TRIPLE CLASSIFICATION OF DRY EYE DISEASES
The knowledge of the different dry eye diseases is still very developing; it is still in the initial phase and will develop greatly throughout the 21st century. It even lacks a practical clinical classification, although there are several excellent classifications for conceptual uses.
For this reason, at the 14th congress of the Societas Ophthalmologica Europaea (Madrid, June 11, 2003), we presented a multicenter study in which we offered a practical clinical classification for patients with ocular surface dryness diseases. According to this Madrid classification, any clinical diagnosis of the dry eye must be defined and expressed with 3 parameters.
A. Etiology: Etiological Decalogue of the Dry Eye
The approximately 100 different causes capable of developing a dry eye syndrome can be grouped into 10 groups, in which the first 5 usually affect numerous exocrine glands (eyes, nose, mouth, vagina, skin), while the last 5 usually affect only the glands of both eyes, only one eye, or even a single glandular variety of one eye
Dry eye syndrome during climacteric in Mexican women.
Introduction. Dry eye syndrome (DES) is a multifactorial disease due to tear film deficiency. It has been reported post-menopause Latin women present a major incidence of it.
Aim. To know the percentage of DES grade 1 and 2 in Mexican women during climacteric period at Instituto Nacional de Perinatología.
Material and method. A retrospective study supervised by the department of ophthalmology of Instituto Nacional de Perinatología was made analyzing clinical records of women between 45 and 55 years, with DES symptoms; quantity and quality tear fill test and bio-microscopic examination.
Results. A marked increase of DES occurs in the climacteric.
Conclusions. Mexican post-menopause women present a major frequency of dry eye disease.
Introduction. Dry eye syndrome (DES) is a multifactorial disease caused by deficiencies in the tear film. DES has been reported to have a greater presence in postmenopause in Latina women.
Objective. To know the percentage of cases of DES grade 1 and 2 in Mexican women during the climacteric, at the National Institute of Perinatology.
Material and methods. A retrospective study authorized by the department of ophthalmology of the National Institute of Perinatology was carried out in records of women aged 45 to 55 years of women who presented symptoms of DES, who were tested for tear quantity and quality and evaluated by biomicroscopy.
Results. The results are shown in percentages and describe an increase in DES during postmenopause.
Conclusion. The Mexican population in the postmenopausal stage presents dry eye more frequently.
DES or tear dysfunction syndrome is a multifactorial condition derived from a deficiency or excessive tear evaporation. In the classical model, the tear comprises three sublayers: mucous, aqueous, and lipidic. The function of the mucosa is to promote the adherence of the tear to the cornea; it is produced mainly by Globet cells. The aqueous one, whose function is to provide nutrients and oxygen to the cornea, is secreted by the main lacrimal gland and the lipid, whose function is to delay the evaporation time of the tear is produced in the meibomian glands. If any of these present deficiencies in its function or production, DES may appear with symptoms such as dryness, irritation, more frequent eye blinking, visual sensitivity that increases when exposed to vapors or air conditioning, among others, causing damage to the interpalpebral ocular surface (1).
DES is classified according to its duration, the affected tear sublayer, or its severity. Due to its duration, it is divided into episodic or chronic. Regarding the affected lacrimal sublayer, DES can be of the aqueous type, commonly associated with Sjogren’s syndrome or evaporative, mainly due to deficiencies in the lipid layer due to dysfunction of the meibomian glands, the use of condoms, vitamin A deficiencies, and allergies. Due to its severity, it is classified into three levels: grade 1, it presents symptoms of dryness in normal environmental conditions, but without signs in the evaluation with biomicroscopy; grade 2, which presents reversible signs detected by biomicroscopy (epithelial erosion, punctate keratopathy, filamentous keratitis) and short tear film break-up time (BUT); grade 3, in which in addition to the above, there are permanent sequelae such as ulcer, opacity and corneal neovascularization or squamous epithelial metaplasia; frequently in untreated patients.
AND he climacteric is the transition period from the reproductive to the non-reproductive stage in women. It starts from the biological changes that indicate that menopause is close to a year after the cessation of menstruation. It includes pre-menopause, menopause that reflects the aging of the ovary, and concomitant hormonal alterations, in addition to the absence of menstrual bleeding for a year, commonly between 45 and 55 years of age, in Mexico, the average is 47.6 years and postmenopause (3- 4).
DES has been reported to have a higher incidence in women than in men and that its prevalence increases with age. In addition, Hispanic and Asian women were more likely to have severe DES-associated symptoms than whites (5-7) but did not receive treatment. A study in Mexico compares one of the characteristics of DES before and after hormonal treatment, describing that it does not significantly modify the amount of tear production (8). The preceding highlights the importance of studying DES in Mexican women during the climacteric. The objective of this work was to know the percentage of cases of DES grades 1 and 2 in Mexican women during the climacteric.
Dry eye syndrome: why it occurs and how to end it
It is the first reason for consultation with ophthalmologists and can affect up to 30% of the population. Common, misunderstood and underestimated, it must be stopped before turning into a disabling disease.
dry eye syndrome causes the solution
If you have ever read “do not cry, because not all tears are bitter,” remember dry eye syndrome and the physiological need for tears to hydrate our eyes. Under normal circumstances, our body secretes them in sufficient quantity to keep them hydrated, thus eliminating particulars that may have remained inside.
However, our eyes face dozens of external and even internal attacks daily, causing dry eye syndrome to affect between 15% and 30% of the population. Age, the use of contact lenses and contact lenses, certain hormonal changes, some drugs or, of course, the world of screens and air conditioners that surrounds us, added to pollution or air currents, are potential enemies of our health ocular, going beyond red eyes or ophthalmic fatigue.
Of all this, dry eye syndrome, which goes unnoticed on many occasions, is the first and suffered step that we face. To put black on white on this topic and learn more about a syndrome with a very high prevalence, we spoke with the ophthalmologist Margarita Cabanás, a specialist in cataract surgery, refractive surgery, cornea, and presbyopia surgery at the Baviera Clinic, who explains to us in what is dry eye, why it occurs, what complications it can have and what can promote its appearance.