Chronic Conjunctivitis and Dry Eye Syndrome

Q: Chronic Conjunctivitis and Dry Eye Syndrome

Hello： 1. <br>The use of tear break-up time test strips is a simple and effective method for assessing the presence of dry eye syndrome, but it does not reflect the severity of the condition. <br>Additionally, the symptoms of dry eye syndrome are not always apparent; some individ

Chronic conjunctivitis and dry eye syndrome?

Hello, doctor.
I previously had chronic conjunctivitis, which the doctor believed was caused by allergies.
Last week, I experienced itchy eyes and felt that my eyes were fatigued and swollen, so I went for an eye examination.
That day, my intraocular pressure was 25 (previously it was 19), but the doctor said not to worry about the pressure.
They also conducted a tear test using strips, which showed 3mm in one eye and 6mm in the other, indicating that I have severe dry eye syndrome.
In previous examinations, no doctor had mentioned that I had dry eyes, and I usually don't feel that my eyes are particularly dry.
I would like to ask: 1.
On that day, my eyes were indeed very uncomfortable, but I usually don’t feel dryness.
In this situation, can the results of the dry eye test truly reflect that I have dry eye syndrome? Could the discomfort in my eyes have affected the results? 2.
If I do have dry eye syndrome, could it be caused by my conjunctivitis? 3.
The doctor prescribed me Anshumin (a steroid, which they were hesitant to prescribe due to the eye pressure), to use when my eyes itch, but it doesn't seem to be very effective.
Are there other methods to improve my conjunctivitis?

Jade, 30~39 year old female. Ask Date: 2023/03/28

Dr. Gao Pilin reply Ophthalmology

Hello: 1.
The use of tear break-up time test strips is a simple and effective method for assessing the presence of dry eye syndrome, but it does not reflect the severity of the condition.
Additionally, the symptoms of dry eye syndrome are not always apparent; some individuals may experience eye fatigue without feeling particularly dry.
Therefore, in such cases, the test strips can still aid in detecting the presence of dry eye syndrome.
2.
Conjunctivitis and dry eye syndrome are two distinct conditions that may have some correlation but do not necessarily cause each other.
Conjunctivitis refers to inflammation of the conjunctiva (the thin membrane covering the surface of the eyeball) due to infection or irritation, while dry eye syndrome is characterized by insufficient tear production or unstable tear film, leading to dryness and discomfort in the eyes.
The treatment approaches for these two conditions are also different, so further examination is needed to determine if you have dry eye syndrome.
3.
In addition to eye drops, some simple methods can help alleviate conjunctivitis, such as avoiding rubbing the eyes, using cold compresses to relieve itching, avoiding exposure to irritants like smoke, chemicals, and dust, cleaning the area around the eyes with warm water, and maintaining adequate sleep and good dietary habits.
If your conjunctivitis symptoms persist, it is advisable to seek medical attention again for further evaluation and treatment recommendations.

Reply Date: 2023/03/28

More Info

Chronic conjunctivitis and dry eye syndrome are two interrelated conditions that can significantly affect a person's quality of life. Understanding these conditions requires a comprehensive approach, as they can often coexist and influence each other.

1. Understanding Dry Eye Syndrome: Dry eye syndrome occurs when the eyes do not produce enough tears or when the tears evaporate too quickly. This can lead to symptoms such as dryness, irritation, redness, and a sensation of grittiness in the eyes. The tear film is essential for maintaining eye health, providing lubrication, and protecting the surface of the eye from environmental factors. The results from the tear break-up time (TBUT) test or the Schirmer test, which measures tear production, can help diagnose dry eye syndrome. In your case, the Schirmer test results of 3mm and 6mm indicate a significant reduction in tear production, which aligns with the diagnosis of severe dry eye syndrome.

2. Impact of Symptoms on Test Results: It is indeed possible that your discomfort and the acute symptoms you experienced during the examination could have influenced the results of the tear tests. Stress, discomfort, and inflammation can lead to temporary changes in tear production. However, the results still provide valuable information, especially when they are significantly below normal levels. In clinical practice, doctors often consider both subjective symptoms and objective test results to make a diagnosis.

3. Connection Between Chronic Conjunctivitis and Dry Eye: Chronic conjunctivitis, particularly allergic conjunctivitis, can lead to inflammation of the conjunctiva, which may affect tear production and quality. Allergens can cause the eyes to become red and itchy, leading to increased tear production as a response to irritation. However, if the underlying cause of the conjunctivitis is not addressed, it can lead to chronic inflammation and contribute to dry eye symptoms. Therefore, it is plausible that your chronic conjunctivitis could be exacerbating your dry eye condition.

4. Treatment Options: The treatment for chronic conjunctivitis often involves identifying and avoiding allergens or irritants, using antihistamines, and applying anti-inflammatory medications. In your case, the use of a steroid like Anshumin (if it is indeed a steroid) can help reduce inflammation and alleviate symptoms. However, due to concerns about elevated intraocular pressure, it is understandable that your doctor is cautious about prescribing stronger steroids.
Other treatment options for managing chronic conjunctivitis and dry eye syndrome include:
- Artificial Tears: Over-the-counter lubricating eye drops can help alleviate dryness and provide relief from irritation.

- Warm Compresses: Applying warm compresses can help improve meibomian gland function, which is crucial for maintaining a healthy tear film.

- Punctal Plugs: These are small devices inserted into the tear ducts to reduce tear drainage, thereby increasing tear film stability.

- Lifestyle Modifications: Reducing screen time, using a humidifier, and staying hydrated can also help manage symptoms.

5. Follow-Up Care: It is essential to follow up with your eye care provider regularly to monitor your condition and adjust treatment as necessary. If your symptoms persist despite treatment, further evaluation may be warranted to rule out other underlying conditions or to consider alternative therapies.

In conclusion, chronic conjunctivitis and dry eye syndrome are complex conditions that require a multifaceted approach to diagnosis and treatment. Your symptoms, test results, and treatment history all play a crucial role in understanding and managing your eye health. It is important to maintain open communication with your healthcare provider to ensure the best possible outcomes for your condition.

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