What is a Dry Eye Syndrome?

Dry Eye Syndrome or DES is a common disorder of the thin tear film that coats the eyes affecting a significant percentage of the population most commonly individuals who are forty years old and above. This thin tear film has three main layers, namely:

Innermost Layer

This is the thinnest layer composed of mucus, which is produced by the tiny cells in the conjunctiva. Conjunctiva is the clear skin that lines the eye.

Middle Layer

• Also known as the aqueous layer, this is the thickest and the largest
• This is composed of very dilute saltwater solution produced by the lacrimal (glands under the upper eyelids) and the accessory tear glands
• This layer functions to keep the eye moist and help eliminate dust, debris, or foreign objects that may enter the eye
• Problems of the aqueous layer gives rise to the common dry eye syndrome or keratoconjunctivitis sicca or KCS.

Superficial layer

• This is composed of thin layers of fats or oils produced by the meibomian glands and the glands of Zeis.
• This layer functions to decrease the evaporation that occurs in the watery layer beneath.

Symptoms

Dry Eye Syndrome often exhibit the following symptoms:

• Dry, scratchy, or filmy feeling in the eyes
• Itching sensations in the eyes
• Eye redness
• Blurry vision
• A feeling of having a foreign object in the eyes
• Sensitivity to light

These symptoms are said to get worse on the following unfavorable conditions:

• Dry climate
• Windy weather
• Higher temperatures
• Lower humidity
• Prolonged use of the eyes (e.g., reading, long-term use of the computer, watching TV)
• Later part of the day

In some cases, a symptom of DES is an intermittent, excessive tearing. And when the eyes is a bit dry and irritated, this may cause reflex tearing, producing large amounts of tears all at the same time in an effort to try to get moist and feel comfortable. However, the situation is not really favorable to you because once the eye produces large amount of liquid, some of it will just overflow down the cheek and are, indeed, wasted. After a few minutes, the eyes will get dry and irritated again.

Causes

Although the main predisposing factor for a person to develop dry eye syndrome is the imbalance in the tear-flow system of the eye, it can also be caused by drying the tear film in the eye, which can be brought about by some conditions such as the following:

1. Aging process
   • The aging process can cause the cells in the body not to regenerate anymore.
2. Side effects of medications such as birth control pills and antihistamine drugs, beta blockers, etc.
3. Diseases that may affect the ability of the eyes to produce tears such as Sjogren’s syndrome, rheumatoid arthritis, and collagen vascular diseases.
4. Eye problems or conditions that do not allow the eyelids to close properly can cause excessive or rapid evaporation of the liquid (e.g., Bell’s palsy, stroke).
5. Decreased tear production.
6. Excessive tear production.
7. Underproduction of lipids in the superficial layer covering the eye which can lead to excessive evaporation of the liquid in the layer beneath it.
   • This happens when there is a dysfunction of the meibomian glands.
   • An infection in the eyelids called blepharitis may break down the oils in the eye, making it insufficient.
8. Abnormal mucin production by the conjunctiva
   • This is the result from chemical burns to the eye brought about by different autoimmune disorders such as Stevens-Johnson syndrome.
   • If there is less production of mucin, there is less spreading of tears in the surface of the eye because this is supposed to be the main function of mucin.
   • Eventually, this can damage the eye.

Treatment

Homecare Treatments

Here are tips on how to alleviate the symptoms of dry eye syndrome:

• Use of humidifier
  • This puts moisture in the air
  • When the air is filled with moisture, tears evaporate more slowly, keeping the eyes feel comfortable
• Decrease the speed of fans because excessive air movement tends to dry out the eyes.
• The use of an air filter may be helpful to ward off large amount of dust and other matters that may enter the eye
• Hot compresses or baby shampoo may help in maintaining a thicker and stable lipid layer. This is often beneficial if you have blepharitis or Meibomian glands dysfunction.
• Artificial tears and lubricating drops helps provide more moisture and lubrication to the eyes. For effective results, these are often applied four times a day but can be used as often as needed.
• For more longer-lasting effect, lubricating eye ointments are used; however, because of its thickness, this can often blur one’s vision if used during the day. Therefore, this is often used during the night.
• If you notice that your eyes get dry when facing the computer or watching TV, take frequent breaks to allow tour eyes to rest. Closing the eyes for ten seconds every ten minutes can help moisturize your eyes and make it comfortable again.

Medical Treatment

Although there is no fix cure for DES, however, the availability of many treatments make it a more manageable condition. Treatment is dependent on the severity of the disease. Some may only need a humidifier or drops and gels while some needs surgery. During surgery, the ducts that drain tears into the nose can be permanently closed to allow more tears to stay in the eyes. This can be done with the patient in local anesthesia and is on an outpatient basis, so this is a rather quick procedure.

What is Alien Hand Syndrome?

The Alien Hand Syndrome is famously known as Dr. Stranglove syndrome; from the famous movie back in the days entitled Dr. Strangelove which presented AHS. This is a proposed neurological disorder that is characterized by the affected person’s own hand or hands that seemingly have taken over its own free will or mind of its own. According to reports, this said phenomenon or condition is a result from a brain surgical intervention, in treatment of worst cases of epilepsy. Some reports would also say that this condition can be acquired after a cerebrovascular accident or stroke. The condition is also known as anarchic hand as this was firstly identified back in the year 1909. There was an accumulation of about forty to fifty patients of AHS in that year, but misdiagnosis is common back in the days.

Symptoms

As what most affected patients would describe the feeling of having alien hand syndrome, they could still sense that their hand is of normal and part of their body, but just provides a distinct behavior on its own without the control of its owner. They mostly describe it with a positive sensation of their hands; it’s just that they have no control to the specific action that the affected hand purposefully demonstrates. The person affected believes that their hand has its own free will and is usually referred as an alien behavior; explaining how alien hand syndrome coined its name.

In order to summarize all the presenting symptoms of alien hand syndrome, here are the following complaints of the affected:

• The hand (affected) provides an action that the person affected is unaware of.
• It would come to a point of awareness to the affected when the hand behavior catches his or her attention.
• The affected would believe that they are being possessed of some sort or they would believe that an alien has taken over his or her hand.

Causes

The condition alien hand syndrome is reported to be caused by a brain injury or infliction that is associated with distinct parts of the brain. But in general, the exact or root cause for this condition is yet to be discovered that can be entirely supportive of the condition. Here are some of the associations of the disease-process in the damage of specific parts of the brain:

Corpus callosum

It is believed that damage to this part of the brain can provide the symptoms of alien hand syndrome on the non-dominant hand. There is an intermanual conflict, a condition that the hands are directed to actions with opposing goals.

Frontal lobe

The frontal lobe is part of the brain that can control our actions or simply referred as the motor area of the brain. As this part of the brain is affected, the symptoms of alien hand syndrome may be manifested. As what mostly complained of, grasping of objects away from the free will of its owner is a manifestation.

Parietal and occipital lobes

These affected lobes of the brain shall provide us distinctive hand movements that are uncoordinated and described as “alien”. But the affectation of this part of the brain is considered purposeful, even though it’s involuntary.

Treatment

There is no known treatment for this condition as this is not entirely sought out as to the definitive cause of the condition. The only aim for the treatment course of alien hand syndrome is to reduce the manifestations and to manage the persons’ hand in the hopes to have a full control of every action. The treatment course would include providing the client exercises. Tasks are provided to clients in order to restore their voluntary control of the affected hand. Another approach is done to patients by reducing the interference of the alien hand to behave on its own. The trainer shall provide task for the alien hand in order for the person to become trained with the voluntary actions.

Facts

The condition was made known to the public because of the many portrayal of alien hand syndrome in movies. Back in the days, this condition is made topic in movies to portray comedic roles and for entertainment purposes. One of the famous pictures to ever been played on the big screen is Dr. Strangelove, a movie based on the phenomenon alien hand syndrome.

Some theories were presented in order to support the phenomenon alien hand syndrome. This condition, as considered rare is very much putting up some speculation to the public. It has been quite a question to every young mind and especially to those who are in the medical field. Because of that, a lot of study has been made in order to attain answers. These theories are presented in accordance to alien hand syndrome:

• Theory of disconnection. This theory explains that there is dissociation between the person’s main control of body movements with the voluntary actions involved. It is believed that the execution of the movements is altered because the main control center of actions is “disconnected”, thus resulting to the loss of sensation that a specific action has been executed.
• Theory of loss of inhibitions: This theory explains that the brain system in control of our actions is out of the hands of the affected. The patient’s drive to do actions is inhibited since the system that is in control of the system is uncontrollable.