Dry eye syndrome as a special case of dystrophic processes (AMD) and its friend - computer
The number of diagnoses of dry eye syndrome around the world is growing along with the development of technology. The main factors are: deterioration of the atmospheric air, in particular, near industrial areas, conditioned air, side effects of many drugs, radiation of LEDs (especially super-bright in the blue part of the spectrum, including AMOLED screens and the like).
Symptoms of the disease: itching, redness, fatigue, dryness in the eye and eyelids. The reason is a violation of tear production.
If you identify the syndrome at an early stage, when the usual clinic does not put it as a diagnosis, you can avoid a whole sea of problems. Let's start with a short table that allows you to understand whether this concerns you or whether you should pass by.
Now we will talk about subjective assessment methods, that is, those that need to be confirmed by analyzes or other special tests. But, if you have a couple of these complaints, read on. No - just skip the post, you're in luck.
')
At the age of 45 years and older, or with rheumatoid diseases, thyroid diseases, herpes transferred, mononucleosis, trigeminal nerve surgery, eye injuries and eye surgeries, or with frequent use of beta-blockers, analgesics, anticholinergics, antidepressants, oral contraceptives estrogens, antimigraine drugs, the presence of botulinum toxin injections for cosmetic purposes in the paraorbital region, wearing soft contact lenses, swimming in chlorinated water increases the risk, and for complaints and should be monitored especially carefully.
But let's move on to a slightly more scientific description of the syndrome.
A symptom is a subjective feeling of dryness (objectively, it may not be).
Sign - an objective decrease in the secretion of fluid (subjectively may not be felt).
Syndrome - Symptoms and signs (up to blepharospasm)
A disease is a clinical picture in which the most important manifestation is a syndrome. Typical situations: menopause, autoimmune exocrinopathy, vitamin deficiency A.
In ancient Greece, the term "xerophthalmia", that is, "dry eye", was first introduced. But then he was called corneal blindness, coupled with the complete drying of the surface of the eye. In the nineteenth century, the meaning of the term shifted to the professional designation of Sjögren's syndrome and a number of keratitis. Only half a century ago, the term adopted the current meaning: von Rött called the quantitative criteria for tear deficiency. Now the diagnosis is divided into water deficiency, mucodeficiency and lipodeficiency, depending on which component of tears is in deficit.
The degree is not the stage of development of the disease, but the level of severity and possible consequences. For example, as a result of injury or chemical exposure, you can start right away from a difficult stage and rather quickly reach the terminal one. But it is better, of course, to avoid it.
In any ophthalmologic office, you can take anamnesis from you, look at your eyes through a microscope and do tests for tears. The latter are particularly important in terms of diagnosing early stages of CVG, so they are included in most regular eye examinations.
If the doctor has suspicions, he can also prescribe special diagnostic methods (vital staining with dyes; tear crystallography; cytocompression research; ultrasound of the lacrimal gland; laboratory studies of LF), which require a sufficiently specific laboratory or diagnostic equipment.
As a rule, most cases of CVD are diagnosed by impaired tear production or by related eye changes, in particular, blepharitis.
The peculiarity is that patients complain of a symptom, and usually there is a picture of the disease. But at the same time in the diagnosis often do not reveal signs and therapy is not appointed. There is even a joke about this in ophthalmology:
- What to do with a patient with blepharitis?
- Send it to a competitor!
So, dry eye syndrome and blepharitis are two related problems. If CVS was not caused by blepharitis, it can cause inflammation of the eyelid. If the CVD was caused by blepharitis, in any case, the treatment of one requires the treatment of the other. The main point is that you can replace a tear for as long as you like, trying to deal with dry eye syndrome with supportive treatment, but this will not give the result. It is also necessary to cure blepharitis (or not to allow it to develop under the scenario, when it was not he who caused the launch of the CVG). Plus solve a number of accompanying problems for the deterioration of the trophic. If the doctor prescribes only a tear substitute or similar means, at first the patient simply suffers, and then the development of the syndrome begins with concomitant irreversible organic disorders of the tear-producing apparatus and the superficial structures of the eye, up to ulceration of the cornea.
From here two rules:
Here is a rough cause and effect diagram.
The treatment is performed not only by protecting the eye from fluid loss, but, most importantly, by removing the cause of the disease. More on this later. For now, be careful. It is better to be examined earlier (a tear test takes 10 minutes) than to join those for whom we launch our bioreactors in the production of the gel.
A little later, I will tell you about the tear and how it works and works.
Symptoms of the disease: itching, redness, fatigue, dryness in the eye and eyelids. The reason is a violation of tear production.
If you identify the syndrome at an early stage, when the usual clinic does not put it as a diagnosis, you can avoid a whole sea of problems. Let's start with a short table that allows you to understand whether this concerns you or whether you should pass by.
What to look for
Now we will talk about subjective assessment methods, that is, those that need to be confirmed by analyzes or other special tests. But, if you have a couple of these complaints, read on. No - just skip the post, you're in luck.
')
- Burning or itching in the eyes.
- Sensation of dryness in the eyes.
- Red eyes.
- Foreign body sensation in the eyes.
- Feeling tired eyes, especially when working at the computer.
- Swelling and redness in the eyelids.
- Unstable, fluctuating, vision.
- Spontaneous tearing.
- Photophobia.
- Hypersensitivity to tobacco smoke.
At the age of 45 years and older, or with rheumatoid diseases, thyroid diseases, herpes transferred, mononucleosis, trigeminal nerve surgery, eye injuries and eye surgeries, or with frequent use of beta-blockers, analgesics, anticholinergics, antidepressants, oral contraceptives estrogens, antimigraine drugs, the presence of botulinum toxin injections for cosmetic purposes in the paraorbital region, wearing soft contact lenses, swimming in chlorinated water increases the risk, and for complaints and should be monitored especially carefully.
But let's move on to a slightly more scientific description of the syndrome.
About terms
A symptom is a subjective feeling of dryness (objectively, it may not be).
Sign - an objective decrease in the secretion of fluid (subjectively may not be felt).
Syndrome - Symptoms and signs (up to blepharospasm)
A disease is a clinical picture in which the most important manifestation is a syndrome. Typical situations: menopause, autoimmune exocrinopathy, vitamin deficiency A.
In ancient Greece, the term "xerophthalmia", that is, "dry eye", was first introduced. But then he was called corneal blindness, coupled with the complete drying of the surface of the eye. In the nineteenth century, the meaning of the term shifted to the professional designation of Sjögren's syndrome and a number of keratitis. Only half a century ago, the term adopted the current meaning: von Rött called the quantitative criteria for tear deficiency. Now the diagnosis is divided into water deficiency, mucodeficiency and lipodeficiency, depending on which component of tears is in deficit.
Degrees of dry eye syndrome
The degree is not the stage of development of the disease, but the level of severity and possible consequences. For example, as a result of injury or chemical exposure, you can start right away from a difficult stage and rather quickly reach the terminal one. But it is better, of course, to avoid it.
- Subclinical degree - there are no bright symptoms, the patient sometimes complains of feeling dry when using a hair dryer, in dry air, in strong winds or when wearing contact lenses for a long time, or during prolonged use of a computer.
- Light - symptoms are pronounced, itching also occurs, less often photophobia, even less often misting, very rarely - slight blepharospasm. Often diagnosed with infectious or allergic conjunctivitis.
- Medium - all symptoms + new signs (erosion, punctate keratopathy, filamentous keratopathy, conjunctival hyperemia). On a moderate level, all changes are reversible.
- Severe - corneal ulcers, an eyesore, neovascularization of the cornea, adhesions and other changes that are already irreversible are added.
- Terminal - significant visual impairment is added due to blocking of the optical field (for example, an ulcer). The end of this stage is the complete loss of the ability to distinguish objects with the eye.
Diagnostics
In any ophthalmologic office, you can take anamnesis from you, look at your eyes through a microscope and do tests for tears. The latter are particularly important in terms of diagnosing early stages of CVG, so they are included in most regular eye examinations.
If the doctor has suspicions, he can also prescribe special diagnostic methods (vital staining with dyes; tear crystallography; cytocompression research; ultrasound of the lacrimal gland; laboratory studies of LF), which require a sufficiently specific laboratory or diagnostic equipment.
As a rule, most cases of CVD are diagnosed by impaired tear production or by related eye changes, in particular, blepharitis.
Relationship to inflammation of the eyelids (blepharitis)
The peculiarity is that patients complain of a symptom, and usually there is a picture of the disease. But at the same time in the diagnosis often do not reveal signs and therapy is not appointed. There is even a joke about this in ophthalmology:
- What to do with a patient with blepharitis?
- Send it to a competitor!
So, dry eye syndrome and blepharitis are two related problems. If CVS was not caused by blepharitis, it can cause inflammation of the eyelid. If the CVD was caused by blepharitis, in any case, the treatment of one requires the treatment of the other. The main point is that you can replace a tear for as long as you like, trying to deal with dry eye syndrome with supportive treatment, but this will not give the result. It is also necessary to cure blepharitis (or not to allow it to develop under the scenario, when it was not he who caused the launch of the CVG). Plus solve a number of accompanying problems for the deterioration of the trophic. If the doctor prescribes only a tear substitute or similar means, at first the patient simply suffers, and then the development of the syndrome begins with concomitant irreversible organic disorders of the tear-producing apparatus and the superficial structures of the eye, up to ulceration of the cornea.
From here two rules:
- If you are dry in the eyes, it is necessary to diagnose, and not wait until it passes.
- If you have found dry eye syndrome and were prescribed only tear replacement, but did not identify the exact causes that caused it, you need to look for and treat them. And to do the prevention of problems that will develop during the course of the SSG.
Here is a rough cause and effect diagram.
Treatment
The treatment is performed not only by protecting the eye from fluid loss, but, most importantly, by removing the cause of the disease. More on this later. For now, be careful. It is better to be examined earlier (a tear test takes 10 minutes) than to join those for whom we launch our bioreactors in the production of the gel.
A little later, I will tell you about the tear and how it works and works.
Source: https://habr.com/ru/post/370747/
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