Dry eye syndrome is the most common eye disease worldwide, which is not always associated with discomfort. The total number of people affected in Germany is estimated at 10-12 million.
The most common cause of dry eyes in 60-80% of patients is meibomian gland dysfunction, which is associated with a disturbance in the lipid phase of the tear film. The meibomian glands (named after the German physician and anatomist Heinrich Meibom (1638-1700)) produce the lipid component of the tear film, thereby protecting the tear film from evaporation. Other important components of the tear film are the aqueous layer (formed by the main lacrimal gland and accessory lacrimal glands), and the mucin layer (formed by the goblet cells of the conjunctiva). A change in the amount or composition of the tear film leads to a tear film disorder, which is not a threatening disease, but can be very uncomfortable and distressing for the patient.
Meibomian gland dysfunction is multifactorial: age, ethnicity, environmental factors and contact lens wear play an important role. Other predisposing factors are: Psychological stress, high cholesterol and high triglycerides, allergies, chronic conjunctival, corneal or lid margin inflammation, autoimmune diseases (e.g. rosacea, lupus, rheumatoid arthritis, Sjögren's syndrome), some medications (e.g. estrogen substitution therapy, androgen-reducing drugs, retinoids used in acne or anti-aging treatment).
The course of the disease can vary - from asymptomatic, with mild burning, itching, tearing, foreign body sensation or recurrent blurred vision that improves with blinking, to chronic eye or eyelid redness/thickening.
The diagnosis is determined by the ophthalmologist and, depending on the severity of the symptoms, a step-by-step therapy is prescribed. Interdisciplinary diagnosis of concomitant diseases that can lead to dry eye and, if necessary, their treatment is also important.
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