Keratoconjunctivitis sicca is one of the terms denoting dry eye disease, which can be seen in a myriad of conditions of different etiologies. Impaired vision, erythema, photophobia, pruritus, and sensations of stinging or as if a foreign body is present are notable signs and symptoms reported in patients with this condition. Without an early diagnosis and appropriate treatment, conjunctival and/or corneal scarring, ulceration, and even perforation might occur. Thus, a full ophthalmological exam coupled with a detailed patient history is a crucial step to recognize keratoconjunctivitis sicca.
The clinical presentation of keratoconjunctivitis sicca (more commonly known as "dry eye") stems from an excessive evaporation of tears and/or their deficiency  . This condition is a relatively frequent disorder in general practice, particularly in the elderly population, with the most common complaints being a burning, stinging, foreign body sensation, as well as pruritus and photophobia    . Keratoconjunctivitis sicca has shown to significantly affect the quality of life due to its overall effect on vision  . Driving could be problematic, reading speed is frequently markedly reduced, while looking at the computer screen can be quite disturbing and unpleasant  . In fact, anxiety and depression were shown to be much more frequent among patients suffering from dry eyes compared to disease-free individuals   . Aside from present complaints, keratoconjunctivitis sicca predisposes individuals to numerous complications. Scarring, ulceration, and even perforation of the cornea, bacterial keratitis (an infection with the potential to cause blindness), post-procedural complications from eye surgeries, blepharitis, meibomitis, and conjunctival pathologies have all been reported  .
Because keratoconjunctivitis sicca may be a constitutive feature of a very large number of diseases, the physician should obtain a detailed patient history and conduct a thorough physical examination in order to determine the underlying etiology. The course of symptoms, their progression, as well as severity must be assessed, whereas the presence of any systemic disease (for example diabetes mellitus), history of drug use (postmenopausal estrogens, tricyclic antidepressants, diuretics, beta-blockers, antihistamines), and recent corneal surgery are some of the factors that might play a crucial role in the pathogenesis   . Sjogren's syndrome, however, is one of the most important causes of keratoconjunctivitis sicca and thus appropriate studies need to be carried out  . After a detailed inspection of the eye (assessment of blinking rate and the lids being important components), a slit-lamp examination can solidify clinical suspicion . Evaluation of eyelid margins, tear film, and meibomian glands, staining of the ocular surface (with fluorescein), and the Schirmer test are recommended studies . On the other hand, appropriate laboratory studies are equally useful. Both anti-Ro (SSA) and anti-La (SSB) antibodies need to be measured to rule out Sjogren's syndrome and other autoimmune disorders as the cause .