A patient who comes to you tearing may actually have dry eye syndrome – a common disorder where there is a lack of tears bathing the eye.



Although it seems paradoxical, the tearing is actually a reflex response to ocular surface irritation prompted by dryness.



According to Dr. Michael Law, consultant ophthalmologist at Tun Hussein Onn National Eye Hospital, dry eye is a very common disorder affecting about 4 percent of the population.



Symptoms of this disorder include ocular burning, itching and foreign body sensation, as well as photophobia and blurred vision. Some patients complain of worsening of symptoms at the end of the day while others may experience discomfort upon awakening. --->Almost the Same...haiz...



Dry eye syndrome is not a disorder to be taken lightly. “Tears are crucial for good vision, protection of the ocular surface and general ocular comfort,” Law explained. In extreme cases, this syndrome may lead to corneal ulceration.



The tear film is made up of three intertwined layers, consisting of a superficial thin layer, a middle thick aqueous layer and an innermost hydrophilic mucin layer.



“Keratoconjunctivitis sicca (KCS) is the name given to the ocular surface disorder that develops in patients with aqueous tear deficiency and is the most common cause of dry eyes,” said Law. He added that patients with KCS, who also have xerostomia and/or evidence of connective tissue disease, might have Sjogren’s syndrome.



The diagnosis of dry eye syndrome is essentially a clinical diagnosis. According to Law, diagnosis is made most accurately on slit-lamp examination. Other tests include Schirmer’s test strips and fluorescein staining.



The severity of dry eye syndrome generally dictates the course of treatment. In mild cases, it can be managed with artificial tears and ointment. Hot compresses and eyelid massage are useful especially if there is associated blepharitis.



In moderate cases that require more frequent application of artificial tears, the artificial tears should be preservative-free. As in mild cases, lubricating ointment can be used at bedtime. Doxycline is useful in severe meibomian gland disorders. The lower puncta (tear drainage openings) may be occluded with implanted plugs.



The treatment in severe dry eye syndrome is similar to that in moderate cases, except that upper punctal occlusions are also indicated. A humidifier to create a moist environment may be helpful to reduce evaporation of tears. Surgically narrowing the palpebral fissure is an option.

I hav to Just Wait and see another doctor..........hmmmm.....