Update: October 2018
- Blepharoplasty and dry eye syndrome
- Risk groups
- The incidence of the syndrome
- Symptoms of dry eye syndrome
- How to treat dry eye syndrome
- Surgical treatments
Dry eye syndrome is a common pathological condition.
in ophthalmology, characterized by insufficient moisture
conjunctiva and cornea of the eye, followed by an increase in symptoms
xerosis According to various sources, the syndrome occurs in 10 to 20% of all
inhabitants of the earth, more often – in women (70%) and older people
(more than 60%).
In a healthy person, the outer part of the eyes is covered with a tear film
10 microns thick. She is responsible for protecting the eyes from damaging
action of the environment and small particles of dust and other foreign
tel. In addition, the film delivers organic
nutrients and oxygen in the cornea. Dissolved in it
immune complexes create a natural barrier to infectious
Syndrome develops when multiple breaks occur.
tear film, causing the cornea to be insufficiently lubricated
fluid and not getting enough nutrients
substances. In this article we will describe in detail the syndrome of dry
eyes, symptoms and treatment of this pathology.
Among the conditions that cause a decrease in the amount produced
слезной жидкости и ее качественного состава, выделяют такие the reasons
dry eye syndrome like:
- Endocrine disorders (estrogen production deficiency), period
premenopause and menopause in women (see first
signs of menopause, how to get rid of hot flashes during menopause)
- Connective tissue diseases, autoimmune conditions
(Sjogren’s disease). Uncontrolled proliferation of connective
tissue in the body is accompanied by blockage of the excretory ducts
fibrous foci of the lacrimal glands, which leads to insufficient
the production of tear fluid and inadequate distribution of it by
- Parkinson’s disease, severe neurological disorders,
inflammatory diseases of the eye and other disorders of the organs of vision
(chronic conjunctivitis, dysfunction of the lacrimal gland),
беременность, заболевания почек, кожные и инфекционные
diseases, severe wasting can cause
dry eye syndrome.
- Any condition in which the eye cannot close completely
is a predisposing factor to the occurrence of dry syndrome
eye. For even lubrication of the eyes with lacrimal fluid of the eyelids
must be closed completely, lubricating the entire surface
- Wearing low quality or inappropriate contact lenses.
- Long-term use of certain drugs
(antihypertensive, antiarrhythmic) leads to dehydration or
reduces the production of fluid in the body, which leads to an increase in
viscosity of tears and a decrease in their total volume. Taking oral
contraceptives, corticosteroids, antihistamines,
uncontrolled long-term use of eye ointments and drops with
anesthetics, beta-blockers, anticholinergics leads to
reducing the production of tear fluid;
- Violation of sleep and rest (long reading, work with
small items at the computer), environmental factors (dry
warm air, strong wind, polluted air).
The development of the disease is more characteristic of residents of climatic conditions.
areas requiring the use of heating systems and air conditioners.
Dry air causes increased evaporation of liquid from the surface.
eye. Continued concentration on a specific item (screen
monitor, tv, work related to watching
certain objects) increases the risk of developing dry eye syndrome
due to insufficient blink rate.
According to the latest research, wearing contact lenses and
dry eye syndrome make up a kind of vicious circle. Due to
contact lens development syndrome begin to cause unpleasant
sensations, and the increase in evaporation of fluid from under the lens worsens
available symptoms. Innovative materials used for
manufacturing a new generation of lenses that can significantly reduce
dry eyes when using them.
Blepharoplasty and dry eye syndrome
More than 25% of patients with a history of blepharoplasty afterwards
Go to the doctor with complaints characteristic of dry syndrome
eye. According to studies, they all noted certain
characteristic symptoms for a long time but by
for some reason did not go to the doctor. Many simply not
paid attention to the manifestations of the syndrome. As it turned out, 26%
patients who have undergone blepharoplasty at the time of going to the doctor
along with dry eye syndrome, more severe
inflammatory disease – chemosis.
Studies by American ophthalmologists in 2013
year, revealed the dependence of the frequency of dry eye syndrome
on the level of air pollution in the area where patients live. For
residents of cities, where air pollution much higher
than in rural areas, the chances of developing the syndrome increase by 3-4
times compared to rural residents. In addition, residents
Highland areas are also more prone to this.
Dry eye syndrome is more often diagnosed in office
employees, often working with computers. Disease development
It was noted more than 75% of women who constantly use
by computer. Japanese researchers found that the detection rate
reduced function of the lacrimal glands and signs of dry eye syndrome
makes up 76.5% among women and 60.2% among men working in
the office. The group of special risk includes persons over 30 years old, and
employees working at the computer for more than 8 hours a day.
Women at risk of over 50 years are at increased risk due to
natural age-related decline in estrogen levels in the blood.
The effect of these hormones on the development of dry eye syndrome is not completely
The incidence of the syndrome
Dry eye syndrome is a very common disease. TO
unfortunately, its frequency continues to grow with each
year despite ongoing prevention and improvement
methods of diagnosis and treatment. At the moment in relation to
syndrome are the following statistics:
- 48% of Americans regularly mark certain manifestations
- 42% of women with dry eye syndrome have significant
blurred vision (blurred, blurred);
- 43% of patients with dry eye syndrome experience difficulties in
- Among patients older than 55, 30% of men and 19% of women report
the presence of symptoms for more than 10 years;
- 19% of respondents up to 5 times a week use eye drops,
over-the-counter. 63% of them say that such drugs
not effective enough.
Symptoms of dry eye syndrome
For большинства людей симптомы заболевания проявляются в стертой
form, but in some cases they can cause serious violations
state of health due to severe pain and development
For больных с диагнозом синдром сухого глаза, симптомы
characterized by bilateral development and manifest themselves:
- Сухостью, ощущением «песка в глазах» и
pain that builds up during the day;
- Red eyes;
- Eyelid sticking in the morning.
These symptoms may become more pronounced under
exposure to smoke or high temperatures
More severe manifestations of the disease are:
- Hypersensitivity to light (photophobia);
- Excessive and prolonged redness of the eyes;
- Unbearable pain in the eyes;
- Visual impairment.
More pronounced manifestations may indicate development
complications, including corneal injury. If such symptoms occur
you must immediately consult a doctor, otherwise the violation
visual function may become irreversible.
For классического течения симптомы синдрома сухого глаза
characterized by seven categories.
- Itching. Patients with dry eye syndrome have an increased
corneal sensitivity and irritability. This leads to
the appearance of itching. Also common cause of burning and itching in
eyes are allergic reactions. Treatment данных состояний
It is carried out by antihistamines, one of the side effects
от применения которых является синдром сухих eye.
- Burning. One of the functions of the tear film is wetting.
corneal surface. In violation of the integrity of the film, the cornea,
containing a large number of nerve endings, dries and
begins to send impulses to the brain that are recognized as
- Foreign body sensation. One of the characteristic symptoms
is a feeling as if there is a grain of sand in the eye or another
subject. Such sensations occur when the eyeball
insufficiently moistened. When these signals appear, the brain
begins to send retaliatory impulses to the eye, causing it
produce more liquid to wash the foreign object.
- Redness. Redness is a sign of inflammation. TOогда
the eye is not sufficiently hydrated, it becomes susceptible to inflammation
diseases. TO функциям слез относится транспорт питательных
substances to the tissues of the eye. If the transport is disturbed, the eyes react to
This condition is inflammation.
- Blurred vision, disappearing when blinking. Tears provide
smooth outer optical layer for incoming light rays. By
as the surface of the eye dries, its surface becomes
uneven, causing blurring pictures. When blinking tear film
refreshed and smooth appears on the surface of the eye
optical layer ensuring the correct perception of light
- Tearing. Most patients experiencing elevated
lacrimation, they are perplexed when they are diagnosed with the syndrome
сухих eye. In this case, the system responsible for generating
tear fluid works in an enhanced mode precisely because of the dryness
eye. Increased tearing can also be reflex in response.
on the feeling of a foreign body, which was described above.
- Increased discomfort after reading or watching TV.
The blink rate is significantly reduced when human
focuses on a specific task. Since when blinking
there is an update of the tear film on the surface of the cornea, then
снижение частоты моргания приведет к повышенной сухости eye.
The danger of this disease is significant
blurred vision with the possibility of its complete loss.
TOак показали исследования, синдром сухих глаз способен не только
лишить human зрения, но и жизни. French scientists have proven
that dry eyes lead to a slower response of drivers in response to
change the situation on the road. Drivers Suffering Dry
eye, do not pay attention to ½ road signs and much slower
react to indications of signs noticed by them.
Even if the symptoms of the disease seem insignificant to you and
can be held independently after a rest or with frequent
blink, tell them to your doctor. Lack of timely
initiated treatment may lead to irreversible effects.
The best solution in this case is to use eye drops.
from the group “artificial tear”. They do not contain harmful
medicinal substances and have the most natural composition.
How to treat dry eye syndrome — глазные капли, гели,
For лечения синдрома сухих глаз препараты должны назначаться
лечащим врачом и обеспечивать устранение the reasons заболевания,
sufficient eye moistening, stabilization of the composition of the tear film,
борьбу с проявлениями болезни и профилактику complications. TOак
cure dry eye syndrome?
Most popular drugs:
Ingredients: leader of eye drops in dry syndrome based on
The drug relieves dryness, redness and irritation, has
Vizin clean tear
Structure: drops for fight against dryness of eyes and their reddening.
Price: 600 rubles.
Ingredients: keratoprotector, except for dry eye syndrome appointed
Price: 420-500 rub.
Ingredients: hyaluronic acid. TOак и другие препараты с этим
Ingredients: polyethylene glycol propylene glycol, hydroxypropyl guar,
Price: 200-400-500 rubles. for 5 ml, 10 ml. 15 ml.
Ingredients: Hypromellose + Dextran
Price: 340-450 rubles.
Ingredients: hyaluronic acid sodium salt
Price: 480-580 rubles
The most widely used drugs, called
�”Artificial tears”. Among the eye drops and gels distinguish
drugs with low, medium and high viscosity:
- For синдрома сухого глаза лечение каплями начинают с применения
drugs with low viscosity (Lakrisifi 250 rub., tear
natural (340-450 rubles), hyphenosis (40 rubles)). Before digging
Drops of contact lenses must be removed.
- In severe and severe violation of tear production
medications are prescribed mediocrity (Lacrisin).
- And high viscosity (gels Vidisik 200 rub., Oftagel 180 rub.,
Lakropos 150 rub).
In this case, gels with high viscosity tend to move into
liquid phase when making blink movements. So provided
sufficient moistening of the cornea in patients with insufficient
products and changes in the composition of the tear fluid.
Between blinks gel structure of tear substitutes
is being restored. High viscosity preparations are used.
for a long time. One application lasts for 1-2 days. A drug
lay behind the eyelid, after which for some time may
there is blurred vision. In this regard, it is recommended
применять увлажняющие гели и ointment перед сном.
For снятия воспаления и нормализации увлажнения глаз могут
apply anti-inflammatory drugs. For this purpose, apply
drops Restasis with cyclosporine (price 3500 rubles). They take off
inflammation and ensure the normalization of the composition of the tear
Hormonal action also has anti-inflammatory effects.
Maxidex drops (180 rubles), Alrex, Oftan (90 rubles), Dexamethasone (30
rub). They can be used as monotherapy or in combination with
by other means. Due to повышенного риска развития побочных
effects of corticosteroid use of these drops
must occur under the strict supervision of the attending physician.
Antibacterial agents are used to treat
inflammatory diseases that are a common cause
dry eye syndrome. Ointment with erythromycin or tetracycline
prescribed courses for 7-10 days and apply before bedtime. They
have a bactericidal effect on pathogens and
provide fight against infectious eye diseases as well
Moisturize the cornea. Thus, the combined effect is achieved.
on the cause and symptoms of the disease.
Another effective solution in the treatment of dry eye syndrome
is a small implantable container with a tear-replacing
fluid. The container (Lacrisert) is installed in the lower eyelid and
exudes fluid, providing corneal wetting for
a long time.
How to treat dry eye syndrome surgically? Treatment
diseases can be produced with the help of several small
operations to ensure the production and maintenance
normal amount of tear fluid.
To maintain a sufficient amount of tear fluid on
the surface of the cornea is applied occlusion of the tear ducts,
responsible for the discharge of fluid from the eyes. When they overlap
fluid accumulates on the outer surface of the eye and provides
sufficient moisture. The ducts are blocked.
special traffic jams, which can later be removed.
This is a simple procedure that can significantly improve the condition.
The plugs of the new generation are small thin
rope-like objects that when heated to
body temperatures transform into a gel form and normally do not
cause no sensations on the part of the patient. The advantage of such
traffic jams is a uniform size for patients of any age and
complexions and the absence of irritating materials in the composition
Автор: TOоробов Никита Александрович врач-анестезиолог