Epidemiology and classification of dry eye.

Dry eye, or keratoconjunctivitis sicca (KCS), is a rubric for a number of clinical disease states characterized by disturbances in the pre-ocular tear film resulting in ocular surface disease.1 KCS accounts for a high percentage of patient visits to ophthalmologists, and its treatment has given rise to a pharmaceutical market in the US of over $100 million per year (industry estimates). Approximately 7–10 million Americans currently require the use of artificial tear preparations.2 KCS is associated with a broad spectrum of ocular symptoms ranging from mild transient irritation to persistent irritation, burning, itchiness, redness, pain, ocular fatigue, and vision disturbances.3,4 In its more severe form, Sjogren’s-associated KCS, it is associated with vision-threatening complications including scleritis, corneal ulceration, and secondary bacterial infection.5 Pathophysiologic factors include deficiencies in aqueous tear production, qualitative changes in tear composition, alterations in the oil secretion of the meibomian glands of the eyelids, blinking abnormalities, and inflammatory changes in the ocular surface.6

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