Thursday, 25 August 2016

Mata kering - dry eye - my opinion

Bismillahirrahmanirrahim

Assalamualaikum w.b.t

Just to share an article written by me about dry eye:

There are many factors contribute to dry eye. Among the factors are contact lens wear, aging factor, medication and climatic condition.

In contact lens wear, it is a challenge for the tears to support not only the anterior segment of the eye but also to support contact lens surface. Dry eye is commonly associated with contact lens wear because of the interaction between contact lens and tear film. If a contact lens wearer has problem with blinking such as incomplete blinking and infrequent blinking rate, it will worsen the dry eye problem while wearing contact lens. Hydrogel lenses also can cause dryness as it loses its water content with wear. Try to give counselling to the patients about blinking skills and habits or reduce the symptoms by using tear lubricant.

Aging also can be a major factor that leads to ocular dryness. As we age, our body produces fewer tears than when we are younger. Older adults are susceptible to lacrimal gland dysfunction especially in elderly women. Secretory function of the lacrimal gland is regulated by androgen. Since women have lower levels of androgen compared to men, therefore more prone to get dry eye disease as they aging. Besides that, menopausal women develop lower level of estrogen which is a hormone that stimulate meibomian glands and help to regulate ocular surface homoestasis. Together, androgen deficiency and estrogen decrease lead to inadequate lacrimal gland secretion which causes elderly women at higher risk of developing dry eye.

Dry eye also can occur as a result from the use of medication. For example, anti-histamine, diuretics, antimetabolites that frequently used in treating rheumatoid athritis or anti-depression drug. These are all drugs that commonly prescribed in older patients. These medications will lower the production of tears.

Exposure to smoke, wind and dry climates can increase tear evaporation resulting in dry eye syndrome. Years of exposure to bright sunlight can lead to meibomian gland dysfunction with evaporative dry eye. Air conditioning especially direct exposure to it is a factor that can contribute to dry eye problem.therefore, for those with dry eye problem must try to avoid air-conditioned room or room with huge ceiling fan.

There are treatments to dry eye problem. Usually, the standard care therapy is with aritficial tears, antibiotics and steroid. For mild dry eye, lubrication with artificial tears is enough to reduce the symptoms. Any environmental factors should be minimized to avoid evaporation. If having dry eye, try to avoid from taking any medication that can exaggerate the problem besides avoid from wearing contact lenses for a certain period until the tear film re-stabilize. 

p/s: In this article, I am not included the references because totally forgot to note the references. 
Hee. Anyway, you can just google to get more details about dry eye.

Thank you.

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