‘Dry eye’ occurs when the eyes are unable to produce adequate tears for lubrication or when their quality is not sufficient to keep the eye moist. This can be due to various factors, such as aging, prolonged use of digital screens, certain types of medications, arid environmental conditions, and problems with the meibonia glands that produce part of the tear film. A reader asks to know more about both the causes and ways to find relief. He replies Rossella Colabelli Gisoldihead of the Lazio Eye Bank, San Giovanni Addolorata Hospital in Rome.
Request. Dear doctor, recently I have noticed a worsening of my vision, accompanied by pain when I look at the light. It has been suggested to me that I may have a form of keratitis or suffer from dry eye. Could you explain to me what the specific symptoms of these conditions are, the possible causes and how they can be treated? Is there anything I can do to prevent their development? Thank you for your attention and I await with interest your response to better understand how to proceed. Fabiana, Verona
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Answer. Dear reader, the discomfort felt in conditions of intense brightness (called photophobia), accompanied by slight visual alterations, may indicate an alteration of the corneal surface. The ocular surface is a functional unit that includes the eyelid border, the eyelashes, the conjunctiva, the corneal limbus (transition area between the conjunctiva and cornea, seat of the stem cells of the corneal epithelium), the cornea and the tear film, in perfect balance between them. The condition that most frequently alters this balance, generating suffering of the ocular surface with the symptoms you have reported, is a poor quality of the tear film or a deficiency of the aqueous component of the tear itself.
Dry eye it is the name of the resulting pathology. Very common among menopausal women, today it is also increasing among young people due to excessive use of computers.
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General autoimmune pathologies, hormonal imbalances, thyroid pathologies, dry environments, excessive use of contact lenses or air conditioning are all factors that can generate this pathology. It is difficult to understand whether the symptoms you are reporting can be traced back to this cause. Consult an ophthalmologist who will be able to carry out specific tests to study the tear film (Schirmer test and But) and submit questionnaires (OSDI) which easily allow a correct diagnosis. In the presence of alteration of the tear film (xerophthalmia), the causes must then be investigated and chronic therapy prescribed with specific tear substitutes capable of restoring balance on the ocular surface, repairing any suffering of the corneal epithelium and providing relief from the symptoms reported.
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