Comprehensive Guide to Keratoconjunctivitis Sicca

Keratoconjunctivitis sicca is the general term for dry eyes, regardless of possible causes. The term dry eye syndrome is also used synonymously. Symptoms affect the cornea and the conjunctiva, a mucous membrane-like tissue that connects the eyeball to the eyelids. If left untreated, dry eyes can lead to secondary damage.

What is keratoconjunctivitis sicca?

The most common symptoms and complaints caused by keratoconjunctivitis sicca are a feeling of dryness, burning eyes and often the feeling that there are foreign bodies on the cornea – a feeling similar to that of conjunctivitis. See AbbreviationFinder for abbreviations related to Keratoconjunctivitis Sicca.

Keratoconjunctivitis sicca is the technical term for the dry eye syndrome without considering the various causes for the appearance of the syndrome. The term keratoconjunctivitis sicca already indicates that the cornea and conjunctiva are affected. The conjunctiva is formed by a mucous membrane-like tissue that connects the eyeball to the eyelids.

Proper, regular moistening of the cornea ensures – in the truest sense of the word – smooth movement of the eyeball, clear optics without streaks and distortions and supply and disposal of the cornea. Except when the eyes are closed, the tear fluid supplies the cornea with oxygen and some nutrients and offers protection against bacterial infections.

In addition, the tear fluid ensures that dead corneal cells or small foreign bodies are flushed out. If left untreated, dry eyes can lead to further problems and diseases. In principle, the syndrome can be caused by insufficient production of tear fluid or by changes in the composition of the tear fluid.


There are many different causes that can lead to keratoconjunctivitis sicca and require different treatments to combat the cause. Temporarily dry eyes can be caused by unusual environmental conditions such as a combination of strong wind and extremely dry air or an air conditioner with integrated air drying, because the tear film dries out very quickly.

Certain diseases can limit the production of serous tear fluid and thus trigger the symptoms of dry eyes. The production of tear fluid depends, among other things, on the hormone and vitamin balance. A lack of testosterone in older men or a lack of vitamin A can contribute to dry eyes.

However, the most common cause is a qualitative change in the tear fluid. Impairment of the accessory meibomian glands in the eyelids is often observed, which normally secrete a fatty substance that coats the tear film in the form of a thin outer lipid layer and from rapid dryingprotects. A pathologically reduced production of the meibomian glands leads to a very rapid evaporation of the tear film due to the missing lipid layer.

Direct diseases and inflammations of the lacrimal glands or the relocation of the outlets and the accessory glands can also result in insufficient production or a changed composition of the tear fluid.

Symptoms, Ailments & Signs

The most common symptoms and complaints caused by keratoconjunctivitis sicca are a feeling of dryness, burning eyes and often the feeling that there are foreign bodies on the cornea – a feeling similar to that of conjunctivitis. The external signs are red and tired eyes, and there is usually an oversensitivity to bright light and drafts.

In some cases, it comes to watery eyes, which may sound counterintuitive at first. The inner layer of the tear film, which is only 18 microns thick, consists of a thin layer of mucus that allows the tear film to adhere to the eyeball. If the function of the accessory lacrimal glands that secrete the mucous film is disturbed, the tear film cannot adhere sufficiently to the eyeball. The tear fluid leaks from the eye and the symptoms of a watery eye appear, although the cornea suffers from dryness.

Diagnosis & course of disease

For a diagnosis of keratoconjunctivitis sicca, the anamnesis, the initial discussion with the patient, is important as the first measure. If there is an initial suspicion, the ophthalmologist can examine the quantity and composition of the tear fluid after inspecting the surface of the eye with a slit lamp. With the so-called Schirmer test, the tear fluid produced within 5 minutes can be recorded and determined with a special piece of paper.

The composition of the tear film is indirectly measured using the tear breakup time. This is the time between blinking and rupture of the tear film. Further examinations can concern hormone status, rheumatoid factors and other parameters. As long as there is no serious damage to the cornea and conjunctiva, dry eye syndrome resolves as soon as the cause is eliminated. If left untreated, keratoconjunctivitis sicca can lead to serious damage and disease of the cornea.


Keratoconjunctivitis sicca causes those affected to suffer primarily from very dry eyes. This can have a negative impact on the patient’s quality of life. If there is no treatment and the symptoms persist, irreversible consequential damage is possible. In most cases, there is also a burning sensation in the eyes.

The patient’s eyes are red and tired. Furthermore, keratoconjunctivitis sicca can also lead to conjunctivitis, which must be treated by a doctor in any case. There is also a strong sensitivity to light. The everyday life of those affected is made more difficult by these complaints and it may no longer be possible to carry out normal work or activities without further ado.

The treatment of keratoconjunctivitis sicca is usually causal and depends on the underlying disease. There are no particular complications and there is usually a positive course of the disease. Life expectancy is also not reduced or restricted by keratoconjunctivitis sicca. With the help of eye drops or other therapies, the symptoms of this disease can be relieved.

When should you go to the doctor?

If the person concerned suffers from a persistent feeling of dryness in the area of ​​​​the eyes, a doctor’s visit is advisable. Burning and itchy eyes indicate existing irregularities that should be examined by a doctor. If you feel a foreign body in your eyes or if your normal vision is disturbed, you should consult a doctor. Check-ups are necessary to clarify the cause.

If there is a feeling of hypersensitivity to normal light influences or to bright daylight, a doctor should be consulted. Sensitivity of the eyes indicates a disorder that should be investigated and treated. Reddened, easily tired or watery eyes should also be examined by a doctor. If the existing symptoms cause itching or open wounds, the affected person needs sterile wound care. Otherwise, pathogens can penetrate the organism and contribute to the development of other diseases.

In the event of a headache, inner restlessness, a reduced sense of well-being or limitations in performing everyday tasks, it is advisable to consult a doctor. If, in addition to the physical symptoms, there are also behavioral abnormalities, mood swings or a depressive appearance, a doctor should be asked for help. Due to the impairment, there is an increased vulnerability to the development of a mental illness.

Treatment & Therapy

In addition to combating the symptoms, the goal of treating dry eyes is primarily to eliminate the cause. If the production of tear fluid is too low, a variety of eye drops can be used as a tear substitute to alleviate the symptoms. If it is a hyperevaporative form of dryness, i.e. the problem of an excessive evaporation rate, eye drops containing lipids can help.

At the same time, however, an attempt should be made to reactivate the function of the Meibomian glands so that the protection of the tear film is restored by a natural lipid layer. There are also other treatment options that aim to eliminate the causal factors.

Outlook & Forecast

A prognosis for keratoconjunctivitis sicca is only possible once the cause of the symptoms has been determined. Dry eyes can be caused by a variety of reasons. In the case of inflammation, drug treatments are often carried out. These usually lead to an alleviation of the existing symptoms within a few days or weeks. In most cases, freedom from symptoms is documented after a short time after the medication has been administered. Consequential disorders are not to be expected in these patients. In the course of life, however, renewed inflammation can also occur at any timecheapprognosis coming.

If there is a chronic underlying disease, the probability of recovery worsens. Some patients face lifelong ailments. You receive long-term therapy in which the dryness of the eye is treated. Regular check-ups are necessary so that any abnormalities or unfortunate changes can be reacted to as quickly as possible.

If the function of the Meibomian glands is permanently damaged, the person concerned is also informed of an unfavorable prognosis. Here, too, ongoing therapy is used so that the symptoms can be regulated. Some patients have no chance of a cure. Nevertheless, the treatment method can achieve a significant improvement in the symptoms. If prescribed medication is discontinued, an immediate recurrence of the irregularities can be expected in this case.


Direct prevention to avoid keratoconjunctivitis sicca is hardly possible due to the large number of possible causes. However, living conditions that promote dry eye syndrome can be avoided. Above all, it is advisable to react to the first signs such as burning eyes and a foreign body sensation in the eye in order to immediately relieve the symptoms. If symptoms persist, an ophthalmologist should be consulted immediately, as it cannot be ruled out that serious diseases are behind the dry eyes.


In most cases, the options for aftercare for keratoconjunctivitis sicca are very limited. Those affected are primarily dependent on an early diagnosis of the disease so that further complications and symptoms can be prevented. The earlier a doctor is contacted, the better the further course.

As a rule, self-healing cannot occur in keratoconjunctivitis sicca. Most patients with this disease are dependent on taking various medications. In any case, the patient should pay attention to regular intake and also to the correct dosage in order to permanently relieve the symptoms.

If anything is unclear or if you have any questions, you should always consult a doctor first so that no further complications can arise. In everyday life, the help and support of one’s own family also has a positive effect on the course of keratoconjunctivitis sicca and can also prevent or alleviate depression or other mental disorders. In some cases, the life expectancy of those affected is reduced as a result of the disease.

You can do that yourself

To improve the quality of life and the success of treatment of keratoconjunctivitis siccasupport, patients work closely with the treating physician and follow directions for taking drugs and other treatment approaches. In therapy, it is essential to recognize the basic causes of the disease and to eliminate or reduce them. As a result, the symptoms usually subside and the quality of life of those affected improves.

Patients take the prescribed preparations, as prescribed by the doctor, which replace tear fluid and relieve dryness of the eye. In addition, the patients try to find those factors in their everyday life that contribute to the existence of keratoconjunctivitis sicca. Depending on the activities and profession, there are different reasons in individual cases, but identifying and reducing them often represents an essential step in the genesis.

Patients reduce the time they spend in front of screens such as computers or televisions. Even with higher humidity, the symptoms of dry eyes are often reduced. However, some patients also suffer from certain allergies that promote dry eyes and need to be diagnosed.


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