title: Ocular Pharmacology of Tear Film, Dry Eye, and Allergic Conjunctivitis.
abstract: Dry Eye Disease (DED) is "a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear-film instability with potential damage to the ocular surface." DED comprises two etiologic categories: aqueous-deficient dry eye (ADDE) and evaporative dry eye (EDE). Diagnostic workup of DED should include clinical history, symptom questionnaire, fluorescein TBUT, ocular surface staining grading, Schirmer I/II, lid and meibomian pathology, meibomian expression, followed by other available tests. New diagnostic tests employ the Oculus Keratograph, which performs non-invasive tear-film analysis and a bulbar redness (BR). The TearLab Osmolarity Test enables rapid clinical evaluation of tear osmolarity. Lipiview is a recently developed diagnostic tool that uses interferometry to quantitatively evaluate tear-film thickness. In DED, epithelial and inflammatory cells produce a variety of inflammatory mediators. A stagnant tear film and decreased concentration of mucin result in the accumulation of inflammatory factors that can penetrate tight junctions and cause epithelial cell death. DED treatment algorithms are based on severity of clinical signs and symptoms, and disease etiology. Therapeutic approaches include lubricating artificial tears and immunomodulatory agents.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, 1855 West Taylor Street, Chicago, IL, USA.
authors.forename: Shilpa
authors.initials: S
authors.lastname: Gulati
authors.affiliation: Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, 1855 West Taylor Street, Chicago, IL, USA. jains@uic.edu.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Jain
mesh_terms: D003233:Conjunctivitis, Allergic / Q000175:diagnosis / Q000188:drug therapy*; D015352:Dry Eye Syndromes / Q000175:diagnosis / Q000188:drug therapy*; D005123:Eye / Q000187:drug effects; D006801:Humans; D009994:Osmolar Concentration; D013666:Tears / Q000737:chemistry*
keywords: Conjunctivitis; Diagnostics; Dry eye; Ocular surface; Tear film; Therapy