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Category: Optometry
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createdon: 10 Feb 2023
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Author: Khoa Tran
Published Feb 10, 2023
Updated Apr 04, 2023

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Dry Eyes (Keratoconjunctivitis)

Etymology and Pronunciation

Keratoconjunctivitis (ker-uh-toh-kon-juhngk-tuh-vahy-tis)
kerato - Greek for cornea
conjunctiv - meaning conjunctiva
itis - Latin for inflammation

History of Dry Eyes (Keratoconjunctivitis)

Dry eyes have been acknowledged as a condition across different cultures throughout history, with various approaches and remedies used to address the discomfort associated with it. From ancient Egypt and Greece to modern times, people have recognized and dealt with dry eyes in their own unique ways, as evidenced by historical texts, medical literature, and advancements in understanding the condition.

The " Ebers Papyrus", dating around 1550 BC from ancient Egypt referenced eye drops made from a mixture of honey and other substances used to alleviate eye discomfort. 

In ancient Ayurvedic medicine (from Charaka Samhita and Sushruta Samhita), a traditional system of medicine in India, various herbal remedies were used to treat dry eyes. For example, a decoction made from the Indian gooseberry (Amla) was used as an eye wash to relieve dryness and discomfort in the eyes. Traditional Chinese Medicine (TCM) has a long history of using natural remedies to treat dry eyes.

Traditional Chinese Medicine (such as "The Yellow Emperor's Classic of Internal Medicine" by Huangdi Neijing, or "The Compendium of Materia Medica" by Li Shizhen) has a long history of using natural remedies to treat dry eyes. Techniques such as eye exercises, acupressure, and acupuncture were used to stimulate the flow of energy and blood to the eyes, which was believed to help with dryness. Herbal remedies, such as chrysanthemum flower tea and wolfberry (goji) berries, were also used to nourish the eyes and alleviate dryness.

In ancient Greece, a poultice made from fenugreek seeds soaked in water was applied to the eyes to alleviate dryness and discomfort. Additionally, aloe vera, known for its moisturizing properties, was used as an eye wash to relieve dry eyes. Some of the notable texts about this topic includes:  "De Medicina" by Aulus Cornelius Celsus, "Historia Plantarum" by Theophrastus, and "De Materia Medica" by Dioscorides

Unani Medicine, from the middle East, a traditional system of medicine practiced in the Middle East, used a variety of natural remedies for dry eyes. For example, rose water was used as an eye wash to relieve dryness and discomfort in the eyes. These remedies are referenced in "The Canon of Medicine" by Ibn Sina, and "Kitab al-Jami' li-mufradat al-adwiya wa al-aghdhiya" by Al-Tabari.

Native American tribes used various remedies for dry eyes. For example, various anthropological and ethnobotanical research papers reference a decoction made from the bark of the witch hazel tree was used as an eye wash to alleviate dryness and soothe eye irritation.

In recent years, research continues to advance our understanding of dry eyes, including the development of new treatment modalities, such as tear substitutes, anti-inflammatory agents, and tear conservation techniques.

Modern Understanding of Dry Eyes (Keratoconjunctivitis)

Dry eyes (Keratoconjunctivitis) are a common condition that occurs when the eyes do not produce enough tears or produce tears that are of poor quality. Tears are essential to keep the eyes moist and comfortable, and to help protect the eyes from foreign objects and harmful substances. A lack of tears or poor quality tears can cause dry eyes and lead to a range of symptoms, such as burning, itching, and redness in the eyes. In severe cases, dry eyes can cause damage to the cornea, the clear front part of the eye, and vision problems.

To diagnose dry eyes, a doctor may perform a comprehensive eye exam and assess your symptoms. They may also measure the quantity and quality of your tears to determine if you have dry eyes.

If you are staring at bright screens for long periods of time, try dimming the lights and reducing time spent on computers, backlights, or any sources of bright lights for 2-3 days to see if this helps the symptoms.

Causes of Dry Eyes (Keratoconjunctivitis)

- Bright light: looking at bright screens or a bright light source for a long period of time.
- Aging: As we get older, our eyes produce fewer tears. As we get older, our eyes produce fewer tears, making us more susceptible to dry eyes
- Medical conditions: Certain medical conditions, such as rheumatoid arthritis, Sjogren's syndrome, and lupus, can cause dry eyes.
- Medications: Certain medications, such as antihistamines, decongestants, and blood pressure drugs, can decrease tear production.
- Environmental factors: Dry air, wind, and exposure to screens for long periods can cause dry eyes.
- Hormonal changes: Changes in hormone levels, such as during menopause, can cause dry eyes.
- Eyelid problems: An eyelid that does not close completely can cause dry eyes.
- Tear gland damage: Injury or inflammation to the tear gland can cause dry eyes.
- Bacterial infections: Bacterial infections can also cause dry eyes, although they are less common than viral infections. The most common bacterial pathogens associated with the condition are Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae.
- Allergies: Allergic reactions to environmental irritants such as pollen, dust, and pet dander can also cause dry eyes. This type of condition is known as allergic conjunctivitis and is often accompanied by other symptoms such as itching, tearing, and redness.
- Chemical irritants: Exposure to chemicals such as chlorine, smoke, and fumes from household cleaning products can also cause dry eyes. This type of condition is known as toxic conjunctivitis and is often accompanied by a burning or stinging sensation in the eyes.
- Contact lenses: Prolonged use of contact lenses can also cause dry eyes, particularly if the lenses are not properly cleaned or if they are worn for too long. This type of condition is known as contact lens-induced dry eyes and is often accompanied by a feeling of discomfort or irritation in the eyes.

Treatments for Dry Eyes (Keratoconjunctivitis)

1. Artificial tears: Artificial tears are the most commonly used treatment for dry eye syndrome. They work by supplementing the natural tears and providing additional moisture to the eyes. There are many different brands and types of artificial tears available, including preservative-free and gel formulations. Your doctor can help you determine which type is best for you.
2. Prescription eye drops: If over-the-counter artificial tears are not effective, your doctor may prescribe prescription eye drops that are designed to treat the underlying cause of your dry eyes. These may include anti-inflammatory medications, antibiotics, or drugs that stimulate tear production.
3. Punctal plugs: Punctal plugs are small devices that are inserted into the tear ducts to help prevent tears from draining away too quickly. This helps to keep the eyes moist and can reduce the symptoms of dry eye syndrome.
4. LipiFlow: LipiFlow is a medical device that is used to treat dry eye syndrome caused by meibomian gland dysfunction. It works by applying heat and gentle pressure to the eyelids to help unclog the blocked glands and improve the quality of the tears.
5. Nutritional supplements: Some studies have suggested that certain nutritional supplements, such as omega-3 fatty acids, may help improve the symptoms of dry eye syndrome. Talk to your doctor about whether these supplements may be appropriate for you.
6. Lifestyle changes: There are several lifestyle changes that you can make to help reduce the symptoms of dry eye syndrome. These may include avoiding exposure to dry or dusty environments, taking frequent breaks when using a computer or other digital device, and using a humidifier to add moisture to the air.

Symptoms

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The eyelids are stuck together, which makes it challenging to open eyes right away
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Opening your eyes feels painful as if there are cuts inside your eye, causing discomfort
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Difficult wearing contact lenses
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Takes a while for your eye to be wet
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Dry, sandy, gritty feeling in your eyes
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Irritation in eyes
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Red eyes / bloodshot eyes
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Itchy, red or watery eyes
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Sensitivity to light (photophobia)
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Blurred vision
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Double vision
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Stinging, burning or scratchy sensation in your eyes

Confirmation Tests

- Eye exam

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