D - Dry Eye - Week 1 redone Flashcards
What is the 2017 TFOS DEWS II definition of dry eye?
A multifactorial disease of the ocular surface characterised by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play aetiological roles
In regards to dry eye: how do you manage signs without symptoms?
Preventative management as appropriate (e.g. pre-surgery)
How do you manage neurotrophic conditions (dysfunctional sensation)?
Signs indicate management of DED is required
How do you manage a patient with dry eye symptoms but it’s another ocular surface disease?
Refer/manage according to differential diaignosis
How do you manage symptoms without signs/pre-clinical state?
Observe/offer education/preventative therapy
How do you manage dry eye patients with no signs and neurotrophic pain?
Refer for pain management
Provide an example how a patient can have signs of dry eye but no symptoms
Nerve damage causing loss of sensation
What is the lacrimal functional unit comprised of?
Lacrimal gland, ocular surface components, MGs, eyelids, assoc. sensory (CNV) and autonomic (CNVII) innervatino
What does the lacrimal functional unit regulate? (3)
Tear secretion
Tear distribution
Tear clearance
What can disruption to one or more components of the lacrimal functional unit lead to?
Loss of tear film homeostasis
From where does the cornea receive sensory input?
From the ophthalmic division of the trigeminal nerve
Is staining enough to diagnose dry eye?
No
What is the difference between nociceptive pain and neuropathic pain?
Nociceptive: pain in response to actual or threatened tissue damage
Neuropathic: pain in response to damage to the somatosensory pathway
Which is more transient: nociceptive pain or neuropathic pain?
Nociceptive (whereas neuropathici is more chronic)
Which type of pain activates the corneal nerves? Nociceptive or Neuropathic?
Nociceptive