Aims: To assess the role of the common inflammatory mechanism in the pathogenesis of the dry eye syndrome.
Methods: 64 patients with eye surface symptoms were studied using a diagnostic algorithm: questionnaire (eye symptoms were graded and a symptomatology SCORE was calculated), objective eye examination (including Schirmer's test and the tear film breakup time-BUT). Histopathological examination of 14 conjunctival bioptic fragments was performed.
Results: 59.37% of the patients had a positive Shirmer's test, while only 23% tested positively for the BUT. No statistically significant correlation was established between Schirmer's test and the BUT or the symptomatology SCORE. There was a significant correlation between BUT and the symptomatology SCORE (p<0.05) and between BUT and the duration of the disease (p<0.01). The histopathological examination of the dry eye conjunctival samples evidenced the following alterations: loss of calyciforme cells, squamous metaplasia of the epithelium, subepithelial inflammation.
Conclusions: The histological analysis confirms the implication of inflammation in the pathogenesis of the disease. The time of onset of the inflammation cannot be established, it may be initial or it may occur with the quantitative decrease of tears or with eye surface alterations.