Faculty of Nursing
Technical Institute of Nursing
Research about :
Dry Eye
» Prpared by » Supervised by
• ( ٦٢٧نهال بدران عبدالجواد يوسف) Dr:Pansée Elsayed
• ( ٦٢٨نهال نبيل مجدي النحال) Dr:Mai Ali
• ) ٦٢٩نهلة سمير عبدالقادر دبور ) Dr:Esraa Elghoul
• ( ٦٣٠نوح ياسر الصابر حسن)
Dr: JosephGuirguis
• ( ٦٣١نور وسام محمد العلقامي)
• ٦٣٢نورا جمال محمود صقر )
• ( ٦٣٣نورا سامي زكريا عالم )
• ( ٦٣٤نورا وائل فؤاد بكار)
• ( ٦٣٥نوران عمر محمد فايد)
• ( ٦٣٦نورهان أمين محمد أمين)
Outline
*Definition
*Cause
*Types
*Signs and symptoms
*Complication
*Treatment
*Nursing interventions
*Reference
O
» Definition
•Dry eye disease (DED) is a condition caused by many
factors that result in inflammation of the eye and the tear-
producing glands.
-•Inflammation can decrease the eye's ability to produce normal
tears that protect the surface of the eye and keep it moist and
lubricated.
» Causes of dry eye
1) Congenital
2) MGD
3) Lagopthalmos
4) Ectropion
5) Vitamin A deficiency
6) Post chemical Injury
7) Coloboma of the lid
8) Chronic Blepharitis
9) Computer worker
10) Long term use of contact
lens
11) Aging: As people age, the tear production decreases, and
the quality of tears may also diminish. This can lead to a higher
risk of developing dry eye symptoms
12) Medications: Many medications commonly used by older
adults, such as antihistamines, decongestants, antidepressants,
and blood pressure medications, can cause dry eye as a side
effect
13) Hormonal changes: Postmenopausal women may
experience hormonal changes that can affect tear production and
quality, leading to dry eye symptoms.
14) Medical conditions: Certain medical conditions that are
more prevalent in older adults, such as Sjögren's syndrome,
rheumatoid arthritis, diabetes, thyroid disorders, and Parkinson's
disease, can increase the risk of developing dry eye
15) Environmental factors: Older adults may be more
susceptible to dry eye due to exposure to environmental factors
such as dry air, wind, smoke, and air conditioning.
16) . Reduced blinking: Some elderly individuals may have
reduced blinking reflexes due to neurological conditions or
medications, leading to inadequate spreading of tears across the
eye's surface
17) Eye surgery: Previous eye surgeries, such as cataract
surgery or refractive procedures, can sometimes disrupt the
normal tear film and contribute to dry eye symptoms in older
adults.
What are the Different Types of Dry Eye Disease?
Dry eye disease is a complex condition that can manifest in various ways,
and it can be classified into different types based on its underlying causes
and characteristics. The main types of dry eye disease include:
1-Aqueous Deficient Dry Eye:
This type of dry eye occurs when the lacrimal glands do not produce enough
of the watery component of tears, called the aqueous layer. It can result
from aging, systemic diseases (e.g., Sjögren’s syndrome, rheumatoid
arthritis), or certain medications that affect tear production.
2-Evaporative Dry Eye:
Evaporative dry eye is the most common form of dry eye disease and
typically arises due to meibomian gland dysfunction (MGD). These glands
are responsible for producing the oily layer of tears, which helps prevent
tears from evaporating too quickly. When the meibomian glands become
clogged or dysfunctional, tears evaporate too rapidly, leading to dryness and
irritation.
3-Mixed Dry Eye:
Many individuals with dry eye may experience a combination of aqueous
deficient and evaporative dry eye. This type can be particularly challenging
to manage as it involves both reduced tear production and increased tear
evaporation.
4-Sjögren’s Syndrome Dry Eye:
Sjögren’s syndrome is an autoimmune disease that primarily affects the
exocrine glands, including the lacrimal and salivary glands. Dry eye is a
common symptom in Sjögren’s syndrome, but it can also occur
independently of this condition. Non-Sjögren’s dry eye refers to dry eye
disease not associated with Sjögren’s syndrome.
5-Contact Lens-Induced Dry Eye:
Wearing contact lenses, especially for extended periods, can lead to dry eye
symptoms. The lenses may disrupt the tear film, increase tear evaporation,
or cause mechanical irritation to the ocular surface.
6-Environmental Dry Eye:
Environmental factors such as low humidity, wind, smoke, and prolonged
exposure to screens or air conditioning can exacerbate dry eye symptoms.
This type of dry eye is often situational and temporary.
7-Neuropathic Dry Eye:
Neuropathic manifestations of dry eye are rooted in disturbances within the
intricate web of our nervous system. These symptoms, though often labeled
as dry eye-related, aren’t always linked to tears not doing their job. This type
of dry eye is often triggered by nerve traumas, becoming persistent over
time. This condition often presents a formidable challenge to convenional
dry eye syndrome treatments, with many patients experiencing limited
relief.
8-Neurotrophic Keratitis:
Neurotrophic keratitis, also known as neurotrophic keratopathy, is a medical
condition that affects the cornea of the eye. It is a subtype of corneal
disease that is characterized by reduced or absent corneal sensitivity due to
damage or dysfunction of the trigeminal nerve, which supplies the cornea
with sensory nerve fibers. The trigeminal nerve plays a crucial role in
maintaining the health and integrity of the cornea by regulating the
production of tears, blinking, and other protective mechanisms .
9-Iatrogenic Dry Eye:
Some medications and medical treatments, such as antihistamines,
decongestants, chemotherapy, and laser eye surgery (e.g., LASIK), can cause
or exacerbate dry eye symptoms
It’s essential to determine the specific type of dry eye a person has, as the
treatment and management approaches can vary accordingly. An accurate
diagnosis by an eye care professional is crucial to develop an effective
treatment plan tailored to the individual’s needs and underlying causes.
Dry eyes can develop for many reasons, including:
Age. Dry eyes are a part of the natural aging process. The majority of people
over age 65 experience some symptoms of dry eyes.
Gender. Women are more likely to develop dry eyes due to hormonal
changes
» Symptoms
Signs and symptoms, which usually affect both eyes, may include:
1. .A stinging, burning or scratchy sensation in your eyes
2. .Stringy mucus in or around your eyes
3. .Sensitivity to light
4. .Eye redness
5. .A sensation of having something in your eyes
6. .Difficulty wearing contact lenses
7. .Difficulty with nighttime driving
8. Watery eyes, which is the body's response to the irritation of dry eyes
9. .Blurred vision or eye fatigue
«Complications of untreated chronic dry eye
1. Dry eye has seven major complications:
2. .Irritation or grittiness
3. .Burning or itching
4. .Feeling there’s something in your eye
5. Blurry vision
6. .Excessive watering
7. ..Eye infections
8. .Damage to cornea
And while you might think watery eyes wouldn’t be a symptom of dry eye, it's
actually a common symptom. The eye tries to lubricate itself when it doesn't
have enough tears or tears of good quality. The tears it can produce come
only from the watery layer, so what you get is spillage.
Treatment:
1. 1)Drops and gel
2. Ointments
Used at bedtime to supplement daytime drops or gel instillation
3. Artificial tears
4. Lubricating ointment at night
5. Punctual occlusion
6. Environmental modification
7. Topical anti-inflammatory agents
» Nursing Intervention
.Examine the patient to discover the signs of the deterioration or
improvement of her state and assess the patients ability to see.
.Encourage the patient to visit an ophthalmologist to determine the nature of
the problem.
.Inform the patient about the possible reasons for the deterioration of the
state of her eye.
.Provide beneficial conditions for the functioning of a patient.
.Explain the basic rules and knowledge for patients suffering from the
problem of this sort.
.The given set of interventions is aimed at the improvement of the state of a
patient and the initiation of the recovery process.
References
Alshamrani AA, Almousa AS, Almulhim AA, Alafaleq AA, Alosaimi
MB, Alqahtani AM, Almulhem AM, Alshamrani MA, Alhallafi AH, Alqahtani IZ,
Alshehri AA. Prevalence and risk factors of dry eye symptoms in a Saudi
Arabian population. Middle East Afr J Ophthalmol 2017;24:67-73 [1] #
The epidemiology of dry eye disease: report of the Epidemiology
Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf.
2007;5(2):93-107.
Nichols KK, Nichols JJ, Mitchell GL. The lack of association between signs
and symptoms in patients with dry eye disease. Cornea. 2004;23:762-770.
De Paiva CS, Pfugfelder SC. Corneal epitheliopathy of dry eye induces
hyperesthesia to mechanical air jet stimulation. Am J Ophthalmol.
2004;137(1):109-115
