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At least 19 recordsLinked to original sources

PubMed2005

[Comparison of local acetylcysteine and artificial tears in the management of dry eye syndrome].

Dry eye syndrome is a common clinical entity causing difficulties to many people, especially the elderly. Standard substitution therapy with artificial tears may frequently prove inadequate, thus any new treatment modality is highly welcome. The syndrome implies lacrimal hyperosmolality, which in turn results in mucus accumulation in the conjunctival sac causing additional irritation. Locally applied acetylcysteine, a mucolytic, regulates mucus secretion and reduces mucus accumulation. The aim of the study was to compare the efficacy of artificial tear therapy and therapy with local acetylcysteine. The study included 32 patients with the symptoms and signs of dry eye attending our department between March 20 and May 9, 2003. All study patients were on long-term substitution therapy with artificial tears. Upon evaluation of subjective discomforts and objective signs, the patients were switched from artificial tear therapy (Isopto-Tears, Alcon, with polyvinyl alcohol as active ingredient) to therapy with locally applied acetylcysteine (Brunac, Bruschettini). All parameters were re-evaluated at 2-week control visit. Thirty of 32 patients (94%) completed the study with control visit. Of these, 18 (60%) patients reported reduction of subjective discomforts, ten (33%) patients observed no change, and two (7%) patients experienced more discomforts with acetylcysteine than with artificial tear therapy. On objective sign evaluation, 12 (40%) patients showed less discomforts, unchanged condition was recorded in 13 (43%) patients, and five (17%) patients had more discomforts as compared with artificial tear therapy. A statistically significant difference (p=0.05) between artificial tear therapy and acetylcysteine therapy was found for the subjective symptom score but not for the objective sign score. Therapy with acetylcysteine proved more efficient than artificial tears in reducing subjective symptoms but had no effect on the objective signs of dry eye syndrome. The advantages of acetylcysteine include more convenient instillation timing (4 times daily) and reduced nocturnal discomfort, whereas shortcomings are the sense of burning on instillation, bad odor, and as yet relatively high price on the Croatian market.

Acetylcysteine↗

PubMed2003

Inflammation: a unifying theory for the origin of dry eye syndrome.

Dry eye syndrome has been difficult to diagnose and treat, due to its heterogeneity. These difficulties are being overcome, however, as evidence becomes available about a common etiology. An inflammatory mechanism apparently underlies the condition. This theory has been proven by use of immunomodulators that show efficacy in treating patients with dry eye syndrome.

Aged↗

PubMed2004

Changes in the tear film and ocular surface from dry eye syndrome.

Dry eye syndrome (DES) refers to a spectrum of ocular surface diseases with diverse and frequently multiple aetiologies. The common feature of the various manifestations of DES is an abnormal tear film. Tear film abnormalities associated with DES are tear deficiency, owing to insufficient supply or excessive loss, and anomalous tear composition. These categorizations are artificial, as in reality both often coexist. DES disrupts the homeostasis of the tear film with its adjacent structures, and adversely affects its ability to perform essential functions such as supporting the ocular surface epithelium and preventing microbial invasion. In addition, whatever the initial trigger, moderate and severe DES is characterized by ocular surface inflammation, which in turn becomes the cause and consequence of cell damage, creating a self-perpetuating cycle of deterioration. Progress has been made in our understanding of the aetiology and pathogenesis of DES, and these advances have encouraged a proliferation of therapeutic options. This article aims to amalgamate prevailing ideas of DES development, and to assist in that, relevant aspects of the structure, function, and production of the tear film are reviewed. Additionally, a synopsis of therapeutic strategies for DES is presented, detailing treatments currently available, and those in development.

Animals↗

PubMed1994

Three different types of dry eye syndrome.

We analyzed patients with dry eye syndrome with regard to autoimmune conditions. A total of 116 patients with dry eye syndrome were divided into three groups: simple dry eye (SDE), i.e., dry eye with no circulating autoantibodies; autoimmune positive dry eye (ADE), dry eye with circulating autoantibodies; and Sjogren's syndrome (SS), dry eye associated with Sjogren's syndrome. Schirmer test showed values of 3.0 +/- 2.2 mm in SDE, 3.1 +/- 2.0 mm in ADE, and 2.4 +/- 2.3 mm in SS reflecting the inadequacy of this test in differentiating among the groups. However, Schirmer test with nasal stimulation showed values of 19.1 +/- 12.4 mm in SDE and 16.4 +/- 10.9 mm in ADE, which were significantly higher than the 7.0 +/- 6.6 mm found in SS (p < 0.01). Moreover, ocular surface alterations evaluated by vital staining and brush cytology were significantly milder in SDE and ADE than in SS. SDE and ADE have less ocular surface abnormalities with good reflex tearing, whereas SS has less reflex tearing and more squamous metaplasia.

Adult↗

PubMed2003

Dry eye syndrome. Etiological and therapeutic aspects.

"Dry eye syndrome" is a common disorder of the tear film that results from inadequate tear production, excessive tear evaporation or abnormality in mucin or lipid components of the tear film. A number of 53 patients suffering from dry eye syndrome were followed up for a period of 18 months. The study group was heterogeneous, including a lot of conditions accompanied by dry eye syndrome: Syogren's syndrome, lupus erythematous, ocular rosacea, patients with systemic treatments with antidepressants, betablockers, diuretics, oral contraceptives, glaucomatous patients with topical beta-blockers, postmenopausal women, aging people, computer users and long-term contact lens wearers. The therapeutical options were dictated by the severity of the syndrome: substitution therapy, treatment of the underlying eyelid diseases, modifying of the environmental conditions and treatment of the complications in the most severe cases. The new pathological approach is innovative and it may provide a real therapeutical measure for this condition: topical A Cyclosporine and androgen drops.

Dry Eye Syndromes↗

PubMed1990

Dry eye syndrome in Pakistani community.

Dry eye syndrome was studied in 30 Pakistani patients, 20 males and 10 females ranging from under 20 to over 60 years. The visual acuity at the time they first reported was 6/60 (20/200) or less in 21 (70%) patients and 6/18 (20/60) or above in nine (30%). Fifteen (50%) patients were hopelessly blind and another six (20%) were with very poor prognosis. Only nine (30%) patients had a chance to escape impending blindness.

Adolescent↗

PubMed2005

Relation between dietary n-3 and n-6 fatty acids and clinically diagnosed dry eye syndrome in women.

BACKGROUND: Dry eye syndrome (DES) is a prevalent condition, but information on risk or protective factors is lacking. OBJECTIVE: We aimed to determine the association between the dietary intake and ratio of n-3 and n-6 fatty acids (FAs) and DES occurrence. DESIGN: Of the 39876 female health professionals in the Women's Health Study (WHS), 32470 women aged 45-84 y who provided information on diet and DES were cross-sectionally studied. We assessed FA intakes by using a validated food-frequency questionnaire and assessed DES by using self-reports of clinically diagnosed cases. Of the sample, 1546 (4.7%) subjects reported DES. We used logistic regression models to estimate the odds ratios (ORs) and 95% CIs to describe the relation of FA intake with DES. RESULTS: After adjustment for demographic factors, hormone therapy, and total fat intake, the OR for the highest versus the lowest quintile of n-3 FAs was 0.83 (95% CI: 0.70, 0.98; P for trend = 0.05). A higher ratio of n-6 to n-3 FA consumption was associated with a significantly increased risk of DES (OR: 2.51; 95% CI: 1.13, 5.58) for >15:1 versus <4:1 (P for trend = 0.01). In addition, tuna consumption [1 serving was 113 g (4 oz)] was inversely associated with DES (OR: 0.81; 95% CI: 0.66, 0.99 for 2-4 servings/wk; OR: 0.32; 95% CI: 0.13, 0.79 for 5-6 servings/wk versus < or =1 serving/wk; P for trend = 0.005). CONCLUSIONS: These results suggest that a higher dietary intake of n-3 FAs is associated with a decreased incidence of DES in women. These findings are consistent with anecdotal clinical observations and postulated biological mechanisms.

Aged↗

PubMed2003

Prevalence of dry eye syndrome among US women.

PURPOSE: Dry eye syndrome (DES) is believed to be one of the most common ocular problems in the United States (US), particularly among older women. However, there are few studies describing the magnitude of the problem in women and how this may vary with demographic characteristics. DESIGN: Cross-sectional prevalence survey. METHODS STUDY POPULATION: we surveyed 39,876 US women participating in the Women's Health Study about a history of diagnosed DES and dry eye symptoms. MAIN OUTCOME MEASURE: we defined DES as the presence of clinically diagnosed DES or severe symptoms (both dryness and irritation constantly or often). We calculated the age-specific prevalence of DES and adjusted the overall prevalence to the age distribution of women in the US population. We used logistic regression to examine associations between DES and other demographic factors. RESULTS: The prevalence of DES increased with age, from 5.7% among women < 50 years old to 9.8% among women aged > or = 75 years old. The age-adjusted prevalence of DES was 7.8%, or 3.23 million women aged > or = 50 in the US. Compared with Whites, Hispanic (odds ratio [OR] = 1.81, confidence interval [CI] = 1.18-2.80) and Asian (OR = 1.77, CI = 1.17-2.69) women were more likely to report severe symptoms, but not clinically diagnosed DES. There were no significant differences by income (P([trend]) =.78), but more educated women were less likely to have DES (P([trend]) =.03). Women from the South had the highest prevalence of DES, though the magnitude of geographic differences was modest. CONCLUSIONS: Dry eye syndrome leading to a clinical diagnosis or severe symptoms is prevalent, affecting over 3.2 million American women middle-aged and older. Although the condition is more prevalent among older women, it also affects many women in their 40s and 50s. Further research is needed to better understand DES and its impact on public health and quality of life.

Aged↗

PubMed1998

Dry eye syndrome.

The present review is of dry eye syndrome, an entity caused by various conditions that lead to tear film abnormalities. The tear film consists of aqueous, mucin, proteins and lipids. Dry eye syndrome may be caused by local ocular disorders or systemic diseases. The symptoms include foreign body sensation, redness, photophobia and burning sensation. Clinical tests such as the Schirmer test, fluorescein staining test and Rose Bengal test are useful diagnostic tools. Laboratory tests are important assets in the diagnosis and identification of the underlying systemic disease. Biopsy of the accessory salivary gland is important in the diagnosis of Sjogren's syndrome. The management of dry eye syndrome includes replacing the deficient tear film and prolonging its residence time on the ocular surface.

Journal Article↗

PubMed1991

Punctal occlusion and blepharoplasty in patients with dry eye syndrome.

Blepharoplasty and inferior punctal occlusion were performed on 24 consecutive patients with dry eye syndrome. Fifteen patients (62.5%) had symptomatic dry eye syndrome preoperatively and nine patients (37.5%) had asymptomatic dry eye syndrome diagnosed during the preoperative workup (subclinical dry eye syndrome). After surgery, nine patients (37.5%) had improvement of their dry eye syndrome, 10 patients (42%) were unchanged, and two patients (8%) had worsening of their dry eye syndrome. A third patient had worsening of the dry eye syndrome 6 months postoperatively when her puncta reopened. Two patients (8%) had increased irritation only when wearing contact lenses, but in one patient this resolved 6 months after surgery. Thus, although a significant number are improved, a few patients will have worsening of dry eye syndrome after blepharoplasty and inferior punctal occlusion.

Adult↗

PubMed2004

[Treating severe dry eye syndromes with autologous serum].

BACKGROUND: Dry eye syndrome with tear deficiency can be improved with artificial tears, which can be associated with topical anti-inflammatory agents. Autologous serum can provide the ocular surface with beneficial growth factors and vitamins. PATIENTS AND METHODS: Twenty-one patients suffering from severe dry eye due to Sjögren's syndrome were treated with 20% autologous serum for 2 Months. The Schirmer I test, break-up time, and fluorescein and lissamine green stainings were performed before and after treatment. Subjective complaints such as burning, foreign body sensation, dryness and photophobia were assessed by a questionnaire as well as a face score reflecting the current condition of patients' eyes. RESULTS: Lissamine green and fluorescein scores improved significantly as well as subjective symptoms of burning, foreign body sensation and dryness (p<0.05). The face score was significantly improved. Bacterial culture of serum delivered to the patients all remained negative. DISCUSSION: Autologous serum provides growth factors and vitamins that are useful for an altered ocular surface due to Sjögren's disease. However, some problems still remain: risk of contamination, arbitrary dilution of autologous serum, and a current lack of regulations for use of autologous serum. A close collaboration between ophthalmologists and the Etablissement Français du Sang (French Blood Bank) is mandatory because autologous serum should be considered as a useful tool to treat severe ocular surface disorders. CONCLUSION: The use of autologous serum improved symptoms and objective signs caused by severe Sjögren's syndrome. Currently, a lack of clear regulations prevents its widespread use in severe ocular surface disorders.

Blood Transfusion, Autologous↗

PubMed2006

Bilateral canaliculitis following SmartPLUG insertion for dry eye syndrome post LASIK surgery.

BACKGROUND: Dry eyes are a common symptom following LASIK corneal refractive surgery. Treatments include topical lubricants to supplement the tear film, and punctal occlusion to reduce tear outflow. Canaliculitis is a recognised complication of punctal plugs, but has not previously been described following insertion of newer generation semi-permanent intra-canalicular plugs, such as the SmartPLUG. METHODS: Case report. RESULTS: We describe a 60-year-old female who underwent bilateral LASIK surgery leading to aggravation of her dry eye syndrome. She was managed with the insertion of semi-permanent intra-canalicular moldable silicone SmartPLUGs. She subsequently developed bilateral canaliculitis requiring bilateral canaliculotomy. CONCLUSIONS: To the best of our knowledge, this is the first report of bilateral canaliculitis following intra-canalicular SmartPLUG insertion. This case illustrates that punctal occlusion with the newer generation intra-canalicular plugs carries a risk of canaliculitis and that irrigation is not always effective in removing these devices.

Dacryocystitis↗

PubMed2004

[Prevalence and risk factors of dry eye syndrome].

The aim of the study was to estimate the frequency of dry eye syndrome and to analyze the risk factors of this disease. We examined a group of 140 patients aged 24-93, suffering from dry eye syndrome. The patients were treated in the Ophthalmology Clinic in Lublin in 1999-2001. A larger number of dry eye syndrome cases was identified in female patients, especially aged over 50 (80% of female and 20% of male). Average age female cases was 67.5 and male 58.5. Patients included in to the study on made up 5.52% of total number of patients treated in the Anterior Segment Disorders Out-Patient Clinic. The frequency of dry eye syndrome in 1999 was 4.24% (female) and 0.76% (male), in 2000: 5% and 1.6%, in 2001: 5.12% and 1.1%. Systemic diseases were diagnosed in 36% of female cases with dry eye syndrome, including 22.3% rheumatoid arthritis and 9.8% Sjogren syndrome. 46.6% of male patients had systemic diseases: 32% rheumatoid arthritis, 7% Sjogren syndrome. The most frequent general medical conditions diagnosed in the group of patients were as follows: arterial hypertension (men and women) and diabetes (women). Smoking, place of living, other eye diseases and surgical operations in the eye area were examined as other potential risk factors of the dry eye syndrome. Smoking appears to stimulate the dry eye syndrome. A stable increase of total dry eye syndrome frequency was observed.

Adult↗

PubMed2006

[Current treatment for dry eye syndrome].

The therapy of dry eye disease as a chronic problem necessitates a long-term therapeutic association between patient and ophthalmologist. The aim of therapy is to relieve symptoms and improve vision as far as possible with an acceptable level of effort on the part of the patient. Therapy of dry eye follows a staged concept including tear replacement, serum eye drops, punctum plugs, novel anti-inflammatory drugs (cyclosporin A), and surgical procedures. Interdisciplinary care, especially of patients with autoimmune disease, is recommended and is best provided in a specialized dry eye outpatient clinic with quality control.

Anti-Inflammatory Agents↗

PubMed2005

[The usefulness of thermography in the diagnostics of dry eye syndrome].

PURPOSE: The aim of the study was to evaluate corneal temperature in patients with dry eye syndrome, and in normal subjects by measuring with infrared radiation thermography. MATERIAL AND METHODS: Each eye of 9 patients with dry eye syndrome and each eye of 13 normal subjects, were evaluated in this study. The corneal surface temperature was measured during 15 seconds after opening the eye. RESULTS: Mean corneal temperature was lower in the dry eye syndrome patients compared with the control group. Decrease in time of mean corneal temperature in patients with dry eye syndrome, was lesser than in the control group. CONCLUSIONS: The study shows the usefulness of thermography in the diagnosis of dry eye syndrome.

Adult↗

PubMed2006

Increasing importance of dry eye syndrome and the ideal artificial tear: consensus views from a roundtable discussion.

BACKGROUND: Dry eye syndrome is a highly prevalent, yet largely under diagnosed, condition that can substantially affect quality of life. Left untreated, dry eye is associated with chronic eye pain and increased risk of ocular surface disease. Current demographic changes and lifestyle factors indicate that the dry eye syndrome patient population will increase significantly, ensuring that general practitioners and ophthalmic clinicians alike will experience more patients presenting with dry eye symptoms. Greater public and practitioner awareness of emerging research, technologies, and therapies is crucial to ensuring appropriate interventions to meet specific patient needs and result in clinically favorable outcomes. ROUNDTABLE ASSEMBLY: In August 2005, a team of ocular surface experts convened for a 1-day roundtable session to discuss the latest information on diagnosing and treating dry eye syndrome and real-world issues in artificial tear therapy, including preservative use. ROUNDTABLE DISCUSSION: The discussion centered on the mild to moderate dry eye patient and critical features of the ideal artificial tear, which are preservative-free formulation, protection from microbial contamination, cost-effective, non-blurring, and easy to use. Products that match this profile have the advantage of being able to benefit the myriad of patients who comprise the dry eye syndrome population. Ocular surface health should always remain a top priority. Preferred Practice Pattern Dry Eye Syndrome Medical Treatment guidelines should be modified to recommend the use of preservative-free formula artificial tear products for all levels of dry eye conditions in consideration of the medical benefit they offer to dry eye syndrome sufferers. CONCLUSION: The growing prevalence of dry eye syndrome demands increased attention. Further research, enhanced diagnostic tests, increased use of preservative-free artificial tear formulations as first-line therapy, greater patient-practitioner interaction, and patient education are warranted.

Cost-Benefit Analysis↗

PubMed1999

Polyacrylic acid/polyvinylpyrrolidone bipolymeric systems. I. Rheological and mucoadhesive properties of formulations potentially useful for the treatment of dry-eye-syndrome.

For the treatment of dry-eye-syndrome preparations containing polymers as active agents are used. Polyacrylic acid (PAA) is a well known mucoadhesive polymer. For ocular use, however, the very high viscous gel systems can cause irritation post application which can result in a low patient compliance. In this study we have shown that it is possible to formulate PAA based low viscous formulations with polyvinylpyrrolidone (PVP) as 2nd polymer. The survey of the systems for the parameters microviscosity with polarization and oscillatory rheology shows that the 2nd polymer influences the structure of the PAA gel framework that causes the significant decrease in apparent viscosity of the combination. The mucoadhesion and rheological characteristics were determined by means of rheological methods. The acquired results, low viscosity and a high mucoadhesion index in comparison with the monopolymer PAA preparation and with two PAA containing commercial artificial tear preparations, Vidisic and Thilo Tears, led to the conclusion that the combination of the two polymers, PAA and PVP, could be advantageous for the treatment of the dry eye.

Acrylic Resins↗

PubMed2006

Chemokine receptor CCR5 expression in conjunctival epithelium of patients with dry eye syndrome.

OBJECTIVE: To characterize chemokine receptor CCR5 expression on the conjunctival epithelium in dry eye syndromes. METHODS: Conjunctival impression cytology samples were obtained from normal subjects (n = 15) and patients with dry eye syndrome (n = 45). Cells were harvested from impression cytology samples, and flow cytometry was performed to quantitatively analyze the cell surface expression of chemokine receptor CCR5. Characterization of CCR5-positive cells was done by 2-color flow cytometry using fluorescein-conjugated anti-CCR5 and phycoerythrin-conjugated anti-CD45 antibodies (where CD45 is a marker for bone marrow-derived cells). To study CCR5 messenger RNA transcripts, real-time polymerase chain reaction was done on RNA isolated from the impression cytology samples of normal subjects (n = 5) and patients with dry eye syndrome (n = 14). RESULTS: We found significant up-regulation in cell surface expression of CCR5 in patients with both aqueous tear-deficient and evaporative forms of dry eye syndrome (P<.001). The real-time polymerase chain reaction results (for messenger RNA) corroborated the flow cytometry data (for protein). The majority of the cells expressing CCR5 were non-bone marrow-derived resident epithelial cells of the conjunctiva. CONCLUSION: Our findings suggest that CCR5 up-regulation is significantly associated with dry eye syndrome-associated ocular surface disease. Clinical Relevance Chemokine receptor CCR5 or its ligands may serve as useful targets for modulation of tissue immunoinflammatory responses in dry eye syndromes.

Adult↗