The clinical presentation of keratoconjunctivitis sicca (more commonly known as "dry eye") stems from an excessive evaporation of tears and/or their deficiency [1] [2]. 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 [1] [2] [3] [4]. Keratoconjunctivitis sicca has shown to significantly affect the quality of life due to its overall effect on vision [2] [5]. Driving could be problematic, reading speed is frequently markedly reduced, while looking at the computer screen can be quite disturbing and unpleasant [2] [5]. In fact, anxiety and depression were shown to be much more frequent among patients suffering from dry eyes compared to disease-free individuals [2] [5] [6]. 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 [1] [2].

• Burning Pain

  The most common symptoms of dry eye syndrome are burning, pain, and redness in the eyes. Other common symptoms include watery tearing or stringy mucus in the eyes. [healthline.com]

  Proviral load, low corrected visual acuity, burning and/or pain and itching were all significantly higher in patients with KCS. [bjid.org.br]

  SCN9A-EM is characterized by recurrent episodes of bilateral intense, burning pain, and redness, warmth, and occasionally swelling. [ncbi.nlm.nih.gov]

• Hypotension

  Systemic ocular hypotensive agents were suggested infrequently. Our results suggest that treatments may vary substantially in ocular conditions, particularly in conditions for which neither guidelines nor high-quality evidence exists. [ncbi.nlm.nih.gov]

  Complications of autologous donation are those inherent to a donor, such as hypotension, anemia, angina, and contamination of the material of the blood bags [ 91 ]. 8. [intechopen.com]

• Blister

  SJS is characterized by painful blisters on the skin and the mucous membranes of the mouth, throat, genitals, and eyelids. Often, SJS begins with flu-like symptoms, followed by a painful red or purplish rash of blisters that spread. [nei.nih.gov]

  The lesions, as the name suggests, follow branching lines, along which minute blisters may form and break, leaving raw areas. The cornea may ultimately become insensitive, so the process may not be painful. [britannica.com]

  Epithelial swelling will also produce tiny blisters on the corneal surface. When these blisters burst, they are extremely painful. At first, a person with Fuchs' dystrophy will awaken with blurred vision that will gradually clear during the day. [web.archive.org]

  Xeroderma pigmentosum, group D MedGen UID: 75656 •Concept ID: C0268138 • Disease or Syndrome Xeroderma pigmentosum (XP) is characterized by: Sun sensitivity (severe sunburn with blistering, persistent erythema on minimal sun exposure in ~60% of affected [ncbi.nlm.nih.gov]

  It is also used to treat sebaceous adenitis (immune response against the sebaceous glands), pemphigus foliaceus (autoimmune blistering skin disease), Inflammatory bowel disease, anal furunculosis (anal inflammatory disease), and myasthenia gravis (a neuromuscular [en.wikipedia.org]

• Dry Eyes

  There is no therapeutic panacea for dry eyes. As a clinician taking care of dry eye patients on a daily basis, I find the treatments often frustrating and unrewarding. [ncbi.nlm.nih.gov]

  Aetiology: Dry Eye Disease (DED) is divided into aqueous-deficient dry eye and evaporative dry eye, and the two forms can occur together. The lists that follow are simplified from TFOS DEWS II: 1. [college-optometrists.org]

  DEWS II treatment recommendations The Management and Therapy Subcommittee of the Tear Film and Ocular Surface Society's Dry Eye Workshop II (TFOS DEWS II) have proposed an updated (2017) algorithm to approach the treatment of dry eye. [emedicine.medscape.com]

• Lacrimation

  Aplasia of the lacrimal and salivary glands may present with symptoms of congenital lacrimal obstruction, and failure to make an early diagnosis will result in inappropriate lacrimal surgery and dry eye. [ncbi.nlm.nih.gov]

  Lacrimal disease is also associated with a reduction in secreted lacrimal proteins. ATDDE is the largest category of dy eye and is more common in women than in men. Evaporative dry eye (EDE), in which lacrimal function is normal. [vismed.trbchemedica.co.uk]

  Eye tear system anatomy, (Description) a. tear gland / lacrimal gland, b. superior lacrimal punctum, c. superior lacrimal canal, d. tear sac / lacrimal sac, e. inferior lacrimal punctum, f. inferior lacrimal canal, g. nasolacrimal canal. [emedicine.medscape.com]

• Blurred Vision

  Even with the most severe dry eyes, it is rare that vision is lost. However, people sometimes feel that their blurred vision or eye irritation is so severe, frequent, and prolonged that it is difficult to function normally. [merck.com]

  The patients were interviewed regarding the 5 major KCS symptoms, foreign body sensation, dry eye sensation, photophobia, ocular pain, and blurred vision, with each graded from none (0) to very severe (4). [ncbi.nlm.nih.gov]

  Treatment of dry eyes is aimed at restoring a more normal tear film to minimize dryness and its consequences, including blurred vision and discomfort. [web.archive.org]

• Foreign Body Sensation

  The patients were interviewed regarding the 5 major KCS symptoms, foreign body sensation, dry eye sensation, photophobia, ocular pain, and blurred vision, with each graded from none (0) to very severe (4). [ncbi.nlm.nih.gov]

  Clinical features: Symptoms: Foreign body sensation, itching, burning and moderate conjunctival redness Decreased vision, pain and photophobia usually occur in advanced cases Exacerbated by wind, blinking or prolonged reading. [columbiaeye.org]

  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. [symptoma.com]

  They may complain of a dry sensation or of a foreign body sensation of the eyes. The conjunctiva is hyperemic, and thick strands of mucus may cover the eye. [sideeffects.embl.de]

  Symptoms Dryness Burning Light sensitivity Foreign body sensation Ocular pain Blurred vision Visual fatigue Discomfort Risk Factors The prevalence of dry eye increases with age and is far more common in women. [quidel.com]

• Excessive Tearing

  "You may experience excessive tearing the same way you would if something got in your eye." But these tears won't necessarily make the eyes feel better. [web.archive.org]

  If high-quality tears are not produced at a steady rate, the surface of your eyes becomes irritated and your eyes will tear excessively in an attempt to lubricate them. This is why excess tearing can occur from dry eyes. [umkelloggeye.org]

  […] or gritty feeling as if something is in the eye Episodes of excess tears following very dry eye periods A stringy discharge from the eye Pain and redness of the eye Episodes of blurred vision Heavy eyelids Inability to cry when emotionally stressed Uncomfortable [eyecenter.emory.edu]

  […] of the condition has changed over time with the progress of understanding the disease process e.g. – in 1995 the National Eye Institute defined DES as “a disorder of the tear film due to tear deficiency or excessive tear evaporation which causes damage [gpnotebook.co.uk]

• Tingling

  Typical symptoms include: Redness or eyes that appear irritated and bloodshot Consistent burning or tingling sensations in the eyes Eyes that feel itchy or as if they have something in them Increased sensitivity to bright lights or sunlight Excessive [vistaeyecare.net]

  It may also cause inflammation in the joints, muscles, and skin; pneumonia; tingling in the fingers and toes; and fatigue. It often occurs with rheumatoid arthritis or other connective tissue diseases. [fpnotebook.com]

  […] with steroids.[18] Side effects[edit] Side effects of ciclosporin can include gum enlargement, increased hair growth, convulsions, peptic ulcers, pancreatitis, fever, vomiting, diarrhea, confusion, increased cholesterol, trouble breathing, numbness and tingling [en.wikipedia.org]

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 [1] [2] [7]. Sjogren's syndrome, however, is one of the most important causes of keratoconjunctivitis sicca and thus appropriate studies need to be carried out [2] [7]. 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 [2]. Evaluation of eyelid margins, tear film, and meibomian glands, staining of the ocular surface (with fluorescein), and the Schirmer test are recommended studies [2]. 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 [2].

This aspect of treatment should not be neglected. [ncbi.nlm.nih.gov]

DEWS II treatment recommendations The Management and Therapy Subcommittee of the Tear Film and Ocular Surface Society's Dry Eye Workshop II (TFOS DEWS II) have proposed an updated (2017) algorithm to approach the treatment of dry eye. [emedicine.medscape.com]

370.33, 710.2 DiseasesDB 12155 MeSH D007638 Keratoconjunctivitis sicca Microchapters Home Overview Pathophysiology Causes Differentiating Keratoconjunctivitis sicca from other Diseases Epidemiology and Demographics Natural History, Complications and Prognosis [wikidoc.org]

Levels of activated CD8+ T cells could be used as a prognosis marker of inflammatory disease manifestation to follow-up AS individuals. [ncbi.nlm.nih.gov]

We also wished to determine the incidence of the various manifestations of Sjögren's syndrome among patients with keratoconjunctivitis sicca and to study the course and prognosis of both conditions. [jamanetwork.com]

Expectations (prognosis) Return to top Most patients with dry eye have only discomfort, and no vision loss. With severe cases, the cornea (clear window on the front of the eye) may become damaged or infected. [web.archive.org]

Keratoconjunctivitis sicca is one of the terms denoting dry eye disease, which can be seen in a myriad of conditions of different etiologies. [symptoma.com]

Third, certain DED etiologies involve multiple mechanisms. [ajmc.com]

Material and Methods: 94 adult patients were treated for follicular conjunctivitis with symptoms of KCS with possible Chlamydia pneumoniae etiology. [eurekaselect.com]

PURPOSE: Herpesvirus infection of the lacrimal gland was investigated as an etiologic factor for keratoconjunctivitis sicca in patients who were positive for human immunodeficiency virus (HIV). [ncbi.nlm.nih.gov]

Tom Lietman, a Professor in both the Departments of Ophthalmology and Epidemiology and Biostatistics at UCSF. Dr. [grantome.com]

[…] click here Keratoconjunctivitis sicca ICD-10 H19.3, M35.0 ICD-9 370.33, 710.2 DiseasesDB 12155 MeSH D007638 Keratoconjunctivitis sicca Microchapters Home Overview Pathophysiology Causes Differentiating Keratoconjunctivitis sicca from other Diseases Epidemiology [wikidoc.org]

The book opens with a review of the epidemiology and the multifactorial etiologies of dry eye disease. [web.archive.org]

C lassification / type of disease: Epidemiology : it becomes more common with increasing age. Dry eyes affects about 7 in 100 people in their 50s, and about 15 in 100 people in their 70s. Women are affected more often than men. [mymedicalstudentnotes.com]

Links: epidemiology classification of dry eye disease risk factors for dry eye aetiology clinical features diagnosis screening and diagnostic tests for dry eyes management Ocular Surface Disease Index (OSDI) referral criteria from primary care - dry eyes [gpnotebook.co.uk]

For patient information click here Keratoconjunctivitis sicca ICD-10 H19.3, M35.0 ICD-9 370.33, 710.2 DiseasesDB 12155 MeSH D007638 Keratoconjunctivitis sicca Microchapters Home Overview Pathophysiology Causes Differentiating Keratoconjunctivitis sicca [wikidoc.org]

For KCS and other forms of dry eye, current treatments are limited, with many medications providing only symptomatic relief rather than targeting the pathophysiology of disease. [ncbi.nlm.nih.gov]

Although recent research has made progress in elucidating DED pathophysiology, currently there are no uniform diagnostic criteria. [ajmc.com]

Pathophysiology : complications can include conjunctivitis, keratitis, corneal ulceration or perforation of globe Transmission Treatment / management: Artificial tears: Eye drops and gels, and are usually good at relieving symptoms. [mymedicalstudentnotes.com]

Pathogenesis Pathophysiology Chronic eyelid inflammation leading to decreased production of aqueous tear film. [vetstream.com]

Prevention It is not possible to prevent keratoconjunctivitis sicca. It is possible to prevent complications of keratoconjunctivitis sicca, such as infections, from developing. [lahey.org]

About Prevent Blindness Ohio Prevent Blindness Ohio, founded in 1957, is Ohio’s leading volunteer nonprofit public health organization dedicated to prevent blindness and preserve sight. [preventblindness.org]

Prevention Return to top There is no way to prevent keratoconjunctivitis sicca. Complications can be prevented by use of wetting and lubricating drops and ointments. Update Date: 11/1/2004 Updated by: Edward B. [web.archive.org]

1. Javadi M-A, Feizi S. Dry Eye Syndrome. J Ophthalmic Vis Res. 2011;6(3):192-198.
2. Messmer EM. The Pathophysiology, Diagnosis, and Treatment of Dry Eye Disease. Dtsch Arztebl Int. 2015;112(5):71-82.
3. Solomon A, Dursun D, Liu Z, Xie Y, Macri A, Pflugfelder SC. Pro- and anti-inflammatory forms of interleukin-1 in the tear fluid and conjunctiva of patients with dry-eye disease. Invest Ophthalmol Vis Sci. 2001;42:2283–2292.
4. Jones DT, Monroy D, Ji Z, Atherton SS, Pflugfelder SC. Sjögren’s syndrome: cytokine and Epstein-Barr viral gene expression within the conjunctival epithelium. Invest Ophthalmol Vis Sci. 1994;35:3493–3504.
5. Miljanovic B, Dana R, Sullivan DA, Schaumberg DA. Impact of dry eye syndrome on vision-related quality of life. Am J Ophthalmol. 2007;143:409–415.
6. Paulsen AJ, Cruickshanks KJ, Fischer ME, et al. Dry eye in the beaver dam offspring study: prevalence, risk factors, and health-related quality of life. Am J Ophthalmol. 2014;157:799–806.
7. Whitcher JP. The treatment of dry eyes. Br J Ophthalmol. 2004;88(5):603-604.