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PPO5 > Dry Eye & Amniotic membrane > Flashcards

Dry Eye & Amniotic membrane Flashcards

1
Q

Dry eye is a multifactorial disease of the ocular surface characterized by a ________ of the tear film, in which tear film instability and ______, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.

A

loss of homeostasis; hyperosmolarity

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2
Q

What are critical diagnostic tests according to DEWSII?

A

symptoms, NIBUT, osmolarity, & cornal/conjunctival/lid margin staining

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3
Q

What are subtype classification aetiologies of dry eye?

A

MGD imaging/observation & expression, lipid thickness, and tear volume tests

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4
Q

Low tech diagnostic test: Ocular surface staining

A

more than 5 corneal spots
more than 9 conjunctival spots
lid margin ≥ 2mm & 25% width

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5
Q

Low Tech Diagnostic Tests: Tear Volume Testing

A

Tear Meniscus Height (TMH)
Schirmer’s
Phenol Red Thread Test

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6
Q

What does the Tear Meniscus Height indicate?

A

tear volume

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7
Q

What is normal TMH?

A

0.3-0.4mm

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8
Q

What does decrease in TMH and accumulation of debris indicate?

A

lacrimal deficiency, unstable tear film

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9
Q

How long does Schirmer’s last?

A

5 minutes

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10
Q

What does Schirmer’s /Jones I measure?

A

measures total tear secreation (reflex and basal)

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11
Q

What does Schirmer’s/Jones II measure?

A

measures basal secretion

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12
Q

Which tear volume testing requires anesthesia?

A

Jones II/modified Schirmer III

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13
Q

What tear measurement is considered borderline for Phenol Red Thread Test?

A

10-20mm

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14
Q

What tear measurement is considered dry eye for Phenol Red Thread Test?

A

0-10mm

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15
Q

What tear measurement is considered normal for Phenol Red Thread Test?

A

more than 20mm

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16
Q

How long does the Phenol Red Thread Test last?

A

15 secs

17
Q

Which test is a Medium Tech Diagnostic test and is an objective, repeatable and quantifiable test for dry eyes?

A

tear osmolarity

18
Q

What measurement of osmolarity is considered loss of homeostasis (dry eyes)?

A

Osmolarity > 300 mOsm/L
Inter-eye difference of >8 mOsm/L

19
Q

Which test is a high tech diagnositic test?

A

non-invasive tear breakup time(NIBUT): Keratograph 5M

20
Q

Which condition might result in alteration of the tearfilm, symptoms of eye irritation, clinically apparent inflamation, and ocular surface disease?

A

MGD

21
Q

What are clinical findings of MGD?

A

keratin plugging of gland openings
thickening of secretion
posterior displacement of MG
telangiectasia of posterior lid margins
notching of lid margin — MG atrophy
tear film instability
fluctuating vision

22
Q

What are some MGD tests?

A

-meibum expressibility
-meibum quality
-tear film interferometry
-meibography

23
Q

What is a low tech diagnostic test for MGD?

A
  • meibum expressibility
  • meibum quality
24
Q

What is the grading scale for meibum expressibilty (5 glands in lower or upper lid)

A

0 = all glands expressed
1 = 3-4 glands expressible
2 = 1-2 glands expressible
3 = no glands exprresible

25
Q

What is the grading scale for meibum quality?

A

8 glands on the central 1/2 of LL on 0-3 scale for each gland

total score range 0-24
0 = clear
1 = cloudy fluid
2 = cloudy particulate fluid
3 = inspissated, like tooth paste

26
Q

If a patient presents with no asymptomatic, and no corneal staining, but there is minimal altered expressibility and secretion quality, what stage is this?

A

stage 1

27
Q

If a patient presents with, minimal to mild symptoms, and little to nothing corneal staining, what stage is this?

A

stage 2

28
Q

If a patient presents with moderate symptoms with corneal staining mainly in the periphery, what stage is this?

A

stage 3

29
Q

If a patient presents with marked symptoms with marked corneal staining centrally in addition, what stage is this?

A

stage 4

30
Q

Explain the meibography scale.

A

0 = no dropout
1 = ≤ 25%
2 = ≤ 50%
3 = ≤ 75%
4 = >75-100%

31
Q

Explain the Tear Film Interferometry test

A

Thicker oil layer, the more colorful the tear film.

32
Q

The keratography 5m for Lipid Layer Thickness, the thicker the layer the ___ vibrant the colors

A

more

33
Q

What is a new treatment used to increase basal tear film production to improve tear film homeostasis?

A

Tyrvaya nasal spray

34
Q

What are some side effects of Tyrvaya nasal spray?

A

82% sneezing
6-16% cough
throat irritation
nose irritation

35
Q

What technique is used to treat cutaneous hemanigomatous lesions on the face?

A

intense pulsed light (IPL)

36
Q

IPL is not sutiable for those with ____ pigmented skin.

A

darker

37
Q

IPL is absorbed with _____

A

pigment melanin

38
Q

Infrared light _____ inflammation and ____ clogged MG

A

reduces; loosen

39
Q

Which technique uses light energy to soften blockages of MG orifices?

A

iLUX

PPO5 (5 decks)

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