Medical history (history of illness) represents an important component in the diagnosis of keratoconjunctivitis sicca (dry eye syndrome).
Family history
- Are there any individuals in your family with ocular disease?
Social history
- What is your occupation? (Screen work?)
- Are you exposed to harmful agents in your occupation? (see under environmental history)
- Is there smoking in your environment, i.e. you are a passive smoker?
Current medical history/systemic history (somatic and psychological complaints).
- Have you noticed any symptoms such as a foreign body sensation or a feeling of dryness?
- Are your eyes burning or itching?
- Are your eyes red?
- Have you noticed mucus secretions from the eye?
- Do you have tired looking/puffy eyes?
- Do you have occasional eye pain – e.g. with drafts?
- Are your eyes sensitive to light?
- Do you wear contact lenses?
Vegetative anamnesis incl. nutritional anamnesis.
- Do you smoke? If yes, how many cigarettes, cigars or pipes per day?
- Do you use drugs? If yes, what drugs and how often per day or per week?
Self history including medication history.
- Pre-existing conditions (diabetes mellitus, autoimmune diseases, e.g. rheumatoid arthritis, infectious diseases).
- Environmental history
- Computer screen work (VDU work)
- Intensive television
- Car fan
- Ozone, e.g. from copiers and printers
- Dry indoor air due tooverheated rooms, underfloor heating, air conditioning systems.
- Insufficient or incorrect lighting
- Cigarette smoke
- Environmental pollution (e.g. dust)
- Operations
Medication history
- Antiarrhythmic drugs
- Class III antiarrhythmics (amiodarone).
- Anticholinergics (atropine, scopolamine, homatropine).
- Antidepressants
- Monoamine oxidase inhibitors (MAO inhibitors).
- Tricyclic antidepressants ( amitriptyline, clomipramine, desipramine, doxepin, imipramine, trimipramine).
- Selective serotonin uptake inhibitors (SSRI = Selective Serotonin Reuptake Inhibitor).
- Antiparkinsonian drugs
- Antipsychotics (neuroleptics) – phenothiazines/chlorpromazines; haloperidol
- Eye drops with preservatives (eg, benzalkonium chloride).
- Beta-blockers (beta-receptor blockers; ß-blockers) – atenolol, metaprolol, oxprenolol, pindolol, propranolol.
- Bisphosphonates (alendronate, pamidronate).
- Benzalkonium chloride (BAC)
- Diuretics
- H1 antihistamines
- 1st generation antihistamines – chlorphenamine, chlorphenoxamine, clemastine, cyproheptadine, dexbromopheniramine, dimenhydrinate, dimetindene, diphenhydramine, doxylamine, hydroxyzine, ketotifen, meclozine, mepyramine, oxomemazine, pheniramine
- 2nd generation antihistamines – bilastine, cetirizine, desloratadine, fexofenadine, levocetirizine, loratadine.
- HCV protease inhibitors (boceprevir.
- Hormones
- Postmenopausal estrogen therapy
- Topical IOP-lowering drugs (IOP-lowering drugs).
- Rauwolfia alkaloids (reserpine).
- Retinoids (acitretin, isotretinoin).
- Systemic chemotherapy
Other risk factors
- Eye drops with preservatives (eg, benzalkonium chloride).