Keratoconjunctivitis sicca: symptoms and treatment


Keratoconjunctivitis sicca, also known as KCS, is a common condition in which the eyes do not produce enough tears or fail to retain a protective layer of moisture. Healthcare professionals sometimes call KCS “dry eye syndrome”.

KCS can cause eye irritation and discomfort in the form of itching, burning, and soiling. The disease can also affect a person’s vision, as inadequate lubrication changes the way light travels through the eyes and onto the retina.

This article describes KCS, including its symptoms. We also describe some risk factors for developing KCS and provide information about diagnosis and treatment.

KCS, or dry eye syndrome, is a commmon, a chronic disorder affecting the production of tears.

Tears are made of oil, meibum, and water. Together, these components help protect and nourish the surface of the eye. The oil prevents moisture evaporation and the meibum allows the tear to spread evenly over the surface of the eyes. In KCS, a person does not produce enough tears, or their tears are of poor quality and lack oil or meibum.

Tears are essential for healthy eyes. They have various functions, including:

  • lubricate the eyes
  • cleaning foreign objects from the surface of the eyes
  • reduce the risk of infection

KCS causes dryness of the conjunctiva and cornea. The conjunctiva is the membrane that covers the whites of the eyes and the inner eyelids. The cornea is the thin protective layer that covers the iris and the pupil.

The main symptom experienced by people with KCS is irritation of the eyes. Irritation can differ in type and severity from person to person.

Potential symptoms from KCS include:

  • inflammation and redness of the eyes
  • a stinging or burning sensation in the eyes
  • a feeling of dryness or grain in the eyes
  • stringy mucus in or around the eyes
  • waking up with eyelids stuck together
  • difficulty keeping your eyes open
  • eye sensitivity to smoke, wind, or light
  • eyes that tear easily
  • blurred or double vision
  • tired eyes after reading
  • discomfort when wearing contact lenses

Living with KCS can be difficult. People with chronic pain may develop anxiety or depression and withdraw from their usual daily activities. Those with visual impairments may be unable to drive, read, or use a computer, which can lead to additional frustration and feelings of hopelessness.

Some causes and risk factors that increase the likelihood of a person of KCS development include:

  • Age: Most people over 65 have some symptoms of KCS.
  • Genre: KCS is more common in women than in men. This is mainly due to hormonal changes that occur during pregnancy, menopause, or as a result of taking hormonal contraceptives.
  • Medications : Some medicines can reduce the production of tears, including:
  • Medical conditions: The following items may to contribute to the development of KCS:
  • Environmental conditions: Exposure to the following can increase tear evaporation, resulting in KCS:
    • smoke
    • wind
    • low humidity environments
  • Other factors: Some other factors that can contribute to KCS include:
    • does not blink regularly when using a computer screen
    • wear contact lenses
    • refractive eye surgery, such as laser eye surgery
    • poor quality of tears – if a person’s tears lack oil or meibum, they will not spread to the cornea

To diagnose KCS, an ophthalmologist or optometrist will perform a comprehensive eye exam that includes testing the amount and quality of tear production.

The assessment can include:

  • Taking a medical history: This will help the doctor determine if the person has risk factors for KCS.
  • External examination: The doctor examines the structure of the eye, including the dynamics of the eyelids and blinking.
  • Eyelid and cornea assessment: The doctor examines the eyelid and cornea using bright light and magnification.
  • Test the quantity and quality of tears: The doctor may use a special dye in the eyes to help them observe the flow of tears and identify any changes to the surface of the eyes caused by insufficient tears.

The overall goal of KCS treatment is to keep the person’s eyes lubricated and to minimize dryness. However, the exact treatment route will vary depending on the underlying cause.

Doctors use four approaches to keep the eyes lubricated. They are:

  • Using artificial tears: Over-the-counter artificial tear solutions are a first-line treatment for people with mild KCS. People should choose solutions without preservatives because they contain fewer additives that can irritate the eyes.
  • Keep the tears: A doctor can block the tear ducts with removable silicone plugs or permanent surgery. Both methods slow the drainage of tears, which means that the tears stay in the eyes longer.
  • Increased tear production: An optometrist or ophthalmologist can recommend methods to increase tear production. Examples include taking prescription eye drops or taking omega-3 fatty acid supplements.
  • Treatment of inflammation and infection: An optometrist or ophthalmologist may recommend one or more of the following treatments for inflammation and infection of the eyelids or the surface of the eyes:

The drug cyclosporine or lifitegrast reduces inflammation in the eyes and may increase the production of tears. Many people experience significant improvement in their symptoms of KCS after taking cyclosporine eye drops.

In some cases, a doctor may recommend a type of contact lens called scleral lens. This lens traps a reservoir of fluid behind it, which prevents the cornea from drying out and allows it to heal. A scleral lens is much larger than a standard contact lens. It covers the cornea as well as the sclera, which is the white part of the eye.

For most people, KCS is uncomfortable but doesn’t cause complications.

However, a severe KCS could result in the following:

KCS can be a symptom of another health problem, so anyone with eye problems should see their doctor for a quick and accurate diagnosis.

KCS is the medical term for dry eyes. Although KCS usually only causes mild discomfort, severe cases can lead to permanent damage to the cornea. The main symptoms are eye irritation in the form of burning, itching or grains. Anyone with symptoms should see their doctor for proper diagnosis and treatment.

Most treatments aim to help lubricate the eyes, but vary depending on the cause of the disease and the severity of a person’s symptoms. A person may also be given drugs to treat complications of KCS, such as inflammation and infection of the eyes.


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