection due to presence of antibacterial substance.
  • It facilitates movement of the lids over the globe.

Case of dry eye:

Dry eye is part of the natural ageing process but It is caused by certain situations that dry out the tear film that includes

  1. Long hours of stay in air conditioned rooms.
  2. Prolonged computer usage.
  3. Drug reaction.
  4. History of anticholinergics, Antiglucoma medication, oral contraceptives, antidepressants or long term use of any topical medication.
  5. Dandruff of the scalp.
  6. Disease that affect the tear film i.e. Rheumatoid Arthritis, Sjogrens syndrome ,Stevens –Johnson syndrome, chemical burn, Bell's palsy, exposure Keratitis, lid abnormalities.
  7. Contact lens.
  8. A dry climate, Wind & dust.

Symptoms of dry eye:

Burning sensation
Irritation
Foreign body sensation
Feeling of dryness
Itching
Redness
Blurring of vision

Signs:

  • Lustreless ocular surface.
  • Reduced or absent marginal tear strips.

Tear film test:

  1. Slit lamp examination: exam of the tear film (A dye such as Fluorescein is used to make the tear film more visible).

  2. Schirmer test: It measures total tear secretions. It is performed with the help of a 5*35mm strip of Whatman-41 filter paper which is placed on the edge of the eye lid.

  3. Rose Bengal Staining: special dye is used to detect even mild cases of dry eye.








Treatment:

  1. Artificial tears: These are available as drops, ointments.
  2. Hot Fomentation or lid cleaning.
  3. Tiny plugs placed in the tear drainage ducts to help the tears to stay in the surface of the eye.

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