eMedicine Specialties > Ophthalmology > Cornea

Keratoconjunctivitis, Sicca: Follow-up

Author: Fernando H Murillo-Lopez, MD, Senior Surgeon, Unidad Privada de Oftalmologia CEMES
Contributor Information and Disclosures

Updated: Apr 21, 2006

Follow-up

Further Outpatient Care

  • The frequency of follow-up care depends on the severity of the signs and symptoms.

Complications

  • Significant punctate epitheliopathy can lead to corneal erosions, corneal ulceration (both sterile and infected), corneal neovascularization, corneal scarring, corneal thinning, and even corneal perforation.

Prognosis

  • The prognosis with keratitis sicca varies considerably with the severity of these conditions. Most patients have mild-to-moderate cases, and they can be treated symptomatically with lubricants, providing good relief of symptoms.
  • Patients with Sjögren syndrome represent a subgroup of patients with a worse prognosis, and, in some cases, they may require more extreme measures, including surgical treatment of perforated ulcers.

Patient Education

  • Patients with Sjögren syndrome can obtain up-to-date information from the following organization: Sjögren Syndrome Foundation, Inc, 333 North Broadway, Jericho, New York 11753, (516) 933-6365 or (800) 4-SJOGREN.
  • For excellent patient education resources, visit eMedicine's Eye and Vision Center. Also, see eMedicine's patient education article Dry Eye Syndrome.

Miscellaneous

Medicolegal Pitfalls

  • Early detection and aggressive treatment may help avoid corneal ulcers and scarring.
 


More on Keratoconjunctivitis, Sicca

Overview: Keratoconjunctivitis, Sicca
Differential Diagnoses & Workup: Keratoconjunctivitis, Sicca
Treatment & Medication: Keratoconjunctivitis, Sicca
Follow-up: Keratoconjunctivitis, Sicca
References
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References

  1. Barber LD, Pflugfelder SC, Tauber J. Phase III safety evaluation of cyclosporine 0.1% ophthalmic emulsion administered twice daily to dry eye disease patients for up to 3 years. Ophthalmology. Oct 2005;112(10):1790-4. [Medline].

  2. Fox RI, Chan R, Michelson JB. Beneficial effect of artificial tears made with autologous serum in patients with keratoconjunctivitis sicca. Arthritis Rheum. Apr 1984;27(4):459-61. [Medline].

  3. Fujita M, Igarashi T, Kurai T. Correlation between dry eye and rheumatoid arthritis activity. Am J Ophthalmol. Nov 2005;140(5):808-13. [Medline].

  4. Lamberts DW, Foster CS, Perry HD. Schirmer test after topical anesthesia and the tear meniscus height in normal eyes. Arch Ophthalmol. Jun 1979;97(6):1082-5. [Medline].

  5. Lee HK, Ryu IH, Seo KY. Topical 0.1% prednisolone lowers nerve growth factor expression in keratoconjunctivitis sicca patients. Ophthalmology. Feb 2006;113(2):198-205. [Medline].

  6. Mathers WD. Ocular evaporation in meibomian gland dysfunction and dry eye. Ophthalmology. Mar 1993;100(3):347-51. [Medline].

  7. Murillo-Lopez F, Pflugfelder SC, eds. Cornea and External Disease: Clinical Diagnosis and Management, Vol II. 1997;663-686.

  8. Nelson JD. Diagnosis of keratoconjunctivitis sicca. Int Ophthalmol Clin. Winter 1994;34(1):37-56. [Medline].

  9. Pflugfelder SC, et al. Correlation of goblet cell density and mucosal epithelial mucin (MEM) expression in patients with ocular irritation. Invest Ophthalmol Vis Sci. 1995;36:S399.

  10. Pflugfelder SC, Roussel TJ, Culbertson WW. Primary Sjogren''s syndrome after infectious mononucleosis. JAMA. Feb 27 1987;257(8):1049-50. [Medline].

  11. Stonecipher K, Perry HD, Gross RH. The impact of topical cyclosporine A emulsion 0.05% on the outcomes of patients with keratoconjunctivitis sicca. Curr Med Res Opin. Jul 2005;21(7):1057-63. [Medline].

  12. Tsubota K, Toda I, Yagi Y. Three different types of dry eye syndrome. Cornea. May 1994;13(3):202-9. [Medline].

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Further Reading

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Keywords

dry eye syndrome, sicca syndrome, keratitis sicca, KCS, xerophthalmia

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Contributor Information and Disclosures

Author

Fernando H Murillo-Lopez, MD, Senior Surgeon, Unidad Privada de Oftalmologia CEMES
Fernando H Murillo-Lopez, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Medical Editor

Stephen D Plager, MD, FACS, Chief, Department of Ophthalmology, Dominican Hospital; Assistant Clinical Professor, Department of Ophthalmology, Stanford University Hospital
Stephen D Plager, MD, FACS is a member of the following medical societies: American College of Surgeons, American Medical Association, American Society of Cataract and Refractive Surgery, and California Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Christopher J Rapuano, MD, Professor, Department of Ophthalmology, Jefferson Medical College; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Hospital
Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Eye Bank Association of America, Pennsylvania Medical Society, and Philadelphia County Medical Society
Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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