Dry Eye
Symptoms of dry eyes:
- grittiness
- soreness
- foreign body sensation
- reduced vision (if severe)
Signs of dry eyes
- reduced tear film
- punctuate epithelial erosions (best seen with fluorescein)
- mucus strands (attached to erosions)
Causes of dry eyes
- Chemotherapy
- Methotrexate
- Cyclophosphamide
- Busulphan
- Radiation therapy (to orbit)
- 0% after ≤ 30Gy
- 100% after ≥ 57Gy
- Stem Cell / Bone Marrow transplantation (inc. GVHD)
- 48% symptomatic
- 62% show clinical signs
Probably caused mainly by adjunctive chemotherapy and radiation
- Lacrimal gland infiltration eg. ALL
Treatment of dry eyes
- Artificial tears (p.r.n. or regular)
- Lubricant ointment (especially at night)
- Cyclosporin drops useful (especially after GVHD)
- Punctal plugs (usually temporary)
- Punctal cautery (usually permanent)
- Stop cause (eg. Chemotherapy agent)
Clinical Tip : Dry eye is the commonest ocular symptom of any oncology patient, the easiest to overlook and often amenable to simple treatment. |
Try simple off-the-counter lubricant drops as an empirical treatment. |
