Impairment of tear secretion – symptoms, causes, diagnosis, treatment

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Impairment of tear secretion is the cause of unpleasant ailments caused by drying out of the conjunctiva and cornea and lacking natural protection by tears. This condition is called dry eye syndrome, which may be a separate disease or occur with other conditions.

Impairment of tear secretion – definition

Impairment of tear secretion, or dry eye syndrome, may be a separate disease, symptom, or coexistence of other conditions. However, it causes unpleasant symptoms in the form of drying out of the conjunctiva and the cornea. In a healthy person, thanks to the blinking of the eyelids, the tear film is properly distributed over the eyeball, it has protective properties that prevent friction between the eyelids and the eyeball. Tears consist of the fat layer and the watery layer of the lacrimal gland secretion, which disinfects the epithelium. The mucous layer adjacent to the eyeball is designed to keep the tears on the surface of the cornea, however, it depends on many factors, including the proper functioning of the glands that produce elements of the tear film, e.g. the conjunctiva.

Symptoms of impaired tear secretion

Patients with dry syndrome complain of dryness:

1. conjunctiva,
2. sometimes the mucous membranes of the nose and throat.

In addition, itching and burning may appear, and if the cornea dries out, it causes stinging pain. In addition, the patient feels the presence of a foreign body, photosensitivity and disturbed vision. There is redness of the eyes. Symptoms may be exacerbated by dry climate, wind, low humidity, long-term work at the computer.

The causes of impaired tear secretion

Dry eye syndrome sometimes occurs in middle-aged and older women with chronic rheumatism. Other causes may be autoimmune diseases, e.g. RA, Hashimoto’s disease, lupus erythematosus, systemic scleroderma. However, the most common cause of impaired tear secretion is old age, when tears are much less secreted than in younger people.

The causes of dry eye also include disorders in the lacrimal gland itself, for example blockage of the ducts leading to the lacrimal gland, the absence of this gland (primary) or the presence of a tumor destructive to the lacrimal gland.

Medicines taken by patients can also cause dry eye syndrome as a side effect. These can be preparations:

1. for arterial hypertension,
2. antiarrhythmic,
3. for Parkinson’s disease,
4. psychotropic,
5. antidepressants,
6. contraceptives,
7. for glaucoma,
8. antihistamine.

Other causes and risk factors for this ailment are:

1. inflammation of the edges of the eyelids and their obstruction,
2. non-closing of the eyelids as a result of a stroke (at the same time incorrect distribution of tears),
3. radiation therapy to the eyes
4. previous ophthalmic surgical procedures,
5. insufficient amount of vitamin A and omega-3 acids in the body,
6. wearing contact lenses.

Diagnosis of impaired tear secretion

If you suffer from dry eye syndrome or notice disturbing symptoms – consult your family doctor who will guide you further. The diagnosis is based on a medical interview, during which the doctor asks questions to facilitate the procedure. It is important to know about symptoms and when they first appeared. Do symptoms come on suddenly and then go away? Has a family history of dry eye occurrences? Does the patient have any other medical conditions or are taking any medications? After the interview, an appropriate specialist examination is ordered successively, most often:

1. tear film break test – it enables qualitative assessment of the tear film;
2. examination of the conjunctival folds parallel to the edge of the eyelid;
3. Schirmer’s test – allows for the quantitative assessment of tear secretion and consists in attaching a special tissue paper to the medial corner of the eye. It should moisten at least 10-15 mm within five minutes – then the secretion of tears is considered normal,
4. blood test for antibodies – performed when an autoimmune disease is suspected,
5. salivary gland biopsy – performed when impaired tear secretion coexists with impaired salivary secretion. This can happen because the salivary and lacrimal glands have a similar histological structure.

Impairment of tear secretion – treatment

One of the treatments for dry eye syndrome is tear point closure. The offered procedure is performed in a specialized ophthalmology clinic. In a situation where the dry eye syndrome has appeared as a result of a given autoimmune disease, the actions are causal treatment. Other cases are symptomatic treatment, including:

1. avoiding dry and hot rooms, but also hot air directed at the eyes (e.g. heating in a car),
2. avoiding the wind (you can also wear glasses to protect yourself from it),
3. using over-the-counter medications in the form of artificial tears,
4. sometimes preparations are also used to reduce inflammation: corticosteroids in drops or cyclosporin A,
5. economical use of air conditioning,
6. blocking the tear drainage pathways (e.g. with silicone plugs or with a laser – permanent).
7. applying compresses and massage of the eyelids,
8. avoiding smoky rooms,
9. using moisturizing eye ointments at night,
10. you quit smoking because nicotine smoke makes your symptoms worse
11. appropriate screen positioning, if your work requires prolonged exposure to the computer monitor, it should be at the level of your eyes,
12. it’s also important to take breaks from your computer work – close your eyes and then blink them for a while. Thanks to this, the tear film will be spread over the eyeball,
13. humidifying rooms where you stay every day (especially in winter, during the heating season).

Can you completely heal yourself?

Currently, there are no effective treatments for an impairment of tear secretion, and the symptoms usually persist for the rest of the patient’s life. Of course, the exception is when dry eye syndrome is caused by taking certain medications, as it usually wears off when you stop taking them.

Read also: Time for health – dry eye syndrome