Dry Eye Syndrome
Definition
Western
Dry Eye Syndrome is a condition where there is a lack of sufficient lubrication and moisture on the surfaces of the eyes. The eye depends on the constant flow of tears to provide moisture and lubrication to maintain clear vision and comfort. When there is an imbalance or breakdown of this tear production system, one may experience dry eyes. Common symptoms experienced such as dry, scratchy or filmy feeling in the eyes, burning or itching sensation in the eyes or redness of the eyes. These symptoms may worsen in dry or windy conditions or where one experiences higher temperatures or lower humidity. Prolonged periods in activities such as reading, watching television or using the computer, would also cause dry eyes.
Traditional Chinese Medicine (TCM)
Under the context of TCM, the Dry Eye Syndrome is defined as the lack of natural lubrication in the eyes brought upon by the malfunctioning of certain vital organs in the body. The physiological functions of the eyes are under the governance of the Liver system, whereby dysfunctioning of any part of this system would trigger discomforts of the eyes, such as dry, red or swollen eyes. The Liver system also helps individuals cope with stress, may it be physical, mental or emotional stress factors.
Classifications in TCM Context
Stress
In TCM, Liver system keeps different types of stress under control, which include emotions, such as anger or fear; or daily stress encountered with relationships at home or at work.
Natural Aging
As a person ages, the physiological functions of vital organs, especially the Liver, Lungs and Kidney systems in generating bodily fluids, will inevitably slow down and hence produce less tears to combat external irritants, such as dust particles.
Chronic illnesses or use of certain medications
Weakened body constitution may affect the production of tears to protect the delicate eyes from irritants. Certain medications, such as anti-histamines, anti-depressants or oral contraceptives may further wear down the Liver or Kidney systems by decreasing tear production.
Causes and Risk Factors
Environment Factors
Environmental factors such as sun, wind, dry climate, hot blowing air or high altitudes, can have drying effects, causing the tears to evaporate faster from the eyes. People are particularly at risk when they are exposed to a combination of these environmental factors.
Natural Aging
Aging will cause less production of tears in preventing external irritants from upsetting the physiological functions of eyes. Other natural hormonal changes, such as menopause or during menstruation, may also trigger the dry eye syndrome.
Occupation & Lifestyle
Prolonged periods of watching television or using the computer, intensive visual concentration is required for these actions and this would also decrease the frequency of blinking and causes excessive evaporation of the tears from the eyes, thus causing dry eyes. Wearing contact lens for long periods of time is another cause for dry eyes.
Medications & Surgery
Certain medications, short-term or long-term, are suspected to cause dry eye syndrome as one of the common side effects, such as use of anti-histamines, anti-depressants, beta-blockers, diuretics and oral contraceptive pills. Some people who have had laser surgeries would also experience the dry eye syndrome shortly after surgery.
Treatments
Herbs commonly used in prescriptions and acupuncture:
1. Gou Qi Zi – 枸杞子
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English/ Common name
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Chinese wolfberries, Lycium berries
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Latin species
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Lycium barbarum L.
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Park of plant used
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Fruit
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Action/s
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Research has shown that this herb contains high levels of antioxidants and commonly used to treat eye ailments and weakened immune system [3-5].
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Precaution/s
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No significant side effects.
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2. Qing Xiang Zi – 青葙子
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English/ Common name
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-
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Latin species
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Celosia argentea L.
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Park of plant used
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Seeds
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Action/s
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Commonly used for a wide range of eye ailments [18-19].
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Precaution/s
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Not recommended for those with glaucoma conditions.
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3. Xia Ku Cao – 夏枯草
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English/ Common name
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Common Selfheal
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Latin species
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Prunella vulgaris L.
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Park of plant used
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Ear of fruit
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Action/s
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Used for dry, red and swollen eye ailments [6,9, 12-17].
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Precaution/s
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Those with weak digestive system should use in caution.
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4. Ju Hua – 菊花
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English/ Common name
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Chrysanthemum
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Latin species
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Chrysanthemum morifolium Ramat.
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Park of plant used
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Flowers
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Action/s
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Found to have anti-bacterial, anti-fungal, anti-viral and anti-inflammatory actions. Also widely used to treat upper respiratory infections, allergies, headaches, red eyes and hypertension [1-2].
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Precaution/s
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No significant side effects.
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5. Shi Hu – 石斛
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English/ Common name
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Dendrobium
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Latin species
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Dendrobium loddigesii Rolfe.
Dendrobium fimbriatum Hook. var. oculatum Hook.
Dendrobium Chrysanthum Wall.
Dendrobium candidum Wall. ex Lindl
Dendrobium nobile Lindl.
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Park of plant used
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Stems
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Action/s
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Commonly used to boost functions of the stomach and kidneys, and often used to help release internal body heat due to illnessesor late nights [7-8,10-11].
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Precaution/s
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No significant side effects.
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Test & Diagnosis
Clinical Examination
A general eye examination would be conducted to collect information from the patient’s complaints as well as feedback using sets of symptom questionnaires.
Eyes are examined using a special microscope, where the following items would be inspected or assessed:
a. Amount and thickness of the tear film
b. Stability of the tear film
c. Conditions of the conjunctiva or cornea
Other Eye Tests
Schirmer tests
Measure the amount of tears produced by the eyes.
Eye Dyes
Different dyes may be used during the eye examination to test for the cellular conditions of the cornea and conjunctiva.
Home Remedies
Shi Hu + Ju Hua + Jue Ming Zi
a) Put all ingredients in a cooking pot and pour enough water to cover.
b) Bring to boil for 10 minutes.
c) Simmer for a further 10 minutes.
d) Remove from heat. Add sugar or honey to taste.
e) Best serve warm.
References
1. Jian Zhang, An Wei Ding et al. Two New Flavonoid Glycosides from Chrysanthemum morifolium.Chinese Chemical Letters 2006, 17(8), pp1051-1053.
2. Zheng Yun, Lio liu, Fang Ji-Nian. A Novel Polysaccharide from Chrysanthemum morifolium. Acta Botanica Sinica 1004, 46(8), pp997-1001.
4. Zhisong Chen, Jinhua Lu, Nalini Srinivasan, Benny Kwong Huat Tan, Soh Ha Chan. Polysaccharide-Protein Complex from Lycium barbarium L. Is a Novel Stimulus of Dendritic Cell Immunogenicity. The Journal of Immunology 2009, 182: 3503-3509.
5. Zhisong Chen, Mei Yun Soo, Nalini Srinivasan, Benny Kwong Huat Tan, Soh Ha Chan. Activation of Macrophages by Polysaccharide-protein Complex from Lycium barbarum L. Phytotherapy Research 2009, 23: 1116-1122.
6. Pharmacopoeia of the People’s Republic of China (2005). Vol1. People’s Medical Publishing House.
7. Zhao W, Ye Q, Tan X, Jiang H, Li X, Chen K, Kinghorn A D. Three new sesquiterpene glycosides from Dendrobium nobile with immunomodulatory activity. Journal of natural products 2001, 64(9):pp1196-200.
8. Kong Jin-Ming, Goh Ngoh-Khang, Chia Lian-Sai, Chia Tet-Fatt. Recent advances in traditional plant drugs and orchids. Acta Pharmacologica Sinica.(Jan 2003). 24(1): pp7-21.
9. McGuffin, M. et al. 1997. Botanical Safety Handbook. Boca Raton: CRC Press.
10. Jian-Ping Luo, Yuan-Yuan Deng, Xue-Qiang Zha. Mechanism of Polysaccharides from Dendrobium huoshanense on Streptozotocin-Induced Diabetic Cataract. Pharmaceutical Biology (Apr 2008), 46(4): pp243 – 249.
11. P. Uma Devi, S. Selvi, D. Devipriya3, S. Murugan, S. Suja. Antitumor and antimicrobial activities and inhibition of in-vitro lipid peroxidation by Dendrobium nobile. African Journal of Biotechnology (May 2009), 8(10): pp2289-2293.
13. Liang Feng, Xiao-Bin Jia, Feng Shi, Yan Chen.Identification of Two Polysaccharides from Prunella vulgaris L. and Evaluation on Their Anti-Lung Adenocarcinoma Activity. Molecules 2010, 15(8): pp5093-5103.
15. Ryu SY, Oak MH, Yoon SK, et al. Anti-allergic and anti-inflammatory triterpenes from the herb of Prunella vulgaris. Planta Med (May 2000), 66(4): 358–60.
16. Fang X, Chang RC, Yuen WH, Zee SY. Immune modulatory effects of Prunella vulgaris L. Int. J. Mol. Med. (March 2005), 15(3): pp491–6.
17. Fang X, Yu MM, Yuen WH, Zee SY, Chang RC. Immune modulatory effects of Prunella vulgaris L. on monocytes/macrophages. Int J Mol Med. (Dec 2005),16(6):pp1109-16.
18. Hiroshi Morita, Hayato Suzuki, Jun'ichi Kobayashi. Celogenamide A, a New Cyclic Peptide from the Seeds of Celosia argentea. J. Nat. Prod. 2004, 67 (9), pp1628–1630.
20. Chu Hua LI, Xiao Yi WEI, Xu E LI, Ping WU, Bao Jiang GUO. A New Anthranquinone Glycoside from the Seeds of Cassia obtusifolia. Chinese Chemical Letters 2004, 15(12): pp 1448-1450.