Advances in Ophthalmology: Literature Review on the Physiology, Approach and Treatment of Dry Eye

Abstract

Introduction: Dry Eye, also known as keratoconjunctivitis sicca (KCS), is a multifactorial condition affecting the ocular surface and tear production, leading to discomfort and visual problems, and is particularly prevalent among the elderly and postmenopausal women. This summary explores a literature review focused on the physiology, diagnosis, and treatment of Dry Eye. Methodology: The review was conducted through research in indexed scientific databases, emphasizing peer-reviewed articles and relevant studies. The aim was to identify the main characteristics of the condition, existing classifications, and the most effective therapeutic options. Development: The tear film, essential for ocular protection, consists of three layers: lipidic, aqueous, and mucosal. The lipidic layer, produced by the meibomian glands, prevents evaporation of the aqueous layer and is regulated by sex hormones. The aqueous layer, derived from the main and accessory lacrimal glands, provides oxygen to the cornea and has antibacterial properties. The mucosal layer, secreted by the conjunctival goblet cells, lubricates the ocular surface. Alterations in this physiology can lead to signs and symptoms consistent with Dry Eye. This condition can be classified into evaporative or aqueous deficiency, according to the International Dry Eye Workshop (DEWS), and also by subsystems (AMLEI) or severity. Diagnostic tests such as the Tear Break-Up Time (BUT) and Schirmer Test are essential for confirming the diagnosis and differentiating it from other ocular conditions. Conclusion: The review highlighted the complexity of Dry Eye and its impact on patients' quality of life. Understanding the layers of the tear film and the classifications is crucial for effective diagnosis and treatment. Therapeutic options include tear substitutes, punctal occlusion, anti-inflammatory agents, and, in severe cases, surgical interventions. Improving diagnostic criteria and treatment options can significantly enhance the management of the condition.