Kwon Jeonghyun, Moghtader Amirhossein, Kang Christie, Bibak Bejandi Zahra, Shahjahan Sumaiya, Alzein Ahmad, Djalilian Ali R
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA.
Department of Physiology and Biophysics, University of Illinois at Chicago, Chicago, IL 60612, USA.
Medicina (Kaunas). 2025 Mar 6;61(3):460. doi: 10.3390/medicina61030460.
Dry eye disease (DED), also known as keratoconjunctivitis sicca, is a multifactorial ocular disease characterized by tear film insufficiency due to diverse etiologies including aging, incomplete and infrequent blinking, hormonal changes, medications, and systemic diseases. Classified into aqueous-deficient dry eye (ADDE), evaporative dry eye (EDE), and mixed subtypes, DED presents with symptoms such as irritation, stinging, redness, foreign body sensation, sensitivity to light, and blurred or fluctuating vision. While rare, severe cases may lead to vision loss. With its rising global prevalence across age groups, DED poses a significant public health challenge. Primary care physicians (PCPs), often the first point of contact for DED patients, require timely screening and management strategies. This review explores the epidemiology, pathophysiology, clinical manifestations, diagnosis, and management of DED, emphasizing practical approaches for PCPs. This narrative review was conducted by searching MEDLINE, PubMed, and Google Scholar databases for relevant articles. Diagnostic approaches, including detailed history taking, patient-reported questionnaires, differential diagnosis, and assessments are discussed alongside management strategies, including symptomatic ophthalmic treatment, risk factor mitigation (e.g., reduced digital device screen time), prevention, and nutrition. By providing a synopsis of early symptoms that PCPs are often the first to encounter, practical approaches to screening and managing DED in the primary care setting, and guidelines on when to refer to specialty care, this comprehensive review aims to equip PCPs with the knowledge to improve DED screening and optimize patient outcomes.
干眼病(DED),也称为角结膜干燥症,是一种多因素眼病,其特征是由于多种病因导致泪膜不足,这些病因包括衰老、眨眼不完全和不频繁、激素变化、药物以及全身性疾病。DED分为水样液缺乏性干眼(ADDE)、蒸发过强型干眼(EDE)和混合型,其症状包括眼刺激感、刺痛、眼红、异物感、畏光以及视力模糊或波动。虽然严重病例罕见,但可能导致视力丧失。随着DED在全球各年龄组中的患病率不断上升,它构成了一项重大的公共卫生挑战。基层医疗医生(PCP)通常是DED患者的首诊医生,需要及时的筛查和管理策略。本综述探讨了DED的流行病学、病理生理学、临床表现、诊断和管理,重点强调了针对PCP的实用方法。本叙述性综述通过检索MEDLINE、PubMed和谷歌学术数据库中的相关文章进行。文中讨论了诊断方法,包括详细的病史采集、患者报告问卷、鉴别诊断和评估,以及管理策略,包括对症眼科治疗、减轻危险因素(如减少数字设备屏幕使用时间)、预防和营养。通过提供PCP常常最先遇到的早期症状概要、在基层医疗环境中筛查和管理DED的实用方法以及何时转诊至专科护理的指南,本全面综述旨在使PCP具备改善DED筛查和优化患者治疗效果的知识。