II. Epidemiology

  1. As many as 30% of over age 50 years old complain of dry, irritated eyes

III. Causes

  1. Sjogren's Syndrome
  2. Allergic Conjunctivitis
  3. Blepharitis
  4. Decreased blinking with prolonged reading or driving
  5. Chronic exposure to dry, dusty conditions
  6. Rosacea
  7. See Medication Causes of Dry Eyes (e.g. Anticholinergic Medications, Diuretics, Estrogen Replacement)

IV. Management

  1. General measures
    1. Sunglasses
    2. Room humidifiers
    3. Tobacco Cessation
    4. Take computer breaks
    5. Protect eyes from fan
    6. Avoid drying, Anticholinergic Agents (Antihistamines, Tricyclic Antidepressants, Diuretics)
  2. Artificial tears or ointments
    1. Preservative-free solutions are preferred (e.g. Refresh Plus), esp. if used more than 4x/day
    2. Contact Lens users may try rewetting drops (e.g. Renu rewetting, Blink Contacts)
    3. Consider eye lubricants (e.g. lacrilube) for moderate symptoms (esp. at night), but may blur vision
    4. Avoid agents with Decongestant (e.g. Visine original)
  3. Consider Muscarinic Agonists and other agents in Sjogren's Syndrome refractory to other measures
    1. Cyclosporine (Restasis)
    2. Pilocarpine (Salagen)
    3. Cevimeline (Evoxac)
  4. Other options in refractory cases
    1. Lifitegrast (Xiidra)
      1. Expensive (>$400/month), with risk of eye irritation, altered Taste Sensation

V. Diagnosis

VI. References

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Ontology: Dry Eye Syndromes (C0013238)

Definition (MSHCZE) Vysychání spojivky a rohovky oka, které může vést k jejich těžkému poškození. Srov. xerostomie, Sjögrenův syndrom, sicca syndrom, vitamin A. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (NCI) A syndrome characterized by dryness of the cornea and conjunctiva. It is usually caused by a deficiency in tear production. Symptoms include a feeling of burning eyes and a possible foreign body presence in the eye.
Definition (NCI_CTCAE) A disorder characterized by dryness of the cornea and conjunctiva.
Definition (MSH) Corneal and conjunctival dryness due to deficient tear production, predominantly in menopausal and post-menopausal women. Filamentary keratitis or erosion of the conjunctival and corneal epithelium may be caused by these disorders. Sensation of the presence of a foreign body in the eye and burning of the eyes may occur.
Concepts Disease or Syndrome (T047)
MSH D015352 , D014985
ICD10 H04.12
SnomedCT 193980001, 155182003, 1249004, 46152009
English Syndrome, Dry Eye, Syndromes, Dry Eye, dry eye, Dry Eye Syndromes, dry eye syndrome (diagnosis), dry eye syndrome, Keratoconjunctivitis Sicca, Dry Eye Syndromes [Disease/Finding], syndrome dry eye, dry eyes syndrome, dry eye syndromes, Dry eye syndrome (disorder), Dry eye (finding), Dry eye, Dry eye syndromes, EYE(S), DRY, DRY EYE(S), Dry eye syndrome, dry eye; syndrome, syndrome; dry eye, Dry Eye Syndrome
Swedish Torrögdhetssyndrom
Czech xeroftalmie, syndromy suchého oka, Syndrom suchého oka, keratitis sicca, KCS, keratoconjunctivitis sicca
Finnish Kseroftalmia, Kuivasilmäisyysoireyhtymät
Russian KSEROFTAL'MIIA, SUKHOGO GLAZA SINDROMY, GLAZA SUKHOGO SINDROMY, ГЛАЗА СУХОГО СИНДРОМЫ, СУХОГО ГЛАЗА СИНДРОМЫ
Croatian KSEROFTALMIJA, Ceratoconjunctivitis sicca, SUHI KERATOKONJUNKTIVITIS, Sindrom suhog oka
Polish Zespoły suchego oka, Zeschnięcie spojówki i rogówki, Zeschnięcie gałki ocznej
Spanish Síndrome de ojo seco, Síndromes de Ojo Seco
Portuguese Síndrome de olho seco, Síndromes do Olho Seco, Xeroftalmia
Dutch droog oogsyndroom, droge ogen; syndroom, syndroom; droge ogen, Droogoogsyndromen, Droogoogsyndroom, Syndromen, droogoog-, Syndroom, droogoog-
French Syndrome des yeux secs, Xérophtalmie, Syndromes de l'oeil sec
German Trockene Augen-Syndrom, Syndrome des trockenen Auges, Xerophthalmie
Hungarian Száraz szem syndroma
Italian Sindrome dell'occhio secco, Sindromi dell'occhio secco, Xeroftalmia
Japanese ガンカンソウショウコウグン, 眼乾燥症候群
Norwegian Tørre øyne, Xeroftalmi, Tørt øye-syndrom, A-vitaminmangel med konjunktival tørrhet

Ontology: Xerophthalmia (C0043349)

Definition (NCI) Dryness of the eye due to inadequate production of tears. Causes include vitamin A deficiency, Sjogren syndrome, rheumatoid arthritis, systemic lupus erythematosus, and scleroderma.
Definition (MSH) Dryness of the eye surfaces caused by deficiency of tears or conjunctival secretions. It may be associated with vitamin A deficiency, trauma, or any condition in which the eyelids do not close completely.
Definition (CSP) dryness of the eye surfaces caused by deficiency of tears or conjunctival secretions; may be associated with vitamin A deficiency, trauma, or any condition in which the eyelids do not close completely.
Concepts Disease or Syndrome (T047)
MSH D014985
ICD9 375.15
ICD10 H04.12 , E50.7
SnomedCT 193887002, 155167008, 193980001, 46152009, 363677007, 69316005
English Xerophthalmias, DRY EYES, XEROPHTHALMIA, ophthalmoxerosis, xeroma, xerophthalmus, Tear film insuffic NOS, Tear film insufficiency, NOS, Xerophthalmia NOS, Xerophthalmia [Disease/Finding], xerophthalmia, Conjunctival xerosis (& [xerophthalmia]), Conjunctival xerosis (& [xerophthalmia]) (disorder), Tear film insufficiency, Tear film insufficiency (disorder), Xerophthalmia (disorder), xerophthalmia (etiology), xerophthalmia (manifestation), Conjunctival Xerosis, Xerophthalmia, Tear film insufficiency, unspecified
French XEROPHTALMIE, YEUX SECS, Xérophtalmie
Portuguese XEROFTALMIA, SECURA DOS OLHOS, Xeroftalmia
Spanish XEROFTALMIA, OJOS SECOS, xeroftalmia (trastorno), xeroftalmia, xeroftalmía, xeroftalmía (trastorno), insuficiencia de la película lagrimal (trastorno), Xeroftalmia
German XEROPHTHALMIE, AUGENTROCKENHEIT, Xerophthalmia
Italian Xeroftalmia
Swedish Ögontorrhet
Czech Xeroftalmie
Polish Kseroftalmia
Hungarian Xerophthalmia
Japanese ガンキュウカンソウショウ, 眼球乾燥症
Dutch xeroftalmie, Xeroftalmie
Russian КСЕРОФТАЛЬМИЯ