Tears are vital to the superficial layers of the eye, such as the cornea and conjunctiva. In particular, tears are very important for the preservation of the transparency of the cornea and the survival of the corneal epithelium, which is a barrier against infective agents.
Complaints of patients in dry eye syndrome; foreign body sensation, burning, stinging, secondary (reflex) watering.
However, dry eye causes loss of corneal transparency (locoma) and sometimes epithelial damage over time. What the skin sheath is to the body, the epithelium is the same to the cornea. Epithelial losses mean an unprotected cornea. In other words, it means the entrance gate to the cornea for infectious agents. In a possible infection, it can lead to total blindness of the eye with keratitis (local corneal infection), corneal abscesses, even corneal perforations and spread of the infection into the entire eye (endophthalmitis). In other words, the clinical situation that starts with a simple lack of tears can go up to the loss of the eye. In addition, over time, dry eye limits vision by impairing the transparency of the cornea.
Patients become looking through a fogged glass. Although transplantation operations (keratoplasty) can be performed for corneas that have lost their transparency, transplantations are not preferred because the fate of the new cornea will be the same in case of dry eye. For this reason, every dry eye should be considered, and necessary practices and measures should be taken by considering the result.
The causes of dry eye syndrome are very diverse. In general, it can be classified as autoimmune and other causes. Steven Johnson Syndrome is one of the autoimmune causes. At the beginning of the other causes, there are many clinical conditions with inflammation involving the surface of the eye. Diseases of the free edge of the eyelid, in which the tear can not be preserved in the eye, and eyelash root inflammation are also among the causes. Aging, menopause, sleep, and the first month of the newborn are physiological causes of dry eye. Radiotherapy applications in the head and neck region and chemical burns of the eye surface also destroy the tear glands and reduce the production of tears. Diseases such as Vitamin A deficiency, Mikulicz Syndrome, and Hepatitis C reduce tear mucus layer production (goblet cell activity), impairing the stabilization of the tears, and as a result, tears that cannot stay in the eye for a sufficient time cause dryness.
Tests such as tear function tests (Schirmer. Tear breakage time), dye tests, viscosity tests (osmolarity test), impression cytology are used to detect dry eye. Tests consistent with the clinical situation are considered significant. With the help of biomicroscopic examination and dyes, an idea about the level of dry eye can be obtained.
If the patients have low tear production according to the test results, artificial tear preparations (lumbrican drops) should be given. Topical (drop) steroids can be applied for a short time to resolve inflammation in the lacrimal glands located on the surface of the eye. Topical Cyclosporine A use is required in patients who are planned for a long treatment period. In cases with dry eyes that cannot be handled with drops or in advanced dry eye disease, the holes (puncta) in both eyelids where the tears leave the eye should be closed with special plugs. In some cases, autograft applications from the oral and nasal mucosa may also be required.
General advice to patients; patients who are performing functions that require close attention for a long time should do intermittently, if the patient wears contact lenses should stop using lenses, not to stay in front of the air conditioner for a long time, measures to increase the humidity of the environment, and corneal laser application for refractive errors, should definitely notify the attending physician that they have dry eyes.
In summary, dry eye; It is vital for eye health. Tears are essential. It should be considered. Patients with dry eye complaints should go to an ophthalmologist at the earliest.