The Clinical Feature Analysis Of Middle-and Old-age Patients With Dry Eye

Objective To explore the morbility characteristics andclinical feature of middle-and old-age patients with dry eye .Methods 70 patients(140 eyes) aged over 40, complainingeye uncomfortable, were analyzed in our hospital from June, 2005 toMarch, 2006.Results In total 70 patiens, 31.43% (22 cases) of thepatients were male and 69.57% (48 cases) were female. Theaverage age was 53.73±9.98. 54 cases (92 eyes) were diagnosedDES at last, the morbidity was 65.71%. Among DES, 15 cases (22eyes) were male, which morbidity was 15.71%, 39 cases (70 eyes)were female, which morbidity was 50.00%. There was significantdifference of morbidity between male and female (P <0.01) , and theDES morbidity was obviously increasing with ages. The mostcommon symptoms of DES were dryness, foreign body sensationand asthenopia. As ages increasing, the result of Schirmer test Ⅰand break up time (BUT) were obviously decreased, and there wassignificant difference at interclasses (P <0.05) . The DES could besevered by the environment of working and living, the ocular chronicinflammation, and the systemic diseases. Ametropia (especiallyfarsightedness) and presbyopia could exacerbate the symptoms.Conclusion DES is a common ocular surface disease. Upto now, there is no epidemiological criteria of dry eye. But themorbidity maybe more higher due to the worse living environmentand public health condition in our country. There was nointernational unified diagnostic criteria of DES at present. Accordingto this clinical investigation, we concluded that clarifying the detailof history and complaint was very important for diagnosing it.Dryness, foreign body sensation and asthenopia were the mostcommon symptoms of DES. These examinations of orthodox werestill specific at diagnosis of DES. As age increased, the basalsecretion of both tear fluid and stability of tear film were decreasing,and the degree of ocular epithelium defection was aggravated. DESshould be differential diagnose with ocular disease such as chronicconjunctivitis, herpes simplex keratitis, in case of misdiagnosis.The morbidity of DES is increased in the people over 40. Itmaybe concerned with the decreasing of lacrimal secretion with age.According to the investigation of ophthalmologic out-departmentpatients in our hospital, patients over 40s take more than 95 percent.There was an obviously increasing of DES morbidity inpostmenopausal women, which was correlated with the decreasedlevel of sex hormone, especially androgen. The chronic ocularinflammation could induce the decreasing of conjunctival gobletcells, and decreased the secretory volume of mucinous, thus makethe tear memebrane unstable and induce the DES. Many kinds ofblepharitis and meibomianitis could obstruct the gland duct andinterrupt the quality and quantity of meibomian gland, and cause tofasten evaporation of tear and lead to the symptoms of dry eye. Wefound that quite a lot of symptoms were related with farsight andpresbyopia. So we should pay attention to the examination ofrefraction, to avoid misdiagnosis. Long time living in theenvironment of air-condition and airtight could produce thesymptoms of dry eye, such as sick building syndrome (SBS), officeeye syndrome (OES). People who usually engaging in the work oractivity of localized attention, such as manipulate computer for along time or gazing at some kind of screens, could produce videodisplay terminals (VDT). In addition, driving car, seeing movies atdark room will broaden eye exposure space and reduce the blinktimes, thus accelerate the tear evaporate. Contact lens also couldaggravate the symptoms of dry eye. Diabetes, arthritis deformans,Sjogren syndrome, collagen thesaurismosis, dermatitis glandulariserythematosa, anaphylactic disease, Steven-Johnson syndrome couldresult in DES. This maybe concerned with the inflammation oflacrimal gland and the lost of conjunctival goblet cells. Among thetotal diseases, diabetes was more common. Experts presumed thatcornea consciousness was insensitive in diabetics, basementmembranes abnormality caused asynthesis with corneal epithelium,and generated the defection and staining of corneal epithelium. Thedecreasing of corneal consciousness could induce subsidence ofocular dry sensation, depress the irritation to lacrimal gland, affectthe secretion of tear, promoted the occurrence of dry eye.