Dry Eye Syndrome (Keratoconjunctivitis) - Medtick

Dry Eye Syndrome (Keratoconjunctivitis)

What is it?

Where one does not produce enough tears or the quality of tear is a poor allowing it to evaporate quickly causing dry eyes.

  • As a result one is prone to get bacterial, viral conjunctivitis since the eye can’t remove debris easily.
  • It can cause watery eyes but these tears do not have the same lubricating quality as normal tears.
  • In severe cases visual impairment, severe sensitivity to light, red eyes, painful eyes and eye scarring can occur if not treated.

Diagnosis Test Questionnaires

Medscape

Once one has done these questionnaires, please show to your optometrist

Visits and follow up appointments
  • Patients should have follow-up visits every 3-6 months are appropriate with their specialists/Medical Doctor, if the condition is in control and one has no progression.
  • For patients with glaucoma progression, treatment adjustment and monitoring every 1-2 months is recommended.
  • For those who have rapid progression, do not wait, seek frequent and rapid follow-up.
  • In contrast, if no progression occurs and the patient has achieved their target intraocular pressure, follow-up visit intervals can be extended to every 6-12 months.
  • Do not miss appointments.

Cause

Syndromes

Medication:

Symptoms

(Symptoms can vary)

(Keratoconjunctivitis sicca)

  • Dry eyes?
  • Sore eyes?
  • Blurred vision?
  • Grit in eyes?
  • Watering eyes (not controlled) when exposed particularly in the wind or hot days (tears evaporate more quickly in these climates)?
  • Sticky discharge causing the eyes to stick together?
  • Slightly painful?

Allergic conjunctivitis (keratoconjunctivitis mainly affecting boys up to puberty age):

  • All the above?
  • Symptoms are often worse in spring and more severe?
  • Giant papillae on the superior tarsal conjunctiva (the inner lining of the upper eye lid)
  • Yellow–white points on the limbus (Horner’s points), conjunctiva (Trantas dots)?
  • Lower eyelid creasing (Dennie’s lines)?

Complications /Information to beware of/General tips:

Do not wait, phone for an ambulance if have or develop:

  • A feeling that something is in your eye
  • Blurred vision
  • Blindness
  • Decreased vision
  • Difficulty opening one’s eyelids due to pain and irritation
  • Severe Sensitivity to light
  • Severe eye pain
  • Keratitis

This condition can lead to:

  • Eyelid twitching
  • Pterygium
  • Eye inflammation (red and watery eyes)
  • Corneal abrasion (a scratch on the surface of the eye)
  • Corneal erosion (thinning of the surface of the eye)
  • Corneal infection
  • Scarring of the eyes

Treatments and General tips

If one has allergic conjunctivitis:

  • Applying a cold compress (five to ten minutes once or twice a day) to the eyes can help reduce swelling and itching.
  • Options for pharmacological management include topical antihistamine eye drops that also contain a vasoconstrictor agent. One drop two to three times per day can be used in those aged above 12 years old. Improvement should be seen in a few days to a week;
  • Mast cell stabiliser, sodium cromoglycate 2% one drop four times a day, is an alternative and can be used in children (check individual products for licensing information) for a minimum of two weeks.

If one has dry eyes:

  • A Low viscosity drops for day time (e.g. hypromellose 0.3%) can be used one drop as required.
  • If one feels it not helping after a four weeks to six weeks trial then consider: Patients can then move up in viscosity to carmellose 0.5% and carbomer 0.2% for night-time treatment, with white soft paraffin or combinations with mineral oil in ointment form added to support hydration.
  • Preservative-free formulations are preferred for frequent use.

Eye, allergy and inflammation. National Institute for Health and Care Excellence. Accessed February 2025. https://bnf.nice.org.uk/treatment-summaries/eye-allergy-and-inflammation/

Dry eye disease. BMJ Best Practice. September 2024. Accessed February 2025. https://bestpractice.bmj.com/topics/en-gb/962?q=Dry%20eye%20disease&c=suggested

  • If still not helping then patient should consider talking to their optician, where an assessment can be made to check it is not due to meibomian gland dysfunction.
  • Patients with elements of meibomian gland dysfunction may need to switch to sodium hyaluronate or a lipid-based preparation.

Dry eye disease. BMJ Best Practice. September 2024. Accessed February 2025. https://bestpractice.bmj.com/topics/en-gb/962?q=Dry%20eye%20disease&c=suggested

Dry eye disease . National Institute for Health and Care Excellence. 2023. Accessed February 2025. https://cks.nice.org.uk/topics/dry-eye-disease

Please do not disregard dry eyes as it may lead to corneal damage and or impact quality of life (i.e. sleep, work driving ) leading to anxiety and depression related conditions.

  • This condition may be associated with:

Driving

  • One should have routine eye tests at least every two years but if one has concerns one should book an eye test at any point
  • Persons over 40 years should have eye test at least every 2 years and you must tell drivers authority if it affects your driving

Exercise your eyes

Focus change

This exercise works by challenging your focus. It should be done from a seated position.

  • Hold your pointer finger a few inches away from your eye.
  • Focus on your finger.
  • Slowly move your finger away from your face, holding your focus.
  • Look away for a moment, into the distance.
  • Focus on your outstretched finger and slowly bring it back toward your eye.
  • Look away and focus on something in the distance.
  • Repeat three times.

Near and far focus

  • This is another focus exercise.
  • As with the previous one, it should be done from a seated position.
  • Hold your thumb about 10 inches from your face and focus on it for 15 seconds.
  • Find an object roughly 10 to 20 feet away, and focus on it for 15 seconds.
  • Return your focus to your thumb.
  • Repeat five times.

Figure eight

  • This exercise should be done from a seated position as well.
  • Pick a point on the floor about 10 feet in front of you and focus on it.
  • Trace an imaginary figure eight with your eyes.
  • Keep tracing for 30 seconds, then switch directions.

20-20-20 rule

  • Eye strain is a real problem for a lot of people. Human eyes are not supposed to be glued to a single object for extended periods of time. If you work at a computer all day, the 20-20-20 rule may help prevent digital eye strain.
  • To implement this rule, every 20 minutes, look at something 20 feet away for 20 seconds.

Vision therapy

  • Vision therapy may include eye exercises, but only as part of a more specialised treatment program done under the supervision of an eye doctor, optometrist, or ophthalmologist.
  • The goal of vision therapy can be to strengthen the eye muscles.
  • It also can help to retrain poor visual behaviour, or help with eye tracking issues.

Healthline : Medically reviewed by Ann Marie Griff, O.D. — Written by Corinne O’Keefe Osborn — Updated on September 29, 2018


This condition can be similar symptoms to:

Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist/Optician) for further advice

Detailed Information

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