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Recently, allergic conjunctivitis and dry eye syndrome have been thought to be the epidemics of XXI century. Allergic conjunctivitis is the commonest form of allergy worldwide. Clinical symptoms of dry eye are the most common cause of patients complains in out-patient ophthalmological clinics. Both, allergic conjunctivitis and dry eye syndrome, may be associated with some systemic diseases. Thus, it is crucial to perform complete allergic tests in patients suspected of allergic conjunctivitis. The assessment of IgE in tears is a very sensitive test in these cases because physiologically this immunoglobulin is not detectable in tear film. In cases of dry eye syndrome the measurement of tear osmolarity has been is thought to be the most specific and sensitive test, recently.

Purpose: To evaluate the role of pro-inflammatory cytokines interleukin-8 (IL-8) and interferon-gamma (IFN-gamma) in pathogenesis of Sjogren's syndrome of dry eye (SS--dry eye), and in induction of ocular changes in this disease., Material and Methods: Tear samples were collected from 25 patients with Sjogren's syndrome of dry eye and 33 healthy volunteers. Cytokine levels were determined by ELISA. Ophthalmic examinations, including tests for dry eye, were used to study the ocular surface. The levels of these cytokines in tears and dry eye findings were compared., Results: The tears level of IL-8 and IFN-gamma in SS--dry eye patients were significantly higher than those in controls. We found positive correlation between the tears levels of pro-inflammatory cytokines and dry eye findings (subjective and objective assessments and diagnostic tests)., Conclusions: The elevated level of pro-inflammatory cytokines in tears fluid of patients with Sjogren's syndrome of dry eye may be important factor in the pathogenesis of this disease. Significant correlation between tears level of cytokines and dry eye findings suggest, that these cytokines induce inflammatory changes of ocular surface in Sjogren's syndrome of dry eye.

Purpose: To evaluate the concentration of sFas in tear film of cystic fibrosis patients., Material and Methods: Tear samples were collected from 20 patients with cystic fibrosis and 20 patients from control group. The sFas levels were determined by immunoenzymatic assay ELISA., Results: We found statistically increased levels of sFas in tear film of patients with cystic fibrosis compared with control group., Conclusions: Apoptosis may play role in the pathogenesis of ocular changes in cystic fibrosis patients. The above results are important for the choice of the treatment of dry eye syndrome in patients with cystic fibrosis.

Authors present one of the ocular diabetic complications--diabetic keratoepitheliopathy. The aim of this article is to summarize the knowledge about diabetic keratoepitheliopathy, its causes, manifestations and treatment options. Diabetes mellitus is associated with structural and functional disturbances in eyelids, conjunctiva and cornea. There are also changes in tear film present. Diabetic neuropathy resulting from the biochemical poor control of diabetes is the probable basic cause of the pathology. Mechanisms responsible for these changes are still not well understood. The corneal and conjunctival complications may occur spontaneously. But more often they arise from undue stress of intraocular surgery procedures. The incidence of diabetic keratoepitheliopathy in diabetic patients is high. However, it is rarely diagnosed. Effectiveness of symptomatic treatment with use of common medications is not satisfactory and it needs further investigation.

Purpose: To evaluate IL-8 concentration in tears fluid in cystic fibrosis patients., Material and Methods: Tears samples were collected from 18 CF Patients and 18 normal controls. Cytokine level was determined by ELISA., Results: A significant increase of IL-8 concentration in tears fluid was found in CF patients compared with controls., Conclusions: Increase IL-8 concentration in tears fluid in CF patients suggests a role of immunologic processes in the pathogenesis of the ocular changes, and may be a marker of the inflammatory status in ocular surface in cystic fibrosis.

Purpose: To evaluate IFN-gamma concentration in tear fluid in CF patients., Material and Methods: Tear samples were collected from 15 CF patients at the age 10-21, and from 15 patients in control group at the age 11-20. Cytokine levels were determined by ELISA., Results: The concentration of IFN-gamma in tear fluid in CF patients was 10.75+/-2.23 pg/ml, and 4.06+/-0.57 pg/ml in control group., Conclusions: The results of this study indicate that increased concentration of IFN-gamma in the tear fluid may be an important factor in the pathogenesis of dry eye in CF patients. They also open new perspectives related to therapeutic management.

Due to the grow-up of number of patients suffering from signs of dry-eye syndrome we are obligated to investigate physiology and pathology of tear film. Data obtained from patients with Sjögren Syndrome and other types of lacrimal dysfunction shows that the expectations for break-up in dry-eye treatment strategy are very high. In our review we are presenting contemporary views concerning tear film production and tear deficiency with special look at the treatment possibilities.

Discussed are the methods of treatment of the disturbances of stability of the pre-ocular tear film and the compounds which are used. In spite of introduction of a considerable amount of new pharmaceutics in the last period the treatment of disturbances of this kind needs a large amount of patience as well from the side of the patient as from the ophthalmic specialist.

Presented are the actual possibilities of diagnosis of the disturbances of stability of the tear fluid. In spite of the existence of quite numerous clinical and laboratory diagnostic tests it is necessary to elaborate new, simple and safe methods of examination which may be applied in the clinical practice.