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The dry eye
Definition
Dry eye, also known as keratoconjunctivitis sicca, is a common eye problem in which tear film stability is impaired, which can lead to symptoms such as burning, scratching and foreign body sensation in the eye.
Causes
Roughly summarized, there are two main causes of dry eyes:
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On the one hand, there may be a qualitative problem, i.e. there are enough tears, but the quality (the protective film) is disturbed. This is controlled by the meibomian glands, which are located along the upper and lower eyelid margins. They produce lipids or oils that coat the tears and protect them from excessive evaporation. When these glands do not function properly, a condition called evaporative stress occurs, in which tear fluid evaporates too quickly, resulting in an unstable tear film composition.
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On the other hand, the amount of tears may be reduced. This refers to the aqueous portion (>90%). We have a tear gland behind the bone of the upper eyelid that constantly releases this fluid and distributes it throughout the eye. In autoimmune, allergic or rheumatic diseases, general inflammation or over the course of life, the function of this gland can be disturbed and volume deficiency stress occurs. You can well imagine that this can put a strain on the surface of the eye.
Treatment & therapy
Often the problem is chronic and cascades of circumstances arise that influence each other and continue to worsen the situation. These include inflammatory processes that, in connection with dry eye, inhibit tear production, impair the quality of the tear film and reduce the protective function of tears against external stimuli. That's why today people always use anti-inflammatory eye drops (e.g. containing cortisone) even if they have dry eyes.
The edges of the eyelids also play an important role in dry eyes. If the edges of the eyelids do not close or move properly, or are chronically inflamed, this can lead to inadequate distribution of tears over the surface of the eye.
You can already guess that when it comes to dry eye, a comprehensive survey (information about the exact symptoms, living conditions, general illnesses, medications, etc.) is important so that targeted therapy can be carried out.
Treatment options range from artificial tears to anti-inflammatory medications to measures to improve meibomian gland function and eyelid edge hygiene. There are also small silicone cones (plugs) that are inserted into the tear duct to limit the natural flow of tears through the nose. With IRPL (Intense Regulated Pulsed Light) you can specifically stimulate the meibomian gland function.
Diabetische Netzhauterkrankung
Bei Grunderkrankungen kann ebenfalls die Durchblutung der Netzhaut mit betroffen sein, hier ist sicher der Diabetes mellitus (Zuckerkrankheit) anzuführen: Durch die Stoffwechselprobleme beim Diabetes werden die Strukturen der Gefässe geschädigt und durchlässiger für die Bestandteile des Blutes. Folge sind Blutungen in die Netzhaut, Ödeme (Wassereinlagerungen), und Neubildung von Gefässen (Neovaskularisationen).
Fazit
Alle erwähnten Erkrankungen brauchen eine intensive augenärztliche Betreuung und ggf. auch Behandlung. Da das Auge in diesen Fällen das Folgeorgan ist (Die Ursachen für Thrombose, Embolie, Infarkt und Diabetes sind systemisch bedingt), ist eine enge Zusammenarbeit mit anderen Fachbereichen notwendig, um die Abklärungen umgehend auszuweiten und zu behandeln (Innere Medizin, Hämatologie, Neurologie, Endokrinologie, Kardiologie usw.)
make an appointment
Dr. med. Matthias Neudeck
Clarastrasse 2
4058 Basel
+41 61 68338 80
neudeck@hin.ch
Reachable by telephone
Mon - Fri
09.00 - 12.00
1.30 p.m. - 5 p.m
closed on Fridays