Dry eye disease in strabismus patients: Does eye deviation harm ocular surface?

Area of Science:

• Ophthalmology
• Ocular Surface Disease

Background:

• Dry eye disease is a common condition affecting the ocular surface, causing discomfort and visual disturbances.
• Strabismus, a misalignment of the eyes, is associated with dry eye, even without prior ocular surgery.
• Iatrogenic dry eye is a known complication following ocular surgeries, including those for strabismus.

Purpose of the Study:

• To hypothesize the mechanisms underlying dry eye in strabismus patients.
• To explore the role of increased conjunctival exposure and dysfunctional lubricity in dry eye pathogenesis.
• To identify potential entry points into the vicious cycle of dry eye disease in strabismus.

Main Methods:

• The study proposes two primary mechanisms contributing to dry eye in strabismus.
• Mechanism 1: Increased exposure of bulbar conjunctiva leading to tear film lipid layer thinning and instability.
• Mechanism 2: Dysfunctional eyelid-globe interaction causing microtrauma, inflammation, and tear hyperosmolarity.

Main Results:

• Strabismus patients may exhibit signs and symptoms of dry eye syndrome.
• Proposed mechanisms include increased bulbar conjunctiva exposure and impaired eyelid-globe lubrication.
• These factors act as entry points into the dry eye disease vicious circle.

Conclusions:

• Strabismus is linked to dry eye syndrome through specific pathophysiological mechanisms.
• Increased ocular surface exposure and altered lubricity are key factors in the dry eye vicious cycle.
• Routine ocular surface assessment and use of tear substitutes are recommended for strabismus patients.