Dried Eyes and Xerophthalmia

Normally, the eye is constantly washed with tears. The tears help to keep your eyes moist and comfortable. Sometimes tears cannot be produced in sufficient quantities. It also may be that the tear quality is impaired and the eye cannot get enough moist. This condition is known as “Xerophthalmia”. This issue is also called “dry eyes”. There are two ways to produce tears in our eyes. The first is slow and steady tear release which provides continuous eye wetting, and the second is excretion in the reflex way in the cases of crying, ocular foreign body evasion, lashing, cold air and wind contact, irritating nose, flu or eye inflammation. It is an interesting situation that the dryness of the eye can lead reflexively to the lachrymation of them. The use of contact lenses can increase the intensity of tears.

What are the signs of Xerophthalmia

  • Burning and stinging
  • Mucus yarns (sticky discharge) in and around the eye
  • Redness,
  • Excessive lachrymation, tiredness
  • Discomfort of contact lenses.

What is the tear film layer?

When we blink our eyes, tears spread to the surface of the eye and form a layer. This is called a tear film layer. This layer contains water, mucus, electrolytes, vitamins, sugar and amino acids. The tear film layer nourishes the front layer of the eye, ensures oxygen exchange and provides that the surface of the eye is smooth and transparent. If this layer is indispensable, a clear vision isn’t possible. Along with this, tears remove foreign bodies and allergic or microbial substances entering the eyes. It contains protective immunoglobulins against microbial agents and immunomodulators.

What are the reasons of dried eyes (Xerophthalmia)?

Normally, the amount of tears decreases when we get older. The incidence of dry eye increases after menopause and by older women’s eyes. However, this disease can be seen by men and women at any age. Dry eye due to lack of vitamin A is very rare and is observed especially in undeveloped countries.

The dry eye may also be associated with other problems. For example, Sjögren’s syndrome can be suspected if there is mouth instability and articular pain in the eye. Some rheumatic diseases can lead to a reduction of the tears. Some medicins may also cause dry eye by reducing tear release.

These medicins;

  • diuretics;
  • beta-blockers;
  • antihistamines.

If the use of these medicins is mandatory, artificial tear drops may be used.

People with dry eyes are more susceptible to toxic side effects of eye drops. Protective materials in some artificial teardrops can irritate the eye. Drops without preservative may be used in this case.

How is Xerophthalmia diagnosticated?

Dry eye can be easily diagnosticated by any ophthalmologist. Tests that measure tear production are made for definite the diagnosis.

Schirmer Test: A filter paper placed on the inside of the lower eyelid can be used to see whether the tear is sufficient. It must be placed at least 10 mm above the eye to avoid eye contact.

Tear Diffraction Time: A colouring is injected into the lower eyelid. After opening and closing the eye several times, it is requested that it should not be closed. It is important for diagnosis to form dry spots on the surface of the eye for 10 seconds.

Treatment

1- Additional Tears

First, the missing tears must be put back into place. Artificial tear drops are very similar to a person’s own tears. They are soothing, moisturizing and relaxing the eye. There are many kinds of artificial tear drops.

  • Patients who are sensitive to tear drops including protective substances or using contact lenses should prefer tear drops without these substances.

Artificial tear drops can be used once or twice a day or even a few times per hour. You should also follow your doctor’s recommendation on this subject.

2- Preserving the exisiting tears (Temporary-Permanent Punctum Tampons)

Another approach to keeping the eyes moist is to protect the own tears.

Tears are drained from the eye through a channel system. (For this reason, when we cry, our nose also flows). These channels may be blocked temporarily or permanently. With this closure, it will be possible to protect the patient’s own tears and prolong the residence time of the artificial tears.

3- Other Methods

Tears have evaporation properties like other body liquids. It may be useful to keep the atmosphere moist to prevent evaporation. For this purpose, it is possible to keep the room moist by putting water in a container over the heater we use to heat in winter.

A person with dry eyes should protect himself from hot rooms, hair dryers or windy conditions and cigarettes.

Medicine that reduces inflammation in the tear bed and increases tear production has recently been used and provided highly effective results.

In rare diseases such as Stevens-Johnson syndrome or pemphigoid, drops containing vitamin A may be useful for dry eye treatment.

Xerophthalmia treatment is done in cooperation with all institutions of Batıgöz.