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Dry eye
1.
2.
Fatemeh Dashti
Optometrist . BSc - MSc
3.
4.
Lacrimal system
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
Dry eye clasification
18.
Tear deficient dry
eye
19.
Evaporative dry eye
20.
Dry eye classification
21.
Classification scheme for
dry eye proposed by NEI/industry workshop
22.
23.
24.
25.
26.
27.
Symptoms of Ocular
Surface Disease Current Triggers of Dry Eye Disease Environment Medications Contact Lens Surgery Rheumatoid Arthritis Lupus Sjögren’s Graft vs Host Postmenopause Meibomian Gland Disease Inflammation Tear Deficiency/ Instability Irritation
28.
29.
30.
31.
symptoms
32.
33.
34.
35.
36.
37.
38.
Propose mechanism of
ocular surface inflammation in dry eye
39.
40.
41.
42.
Dry eye diagnostic
tests Type of evaluation Test Tear secretion Schirmer I,John”s test, cotton thred test, Dye clearance test, Fluorophotometery Tear stability Invasive BUT- NoninvasiveBUT Tear film integrity Epithelial integrity Rose bengal staining Physical feature Osmolality , PH, Ferning evaporation rate Chemistry Electrolytes, Protein(lysozyme, lactoferin) Histology Imperssion cytology, lacrimal gland biopsy, minor salivary gland biopsy
43.
44.
Tear break up-
time test
45.
46.
47.
NITBUT
48.
NITBUT
49.
50.
51.
Fluorescein clearance test
(FCT)
52.
53.
Tear film osmolarity
Lacrimal gland disease Decreased corneal sensation Increased palpebral fissure Meibomian gland dysfunction Decreasde sensation Increased evaporation Increased tear osmolarity
54.
55.
Normal osmolarity :
300-310 mosm/l
56.
Tear film osmolarity
Condition Expected range of value Normal < 312 mosm/l Borderline dry eye 312- 323 mosm/l Moderate/severe dry eye > 323 mosm/l
57.
58.
Schirmer test
59.
60.
61.
62.
63.
Phenol red test
64.
65.
66.
67.
68.
69.
70.
71.
72.
73.
Meibomian gland evaluation-NORMAL
74.
Meibomian gland evaluation-MGD
75.
76.
77.
78.
Corneal esthesiometry
79.
80.
81.
VALUES IN NORMAL
TEAR AND DRY EYE
82.
INTERFEROMETRY OF THE
LIPID LAYER
83.
Tearscope –plus lipid
layer thickness(LLT)
84.
85.
86.
87.
Ferning test
88.
Levels of severity
of dry eye disease
89.
Treatment
90.
91.
92.
93.
94.
95.
96.
97.
98.
99.
Preservative – free
artificial tears
100.
101.
102.
103.
104.
Emollients : simple
Eye pomades
105.
106.
107.
artificial tear spray
Less chance of contamination . Tears Again Liposome spray (10cc) ($15) ( occusoft) Natures Tears Eye Mist (10cc) ($7) (all scripts)
108.
109.
110.
111.
112.
collagen discs &
plugs
113.
114.
115.
116.
117.
Transplantation of secretory
glands
118.
Dry eye treatment
recommendations by severity level
119.
Dry eye treatment
recommendations by severity level
120.
Dry eye treatment
recommendations by severity level
121.
Dry eye treatment
recommendations by severity level
122.
Never walk on
the traveled path, because it only leads you where the others have been. Graham Bell
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