What is Keratoconjunctivitis Sicca (Dry Eye Syndrome)?

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Keratoconjunctivitis sicca, also known as dry eye syndrome, is a common dysfunction of the eyes. It occurs when the eyes cannot produce tears or produce insufficient quantities of tears, or when there is an imbalance in the amount of oil, water, and mucus in the tear fluid.

The condition is a common cause of ocular irritation, typically resulting in a feeling of grittiness in the eyes, redness, and blurred vision, among other symptoms.^[1] While there are numerous potential underlying causes of dry eye syndrome, some of the most common include long periods spent in front of TV or computer screens, aging, and certain medical conditions, including Sjögren syndrome, allergic conjunctivitis, and rheumatoid arthritis.^[2]

Keratoconjunctivitis sicca can generally be effectively managed, with the choice of treatment method depending on the underlying cause, the symptoms, and the severity of the condition. Mild cases may respond well to simple environmental changes or over-the-counter eye drops, while more severe cases may require treatment methods such as anti-inflammatory medication or surgery.^[1]

Keratoconjunctivitis sicca symptoms

The symptoms of keratoconjunctivitis sicca are mild in most instances, but can nevertheless be highly troublesome for the affected person.

Symptoms typically affect both eyes and may include:^[2][3]

• Irritation and redness
• Dryness and grittiness
• A discharge of mucus
• Temporarily blurred vision
• Itching
• Sensitivity to light
• The sensation of a foreign-body in the eye
• Excessive tear production

Symptoms tend to be at their worst at the end of the day or after protracted use of the eyes; after driving, for example.^[3] People experiencing possible symptoms of keratoconjunctivitis sicca Can search for a Nearest doctor to carry out a symptom assessment.

When to see a doctor

If any of the symptoms of dry eye syndrome persist or cause serious pain, medical attention should be sought.

Causes of keratoconjunctivitis sicca

Tears are composed of a mixture of oil, water, and mucus, a combination that ensures the surface of the eyes remains smooth and clear, as well as protecting the eyes from infection.^[4]

Dry eye syndrome generally occurs for one of three reasons:

• The glands of the eyes are unable to create an adequate amount of tears
• The tears evaporate too rapidly
• There is an imbalance in the composition of the tears

Deficiency of tears

One common cause of dry eye syndrome is an inability of the glands in the eyes to produce enough tears to keep them moist. Typical reasons for this include:^[1]

• Underlying medical conditions, including Sjögren syndrome, diabetes, rheumatoid arthritis, scleroderma, systemic lupus erythematosus, thyroid disorders and vitamin A deficiency
• Aging
• Certain medications including decongestants, antihistamines, hormone replacement therapy and antidepressants; medications used to treat high blood pressure, acne and Parkinson’s disease, as well as birth control drugs
• Laser eye surgery
• Damage to the tear glands from inflammation or radiation

Evaporation of tears

Another common cause of dry eye syndrome is the evaporation of tears at an increased rate. Causes of this can include:

• Dry, windy, smoky or air-conditioned environments
• Blinking less often, typically when reading, driving, watching TV or using a computer
• Problems with the eyelids, such as ectropion, an out-turning of the eyelids, or entropion, an in-turning of the eyelids

Imbalance in tear composition

The tear film that coats the eyes is composed of three substances, each with a different role within the eye:^[4]

• Lipid: The oily outer layer produced by the meibomian glands. Prevents tears from evaporating too quickly.
• Aqueous: The watery middle layer produced by the tear glands. Helps to nourish the cornea and the conjunctiva.
• Mucus: The inner layer produced by goblet cells. Aids in binding water to the eyes, helping them to stay moist.

Keratoconjunctivitis sicca can result from problems with any one of these layers. For example, the meibomian glands can become blocked, resulting in decreased production of oils or the production of lower-quality oils.^[5]

Diagnosing keratoconjunctivitis sicca

People experiencing any of the symptoms of keratoconjunctivitis sicca should visit a doctor or ophthalmologist, an eye specialist, as soon as possible. In addition, a symptom assessment using the Adoctor conditions and symptoms can be carried out.

Doctors may run a number of tests to identify the cause of the condition. These may include:^[6]

• Fluorescein eye test: Fluorescent eye drops are used to highlight the tears in the eyes, enabling a specialist to monitor how tears are being produced and how quickly they are evaporating. The drops may also show any damage to the surface of the eye.
• Schirmer’s test: Blotting paper is placed over the lower eyelids and left for five minutes. The wetness of the paper determines the diagnosis, with less than 10 mm indicating the presence of dry eye syndrome.
• Lissamine green test: A strip of paper containing a special dye is placed over the surface of the eyes, allowing specialists to identify any damage to the surface of the eye.

Keratoconjunctivitis sicca treatment

After being diagnosed with keratoconjunctivitis sicca, a specialist will recommend a treatment route appropriate to the underlying cause, the specific symptoms, and the severity of the condition. There is no cure for dry eye syndrome, but it can be effectively managed.

Treatment may involve:[^9]

Medication change

For people who experience keratoconjunctivitis sicca as a reaction to a certain medication, treatment may involve their doctor prescribing an alternative medication that is not associated with dry eyes.

Even if there is a suspicion that a certain type of medication is causing keratoconjunctivitis sicca, never stop taking the medication without first consulting a doctor.

Environmental and lifestyle changes

Mild cases of keratoconjunctivitis sicca may respond well to simple environmental and lifestyle changes. These may include:^[1][4]

• Taking regular breaks from time spent in front of TV, computer or phone screens.
• Taking steps to reduce dryness in the environment. This may involve using a humidifier, reducing the heating or hanging up a damp cloth.
• Wearing glasses or goggles when exposed to dry, dusty or windy environments.
• In some cases, warm eye compresses and scrubs may be useful.
• In some cases, stopping smoking or reducing exposure to secondhand smoke may be useful.

Lubricants (artificial tears)

Lubricant treatments, sometimes called artificial tears, include eye drops, ointments, and gels. They are often effective in mild to moderate cases of keratoconjunctivitis sicca, and most are available from pharmacists without a prescription.^[7] At first, lubricant treatments may need to be used frequently – every hour, for example. Once symptoms begin to improve, they may be necessary less often.^[1] Artificial tears containing preservatives should be avoided.

Anti-inflammatory medications

In severe or persistent cases, certain kinds of anti-inflammatory medications may be prescribed by a doctor. Generally, these medications will only be recommended if the condition does not respond to lubricants.

Anti-inflammatory medications include:^[7]

• Corticosteroid eye drops and ointments
• Oral tetracyclines, such as doxycycline, lymecycline and oxytetracycline
• Ciclosporin eye drops

Surgery

In severe cases and depending on the case, surgery may be recommended as a treatment method for keratoconjunctivitis sicca.

A punctal occlusion is the most common type of surgery used for this purpose. The procedure involves inserting small plugs into the tear ducts, blocking the drainage route of tears, and keeping the surface of the eyes moist as a result. Temporary plugs may be inserted at first to test the efficacy of the procedure. Later, more permanent plugs may be inserted.

More rarely, a procedure known as a salivary gland autotransplantation may be carried out. This procedure involves transplanting glands responsible for the production of saliva from the lower lip to the area around the eyes. The saliva is then used as a substitute for tears.^[7]

Serum eye drops

In very rare cases, when all alternative treatment methods have proven ineffective, serum eye drops may be recommended.

Serum eye drops are created by removing the blood cells from the blood of the affected person or that of a donor, leaving just the serum, which is then combined with a diluent and contained in a dropper bottle.^[7] Due to the complexity of the process, serum eye drops can take several months to produce.

Keratoconjunctivitis sicca FAQs

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1. Patient. “Dry Eyes.” January 26, 2018. Accessed December 3, 2018. ↩ ↩ ↩ ↩ ↩

2. NHS. “Dry eye syndrome: Causes.” March 17, 2016. Accessed December 3, 2018. ↩ ↩

3. Medscape. “Dry Eye Disease (Keratoconjunctivitis Sicca) Clinical Presentation.” October 9, 2018. Accessed December 3, 2018. ↩ ↩

4. National Eye Institute. “Facts About Dry Eye.” July 2017. Accessed July 25, 2017. ↩ ↩ ↩

5. American Association for Pediatric Ophthalmology and Strabismus. “Meibomian Gland Dysfunction and Treatment.” April, 2016. Accessed July 25, 2017. ↩

6. NHS Choices. “Dry eye syndrome – Diagnosis.” March 17, 2016. Accessed July 25, 2017. ↩

7. NHS Choices. “Dry eye syndrome – Treatment.” March 17, 2016. Accessed December 4, 2018. ↩ ↩ ↩ ↩

8. Ophthalmology Times. “In-office treatments for MGD may provide relief.” May 1, 2016. Accessed April 24, 2018. ↩

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**Keratoconjunctivitis Sicca (Dry Eye Syndrome): A Comprehensive Overview**



**Q: What is Keratoconjunctivitis Sicca (Dry Eye Syndrome)?**



**A:** Keratoconjunctivitis Sicca (KCS), commonly known as dry eye syndrome, is a chronic eye condition ​caused by insufficient or poor-quality tear production. Tears are essential for ⁢maintaining the eye’s health, lubricating the cornea (the clear front surface of the eye) and ‌conjunctiva (the thin membrane that ​lines the eyelid and covers the white of the eye).



**Q:‌ What are the Causes of Dry Eye Syndrome?**



**A:** Dry eye syndrome can be⁢ caused by various factors, including:



* Autoimmune disorders (such as Sjogren’s syndrome and lupus)

* Medications (such as antihistamines, decongestants, and birth ⁤control pills)

* Age-related ⁤hormonal changes ⁢(especially in women during menopause)

* Contact lens use

* Environmental factors (such as smoke, wind, and low humidity)



**Q: What are the Symptoms of Dry Eye Syndrome?**



**A:** Symptoms ⁢of dry eye syndrome can ⁤vary depending on the severity of the condition and may include:



* Burning or stinging sensations

* Itching or irritation

* Redness

* Excessive ⁣tearing (paradoxically)

*⁣ Scratchy or gritty feeling in the eyes

* Blurred vision

* Sensitivity to light



**Q: How is Dry Eye Syndrome Diagnosed?**



**A:** Dry eye syndrome ⁤is typically diagnosed through a comprehensive eye exam by an ophthalmologist or optometrist. The exam will include:



* A review ⁤of‌ the patient’s medical history ⁤and symptoms

* Measurement of tear production using a Schirmer’s test

* Examination​ of the cornea and conjunctiva ​for signs of dryness or inflammation



**Q: What are ‍the Treatment Options for Dry⁢ Eye Syndrome?**



**A:** Treatment for dry eye syndrome aims to‌ restore ‍moisture and lubrication ⁣to ⁤the eyes.‍ Options ⁢may include:



* Artificial tears (eye drops or ointments)

* Punctal plugs (small devices inserted into the tear ducts to slow tear drainage)

* Anti-inflammatory medications (to‌ reduce inflammation)

* Corticosteroids‍ (in severe cases)

* Tear stimulation medications (to increase tear production)



**Q: Can Dry Eye Syndrome‌ be⁢ Prevented?**



**A:** While ​not always preventable,⁤ there are steps you can take to reduce your risk of developing dry eye syndrome, such ⁣as:



* Avoiding exposure to smoke and wind

* Using‍ a humidifier indoors

* Blinking frequently

* Limiting ‌screen time

* Getting regular‌ eye exams, especially if you have underlying health conditions

* Following good contact ‌lens hygiene practices



**Remember:** If you experience any symptoms of dry eye syndrome, it’s essential to schedule an appointment with an ⁣eye care professional⁢ for proper diagnosis and treatment. Early diagnosis‍ and management can help prevent complications and preserve eye health.