Whether mourning a family member’s death, enduring physical pain, experiencing conjunctivitis, or simply cutting an onion, one reaction is consistently observed – the shedding of tears. These liquid drops are critical for the maintenance of a healthy eye, and a dysfunctional tear mechanism can result in vision loss. An example of this is seen in patients with xerophthalmia (aka dry eyes), a disorder often witnessed along with the condition of vitamin A deficiency. It can also be associated with systemic diseases such as Sjogren’s (an immune system illness characterized by a dry mouth and eyes) and diabetes mellitus. Xerophthalmia has become increasingly common with reports stating that in the United States alone there are approximately 7.1 million adults with this condition. So why should you become familiar with the typical presentation of xerophthalmia? Simply stated: if the symptoms are detected early, patients will not only enjoy considerable improvement, but also reduce their risk of developing permanent vision impairment.
Tears are composed of a mixture containing proteins, electrolytes, and vitamins, all of which arise from different glands within the eyes. The anatomical purpose of tears is to moisten the eye, and in so doing help preserve the underlying tissue. In addition to this, they also wash away bacteria and dust particles. Xerophthalmia occurs for one of two reasons: either there is an abnormality within a gland leading to a decrease in tear production, or the exposed eye is losing its fluid content due to excessive evaporative loss. Patients with this condition typically complain of dryness and redness of their eye, and they may also experience irritation, light sensitivity, and blurry vision. Scientists have found a variety of risk factors that frequently lead to this disorder and they include: older age, hormonal changes, systemic diseases (e.g. Parkinson’s), contact lens use, medications (e.g. antihistamines such as Benadryl), nutritional deficiencies, eye surgery, and environments in which there is low humidity. The diagnosis of this disorder is made with a combination of the patient’s history and physical exam. There are numerous treatment options for xerophthalmia but of course they vary according to the specific cause. The first line of treatment is over-the-counter artificial tears, such as Visine or Clear Eyes, which work by maintaining the appropriate eye viscosity level as well as reducing the rate of liquid evaporation.
For patients with xerophthalmia, it’s sensible to decrease exposure to areas in which there are air conditioners and heaters, but if these environments cannot be avoided, patients should purchase humidifiers. Other specialized prescribed therapies include topical cyclosporine (aka Restasis) and steroids, which work by decreasing inflammation within the eye. Surgery may also be an option for people who have more significant conditions, such as structural eye abnormalities that predispose them to an increase in evaporative loss. If you are experiencing eye irritation and dryness, seek an evaluation by an ophthalmologist – and don’t just assume that you have seasonal allergies. If you take the right approach, you are sure to receive the appropriate medical treatment. Moreover, you may even discover that your dry eyes are part of a systemic disorder, a diagnosis that would have been picked up somewhat routinely during an eye exam by an ophthalmologist.