Xerophthalmia

Alternative names
Keratitis sicca; Keratoconjunctivitis sicca; Dry eye syndrome

Definition

Keratoconjunctivitis sicca is a persistent dryness of the cornea and conjunctiva due to decreased function of the tear glands or increased evaporation of tears. The cornea may be thickened and visual acuity may be decreased.

See also conjunctivitis, decreased tearing, vitamin A deficiency, and Sjogren syndrome.

Causes, incidence, and risk factors

Dry eye syndrome usually occurs in people who are otherwise healthy. It is more common with older age, because tear production decreases with age. In rare cases, it can be associated with rheumatoid arthritis, lupus erythematosis, and other similar diseases. It may also be caused by thermal or chemical burns.

Symptoms

Symptoms of dry eye range form mild irritation and foreign body sensation to severe discomfort with sensitivity to light.

Signs and tests

The tear film can be inspected at the slit lamp (biomicroscope) by the ophthalmologist. A dye such as fluorescein may be placed in the eye to make the tear film more visible. Your health care provider may do a Schirmer’s test, measuring the rate of tear production using a calibrated paper wick placed on the edge of the eyelid.

Treatment

Wetting drops called artificial tears may be used for treatment. Lubricating ointments may help more severe cases. Tiny plugs may be placed in the tear drainage ducts to help the tears remain on the surface of the eye.

Expectations (prognosis)

Most patients with dry eye have only discomfort, and no vision loss. With severe cases, the cornea (clear window on the front of the eye) may become damaged or infected.

Complications

Ulcers or infections of the cornea are serious complications.

Calling your health care provider

See your health care provider immediately if you have dry eyes and have a sudden increase in discomfort or redness, or a sudden decrease in vision.

Prevention

There is no way to prevent keratoconjunctivitis sicca. Complications can be prevented by use of wetting and lubricating drops and ointments.

Johns Hopkins patient information

Last revised: December 8, 2012
by Brenda A. Kuper, M.D.

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