Dry Eye Syndrome

The human eye is one of the most important vital sense organs of the body. Just close your eyes and imagine
how life would be without proper eyesight. Well everything would come to a standstill. The front part of the eye
contains a glass like structure called the cornea that allows light to enter the eye and get focussed on the light
sensitive layer of the eye ie the retina. Any factor that affects the health of the cornea leads to degradation of its
clarity and thereby directly affects the quality of vision.

The health of the ocular surface is maintained by the tear film, normal functioning eyelids, and healthy population
of corneal stem cells. The tear glands continuously produce a watery secretion that moistens and lubricates the
ocular surface, allowing smooth movement of the eyelids and the eyeball. The tear film also washes away any
debris that accumulates on the surface of the eye, and provides a smooth refracting surface of the cornea.

Any deficiency of a stable tear film, directly affects the quality of vision, besides producing a variety of symptoms.
These range from dryness, burning sensation, irritation, foreign body sensation, itching, and redness etc. I am
sure as you read this section, you will recall experiencing some of these symptoms in the past. Well with the
advent of 24 hours television channels, and usage of computers in day to day work, dry eye syndrome has
become quite common, and is often referred to as "Computer Vision Syndrome"

While watching television or working long hours on computer, people tend to blink less frequently. This leads to
drying of the ocular surface in between blinks, making the surface rough, with resultant symptoms of irritation and
burning etc. Moreover sitting in an air conditioned environment leads to faster evaporation and drying of the
eyes. Hence it is important to realize this and consciously blink more frequently, or take a break after an hour,
and keep the eyes closed to allow the surface to recover.

Dry eye condition, also leads to poor lid hygiene, due to which there may be recurrent episodes of lid marign
infections, painful boils in the eye lids. These often tend to recur if the dry eye condition is not properly treated.

But it is extremely important to remember that all dry eyes may not be a result of infrequent blinking.... There may
be an actual reduction in tear production, leading to all the symptoms described earlier. A proper assessment of
the ocular surface status by a well trained corneal surgeon is essential to diagnose the exact etiology, and then
provide correct treatment to resolve the same.

Frequently dry eye symptoms may be the first indicator of systemic connective tissue disorders or rheumatoid
arthritis, so it is important that your corneal surgeon does a proper evaluation to rule out the same. The routine
ophthalmologist (eye specialist), may not be able to assess the surface changes in a detailed manner, as
compared to a well trained corneal surgeon.

At the cornea clinic, a detailed history is recorded, followed by clinical tests in a logical sequence, to assess the
correct etiology, and severity of the surface damage secondary to dry eye condition.

Proper counselling of the patient is done, following which appropriate dry eye therapy is started. Follow up visits
are essential to assess the extent of recovery of the health of the ocular surface. Patients often tend to skip
these visits as they get symptomatically better with the medications. Due to this, often it leads to inadequate
treatment, and recurrence of symptoms after some time..

Newer medications, such as "Restasis", can help reduce surface inflammation, & improve the surface sensitivity,
which tends to improve tear secretion. This is essential to restore the health of the ocular surface and reduce
patient symptoms, and dependence on artificial tear drops.

Dr Rajesh Fogla DNB, FRCS, MMed ,   senior corneal surgeon, specializes in ocular surface disease management.
He has been treating all kinds of complex cases with ocular surface disorders, including dry eye syndromes for
the past 9 years. He is on the National Advisory Board for dry eye disease management sponsored by Novartis,
and has delivered lectures on dry eye disease and its management on numerous occasions both national and
international symposiums.

Dr Fogla is available in the clinic on weekdays between 9am to 5pm, ( 6 - 8 pm with prior
appointments only)

You can reach him on +91 9866076750 or dr_fogla@yahoo.com
Cornea Clinic
Tel 91 40 23607777,  Fax 91 40 23608050 ,24 hours emergency services call 1066
Cornea Clinic - Eye Department - Apollo Hospitals, Jubilee Hills, Hyderabad 500 033, A P,  INDIA
Cornea Clinic - toll free number 1600 345 1066, other numbers 91 40 23608333 / 23548888 / 23606655