What Causes Dry, Itchy Eyes?

Dry eye, also known as dry eye, dry corneal and conjunctival disease, is caused by any cause of abnormal quality or quantity of tear fluid or kinetic abnormalities, and is accompanied by eye discomfort and / or ocular surface tissue lesions. A general term for this disease. Common symptoms include dry eyes, itchy eyes, foreign body sensation, burning sensation, sticky secretions, fear of wind, light, and sensitivity to external stimuli; sometimes the eyes are too dry, which stimulates reflective tear secretion, causing frequent tears; In severe cases, the eyes may become red and swollen, congested, and the corneal epithelium may be peeled and stick with filaments, which will affect vision. At present, there is no effective treatment method for dry eyes. Appropriate amount of eye drops made of artificial tears can be used to alleviate symptoms and close small punctum. Eyelid dryness caused by incomplete eyelid closure is feasible for blepharoplasty.

Basic Information

nickname

Dry eye, xerostomia conjunctiva

Visiting department

Ophthalmology

Common causes

Lacrimal gland inflammation, trauma, infection, long-term use of certain eye drops or certain drugs, long-term contact lens wear, eyelid disease, lack of vitamin A1, chronic conjunctivitis

Common symptoms

Dry, astringent, itchy, foreign body sensation, burning sensation, fear of wind and light, sensitive to external stimuli; or tears often; severe redness, swelling, congestion, etc.

Causes of dry eyes and common diseases

1. Insufficient secretion of lacrimal glands in the aqueous layer

Is the most common cause of dry eye angle; congenital absence of lacrimal glands, senile lacrimal gland function or some autoimmune diseases cause tear gland inflammation, trauma, infection, etc. Long-term use of certain eye drops or taking certain drugs can cause tear secretion Inadequate; long-term wear of contact lenses.

2. Insufficient secretion of the oil layer

Meibomian gland dysfunction due to eyelid disease.

3. Insufficient secretion of the mucin layer

Vitamin A1 deficiency, chronic conjunctivitis, chemical burns, etc.

4. Excessive evaporation of tear fluid and uneven distribution of tear film

Eyelid disease results in poor eyelid closure, reduced blinks, and prolonged stay in an air-conditioned room or an outdoor strong wind and hot environment.

Differential diagnosis of dry eyes

Sjogrens syndrome includes: dry mouth, dry eyes, and arthritis. It can also occur in many autoimmune diseases, and systemic diseases such as sarcoma and Waldenstroms macroglobulinemia.

Dry eye examination

Tear secretion test

The normal value is 10 ~ 15mm, more than 10mm is low secretion, and less than 5mm is dry eye.

2. tear film rupture time

The tear film is less than 10 seconds.

3. Tear liquid fern test

People with mucin deficiency, such as ocular pemphigus and Stevens-Johnson syndrome, have reduced or even disappeared their "ferns".

4. Biopsy and Blot Cytology

In dry eye patients, the density of goblet cells in the conjunctiva decreases, the ratio of nuclear to plasma increases, the squamous metaplasia of epithelial cells, and the conjunctiva of corneal epithelium. By calculating the density of goblet cells in the conjunctiva, the severity of the disease can be assessed indirectly.

5.fluorescein staining

Positives represent corneal epithelial defects. You can also observe the height of the tear river.

6.Tiger red staining

Sensitivity was higher than that of fluorescein staining. Corneal and conjunctival inactivated cells stained as positive cells.

7. Tear lysozyme content

If the content is less than 1200 g / ml, or the bacteriolytic area is less than 21.5 mm2, dry eye disease is indicated.

8. Tear osmotic pressure

For dry eye and contact lens wearers, tear osmotic pressure increased by 25mOsm / L compared with normal people. If it is greater than 312mOsm / L, dry eye can be diagnosed.

9. Lactoferrin

Patients younger than 69 years of age can diagnose dry eye if they are lower than 1.04bg / ml, and patients older than 70 years of age are lower than 0.85mg / ml.

10.Tear fluid clearance check

The goal is to understand if there is a delay in tear clearance. Detection using fluorescence spectrophotometry.

11. Dry eye or tear film interference imager

Understand the tear film lipid layer, dry eye disease, especially LTD (lipid deficiency dry eye disease) patients can see tear film lipid layer abnormalities, compared with the standard image can be estimated dry eye severity.

12. Corneal topographic examination

Understanding the regularity of the corneal surface, the regular parameters of the corneal surface of dry eye patients are higher than normal people, and the higher the parameter, the heavier the dry eye is.

13. Serology

Knowing autoantibodies, patients with Sjogren's syndrome often see positive ANA antibodies and rheumatoid factors. This is helpful for the diagnosis of dry eye caused by immune diseases.

Dry eye treatment principles

At present, there is no effective treatment method. In order to reduce the pain, an appropriate amount of artificial tears can be used; or the small punctum can be closed to reduce the outflow of tears. For dry eyeballs due to incomplete eyelid closure, blepharoplasty is feasible.