“Dry eyes” occur when the eyes are unable to produce enough tears to lubricate them or when their quality is insufficient to keep the eye moist. This can be due to various factors such as aging, prolonged use of digital screens, certain types of medications, dry environmental conditions and problems with the meibon glands, which produce part of the tear film. A reader would like to learn more about the causes and options for relief. He replies Rossella Colabelli GisoldiHead of the Lazio Eye Bank, San Giovanni Addolorata Hospital in Rome.

Inquiry. Dear doctor, recently I noticed a deterioration in my vision, accompanied by pain when I look at the light. It has been suggested to me that I may have keratitis or suffer from dry eyes. Can you explain to me what the specific symptoms of these diseases are, what the possible causes are, and how they can be treated? Is there anything I can do to prevent their development? Thank you for your attention and I await your response with interest to better understand what happens next. Fabiana, Verona

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Answer. Dear reader, the discomfort felt in strong brightness (so-called photophobia), accompanied by slight visual disturbances, can indicate a change in the surface of the cornea. The ocular surface is a functional unit that includes the eyelid margin, the eyelashes, the conjunctiva, the corneal limbus (transitional area between the conjunctiva and the cornea, the seat of the stem cells of the corneal epithelium), the cornea and the tear film – a perfect balance between them. The condition that most often alters this balance and results in ocular surface compromise with the symptoms you describe is poor quality of the tear film or a deficiency in the watery component of the tear itself.

Dry eye it is the name of the resulting pathology. Very common in menopausal women, nowadays it is also increasing in young people due to excessive use of computers.

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General autoimmune diseases, hormonal imbalances, thyroid diseases, dry environments, excessive use of contact lenses or air conditioning are all factors that can provoke this pathology. It is difficult to understand whether the symptoms you report are due to this cause. Contact an ophthalmologist who can carry out special tests to examine the tear film (Schirmer’s test and BUT) and submit questionnaires (OSDI) that will easily allow a correct diagnosis. If there is a change in the tear film (xerophthalmia), the causes must be investigated and long-term therapy prescribed with specific tear substitutes capable of restoring balance on the surface of the eye, repairing any damage to the corneal epithelium and alleviating the reported symptoms.

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