scholarly journals Aging: A Predisposition to Dry Eyes

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Anushree Sharma ◽  
Holly B. Hindman

Dry eye syndrome is a disease of the ocular surface and tear film that is prevalent in older adults. Even though the degree of visual acuity loss in dry eye patients is commonly mild-to-moderate, in the aging population, this minimal change in visual status can lead to a significant decrease in visual function and quality of life. A healthy ocular surface is maintained by appropriate tear production and tear drainage, and deficiencies in this delicate balance can lead to dryness. In the aging eye, risk factors such as polypharmacy, androgen deficiency, decreased blink rates, and oxidative stress can predispose the patient to developing dry eye that is frequently more severe, has higher economic costs, and leads to worse consequences to the well-being of the patient. Understanding why elderly patients are at higher risk for developing dry eyes can provide insights into the diagnosis and management of the growing number of older adults struggling with dry eye and minimize the burden of disease on our aging population.

2005 ◽  
Vol 6 (3) ◽  
pp. 185-196
Author(s):  
Lorenzo Pradelli ◽  
Letizia Vacchini

BACKGROUND: The dry eye sindrome refers to a group of disorders of the tear film due to reduced tear production or excessive tear evaporation that is associated with symptoms of ocular discomfort and may cause disease of the ocular surface. Dry eye syndrome varies in severity, duration and etiology. The cornerstone of dry eye syndrome therapies includes the intraocular gel or ophthalmic solutions instillation, reaching correct artificial lubrication. Molecules that can produce a stable lubricating film are the carbomers. METHODS: In the first step of our work we reviewed the data from literature reporting about carbomers’ characteristics in respect to other lacrimal substitutes. Then, a pharmacoeconomical analysis has been performed on ophtalmic gels derived from carbomers 974P and PVA. RESULTS: Dry eye sindrome, if not adequately treated, determines a deterioration of the patient’s quality of life, other than high secondary costs. CONCLUSION: The high therapeutical index of carbomers 974P and PVA-based gels, in addition to the their limited cost (totally free for Sjögren patients in Italy), suggests that this product is characterized by one of the best benefits-to-costs ratios in the treatment of dry eye sindrome.


2022 ◽  
Vol 7 (4) ◽  
pp. 667-671
Author(s):  
Prajwalli Reddy ◽  
Wajeeha Umam

: Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface. Meibomian Gland Dysfunction (MGD) is an abnormality of the meibomian gland that blocks the secretion of lipids. Without sufficient lipid production, tears evaporate quickly causing Dry Eye.MGD is associated with multiple pathological mechanisms including inflammation, microbial factors and lipid deficiencies. Topical Cyclosporine A (CsA) 0.05% is a calcineurin inhibitor that reduces inflammation by specifically inhibiting T‑cell activity, which reduces ocular surface inflammation and improves tear film dynamics. This was a prospective observational study done on 100 patients at the Department of Ophthalmology Basaveshwar teaching and general hospital, on patients of dry eyes due to meibomian gland dysfunction. Patients who were diagnosed with dry eyes due to meibomian gland dysfunction were invited to take part in the study. Patients were divided randomly into two groups of 50 patients each. This study, was explained in detail to them. An informed consent was obtained. Patients fulfilling the inclusion criteria were listed.All OSDI scores (symptom intensity, frequency and aggravation) revealed decreasing patterns throughout the observation period in both the groups. In single analysis, the cyclosporine A 0.05% group showed a significant improvement for each score at 3 months (p < 0.01, p = 0.01, p = 0.02, respectively). The mean TBUT after treatment in the group A (cyclosporine A group) increased to 12.36± 3.58(p<0.001) seconds, and in the group B (Control group) the TBUT score increased to 11.01±3.06 seconds. After 3 Months, there was statistically significant improvement in the mean Schirmer’s scores in both the treatment groups, however improvement was significantly greater in Cyclosporine A group. Prior to the treatment in group A (Cyclosporine A) mean Lissamine staining score was 2.73±0.15 and post treatment it reduced to 1.32±0.15 which was statistically significant (P<0.001). In group B (Control group) score before treatment was 2.46±0.15 and after treatment it reduced to 2.39±0.27 (p=0.11), not much difference was seen. : Findings from our study showed that there were significant improvements in the dry eye conditions due to defect in meibomian gland by treatment of topical Cyclosporine A 0.05% and sodium hyaluronate 0.1%.


2014 ◽  
Vol 07 (02) ◽  
pp. 109
Author(s):  
Vasilis Achtsidis ◽  
Eleftheria Kozanidou ◽  
Panos Bournas ◽  
Nicholas Tentolouris ◽  
Panos G Theodossiadis ◽  
...  

Dry eye disease (DED) is a clinically significant multifactorial disorder of the ocular surface and tear film as it results in ocular discomfort and visual impairment and predisposes the cornea to infections. It is important for the quality of life and tends to be a chronic disease. It is also common, as the prevalence is estimated between 5 % to 30 % and this increases with age. Therefore, it is recognized as a growing public health problem that requires correct diagnosis and appropriate treatment. There are two main categories of DED: the deficiency of tear production (hyposecretive), which includes Sjögren’s syndrome, idiopathic or secondary to connective tissue diseases (e.g. rheumatoid arthritis), and non-Sjögren’s syndrome (e.g. age-related); and the tear evaporation category, where tears evaporate from the ocular surface too rapidly due to intrinsic causes (e.g. meibomian gland disease or eyelid aperture disorders) or extrinsic causes (e.g. vitamin A deficiency, contact lenses wear, ocular allergies). Management of the disease aims to enhance the corneal healing and reduce patient’s discomfort. This is based on improving the balance of tear production and evaporation by increasing the tear film volume (lubrication drops) and improving quality of tear film (ex omega-3 supplements, lid hygiene, tetracyclines), reducing the tear film evaporation (paraffin ointments, therapeutic contact lenses), reducing tear’s drainage (punctal plugs, cautery), and finally by settling down the ocular surface inflammation (steroids, cyclosporine, autologous serous), as appropriate. In this article we will review the clinical presentation, differential diagnosis, and treatment options for DED.


2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Sameera Irfan

Dry eyes is a common, chronic condition that has a prevalence of about 5- 50%.1 According to the Dry Eye Workshop II report (DEWS II report), published in 2017, the updated definition of Dry Eye Disease is, “a multifactorial disease of the ocular surface characterised by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyper-osmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.” The Tear Film & Ocular Surface Society (TFOS) released their report on the international work on Meibomian Gland Dysfunction (MGD)2 in 2011, which defined MGD, classified it and considered it as the primary cause of dry eye disease worldwide. Previously dry eye disease was considered as an aqueous deficiency problem, but after this report by TFOS, there is a paradigm shift towards “not producing enough lipids to retain the tears that are being produced”. This has led to a huge impact on the treatment protocols which were previously focused on managing the sequelae and symptoms of dry eyes rather than targeting directly on the underlying cause, the MGD. It has now been accepted worldwide that dry eye occurs when the ocular surface system cannot adequately protect itself from the desiccating stress due to the lack of a healthy meibomian gland secretion. This article is mainly focussed on the Meibomian Gland Dysfunction, discussing the normal anatomy of the glands, how they are affected by disease, its implications on the ocular surface and finally, the various treatment strategies. Key words: Blepharitis, Dry eyes, Meibomian gland dysfunction, blepharospasm.


2021 ◽  
Vol 7 (2) ◽  
pp. 302-307
Author(s):  
Vandana Sharma ◽  
Parag Tyagi ◽  
J P Chugh ◽  
R S Chauhan ◽  
Ashok Rathi

Dry eye disease (DED) is a multifactorial disease of the tear film which leads to ocular discomfort, visual disturbances and damage to ocular surface. The objective of treatment of DED has now shifted from managemnt of ocular symptoms and patient relief to attainment of normal physiological composition of the tear film.Aim of this study was to compare the efficacy of chloroquine phosphate 0.03% (CQP) eye drops with sodium carboxymethyl cellulose 1% (CMC) eye drops in the management of DED. A single blind, prospective and comparative study including 100 patients of dry eyes was planned. The patients were randomly divided into two groups, each comprising of 50 patients. Group-1 patients were given CMC 1% eye drops 4 times a day for 12 weeks and Group-2 patients were given CQP 0.03% eye drops as the treatment modality 2 times a day for 12 weeks. The efficacy of both the drugs was compared and evaluated statistically. The study showed that both CQP and CMC eye drops are effective in treating DED, although faster onset of action was observed with CQP on ocular surface staining tests and Schirmer’s test. Also, it was noted that patients with severe DED showed least improvement in both the groups suggesting that mono-drug therapy is least effective in treatment of severe DED and multi drug therapy should be used early in treatment of severe DED.


2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Munir Baig Rabeeya Munir

Purpose: To find the changes in tear film and ocular surface in patients with pterygium. Study Design: A descriptive cross sectional study. Place and Duration of Study: Federal Government Services Hospital Islamabad during June 2013 to December 2014. Material and Methods: Dry eye questionnaire (DEQ-6) was administered by a trained researcher and DE tests were performed in all 256 willing subjects (136 with pterygium+120 control) age 30-76 years, by a single surgeon under same physical conditions after taking the consent and approval from Hospital Ethical committee. Diagnosis was made on presence of both symptoms and tear film parameters. Statistical analysis by simple percentages. Results: Dry eyes (DE) were found in 73 (53.7%) of the pterygium cases and 28 (23.5%) of the normal patients. In this study, 55 (40.5%) patients were symptomatic, defined as reporting 1 or more DE symptoms often or all the time. There were 53 (39%) patients that showed corneal fluorescein staining (CFS) and 69 (51%) showed plugging/mucous threads in both groups. Of 136 eyes with pterygium there were 91 (67%) males and 45 (33%) females. Out of these 50 (36.7%) patients showed normal tear film and 86 (63.2%) showed deranged functions. Moreover, among the 120 control eyes there were 73 (61%) males and 47 (39%)] females. Out of these 86 (72.3%) patients were normal and 34 (27.7%) had abnormal functions. These values were reduced indicating altered tear film in these patients. Conclusion: Pterygium disturbs tear functions causing dry eye like symptoms. Key Words: Dry eye, pterygium, tear film instability, ocular surface.


2021 ◽  
Author(s):  
Tri Wahyu

Dry eye disease (DED) is a multifactorial disease of tears and ocular surface that results in various symptoms with the potential damage to the ocular surface. It can range from mild to severe signs and symptoms and may affect patient’s quality of life. Various techniques and methods have been developed to evaluate DED for initial examination or regular follow up. The simple evaluations that can be performed in clinic include eyelid examination, tear break-up time, and ocular surface stainings; while the advanced ones may require certain devices or laboratory equipment. Careful and thorough examinations are important to guide the clinician to assess and evaluate dry eye.


2018 ◽  
Vol 28 (4) ◽  
pp. 385-392 ◽  
Author(s):  
Anton Hommer ◽  
Doreen Schmidl ◽  
Martina Kromus ◽  
Ahmed M Bata ◽  
Klemens Fondi ◽  
...  

Purpose: Long-term glaucoma therapy with preservative-containing eye drops may impact ocular surface health. This study was performed to investigate whether a switch from preserved topical prostaglandin therapy to preservative-free tafluprost therapy improves precorneal tear film thickness in patients with glaucoma or ocular hypertension. Methods: A total of 30 patients who were under topical preservative-containing prostaglandin monotherapy for at least 6 months were included. Patients were then switched from preserved prostaglandin therapy to unpreserved tafluprost drops once daily. Tear film thickness was measured at baseline and 4 and 12 weeks after therapy change with an ultrahigh-resolution optical coherence tomography system. Furthermore, clinical measures of ocular surface disease were determined and symptoms were assessed using the Dry Eye–Related Quality-of-Life Score. Results: After switching to unpreserved tafluprost, tear film thickness significantly increased from 4.7 ± 0.5 to 5.0 ± 0.6 µm 4 weeks after therapy change and still tended to be increased after 12 weeks (4.8 ± 0.7 µm). Breakup time significantly increased from 5.1 ± 2.3 to 7.2 ± 3.4 s and to 10.1 ± 3.6 s after therapy change. In addition, a significant decrease in corneal staining score from 1.8 ± 0.7 to 1.4 ± 0.8 after 4 weeks and to 0.7 ± 0.7 after 12 weeks treatment was observed. Switching to preservative-free drops reduced Dry Eye–Related Quality-of-Life Score from 11.4 ± 11.0 to 5.7 ± 6.4 and to 4.7 ± 7.5. Conclusion: Our data show that switching to preservative-free tafluprost leads to an increase in tear film thickness, breakup time, and an improvement of Dry Eye–Related Quality-of-Life Score. Our results therefore indicate that a switch to unpreserved tafluprost is beneficial for ocular surface health in patients under long-term preserved prostaglandin eye drops.


2018 ◽  
Vol 159 (20) ◽  
pp. 775-785 ◽  
Author(s):  
András Berta ◽  
Edit Tóth-Molnár ◽  
Adrienne Csutak

Abstract: Ten years have passed since the publication of the DEWS Report that summarized the information based on scientific literature concerning dry eye disease. Hundreds of papers have been published since then and time has come for a new summary. Organized by the Tear Film & Ocular Surface Society, 12 working groups summerized former and recent data. The DEWS II Report was created. The authors of the present publication summarize the most important changes in definition, classification, diagnostics, and therapy concerning dry eye disease. They also disclose the relevant changes on which the non-ophthalmologist specialists have to be informed. The DEWS II Report published by TFOS consists of 11 chapters. Completely new chapters deal with the role of sensation/pain and iatrogenic dry eyes. Orv Hetil. 2018; 159(20): 775–785.


2014 ◽  
Vol 08 (01) ◽  
pp. 17 ◽  
Author(s):  
Vasilis Achtsidis ◽  
Eleftheria Kozanidou ◽  
Panos Bournas ◽  
Nicholas Tentolouris ◽  
Panos G Theodossiadis ◽  
...  

Dry eye disease (DED) is a clinically significant multifactorial disorder of the ocular surface and tear film as it results in ocular discomfort and visual impairment and predisposes the cornea to infections. It is important for the quality of life and tends to be a chronic disease. It is also common, as the prevalence is estimated between 5 % to 30 % and this increases with age. Therefore, it is recognised as a growing public health problem that requires correct diagnosis and appropriate treatment. There are two main categories of DED: the deficiency of tear production (hyposecretive), which includes Sjögren syndrome, idiopathic or secondary to connective tissue diseases (e.g. rheumatoid arthritis), and non-Sjögren syndrome (e.g. age-related); and the tear evaporation category, where tears evaporate from the ocular surface too rapidly due to intrinsic causes (e.g. meibomian gland disease or eyelid aperture disorders) or extrinsic causes (e.g. vitamin A deficiency, contact lenses wear, ocular allergies). Management of the disease aims to enhance the corneal healing and reduce patient’s discomfort. This is based on improving the balance of tear production and evaporation by increasing the tear film volume (lubrication drops) and improving quality of tear film (ex omega-3 supplements, lid hygiene, tetracyclines), reducing the tear film evaporation (paraffin ointments, therapeutic contact lenses), reducing tear’s drainage (punctal plugs, cautery) and finally by settling down the ocular surface inflammation (steroids, cyclosporine, autologous serous), as appropriate. In this article we will review the clinical presentation, differential diagnosis and treatment options for DED.


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