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].

• Camping

  IL-2 also binds to the delta opioid receptor and inhibits cAMP production and neuronal function. This loss of neuronal function diminishes normal neuronal tone, leading to sensory isolation of the lacrimal gland and eventual atrophy. [emedicine.medscape.com]

• 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]

• Malaise

  A thorough review of systems should be obtained, focusing specifically on dry mouth, arthritis, cutaneous changes, malaise, weight loss, and lymphadenopathy. [emedicine.medscape.com]

• Hypothermia

  not associated with low environmental temperature) 제외 : 저온증(hypothermia)NOS(우발적)(accidental)(T68) 마취성(의)(에 의한) (의)(에 의한) (due to) (of) 저온증(hypothermia (due to) (of) anaesthesia) (T88.5) 낮은 외부 온도(의)(에 의한) 저온증(hypothermia (due to) (of) low environmental [dic.impact.pe.kr]

• Diarrhea

  Although the drug comes as an eye drop, for KCS it is actually given orally at an increasing dose until side effects are seen (diarrhea, drooling, vomiting). If side effects are encountered, the dose is reduced to that which the animal tolerates. [veterinarypartner.com]

  Sommer A, Katz J, Tarwotjo I : Increased risk of respiratory disease and diarrhea in children with pre-existing mild vitamin A deficiency Am J Clin Nutr 1984, 40 : 1090–5. 68. [nature.com]

  […] acute severe ulcerative colitis and hives that do not respond to treatment with steroids.[18] Side effects[edit] Side effects of ciclosporin can include gum enlargement, increased hair growth, convulsions, peptic ulcers, pancreatitis, fever, vomiting, diarrhea [en.wikipedia.org]

• Ulcer

  We reviewed the records of 56 patients (109 eyes) who satisfied our criteria for keratoconjunctivitis sicca (KCS) to determine factors associated with the development of sterile corneal ulcers. [ncbi.nlm.nih.gov]

  Corticosteroids cannot be used in the face of ulcers because they may decrease healing speed and enhance the ulcerative process. Artificial tear preparations are often indicated to supplement the deficient tear film. [theanimaleyecenter.com]

  Without an early diagnosis and appropriate treatment, conjunctival and/or corneal scarring, ulceration, and even perforation might occur. [symptoma.com]

  ulcer Corneal vascularization and corneal scarring Corneal perforation Race No racial predilection exists. [web.archive.org]

  Corneal ulceration and perforation associated with Sjogren’s syndrome. Arch Ophthalmol 1980 ; 98 : 89 –94. ↵ Zierhut M, Thiel HJ, Weidle EG, et al. Topical treatment of severe corneal ulcers with cyclosporin A. [doi.org]

• Photosensitivity

  Typical symptoms include intermittent itching; burning; blurring, a gritty, pulling, or foreign body sensation; and photosensitivity. [msdmanuals.com]

  Symptoms Of Dry Eyes Or Keratoconjunctivitis Sicca Include: Stinging and burning sensation in the eye Presence of mucus around the eyes Severe irritation of the eyes, especially from wind or smoke Fatiguing of the eyes Photosensitivity Redness of the [epainassist.com]

  There are both photosensitive and nonphotosensitive forms of the disorder. TTD patients have not been reported to have a predisposition to cancer (summary by Faghri et al., 2008). [ncbi.nlm.nih.gov]

  CXL is a minimally-invasive surgical procedure that combines a photosensitive solution applied to the cornea with a low dose of UV light. [nei.nih.gov]

• 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]

• Irritability

  After 2 weeks of topical application, three to four times per day, moderate (43%) or complete (57%) relief of irritation symptoms was experienced by all patients and no complications were observed. [ncbi.nlm.nih.gov]

  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]

  Even with the most severe dry eyes, it is rare that vision is lost; however, people sometimes feel that their vision blurs with use, or the irritation is so severe that it is difficult to use the eyes. [web.archive.org]

  In some cases, the cause is obvious, such as environmental irritants or short-term inflammation. [vistaeyecare.net]

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.