Abstract

Dry eye is the most common cause of chronically red, irritated eyes. Thus, in cases of chronic conjunctivitis dry eye must be excluded. The noncritical use of vasoconstrictive eye drops and/or corticosteroids is obsolete. Up to now the diagnosis of dry eye has been based on a combination of the patient's history, slit-lamp examination, determination of tear film break-up time, the Schirmer test and basic secretion test. Unfortunately, there is enormous deviation in all of these tests, which means that they provide poor diagnostic reliability. Dry eyes are rarely associated with systemic diseases, e.g. Sjogren's syndrome. This autoimmunological disease is often first diagnosed by the ophthalmologist. Quantitative or qualitative deficiencies of one or more layers of the complex tear film can result in dry eyes, but inflammatory agents or primary ocular surface diseases may also be involved. Within the next few years analyses of tear-film proteins, toposcopy, tear-film fluorophotometry, impression cytology and corneal epithelial fluorophotometry may prove to be reliable tests for the detection of dry eye. The improved mucomimetic quality of artificial tears, the avoidance of toxic preservatives, tear production stimulants (eloisin, physaelamin), fibronectin or the epithelial growth factor may facilitate the management of dry eye.