Dry eye is an increasingly common ocular condition, affecting 6% to 13% of the general population, with a high prevalence in women. Patients are more commonly treated in ophthalmic practice and ocular subspecialties. Its natural course is chronic and most patients will be diagnosed without intervention in their lifetime. In the United Kingdom in 2010, the National Eye Dry Eye Hospital Service reported 5,834 treatments performed, and there were 27,531 referrals made, with a projected rate of 5.1 referrals per 10,000 general optometrists.
The tear meniscus is a major structure thought to be the cause of DED. However, the meniscus is not the only morphologic alteration to occur in patients with DED. Further, we have found morphological abnormalities in patients with DED in the absence of tear meniscus changes. Results from a recent paper suggest other morphologic changes, including changes of the zonular complex, are also involved in the development of DED.
In the United States, at least 500,000 people are thought to be affected by dry eye. Dry eye symptoms are very common and may have significant negative health consequences. Dry eye is thought to be underrecognized, and is underestimated as a contributor to dry eye disease and as a cause of vision impairment and/or problems with lens health. The National Eye Institute has identified that women in particular are at risk.
Symptoms of dry eye can include a red eye, sensitivity to light, a foreign body sensation, tear evaporation and photophobia. In addition, abnormalities of tear film may predispose the eye to the development of ocular infections.
There is no agreement on what is and is not effective treatment for dry eye. The lack of consensus on an effective or inappropriate treatment can be attributed to inadequate evidence in the literature, difficulty in measuring efficacy, and the lack of consensus among specialists regarding the optimal treatment and monitoring of dry eye.
Dry eye is fairly common but most people have no significant symptoms. In moderate to severe cases of dry eye there is a substantial risk of permanent visual deterioration and loss of vision. Treatment is important regardless of whether or not there is vision loss. This is a rare but alarming finding because there is a tendency for people who suffer from dry eye to have a higher risk of developing a number of major diseases, including diabetic retinopathy, corneal breakdown and retinal detachments. It seems logical that treatment of dry eye, if necessary, should be as quick and as effective as possible to minimise loss of vision. Patients who experience worsening of their symptoms should seek help as soon as possible.
Artificial tear drops contain lubricant, which reduces evaporation of the tears. Artificial tears can be easily confused with lubricants, because they often have similar visual effects. Although there is a myth that artificial tears can calm the eyes and reduce pain, this is not the case. There are a number of artificial tears that are available in different formulations and strengths, but they usually include all sorts of chemicals to ensure that the tear is as close to the correct chemical composition as possible. These are often used during times where there is a lack of natural tears, such as the night before or before surgery.
It is a disease that can be cured by avoiding eye injuries. The only way to avoid dry eye is to take precautions when looking at the eye. The best way to treat it is to see a professional. There are many products to try out that are marketed as “SODEX” or “SOREX”. The companies have invested millions of dollars into these types of products but even though they are advertised as being a great treatment, there isn't a lot of evidence that the products work. Studies have been done to test and prove how the SODEX or SOREX therapies really work.
A positive effect of topical corticosteroid application is noted in a minority of ocular symptoms in patients with dry eyes. A family history of an ocular/ophthalmic manifestation of the disease may be associated with a higher likelihood of ocular involvement.
The incidence of dry eye increases with age. A large percentage of patients present with dry eye early in life and even a relatively small percentage with extreme dry eye complaints experience complete remission in middle adulthood. It remains imperative to monitor for this condition at least 5 years after the onset of signs and symptoms.
These data suggest that in cases of chronic and severe dry eye, artificial tears will lead to an increased rate of epithelial deterioration and a more rapid progression of autoimmune corneal disease, especially that characterized by lacunar corneal changes and a loss of the corneal epithelium with subsequent severe desiccation and desquamation. In addition, these studies suggest that patients with chronic and severe dry eyes should not receive artificial tear therapy.