Abstract
Dry eye, or keratoconjunctivitis sicca (KCS), is a rubric for a number of clinical disease states characterized by disturbances in the pre-ocular tear film resulting in ocular surface disease.1 KCS accounts for a high percentage of patient visits to ophthalmologists, and its treatment has given rise to a pharmaceutical market in the US of over $100 million per year (industry estimates). Approximately 7–10 million Americans currently require the use of artificial tear preparations.2 KCS is associated with a broad spectrum of ocular symptoms ranging from mild transient irritation to persistent irritation, burning, itchiness, redness, pain, ocular fatigue, and vision disturbances.3,4 In its more severe form, Sjögren’s-associated KCS, it is associated with vision-threatening complications including scleritis, corneal ulceration, and secondary bacterial infection.5 Pathophysiologic factors include deficiencies in aqueous tear production, qualitative changes in tear composition, alterations in the oil secretion of the meibomian glands of the eyelids, blinking abnormalities, and inflammatory changes in the ocular surface.6
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References
Lemp MA. Basic principles and classification of dry eye disorders. In: Lemp MA, Marquardt R, eds. The Dry Eye. New York: Springer Verlag; 1993:101–130.
Kaswan R. Cyclosporine drops: A potential breakthrough for dry eyes. In: Research to Prevent Blindness Science Writers Seminar. New York: Research to Prevent Blindness; 1989:18–20.
Lemp MA. Recent developments in dry eye management. Ophthalmology. 1987;94:1299–1304.
Toda I, Fujishima H, Tsuboto K. Ocular fatigue is a major symptom of dry eye. Acta Ophthalmol. 1993;71:347–352.
Lemp MA, Keenan PC. Sjögren’s syndrome. In: Fraunfelder FT, Roy FN, eds. Current Ocular Therapy. Philadelphia: WB Saunders; 1995:238–239.
Holly FJ, Lemp MA. Tear physiology and dry eyes. Sury Ophthalmol. 1977;22:69–87.
Lemp MA. Report of the National Eye Institute/Industry Workshop on Clinical Trials in Dry Eyes. CLAO J. 1995;21:221–232.
Mathers WD, Shields WJ, Petroll WM, Jester JV. Meibomian gland dysfunction in chronic blepharitis. Cornea. 1991;10:277–285.
Mathers WD. Ocular evaporation in meibomian gland dysfunction and dry eye. Ophthalmology. 1993;100:347–351.
Driver PJ, Lemp MA. Meibomian gland dysfunction. Sury Ophthalmol. 1996;40:343–367.
American Academy of Ophthalmology. Blepharitis and the dry eye in the adult. Preferred Practice Pattern. San Francisco. 1991.
Homma M, Sugai S, Tojo T, Miyaraka N, Arizuki M, eds. Sjögrens Syndrome - State of the Art. Amsterdam: Kugler Publications; 1994.
Daniels TE. Sjögren’s syndrome in a nutshell. Report. Port Washington, NY: Sjögren’s Syndrome Foundation; 1990.
Talai N, Moutsopoulos HM, Kasson SS, eds. Sjögren’s Syndrome: Clinical and Immunological Aspects. Berlin: Springer Verlag; 1987.
Fox RI, Kanh HI. Pathogenesis of Sjögren’s syndrome. Rheum Dis Clin North Am. 1992;18:517–538.
Tsubota K. Sjögren’s syndrome dry eye and non-Sjögien’s syndrome dry eye: What are the differences? In: Homma M, Sugai S, Tojo T, Miyasaka N, Akizuki M, eds. Sjögrens Syndrome - State of the Art. Amsterdam: Kugler Publications; 1994:27–31.
Jacobsson LTH, Hansen BV, Manthorpe R. Association of dry eyes and dry mouth with anti-Ro/SS-A and anti-Ro/SS-B autoantibodies in normal adults. Arthritis Rheum. 1992;35:1492–1501.
Manthorpe R, Jacobsson LTH. Sjögren’s syndrome. Baillieres Clin Rheumatol. 1995;9:483–496.
Vitali C, Moutsopoulos HM, Bombardiere S. The European Community Study Group on Diagnostic Criteria for Sjögren’s Syndrome. Sensivitivity and specificity of tests for ocular and oral involvement in Sjögren’s syndrome. Ann Rheum Dis. 1994;53:637–647.
Mathers WD, Lane JA, Zimmerman MB. Tear film changes associated with normal aging. Cornea. 1996;15:229–234.
Sullivan DA, Wickham A, Krenzer KL, Rocha AM, Toda I. Aqueous tear deficiency in Sjögren’s syndrome: Possible causes and potential treatment. In: Pleyer U, Hartmann C, Sterry W, eds. Ocular Diseases: Immunology of Bullous Oculo-Muco-Cutaneous Disorders. Buren The Netherlands: Aeolus Press; 1997:95–152.
Fox RI, Saito I. Sjögren’s syndrome: Immunologic and neuroendocrine mechanisms. Adv Exp Med Biol. 1994;350:609–621.
Ahmed SA, Talal N. Sex hormones and the immune system. Part 2. Animal data. Baillieres Clin Rheumatol. 1990;4:13–31.
Fox RI, Luppi M, Kang HI, Pisa R Reactivation of Epstein-Barr virus in Sjögren’s syndrome. Springer Semin Immunopathol. 1991;13:.
Sullivan DA, Sato EH. Potential therapeutic approach for the hormonal treatment of lacrimal gland dysfunction in Sjögren’s syndrome. Clin Immunol Immunopathol. 1992;64:9–16.
Fox R. Epstein-Barr virus and human autoimmune diseases: Possibilities and pitfalls. J Virol Methods. 1988;21:19–27.
Fox RI, Chelton T, Scott S, Benton L, Howell FV, Vaughan FH. Potential role of Epstein-Barr virus in Sjögren’s syndrome. Rheum Dis Clin North Am. 1987;13:275–292.
Burns JC. Persistent cytomegalovirus infection -- the etiology of Sjögren’s syndrome. Med Hypotheses. 1983;10:451–460.
Fox RI, Pearson G, Vaughan JH. Detection of Epstein-Barr virus-associated antigens and DNA in salivary gland biopsies from patients with Sjögren’s syndrome. J Immunol. 1986;137:3162–3168.
Pflugfelder SC, Tseng SCG, Pepose JS, Fletcher MA, Klimas N, Feuer W. Epstein-Barr virus infection and immunological dysfunction in patients with aqueous tear deficiency. Ophthalmology. 1990;97:313–323.
Pepose JS, Akata RF, Pflugfelder SC, Voigt W. Mononuclear cell phenotypes and immunoglobulin gene rearrangements in lacrimal gland biopsies from patients with Sjögren’s syndrome. Ophthalmology. 1990;97:1599–1605.
Shillitoe EJ, Daniels TE, Whitcher JP, Strand CV, Tolol N, Greenspan JS. Antibody to cytomegalovirus in patients with Sjögren’s syndrome as determined by an enzyme-linked immunosorbent assay. Arthritis Rheum. 1982;25:260–265.
Krueger GRF, Wassermann K, de Clerck LS, et al. Latent herpes virus-6 in salivary and bronchial glands. Nature. 1990;336:1255–1256.
Mariette X, Gozlan J, Clerc D, Bisson M, Morinet F. Detection of Epstein-Barr virus DNA by in situ hybridization and polymerase chain reaction in salivary gland biopsy specimens from patients with Sjögren’s syndrome. Am JMed. 1991;90:286–294.
McMurray R, Keisler D, Kanuckel K, Izui S, Walker SE. Prolactin influences autoimmune disease activity in the female B/W mouse. Jlmmunol. 1991;147:3780–3787.
Ahmed SA, Penhale WJ, Talal N. Sex hormones, immune responses and autoimmune disease. Am J Pathol. 1985;121:531–551.
Sullivan DA. Possible mechanisms involved in reduced tear secretion in Sjögren’s syndrome. In: Homma M, Sugai S, Tojo T, et al., eds. Sjögrens Syndrome --State of the Art. Amsterdam: Kugler Publications; 1993:11–19.
Sullivan DA. Possible mechanisms involved in the reduced tear secretion in Sjögren’s syndrome. In: Homma M, Sugai S, Tojo T, et al., eds. Sjögren’s Syndrome --State of the Art. [Proceedings of the 4th International Symposium, Tokyo, Japan, August 11–13, 1993.] New York: Kugler Publications; 1994:13–19.
Mircheff AK. Understanding the causes of lacrimal insufficiency: Implications for treatment and prevention of dry eye syndrome. In: Research to Prevent Blindness Science Writers Seminar. New York: Research to Prevent Blindness; 1993:51–54.
Sullivan DA, Allansmith MR. Hormonal influence on the secretory immune system of the eye: Androgen modulation of IgA levels in tears of rats. J Immunol. 1985; 134:2978–2982.
Kramer P, Lubkin V, Potter W, Jacobs M, Labay G, Silverman P. Cyclic changes in conjunctival smears from menstruating females. Ophthalmology. 1990;97:303–307.
Lubkin V, Nash R, Kramer P. The treatment of perimenopausal dry eye syndrome with topical estradiol. ARVO Abstracts. Invest Ophthalmol Vis Sci. 1992;33:S1289.
Mircheff AK, Warren DW, Wood RL. Hormonal support of lacrimal function, primary lacrimal deficiency, autoimmunity, and peripheral tolerance in the lacrimal gland. Ocular Immunol Inflamm. Aeolus Press, Buren (The Netherlands) 1996;4: No 3 pp. 145–172.
Sullivan DA, Sato EH. Potential therapeutic approach for the hormonal treatment of lacrimal gland dysfunction in Sjögren’s syndrome. Clin Immunol Immunopathol. 1992;64:9–16.
Mamalis N, Harrison D, Hiura G, et al. Are “dry eyes” a sign of testosterone deficiency in women? Presentation, 10th International Congress of Endocrinology,San Francisco June 12–15, 1996 Abstract # P3–379, page 849.
Jacobsson LTH, Axell TE, Hansen BU. Dry eyes or mouth: An epidemiologic study in Swedish adults, with special reference to primary Sjögren’s syndrome. JAutoimmun. 1989;2:521–527
Strickland RW, Tesar.1T, Beene BH. The frequency of sicca syndrome in an elderly population. J Rheumatol. 1987;14:766–771.
Schein OD, Munoz B, Tielsch TM. Estimating the prevalence of dry eye among elderly Americans: SEE Project. ARVO Abstracts. Invest Ophthalmol Vis Sci. 1996;37:S636.
McMonnies CW, Ho A. Patient history in screening for dry eye conditions. J Am Optom Assoc. 1987;58:296–301.
Vitali C, Bombardieri S, Moutsopoulos HM, et al. Preliminary criteria for the classification of Sjögren’s syndrome. Arthritis Rheum. 1993;36:340–347.
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Lemp, M.A. (1998). Epidemiology and Classification of Dry Eye. In: Sullivan, D.A., Dartt, D.A., Meneray, M.A. (eds) Lacrimal Gland, Tear Film, and Dry Eye Syndromes 2. Advances in Experimental Medicine and Biology, vol 438. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5359-5_111
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