الفهرس 
Physiology of the Pre-Ocular Tear FilmOnly 14 pages are availabe for public view
 |  | from | 187 |  |  |
| | | from | 187 | | |
Abstract
Dry eye is a disorder of the tear film due to tear deficiency or excessive tear evaporation which causes damage to the interpalpebral ocular surface and is associated with symptoms of ocular discomfort.
The current understanding of the pathogenesis of dry eye has proceeded from the mere recognition of a lack of, or altered quality of tears to recognition of inflammation as the key pathogenetic mechanism, whether from a systemic autoimmune disease or a local autoimmune event.
Clinical features of dry eye include an unstable tear film, ocular surface inflammation, and epitheliopathy, resulting in symptoms ranging from discomfort to blindness.
Clinical diagnostic tests of dry eye includes grading ocular surface staining, Tear break up time, and Schimer’s test. Histopathological tests such as impression cytology, conjunctival and labial salivary gland biopsy. Laboratory tests include Tear flourescein clearance, tear function index, tear osmolarity, analysis of protein, lactoferrin, tear lysozyme. Study of lipid layer that involves meibometry, lipid layer thickness, and lipid layer appearance.
Many years ago, the traditional approach to treating dry eye has been to lubricate the ocular surface by either replacing or conserving the patient’s tears.
Tear supplementation is the first line of treatment, artificial tears increase available tears and lower tear osmolarity through dilutional effects, however, significant advances have been made in treating many facets of dry eye including ; nonpreserved tear preparations, autologous serum and umbilical cord serum eye DROPs, punctual plugging, hydrogel soft contact lenses.
Corticosteroids, cyclosporine A, and tetracyclins have all been used with success to treat the secondary inflammatory response and consequential cellular changes of dry eye.
The omega-3 revolution with TheraTears Nutrition for dry eyes is a new approach to dry eye treatment. It is a supplement containing a blend of flaxseed oil, fish oil and vitamin E. TheraTears Nutrition will be taking a major role in the treatment of dry eyes, addressing the conditions that lead to increases in tear film osmolarity.
Surgical treatment is indicated in severe cases of dry eye that are refractory to other methods of treatment. It must not be given as an isolated act, but should be combined with the psychological, medical and environmental treatments. It involves punctual occlusion, stem cell transplantation and salivary gland transplantation.
In severe cases, a partial or complete tarsorrhaphy, amniotic membrane transplantation, and conjunctival flap may be necessary to prevent complete decompensation of the cornea.