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Dry eye syndrome

Dry eye syndrome is an abnormality of the tear film. Patients with dry eye experience eye discomfort and/or visual symptoms and it may lead to eye surface disorders. Dry eye syndrome is fairly common in adults over the age of 40.


The most common symptoms are the sensation of sand (or other foreign body) in the eye, reddening, irritation, pain, burning and sensitivity to bright light (photophobia)

Main causes

The main causes of dry eye syndrome include:

  • Age (notably menopause)
  • Certain inflammatory conditions such as Sjögren’s Syndrome or rheumatoid arthritis
  • Certain autoimmune conditions such as Stevens-Johnson Syndrome
  • Drugs
  • Overuse and misuse of contact lenses
  • Changes in the surface of the cornea, caused by scarring or dystrophy

Some drugs such as beta-blockers, antihistamines and antidepressants, or diseases such as diabetes, can result in dry eye symptoms.



A physical eye examination will detect changes in the conjunctiva and the tear film. In addition, tests can be performed, examples include:

  • The Schirmer’s test (performed by placing small strips of absorbent paper on the eyelid margin) permits a quantitative assessment of tears produced within a certain period of time.
  • The break-up time (BUT) test (analysis of tear film breaks stained with fluorescein) permits a qualitative assessment of the superficial lipid layer.


The treatment of this condition is based on lubricant eye drops. In addition, it is fundamental to treat any underlying conditions (eye-related or not), to review systemic drug treatments which may cause eye dryness, and to make any necessary lifestyle changes, particularly related to diet and smoking.

Finally, it is useful to advise patients on how to reduce eye strain, such as blinking frequently, changing focus from near vision to distance vision, taking regular short breaks, checking ambient light, eliminating sources of reflected glare and regulating humidity and ventilation.


  1. Report of the International Dry Eye Workshop (DEWS) 2007. The Ocular Surface 2007;5(2)

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