What is Dry Eye Syndrome?

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Dry eye is a multifactorial disease noted for alterations in the tear film that cause eye discomforts and changes in vision. This disease is accompanied by an increase in osmolality (total concentration, measurement is osmoles per litre, of a substance in a solution) of the tear film, inflammation of the eye surface and neurosensory changes.

Classification of Dry Eye Syndrome

Ojo agrietado con una gota tachada, ojo seco acuodeficiente

Aqueous tear-deficient dry eye. Is produced due to a lack of tear production.

  • Primary or secondary Sjögren syndrome. Primary Sjögren syndrome is a systemic disease that is noted for an autoimmune destruction of the exocrine glands of the whole body. The organs most affected are the eyes, the gastrointestinal system, the respiratory system, the skin, and the genitourinary system. It is diagnosed by the presence of dry eye combined with a dry mouth, by the presence of certain antibodies, a reduction in the salivary secretion and by the focal inflammation in a salivary gland biopsy. Secondary Sjögren syndrome has the same characteristics as primary Sjögren syndrome, but it is combined to the presence of another autoimmune disease such as rheumatoid arthritis, systemic lupus erythematosus, scleroderma, dermatomyositis, mixed connective tissue disease, Hashimoto’s thyroiditis, primary biliary cirrhosis, or autoimmune chronic hepatitis.
  • Without associated autoimmune disease. Due to an isolated lack of aqueous secretion of the tear gland, or as a secondary effect to other systemic medications such as anti-histamines, beta-blockers, antidepressants, tranquilisers, etc. 
Ojo agrietado con agua evaporada, ojo seco evaporativo

Evaporative dry eye. It appears due to the excessive loss of water of the exposed eye surface (due to evaporation).

  • Diseases of the Meibomian glands (rosacea, psoriasis, seborrheic dermatitis, etc.). The Meibomian glands found in the eyelid tarsi are the main source of the lipids of the tears.
  • Changes in the eyelids or the lacrimal aperture [Seventh cranial nerve paralysis, proptosis (forward displacement of the eyeball)] due to hyperthyroidism, low frequency of blinking, etc.
  • Vitamin A deficiency, interaction with topical medicine preservatives, changes due to contact lenses, allergic conjunctivitis.

Evaporative dry eye is more common than dry eye due to lack of aqueous secretion, although on many occasions both types are superimposed and there is simply a preponderance of one over the other.

How many people are affected by Dry Eye?

Dry eye syndrome is a very common disease, although in many casesunderdiagnosed. Its prevalence varies between 20% and 30% of the population, although it could rise to 33% in oriental populations. According to some estimates, around 100 million people worldwide have this disease. It is much more frequent in women, and increases with age.

Substantiated information by:

Maria Teresa Sáinz de la Maza Sierra

Published: 23 May 2019
Updated: 23 May 2019


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