Ординатура / Офтальмология / Английские материалы / Dry Eye and Ocular Surface Disorders_Pflugfelder, Beuerman, Elliot Stern_2004
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Therapy of Lacrimal Keratoconjunctivitis
Stephen C. Pflugfelder
Baylor College of Medicine, Houston, Texas, U.S.A.
Michael E. Stern
Allergan, Inc., Irvine, California, U.S.A.
Therapy of dry eye, or lacrimal keratoconjunctivitis (LKC), requires a multipronged approach aimed at eliminating exacerbating factors, supporting the tear-producing glands, hydrating the ocular surface, restoring normal tear film osmolarity, stabilizing the tear film, and inhibiting the production of inflammatory mediators and proteases (Fig. 1). These therapies may be tailored to individual patients based on the severity of their secretory dysfunction, ocular surface disease, and inflammation.
I.ELIMINATING EXACERBATING FACTORS
Factors that may decrease tear production or increase tear evaporation, such as the use of systemic anticholinergic medications (e.g., antihistamines and antidepressants) and desiccating environmental stresses (e.g., low humidity and airconditioning drafts) should be minimized or eliminated. Video display terminals should be lowered below eye level to decrease the interpalpebral aperture, and patients should be encouraged to take periodic breaks with eye closure when reading or working on a computer. A humidified environment is recommended to reduce tear evaporation. This is particularly beneficial in dry climates and high altitudes. Tear evaporation can be reduced by placement of side panels and moist inserts on eyeglasses [1]. Nocturnal lagophthalmos can be treated by wearing swim goggles, taping the eyelid closed, or tarsorrhapy.
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