In normal clinical work, many patients will ask when they come to the clinic: "Doctor, my eyes are very dry, and it is difficult to open my eyes. Is it dry eyes?" Or "My eyes are always red, is it also dry eyes?" "Why do I still cry when I have dry eyes?"
Indeed, patients with dry eyes currently account for a large proportion of outpatient patients. So is it dry eyes a lot? Today I will introduce you to the knowledge related to dry eye syndrome.
2020 China dry eye experts agree that dry eye is a chronic ocular surface disease caused by multiple factors. It is caused by abnormal quality, quantity and kinetic abnormalities in tears or the microenvironment of the eye surface. It may be accompanied by inflammation, damage and neurosesthetic abnormalities in the eye surface, manifested as multiple discomfort symptoms and/or visual dysfunction in the eye. Maybe everyone doesn't understand this very well. In fact, our eyes will usually secrete tears, forming tear films on the surface of our eyes to maintain a healthy state on the surface of our eyes. If we have insufficient secretion of tears due to various reasons, the composition of tears changes, or the tears cannot form a tear film well, and these problems continue to exist, it will lead to problems on our eye surface and produce inflammatory reactions, which will cause various eye discomforts such as dry eyes, fatigue, red eyes, irritation and tears, and even blurred vision.
If you have the above eye symptoms and it lasts for a long time and does not relieve it, you must go to the hospital in time and the doctor will help you check and confirm the diagnosis. The examination of dry eye disease mainly includes using slit lamps to check the eye surface, performing instrument examinations such as tear secretion, eye surface staining, and meibomian gland photography to clarify the type, degree, and eye surface status of the eye surface. These tests are non-invasive and do not cause pain.
Currently, dry eyes are mainly divided into 5 types: 1. Water deficiency type dry eyes: caused by insufficient generation of aqueous tear fluid and (or) qualitative abnormalities, such as Sjogren syndrome and many systemic factors; 2. Lipid abnormalities (dry eyes that are too strong evaporated): caused by abnormalities in the quality or quantity of lipid layers, such as meibomian gland dysfunction, blepharitis , visual terminal syndrome, eyelid defects or abnormalities, etc.; 3. Mucin abnormal types (mucin deficiency type) dry eyes: caused by damage to the epithelial cells on the surface of the eye, such as drug toxicity, chemical injuries, damage to the surface of the heat burn and limbal dysfunction; 4. Dry eyes of tear kinetic abnormalities: caused by abnormal kinetic abnormalities of tears, such as abnormal eyelashes, delayed tear discharge, and relaxed conjunctiva; 5. Mixed dry eyes: the most common type of dry eyes in clinical practice, which is dry eyes caused by two or more reasons. After the diagnosis of
is clear, we will give corresponding treatment based on your eye condition and type of dry eyes. The current main goal of treatment for dry eyes is to relieve eye symptoms and protect patients' visual function. First remove the cause and treat the primary disease: If it is caused by systemic diseases, the primary disease should be treated in conjunction with the corresponding specialist; if it is related to the living and working environment, such as working in an air-conditioned environment for a long time, using computers frequently or driving at night, etc., the work and living environment should be actively improved; drugs and eye cosmetics that can cause dry eyes for a long time should be stopped in time.
followed by drug treatment: the most commonly used is artificial tears: artificial tears are the first-line medication for treating dry eyes. Lubrication of the eye surface is the main function of artificial tears. At the same time, it can replenish the missing tears, dilute the soluble inflammatory mediator on the surface of the eye, reduce the permeability of tear fluid and reduce the osmotic reaction caused by high osmotic pressure; for the inflammation caused by dry eyes, the doctor will also give some other anti-inflammatory drugs, and these drugs must be used under the guidance of the doctor.
For some patients with clear causes or poor drug treatment effects, we will also use non-drug treatment methods such as wet atrial lenses and silicone eye masks, soft corneal contact, lacrimal tract embolism, and physical therapies such as meibomian gland massage and local fumigation.
To summarize it briefly: Dry eye disease is a very common disease at present, and its clinical manifestations are diversity .When you experience dry eyes, fatigue, red eyes, irritation and tears, or even blurred vision, you must go to the hospital in time and the doctor will help you diagnose and treat it through examination.
[Experts in this issue]
Liu Lei, deputy chief physician of the Corneal Disease Professional Group of Shenyang Fourth People's Hospital of China Medical University. Young member of the Ophthalmology Branch of Liaoning Medical Association. Professional expertise: corneal disease , ocular surface diseases, corneal and intraocular refractive surgery, etc.
