Sicca syndrome is one of the most common eye diseases. Read here everything about possible causes, symptoms and treatment of dry eyes.
What is Sicca Syndrome?
Dry eyes, also known as "sicca syndrome, occur when the eyes are not sufficiently wetted with tear fluid. As a result, they start to itch or burn, become red and react sensitively to light.
Unpleasant consequences that probably everyone has experienced after long computer work or in rooms with dry heating air. But dry eyes can also become a permanent problem. This happens not at all infrequently: Sicca syndrome is considered a common disease. About every sixth person suffers from it. As a rule, the affected person can be quickly treated with eye drops. Uncomplicated help. However, if no treatment takes place, the sicca syndrome can become dangerous: If the eyes are permanently too dry, they can become damaged and a visual disorder can develop – which could easily have been avoided with the right therapy.
Different forms of sicca syndrome
Doctors distinguish between two different forms of sicca syndrome, which sometimes occur in combination: The first is the hypovolemic form, in which the eye produces too little tear fluid and therefore dries out.
In the second form, hyperevaporative, the composition of the tear fluid is disturbed. The human tear film is not a homogeneous fluid, but consists of three layers: The lowest is the mucin layer, or mucus layer, which lies directly on the cornea. There is a watery layer on top of it, which is sealed with a greasy film (lipid layer). If there are disturbances of this composition, it can happen that the tear fluid evaporates for example too fast. It is produced sufficiently or even increased, but still can not keep the eye moist. This also explains why the eyes paradoxically sometimes tear more – despite dryness.
Symptoms of Sicca Syndrome
Typical signs are burning or itchy eyes that are sensitive to light and begin to water at even minor external influences, such as a slight gust of wind. Somewhat blurred vision can also be a symptom of sicca syndrome.
Dry eyes are usually reddened, because the fine veins in the eye are more strongly supplied with blood by the constant irritation, whereby the eye white appears discolored. In addition, many sufferers complain of a feeling of constantly having something in their eye – although this is not the case. Affected people also report that their eyelids are stuck together with secretions in the morning.
Risk factors for dry eyes
The risk of developing sicca syndrome increases with age. The older a person gets, the less tear fluid they produce. At the same time, the blinking of the eyelids becomes less frequent, which further promotes the drying of the eyes.
Women also have an increased risk of the disease at a young age, as female sex hormones promote the development of dry eye.
Other risk factors are pre-existing conditions such as "acne rosacea", an inflammatory skin disease, or" Diabetes mellitus", popularly known as diabetes. Dry eyes are also not uncommon during drug treatment of glaucoma or radiation therapy of the head.
Vitamin A deficiency is also conducive to the development of sicca syndrome. Among other things, this vitamin is important for keeping eyes and mucous membranes healthy and is found primarily in animal foods such as butter and cheese. But fruit and vegetables, such as carrots, spinach, peppers and apricots, also contain a lot of this important vitamin.
You can find more on the subject of eye health in the Better Hearing, Sharper Vision ie of FOCUS-GESUNDHEIT, available as a E-Paper or Print booklet.
Causes of dry eyes
The causes of sicca syndrome are varied: there may be an underlying disease, the dry eyes may be a reaction to hormonal changes or an allergy, or the reason for the irritated eyes is not in the body itself but in the environment.
Environmental influences as a cause
Environmental influences that cause dry eyes are mainly tobacco smoke and air conditioning or heating air. Particularly in winter, in strongly heated rooms, the complaints accumulate, because with dry air the tear film evaporates faster than normal and can not hold so the eye more moistly.
Draught can also dry out the eyes. After driving in a convertible or when the car's fan is cranked up high, many notice the symptoms. If the eyes are already irritated, a light breeze or draft is enough to dry them out.
Long hours at the computer are also often causative for the complaints: People who constantly look at the screen blink less often. As a result, the tear fluid is distributed more poorly. This phenomenon is known as "office eye syndrome". This usually results from a combination of computer work and too dry air in the office. There is also the term "gamer's eye" For people who complain of dry eyes after playing on the computer – not infrequently these are children and adolescents.
Allergies as a cause
In summer, many hay fever patients complain of watery eyes. A natural reaction of the body, which wants to protect itself against intruders during pollen count and tries to flush them out of the eyes with tears. Also with other allergies, like house dust or cat hair allergy, the eyes begin to tear frequently. There is an overproduction of tear fluid. Since the body produces the aqueous layers of the tear film faster than the oily film, the composition of the fluid changes accordingly. This causes them to evaporate more quickly. Dry eyes eventually occur.
People who take an allergy medication called an antihistamine to stop their eyes from watering can also develop dry eyes, because the medication inhibits the production of the tear film.
Hormones as a cause
Hormones can influence the eye. Women in particular notice this, because the female sex hormones, estrogens, increase the risk of dry eyes. At the beginning of a menstrual cycle, estrogen levels are low, but they increase over time – and so does the likelihood of getting irritated eyes.
For the same reason, hormonal contraceptives, such as the pill or contraceptive ring, can be the cause. Because they often increase estrogen levels, they also increase the risk of dry eyes.
Many women notice irritated eyes during their menopause, called "climacteric" by doctors called. During this time, there are major hormonal changes that can cause discomfort – including to the eyes. Sicca syndrome is not uncommon, especially when women use estrogen therapy to relieve their menopausal symptoms. In hormone therapy, women take replacement hormones to compensate for the natural decline in female sex hormones during menopause. Similar to hormonal contraception, this artificially increases hormone levels and thus the risk for dry eyes.
Contact lenses as a cause
Contact lens wearers often suffer from dry eyes. About half struggle with it – even more often with soft contact lenses than hard ones.
Ideally, contact lenses, whether daily, weekly, monthly or annual lenses, float on the tear film. This means that the oxygen supply and the supply of nutrients can continue unhindered, despite a shielding lens in the eye.
Contact lenses can sometimes act like a sponge, drawing fluid from the eye and thus being the cause of sicca syndrome. It is advisable to talk to your ophthalmologist about this, as they may recommend other contact lenses. Or sufferers resort to glasses – the easiest way to alleviate discomfort.
Diseases as a cause
The cause of the sicca syndrome can also be a disease that causes a wetting disorder of the eye – for example, thyroid gland disorders, which can upset the hormone balance.
People with Sjogren's syndrome, an autoimmune disease named after a Swedish doctor, suffer particularly badly from dry eyes. In this condition, salivary and lacrimal glands become inflamed. With the consequence that not only the mucous membranes of the eye, but also in the mouth dry out.
In the case of inflammation of the eye, for example conjunctivitis, the eye becomes red, swollen and begins to water. Due to the increased production of tears, there may be changes in the composition of the tear film, causing the eye to dry out. This triggers a vicious circle, because the dryness in turn promotes inflammation.
People suffering from psoriasis are particularly at risk for inflammation of the eye. Especially when the eyelids are affected and the delicate skin around the eye becomes dry, red and scaly.
In addition to diseases, there are also congenital malformations that lead to disturbed eyelid closure and thus promote dry eyes. Paralysis of the facial nerves, for example as a result of a stroke, can also cause altered blinking. Sometimes the patient can no longer close one or both eyelids completely or blinking is completely impossible.
Parkinson's patients also frequently complain of dry eyes. Parkinson's is a disease that primarily affects motor function and leads to reduced blinking frequency in many patients. The infrequent blinking of the eye causes eye dryness.