严重干眼症易于诊断,但中度泪液分泌减少,则临床征象可能是不明确的。可疑干眼症意指患者有干眼症状,并有眼睛干燥的一个特征,但这只有对全身性红斑狼疮才是重要的早期表现。药物引起的干眼也是很重要的。一、鉴别诊断: (一)慢性睑结膜炎:与皮脂溢出症或其它皮肤病有关。致病菌是金黄色葡萄球菌或其它低级病原体。病人可有结痂或溃疡性慢性睑缘炎。睑缘可有血管扩张,围绕睫毛有鳞屑。几乎总伴有葡萄球菌毒素引起的慢性乳头性结膜炎;也可有慢性睑板腺炎。 (二)酒糟鼻性角膜结膜炎:以睑球结膜充血、睑缘毛细血管扩张、霰粒肿及睑缘炎为特征。角膜下半有上皮糜烂,或有上皮变性。随着疾病的进展,角膜炎可以加重而导致血管侵入、实质层变薄及穿孔。作者经常见有乳头性结膜炎。Borrie发现20%的酒糟鼻病人首先表现于眼部。常伴有葡萄球菌结膜感染,对四环素反应极佳。 (三)过敏性结膜炎:若无显著反射性流泪,则烧灼感、粘性分泌物及伴发的乳头性结膜 Severe dry eye is easy to diagnose, but moderate tear secretion is reduced, the clinical signs may not be clear. Suspected dry eye syndrome means that the patient has dry eye symptoms and is characterized by dry eyes, but this is only an early manifestation of systemic lupus erythematosus. Dry eye caused by drugs is also very important. First, the differential diagnosis: (A) chronic conjunctivitis: and seborrhea or other skin diseases. Pathogens are Staphylococcus aureus or other low-grade pathogens. Patients may have scab or ulcerative chronic blepharitis. Eyelid may have vasodilation, scaling around the eyelashes. Almost always accompanied by staphylococcal toxins caused by chronic papillary conjunctivitis; may also have chronic meibomitis. (B) rosacea keratoconjunctivitis: to the bulbar conjunctival congestion, eyelid telangiectasia, chalazion and blepharitis is characterized. Lower corneal epithelial erosion, or epithelial degeneration. As the disease progresses, keratitis can aggravate vascular invasion, thinning of the parenchyma and perforation. The author often see nipple conjunctivitis. Borrie found that 20% of patients with rosacea first manifested in the eye. Often accompanied by staphylococcal conjunctival infection, excellent response to tetracycline. (C) allergic conjunctivitis: If there is no significant reflective tear, the burning sensation, viscous secretions and concomitant papillary conjunctiva