Dry Eye Syndrome (DES) or Dysfunctional Tear Syndrome (DTS) is extremely common, and until recently, had been a fairly poorly understood problem. Treatment was only for symptomatic relief and patients continued to suffer.A new paradigm is surfacing with our new understanding of the different mechanisms and pathways involved in keeping the ocular surface and tear film stable.
The Yin and Yang of Dry Eyes
The ocular surface quality is vital to our vision, and has adapted to combat the environment despite being the most exposed of all our mucus membranes. A delicate balance maintains appropriate exposure, tear film constitution, as well as inflammatory mediators, for each given environment. As in all homeostatic systems, the tear surface maintenance system requires a sensory as well as action arm.
I will discuss in greater detail how this impacts refractive surgery soon. I am also a co-author on an article reviewing the use of punctal plugs in a soon to be published article in Comprehensive Ophthalmology Update.