What Is Keratitis Sicca?

Patients complain of itching, burning, photophobia, grit, stretch, back pressure or foreign body sensation. Some patients notice a lot of tears after severe irritation. Applying eyesight such as reading, computer operation, driving for a long time Or watching TV can aggravate symptoms. Special local conditions can also aggravate symptoms, such as smoke and dusty areas and dry environments, such as on airplanes, in supermarkets, on days with low humidity, and when using air conditioners (especially in cars), fans or Warmers. Certain systemic medications can also aggravate symptoms, including isotretinoin, tranquilizers, diuretics, antihypertensives, oral contraceptives, and all anticholinergics (including antihistamines and Many gastrointestinal drugs). Cool, rainy, foggy, or other high humidity environments such as showers can improve symptoms. Although dry keratoconjunctivitis rarely reduces vision, sometimes it still complains of stinging eyes, making it difficult Use your eyes.

Dry keratitis

Dry keratitis refers to insufficient tear fluid capacity (also known as lacrimal dry keratoconjunctivitis), or excessive tear loss due to accelerated tear evaporation due to poor tear quality (also called evaporative dry keratoconjunctivitis), Caused by chronic, binocular conjunctival and corneal dryness.

Symptoms and signs of dry corneal inflammation

Patients complain of itching, burning, photophobia, grit, stretch, back pressure or foreign body sensation. Some patients notice a lot of tears after severe irritation. Applying eyesight such as reading, computer operation, driving for a long time Or watching TV can aggravate symptoms. Special local conditions can also aggravate symptoms, such as smoke and dusty areas and dry environments, such as on airplanes, in supermarkets, on days with low humidity, and when using air conditioners (especially in cars), fans or Warmers. Certain systemic medications can also aggravate symptoms, including isotretinoin, tranquilizers, diuretics, antihypertensives, oral contraceptives, and all anticholinergics (including antihistamines and Many gastrointestinal drugs). Cool, rainy, foggy, or other high humidity environments such as showers can improve symptoms. Although dry keratoconjunctivitis rarely reduces vision, sometimes it still complains of stinging eyes, making it difficult Use your eyes.

Diagnosis of dry keratitis

There are two types of dry keratoconjunctivitis. Conjunctival hyperemia, corneal epithelium (superficial punctate keratitis) and / or conjunctival epithelium are scattered, slender dots fall off, and the lesion area is mainly between the upper and lower eyelids (in the eyelid or exposed Area), can be stained with fluorescein. Patients blink more often, but there are a few patients who blink less because of dry eyes.

In patients with lacrimal dry keratoconjunctivitis, the conjunctiva may appear dry, tarnished, and have many wrinkles. This type of dry keratoconjunctivitis is the most common type of isolated, idiopathic disease, which is more common in postmenopausal women. More common. It is less common in some other lesions that can cause lacrimal duct scarring, such as cicatricial pemphigoid; it can also be secondary to Stevens-Johnson syndrome or trachoma; or as a result of damage to the lacrimal gland or abnormal function of the lacrimal gland, Examples include graft-versus-hostdisease, radiotherapy, or familial autonomic dysfunction.

The Schirmer test does not require local anesthesia. A standard filter paper strip is placed in the lower eyelid, at the outer 1/3 junction. If the filter paper strip is moistened 5 mm 2 times in 5 consecutive minutes, it can be diagnosed as dry tears . Rare, severe, progressive, chronic dryness can cause keratosis of the eye surface or corneal epithelium shedding, resulting in scarring, angiogenesis, infection, ulceration or even perforation. The vision of these severe cases is often significantly reduced.

Evaporative dry keratoconjunctivitis can also cause a lot of foamy tears on the edge of the eyelid. This disease is often accompanied by blepharitis and rosacea (see section 116). This type of dry eye can be very dry and cause corneal epithelium to fall off or Vision loss is rare. Schirmer test results are usually normal. A small amount of high concentration of fluorescein can see the tear film, which can reveal the accelerated rate of tear damage (tear film rupture test).

Patients with Sj & Ouml; gren syndrome (see section 50) suffer from lacrimal keratoconjunctivitis and xerostomia. This syndrome can occur in isolation (primary Sjgren syndrome) or with systemic connective tissue disease such as Rheumatoid arthritis or systemic lupus erythematosus (secondary Sjgren syndrome). Serology and biopsy of the salivary glands can be used to make a diagnosis. Non-Hodgkin's disease occurs in patients with primary and secondary Sjgren syndrome Chidgin lymphoma is 40 times the normal rate, so physicians must follow up carefully.

Keratitis sicca treatment

Frequent use of artificial tears is beneficial to both types of dry keratoconjunctivitis. Application of more viscous artificial tears can cover the surface of the eye for a longer time, especially for evaporative dry keratoconjunctivitis. When patients have nocturnal rabbit eyes and / Or those who have tingling when waking up early, it is especially effective to apply artificial tear ointment before going to bed. Most patients can be appropriately treated with this adjuvant therapy throughout their lives. Avoiding dry and arid environments and using a humidifier are often helpful. Treating cases may require closed nasolacrimal puncture. In severe cases, partial eyelid suture can reduce tear evaporation and reduce tear loss.

Patients with evaporative dry keratoconjunctivitis often benefit from treating concomitant blepharitis, including hot compresses, blepharoplasty or oral tetracycline