Golden Mark I., Meyer Jay J., Zeppieri Marco, Patel Bhupendra C.
University of Auckland
University Hospital of Udine, Italy
Dry eyes, also known as dry eye syndrome (DES), dry eye disease (DED), ocular surface disease (OSD), dysfunctional tear syndrome (DTS), and keratoconjunctivitis sicca (KCS), are among the most common reasons for a visit to an eye doctor. The definition of a dry eye according to the Tear Film and Ocular Surface Society (TFOS) Dry Eye Workshop II (DEWS II) is, "Dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiologic roles." The tear film is approximately 2 to 5.5 µm thick over the cornea and comprises 3 main components. These components (lipid, aqueous, and mucin) are often described as layers, although this may oversimplify the tear film milieu. The tear film is approximately 2 to 5.5 µm thick over the cornea. It is composed of 3 main components, often described as layers (although this may be an oversimplification of the tear film milieu): 1. The most superficial layer; produced by the meibomian glands of the eyelids and functions to reduce the evaporation of tears . 2. The middle layer and the thickest component of the tear film; produced by the lacrimal glands, located in the orbits and the accessory lacrimal glands (glands of Krause and Wolfring) in the conjunctiva. Aqueous fluid contains water, metabolites, electrolytes, peptides, proteins, etc. 3. Composed of mucins, or glycoproteins; predominantly produced by conjunctival goblet cells. Mucins enhance the spread of the tear film over the corneal epithelium through the regulation of surface tension. DES and DED relate to a common ocular illness in which there is insufficient lubrication and moisture on the eye's surface. Numerous symptoms, such as dryness, irritation, burning, redness, and blurred vision, can be brought on by this illness. Even though the names are frequently used interchangeably, DED refers to a more comprehensive understanding of the disorder. It can be confusing because different medical practitioners and researchers use different terminologies. This term is frequently used informally to refer to inadequate tear production or poor tear quality, which causes ocular pain and associated symptoms. Patients and medical professionals frequently use it to characterize the disease. The multifaceted character of the ailment is better described by the more inclusive term DED. It recognizes that evaporative dry eye, aqueous deficit, and mixed etiologies are some underlying causes of dry eye, a complex and heterogeneous disease. DED covers a broader spectrum of clinical manifestations and causes. DES is a broader term that emphasizes symptoms and a decline in tear quantity or quality rather than focusing on underlying causes in detail. DED acknowledges that the disorder has several facets and different subtypes. The 2017 TFOS DEWS II report offers a thorough categorization and in-depth explanation of dry eye illness. Inflammation, neurosensory abnormalities, and environmental triggers are just a few of the contributing elements the report considers when classifying DED into aqueous-deficient and evaporative subtypes. Diagnostic procedures and therapies for DES and DED are comparable. A thorough eye exam that includes tests for tear film quality and quantity, a review of the ocular surface, and an evaluation of the patient's stated symptoms is frequently required for diagnosis. Artificial tears, lubricating eye drops, dietary changes, antiinflammatory drugs, and, in extreme circumstances, procedures or operations may all be used as treatments. The underlying cause and severity of the condition determine the best course of action. Over time, dry eye research has advanced, and our understanding of the condition has become more complex. In contemporary medical literature and research investigations, the term DED is used more frequently to reflect this thorough understanding. Inflammation, meibomian gland dysfunction, and the effect of the environment on the ocular surface have all been studied in recent DED studies. Researchers hope to advance patient care by utilizing the term DED to cover various contributing factors.
干眼症,也被称为干眼综合征(DES)、干眼病(DED)、眼表疾病(OSD)、功能性泪液综合征(DTS)和角结膜干燥症(KCS),是人们前往眼科就诊的最常见原因之一。根据泪膜与眼表协会(TFOS)干眼研讨会II(DEWS II)的定义,“干眼症是一种眼表的多因素疾病,其特征在于泪膜稳态失衡,并伴有眼部症状,其中泪膜不稳定和高渗、眼表炎症和损伤以及神经感觉异常起着病因学作用。”泪膜在角膜上的厚度约为2至5.5微米,由3个主要成分组成。这些成分(脂质、水液和黏液)通常被描述为层,尽管这可能过于简化了泪膜环境。泪膜在角膜上的厚度约为2至5.5微米。它由3个主要成分组成,通常被描述为层(尽管这可能是对泪膜环境的过度简化):1. 最表层;由眼睑的睑板腺产生,其功能是减少泪液蒸发。2. 中间层,也是泪膜最厚的成分;由位于眼眶的泪腺和结膜中的副泪腺(克劳斯腺和沃尔夫林腺)产生。水液含有水、代谢物、电解质、肽、蛋白质等。3. 由黏液或糖蛋白组成;主要由结膜杯状细胞产生。黏液通过调节表面张力增强泪膜在角膜上皮上的扩散。DES和DED涉及一种常见的眼部疾病,即眼表润滑和水分不足。这种疾病会引发许多症状,如干涩、刺激、灼烧感、发红和视力模糊。尽管这些名称经常互换使用,但DED指的是对该病症更全面的理解。这可能会令人困惑,因为不同的医生和研究人员使用不同的术语。这个术语经常被非正式地用来指泪液分泌不足或泪液质量差,这会导致眼部疼痛及相关症状。患者和医学专业人员经常用它来描述这种疾病。更具包容性的术语DED能更好地描述该病症的多面性。它认识到蒸发型干眼、水液缺乏型干眼以及混合病因是干眼这种复杂且异质性疾病的一些潜在病因。DED涵盖了更广泛的临床表现和病因。DES是一个更宽泛地强调症状以及泪液量或质下降的术语,而非详细关注潜在病因。DED承认该病症有多个方面和不同亚型。2017年TFOS DEWS II报告对干眼病进行了全面分类和深入解释。在将DED分为水液缺乏型和蒸发型亚型时,该报告考虑的促成因素包括炎症、神经感觉异常和环境触发因素等。DES和DED的诊断程序和治疗方法相似。诊断通常需要进行全面的眼部检查,包括泪膜质量和量的检测、眼表检查以及对患者所述症状的评估。人工泪液、润滑眼药水、饮食调整、抗炎药物,在极端情况下还可能包括手术或操作等都可作为治疗手段。治疗的最佳方案取决于病情的潜在病因和严重程度。随着时间推移,干眼研究不断发展,我们对该病症的理解也变得更加复杂。在当代医学文献和研究调查中,DED这个术语被更频繁地使用以反映这种全面的理解。最近关于DED的研究涉及了炎症、睑板腺功能障碍以及环境对眼表的影响等方面。研究人员希望通过使用DED这个术语来涵盖各种促成因素,从而推动对患者的治疗。
2025-1
2025-1
J Fr Ophtalmol. 2007-3
Ocul Surf. 2017-7-20
Ocul Surf. 2017-7-20
Curr Eye Res. 2022-6
2025-1
Ocul Surf. 2017-7-20