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Dry Eye Syndrom
Dry Eye Syndrom
Dry Eye Syndrom
Ratna Muslimah 2
Definition
Dry eye (DEWS committee; 2007):
• Multi factorial disease of tears and ocular
surface
• Discomfort, visual disturbance and tear film
instability
• Potential damage to the ocular surface
Ratna Muslimah 3
Definition
• Dry eye is accompanied by increased
osmolarity of the tear film and inflammation
of the ocular surface.
Ratna Muslimah 4
Epidemiology
• USA : 10- 30 % population
• Age : > 40 years old
• Sex : estimate 3,23 million women, 1,68
million men
Ratna Muslimah 5
Anatomy of Lacrimal System
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Neural pathways linking
components of the lacrimal
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Structure of the tear film
Ratna Muslimah 8
Ratna Muslimah 9
Etiology Dry Eye Syndrome
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I. Decreased Tear Secretion
1. Sjogren syndome
2. Non Sjogren syndrome
•
Primary Lacrimal Gland Deficiencies
•
Secondary Lacrimal Gland Deficiencies
•
Lacrimal Obstructive Disease
•
Medication
•
Refleks Hyposecretion
Ratna Muslimah 11
Sjogren syndome
• Sjogren Syndrome is a systemic autoimmune
disorder
• keratoconjunctivitis sicca, dry mouth, and
positive Antinuclear Antibody (ANA)
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Primary Lacrimal Gland Deficiencies
•
Idiopathic
•
Age Related Dry Eye
•
Congenital Alacrima ( eg. Riley day syndrome)
•
Familial dysautonomia
Ratna Muslimah 13
Secondary Lacrimal Gland Deficiencies
•
Lacrimal gland disease
•
Sarcoidosis
•
Lymphoma
•
AIDS
•
Trachoma
•
Vitamin A deficiency
Ratna Muslimah 14
Lacrimal Obstructive Disease
•
Trachoma
•
Ocular Cicatricial Pemphigoid
•
Steven Johnsons Syndrome
•
Chemical and Thermal burns
•
Endocrine Imbalance
•
Post Radiation Fibrosis
Ratna Muslimah 15
Medication
Ratna Muslimah 16
II. Increased Evaporation
Meibomian Gland Disease : reduced number, dysfunction
Low blink rate :
Physiological : working at Computer and Microscope
Extrapiramidal disorder (Parkinson)
Disorder of eyelid aperture :
Exposure ( eg, proptosis, exophtalmos, high myopia)
Lid palsy
Ectropion
Lid coloboma
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Dry eye
Tear deficiency Evaporative
Ratna Muslimah 18
M.S. A
Suramadu 2009
Ratna Muslimah