Keratoconjunctivitis sicca, or KCS, occurs when eyes don’t produce the required amount of moisture.
Some doctors call the ksc syndrome dry eyes syndrome.
Keratoconjunctivitis sicca can cause skin irritation, burns and grittiness to your eyes.
The disorder may cause impairment to the vision of people because of the ineffective fluid circulation that passes through the eyes.
The following article explains the Keratoconjunctivitis sicca and their symptoms.
We outline the risks associated with Keratoconjunctivitis sicca, as well as information on diagnosis or treatment.
What is keratoconjunctivitis sicca (dry eye syndrome)?
Keratoconjunctivitis sicca (KCS) is a condition that is also commonly referred to as dry eye syndrome.
The medical term means inflammation of the cornea and surrounding tissues from drying.
It is a common eye condition resulting from inadequate production of the aqueous portion of the tear film by the lacrimol glands.
Dry eye syndrome is an eye condition that occurs when the eyes do not produce enough tears or when the tears evaporate too quickly.
Keratoconjunctivitis sicca is an eye-related problem that occurs primarily during keratoconjunctivitis syncytial infections.
It occurs where the eyes do not produce tears or produce sufficient quantities.
It is often caused by ocular discomfort and can cause dry eyes, red eyes, and blurred eyes, among other symptoms.
Although keratoconjunctivitis sicca usually causes only mild discomfort, severe cases may result in permanent damage to the cornea.
Histories
While dry eyes are often due either to aqueous tear deficiency or just evaporation, the condition generally has a mixed etiology.
Sjogren’s Syndrome associated dry vision disease which consists of the eyes of people with dry eye diseases.
Approximately 10 percent of the dry eye patients have Sjogren syndrome.
In the absence of xerostomia and CTD patients will be diagnosed with dry eye disease if their Sjogren’s syndrome is suspected.
Sjogren’s related dry eye disease has been subclassed either primary SS or secondary SS.
Symptoms
The primary symptoms are eye irritation in the form of burning, itchiness, or grittiness.
Symptoms typically affect both eyes and may include:
- Irritation and redness
- Dryness and grittiness
- A discharge of mucus
- Temporarily blurred vision
- Itching
- Sensitivity to bright light
- The sensation of a foreign-body in the eye
- Excessive tear production
Symptoms tend to be at their worst at the end of the day or after protracted use of the eyes; after driving, for example.
Sometimes people feel that their blurred vision or eye irritation is so severe, frequent, and prolonged that it is difficult to function normally.
In some people with severe dryness, the surface of the cornea can thicken, or ulcers and scars can develop.
Occasionally, blood vessels can grow across the cornea.
Should I be worried about blurred vision as a result of keratoconjunctivitis sicca?
Temporarily blurred vision can be a symptom of keratoconjunctivitis sicca.
Although an inconvenience, it can usually be managed through treatment.
Causes of keratoconjunctivitis sicca dry eye syndrome
There are a number of conditions that can cause dry eye with dry eye syndrome accounting for most dry eye cases.
Tears contain a mixture containing oil, water and fluid which ensures smoothness on the eye surfaces and also prevents infections on their surface.
Dry eyes may be due to inadequate tear production (aqueous tear-deficient dry eyes). With this type of dry eyes, the tear gland (lacrimal gland) does not produce enough tears to keep the entire conjunctiva and cornea covered by a complete layer of tears.
It is more common in patients over 50 years.
It can be associated with dry mouth (Sjögren syndrome) and rheumatoid arthritis .
Dry eyes can follow trachoma , in which the lacrimal gland ducts and conjunctival goblet cells , are damaged
Dry eyes are typically diagnosed from the following two sources:
Sjogren’s
Sjögren syndrome is one of the leading causes of dry eye syndrome.
of the salivary glands, and arthritis in patients with keratoconjunctivitis sicca. The association of these conditions with keratoconjunctivitis sicca since then has been designated as Sjögren’s syndrome.
Characterized by diminished lacrimal and salivary gland secretion (sicca complex).
May present with fatigue and dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia).
Diagnosed by positive antinuclear antibodies, anti-60 kD (SS-A) Ro and anti-La autoantibodies, decreased saliva and tear production, lymphocytic infiltration in labial salivary gland biopsy.
Rheumatoid Arthritis (RA)
Rheumatoid arthritis is an inflammatory arthritis in which joints, usually including those of the hands and feet, are inflamed, resulting in swelling, pain, and often destruction of joints.
Systemic Lupus Erythematosus (SLE)
SLE is a chronic autoimmune inflammatory connective tissue disorder that can involve joints, kidneys, skin, mucous membranes, and blood vessel walls.
Pathophysiology
Tear hyperosmolarity instabiliy is a major contributor to Dry Eye Disease.
The two most common types of DED are aqueous deficient dry eye (ADDE) or evaporated dry eyes (EDE) a combination of tears hyperosmosis.
Meibomian gland disease
A tear film deficiency caused by meimomian gland dysfunction causes evaporation in the tear film.
It can cause tear hyperosmolarization with lacrimal abnormalities.
A decreased tear sensitivity caused by a lacrimal gland injury (example, Sjogren disease) causes a hyperosmosis in the tear film despite normal evaporation rate.
Epidemiology
Dry eye disease occurs mainly in older adults but also in younger adults.
The prevalence estimate varies between 14% and 30%.
About 3.8 million women aged over 50 will be affected.
Dry eyes diseases are also increasing among adolescents aged 17 – 34, mainly due to the increase in the wearing softer contact lenses and frequent use of smartphones or computers.
Dry eye disease can cause serious complications in patients seeking eye care.
In addition, its widespread prevalence has significantly imposed socio-economic pressure on the US healthcare system.
Etiology
The international Dry Eye Workshop II (DEWS II) defines dry eye diseases as follows: a dry ocular surface and water deficiency.
Anatomy
Tear film covers ocular surfaces that protect the eyes and retina.
The previous 3-layer modeling of lipids, aqueous lipids and mucin layers have now been replaced with a 2-layer model for the tear film.
Diagnosing keratoconjunctivitis sicca dry eye
Poor tear film and drying of the cornea is revealed by a drop of fluorescein and blue light.
Corneal desiccation leads to punctate staining.
Treatment is with artificial tears, such as hypromellose eye drops, as required.
Those with severe keratoconjunctivitis should seek help with eye surgery immediately.
Additionally, symptoms evaluations are performed via the free app Ada.
Doctors will perform several tests to determine the causes.
Symptom assessment in dry eye (SANDE) and Ocular Surface Disease Index (OSDI) symptom questionnaires, fluorescein tear break-up time (TBUT), Schirmer I test, cornea fluorescein and conjunctival lissamine green dye staining, and tear meniscus height measurement using optical coherence tomography (OCT) were performed as previously described.
The Schirmer test can be used to detect reduced tear production. If the test strip is wet by less than 5 mm after 5 min in the unanesthetized eye, this indicates severe tear deficiency.
Keratoconjunctivitis sicca treatment
Mild cases may respond well to simple environmental changes or over-the-counter eye drops, while more severe cases may require treatment methods such as anti-inflammatory medication or surgery.
Treatment of Keratoconjunctivitis Sicca Artificial tears Cyclosporine eye drops.
Generally, these medications will only be recommended if the condition does not respond to lubricants. Anti-inflammatory medications include: Corticosteroid eye drops and ointments Oral tetracyclines, such as doxycycline, lymecycline and oxytetracycline, or Ciclosporin eye drops.
A keratoconjunctivist can determine if kératoconjunctivitis sicca has a treatment strategy that suits the underlying disease, the specific symptoms and severity.
The disease is not cured and can be successfully managed.
The treatment of dry eye has two objectives: to stimulate tear production and to replace tear film, thereby protecting the cornea.
There are two commonly used ophthalmic medications to stimulate tear production, cyclosporine (brand name Optimmune®) and tacrolimus. Both are easily placed in the eyes once or twice daily.
TrueTear® Intranasal Tear Neurostimulator
A device that improves dry eyes symptoms by electrically stimulating tear production through a soft-tipped probe placed into the nose several times a day can also be tried, if other methods for treating aqueous deficient dry eye were insufficient
Punctal Plugs
Block the tear ducts with removable silicone plugs or a permanent surgical procedure. Both methods slow down tear drainage, meaning the tears remain in the eyes for longer.
Artificial Tears
Over-the-counter artificial tears solutions are a first-line treatment for people with mild keratoconjunctivitis sicca.
Eye drops are a popular treatment, but how do you choose the right kind?
Artificial tears applied every few hours can generally control the problem.
Artificial tears are eye drops prepared with substances that simulate real tears and help keep the eyes coated with moisture.
Lubricating ointments applied before bed last longer than artificial tears and help prevent dryness in the morning.
In people with extremely dry eyes, the eyelids may be partially sewn together to decrease tear evaporation.
Practice essentials
Dry eye disease (DED) also termed dry ear syndromes (DE), kersattoconjunctivites sicca (KCS), orkertitis sicca, is a multifactory disease that causes damage in the eye’s ocular surface.
It often causes vision problems, ocular problems, ocular surface irritation, and damaged and neuorsensory disorders.
Dry eye disease is one commonly encountered form of ocular surface disease (OSD), which is a common cause of OSD.
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References
What to know about keratoconjunctivitis sicca Medically reviewed by Leela Raju, MD — Written by Zia Sherrell, MPH on December 22, 2021
Efficacy and Safety of Diquafosol Ophthalmic Solution in Patients with Dry Eye Syndrome: A Japanese Phase 2 Clinical Trial. Ophthalmology . 2012 Jun 25. [QxMD MEDLINE Link]
sodium hyaluronate solution (Fermavisc) in the treatment of dry eye syndrome. Br J Ophthalmol 1999; 83:1121. McDonald CC, Kaye SB, Figueiredo FC, et al.
Efficacy and Safety of Diquafosol Ophthalmic Solution in Patients with Dry Eye Syndrome
