Dry Eye Disease
Title: Dry Eye Disease
Author: Tanner Ferguson, 4th year medical student, University of South Dakota Sanford School of Medicine
Description: Dry eye disease is a very common condition and is one of the most common causes of eye discomfort in the general population. Dry eye disease is typically split into two categories: evaporative dry eye and decreased aqueous production1. Recently, increased interest in dry eye disease and the importance of the ocular surface has paved the way to newer treatment modalities. Being equipped with the awareness of the signs and symptoms will help clinicians manage these patients appropriately. It is important to recognize the risk factors, common signs and symptoms of dry eye disease so that patients can be appropriately treated.
Patients with dry eye can present with a variety of signs and symptoms. Symptoms of fluctuations in vision, discomfort, burning or a foreign body sensation are common2. Patients may demonstrate conjunctival injection and eyelid swelling/inflammation, or blepharitis.
Firstly, take a careful history as environmental factors and diet can significantly contribute to dry eye disease2. Ask the patient about the use of ceiling/direct fans, humidifiers, water intake, contact lens wear, time outdoors, direct sun exposure and daily activities. Patients who work long hours on near tasks such as a computer frequently blink less and are subsequently at-risk for dry eye3,4. Some medications may also contribute to dry eyes, such as antihistamines, pain relievers, certain anti-hypertensives, decongestants, hormones, antidepressants, antipsychotics, chemotherapeutics and acne medications2. Diet is another significant contributor; studies suggest that patients who supplement with omega-3-based vitamins report less dry-eye related symptoms.5
When a patient presents with an irritated red eye, it is important to be cognizant of dry eye disease and gather a full history to prevent unnecessary treatments with extensive or prolonged antibiotic regiments. If you suspect a patient is suffering from dry eye disease, encourage them to seek out an eye care provider and manage any modifiable risk factors in the meantime.
- The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf. 2007;5(2):75-92.
- Lemp MA. Advances in understanding and managing dry eye disease. American Journal of Ophthalmology. 2008;146(3):350-356. doi:10.1016/j.ajo.2008.05.016.
- Tsubota K, Nakamori K. Dry Eyes and Video Display Terminals. N Engl J Med. 1993;328(8):584-584. doi:10.1056/NEJM199302253280817.
- Tsubota K. Tear dynamics and dry eye. Progress in Retinal and Eye Research. 1998;17(4):565-596.
- Korb DR, Blackie CA, Finnemore VM, Douglass T. Effect of Using a Combination of Lid Wipes, Eye Drops, and Omega-3 Supplements on Meibomian Gland Functionality in Patients With Lipid Deficient/Evaporative Dry Eye. Cornea. 2015;34(4):407-412. doi:10.1097/ICO.0000000000000366.