Dry eye disease in keratoconus: etiology and medical treatment

Abstract

This paper reviews published data on the studies on keratoconus associated with dry eye disease (DED) presentations. Despite the lack of a direct correlation between DED and keratoconus, many studies have demonstrated that keratoconus is associated with DED in more than 80% of cases. The author describes major endogenous and exogenous (inflammatory, immune/allergic, mechanical, neuropathic) factors triggering the development and association of these conditions. Approaches to the medical treatment of disorders resulting from the association of these entities are discussed. The primary management strategy implies tear film and ocular surface protection with tear substitutes based on the sodium salt of hyaluronic acid. In the lack of the effect of tear substitutes or in rigid gas permeable contact lens wearers, gel-based dexpanthenol in high concentrations is recommended. This treatment significantly increases drug bioavailability and prolongs the ocular surface reparation. Scleral contact lenses ensuring intact corneal epithelium and high visual acuity in irregular astigmatism caused by keratoconus are also used for corneal protection and DED therapy. Keywords: keratoconus, keratectasia, dry eye disease, epitheliopathy, tear film. For citation: Averich V.V. Dry eye disease in keratoconus: etiology and medical treatment. Russian Journal of Clinical Ophthalmology. 2022;22(2):122–126 (in Russ.). DOI: 10.32364/2311-7729-2022-22-2-122-126.