Current Concepts about the Etiology of Dry Eye Syndrome

The revolution in understanding the etiology and clinical manifestations of the disruption of the tearing process and the development of dry eye syndrome (CVS) has occurred in last 20–30 years. It has been established that the loss of the tear film homeostasis can occur not only because of a violation of systemic and autoimmune disorders, but also as a result of a blinking disorder and distribution of the tear film over the ocular surface. Therefore, new pathogenetic disease development mechanisms have been identified. The prevalence of diseases of the ocular surface and CVD in recent years has increased significantly. It is mostly caused not only by scientific discoveries in the field of understanding, for example, the etiological and pathophysiological role of the neurosensory mechanism of development of CVS. An important aspect is the emergence of new risk factors that potentiate the development of ocular surface diseases and CVL. These factors include the use of various drugs — antidepressants, antihistamines, hormone therapy, and others; instillation of eye drops — antiglaucoma drugs, etc., as well as the appearance of little-studied factors such as cosmetology procedures (eyelids tattooing, eyelash extensions, botulinum toxin injections for aesthetic purposes, etc.). They are carried out in proximate close to the eye and eyelids, causing multiple pathological reaction. The experience of observing patients, literature data, and the conducted study have showed that various cosmetological effects in the periorbital zone, whose popularity has increased in recent years, may cause the appearance of iatrogenic dry eye syndrome. The following most vivid clinical examples will help, encountered in our practice, to illustrate the data presented. Collecting the anamnesis, it is necessary to identify the presence of risk factors for the development of diseases of the ocular surface and CVD, to eliminate them, if possible, and to carry out adequate pathogenically based therapy