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Dry eye syndrome (age-related macular degeneration of the retina) and his friend – computer

The number of diagnoses of dry eye syndrome in the world is growing along with the development of technology. The main factors: deterioration of atmospheric air, in particular, near industrial zone, conditioned air, side effects of many drugs, radiation of light-emitting diodes (especially super-bright in the blue part of the spectrum, including AMOLED screens and the like).

Symptoms of the disease: itching, redness, fatigue, dryness in the eyes and eyelids. The cause is a violation of tear production.

If you identify the syndrome at an early stage, when the usual polyclinic does not put it as a diagnosis, you can avoid a whole sea of ​​problems. Let's start with a short table that allows you to understand whether it touches you or whether you should pass it by.

What to look for

Now we will talk about subjective methods of evaluation, that is, those that need to be confirmed by analyzes or other special tests. But, if you have a couple of these complaints, read on. No – just skip the post, you're in luck.

  • Burning or itching in the eyes.
  • Sensation of dryness in the eyes.
  • Red eyes.
  • The feeling of a foreign body in the eyes.
  • The feeling of tired eyes, especially when working at the computer.
  • Edema and redness in the eyelids.
  • Unstable, fluctuating, vision.
  • Spontaneous lacrimation.
  • Photophobia.
  • Hypersensitivity to tobacco smoke.

At the age of 45 years and older, either with rheumatoid diseases, thyroid diseases, herpes, mononucleosis, trigeminal nerve surgery, eye injuries and eye operations, or with frequent use of beta-blockers, analgesics, anticholinergics , Antidepressants, oral contraceptives, estrogens, antimigrenous drugs, injections of botulinum toxin for cosmetic purposes into the paraorbital area, wearing soft contact lenses, swimming in chlorinated water, the risk rises, and For complaints it is necessary to watch especially carefully.

But let's move on to a slightly more scientific description of the syndrome.

About terms

Symptom – subjective feeling of dryness (objectively it may not be).
The symptom – an objective decrease in fluid secretion (subjectively may not be felt).
Syndrome – symptoms and signs (up to blepharospasm)
Disease – a clinical picture in which the most important manifestation is the syndrome. Typical situations: menopause, autoimmune exocrinopathy, avitaminosis A.

In ancient Greece, the term "xerophthalmia", that is, "dry eye", was first introduced. But then they were called corneal blindness, coupled with complete drying of the surface of the eye. In the nineteenth century, the meaning of the term shifted to the professional designation of Sjögren's syndrome and a number of keratitis. Only half a century ago the term adopted the current meaning: von Rötht called the quantitative criteria for the deficiency of tears. Now the diagnosis is divided into water deficiency, mukodefitsit and lipodeficiency, depending on which component of the tear is in deficit.

Degrees of dry eye syndrome

The degree is not the stage of the development of the disease, but the level of severity and possible consequences. For example, as a result of a trauma or chemical attack, you can start immediately from a severe stage and get off to the terminal stage fairly quickly. But it is better, of course, to avoid this.

  1. Subclinical grade – there are no bright symptoms, the patient sometimes complains of a feeling of dryness when using a hair dryer, in dry air, in a strong wind or with prolonged use of contact lenses, or with prolonged use of a computer.
  2. Lung – symptoms are expressed, itching also appears, less often  photophobia, even less often  misting, very rarely – a small blepharospasm. Often diagnosed with infectious or allergic conjunctivitis.
  3. Mean – all symptoms + new signs (erosion, spot keratopathy, filamentous keratopathy, conjunctival hyperemia). On an average degree, all changes are reversible.
  4. Heavy – corneal ulcers, thorns, corneal neovascularization, adhesions and other changes that are irreversible are added.
  5. Terminal – a significant visual impairment is added due to the obstruction of the optical field (eg, ulcer). The end of this stage is the complete loss of the ability to distinguish objects with the eye.

Diagnostics

In any ophthalmology room, you can collect an anamnesis from you, look at your eyes through a microscope and make tests for tear production. The latter are particularly important in terms of diagnosing early stages of GCC, so they are included in most regular regular eye examinations.

If a doctor suspects, he can also prescribe special diagnostic methods (vital staining with dyes, tear crystallography, cytocompression, ultrasound of the lacrimal gland, laboratory tests of the LJ), which require a specific laboratory or diagnostic center technique.

As a rule, most of the cases of CER are diagnosed by tearing disorders or by bound eye changes, in particular, blepharitis.

Connection with the inflammation of the eyelids (blepharitis)

The peculiarity is that patients complain of a symptom, and usually there is a picture of the disease. But in this case, the diagnosis is often not revealed signs and therapy is not prescribed. There is even an anecdote about this in ophthalmology:
– What to do with a patient with blepharitis?
– Send it to a competitor!

So, dry eye syndrome and blepharitis are two related problems. If the SSH was not caused by blepharitis, then it can cause inflammation of the eyelid. If the SSH was caused by blepharitis, in any case, treatment of another is required to treat one. The main point is that you can replace the tear for as long as you want, trying to fight with the dry eye syndrome with supportive treatment, but this will not give a result. It is necessary to cure and blepharitis (or prevent it from developing under the scenario, when it did not cause the launch of the SSH). Plus to solve a number of accompanying problems for worsening trophism. If the doctor appoints only a substitute for tears or a similar remedy, the patient will first tolerate and then develop the syndrome with the attendant irreversible organic disturbances of the tear-producing apparatus and the superficial structures of the eye until the corneal ulceration.

From here two rules:

  1. If you are dry in the eyes, you need to diagnose, and not wait until it passes.
  2. If you have found a dry eye syndrome and prescribed only a tear replacement, but did not specify the exact causes that caused it, you need to look for them and treat them. And already to deal with the prevention of problems that will develop during the course of the SSG.

Here is an approximate diagram of the causes and consequences.

Treatment

Treatment is performed not only by protecting the eye from losing fluid, but, most importantly, by removing the cause of the disease. About this later. While more accurate. It is better to be examined earlier (tear test takes 10 minutes), than to join those for whom we launch our bioreactors in the production of gel.

A little later I will tell you about the tear and how it works and works.