Göbbels M
Universitäts-Augenklinik, Bonn, Bundesrepublik Deutschland.
Fortschr Ophthalmol. 1990;87 Suppl:S190-7.
Dry eye is the most common cause of chronically red, irritated eyes. Thus, in cases of chronic conjunctivitis dry eye must be excluded. The noncritical use of vasoconstrictive eye drops and/or corticosteroids is obsolete. Up to now the diagnosis of dry eye has been based on a combination of the patient's history, slit-lamp examination, determination of tear film break-up time, the Schirmer test and basic secretion test. Unfortunately, there is enormous deviation in all of these tests, which means that they provide poor diagnostic reliability. Dry eyes are rarely associated with systemic diseases, e.g. Sjogren's syndrome. This autoimmunological disease is often first diagnosed by the ophthalmologist. Quantitative or qualitative deficiencies of one or more layers of the complex tear film can result in dry eyes, but inflammatory agents or primary ocular surface diseases may also be involved. Within the next few years analyses of tear-film proteins, toposcopy, tear-film fluorophotometry, impression cytology and corneal epithelial fluorophotometry may prove to be reliable tests for the detection of dry eye. The improved mucomimetic quality of artificial tears, the avoidance of toxic preservatives, tear production stimulants (eloisin, physaelamin), fibronectin or the epithelial growth factor may facilitate the management of dry eye.
干眼症是慢性眼红、眼刺激最常见的病因。因此，在慢性结膜炎病例中，必须排除干眼症。不规范使用血管收缩性眼药水和/或皮质类固醇已过时。到目前为止，干眼症的诊断基于患者病史、裂隙灯检查、泪膜破裂时间测定、泪液分泌试验和基础分泌试验的综合判断。遗憾的是，所有这些检查都存在很大偏差，这意味着它们的诊断可靠性较差。干眼症很少与全身性疾病相关，如干燥综合征。这种自身免疫性疾病往往首先由眼科医生确诊。复杂泪膜一层或多层的定量或定性缺陷可导致干眼症，但炎症介质或原发性眼表疾病也可能参与其中。在未来几年内，泪膜蛋白质分析、地形图检查、泪膜荧光光度测定、印迹细胞学检查和角膜上皮荧光光度测定可能被证明是检测干眼症的可靠检查方法。人工泪液模拟黏液质量的改善、避免使用有毒防腐剂、泪液分泌刺激剂（依洛辛、毒扁豆碱）、纤连蛋白或上皮生长因子可能有助于干眼症的治疗。
