Dry eye diagnosing, treatment, and management

Question 1

dry eye disorder of the tear film is due to…

Answer 1

tear deficiency or excesseive tear evaporation

Question 2

what are teh 3 forms of dry eye

Answer 2

1. evaporative: lipid deficient caused by MGD
   - occurs when the water in tears evaporates at a faster rate than normal
   - 86% of dry eye paitnets
2. aqueous deficient
   - occus when aq generation from lacrimal gland is insufficient to keep eyes moist
3. mucin deficieny (rare): reduced # of goblet cells=> poor wetting

Question 3

what is the diff btwn lid wiper epitheliopathy and line of marx

Answer 3

LWE: line on upper lid that stains as a result of constant rubbing, narrow zone of parakeratinzied cells located at the surface of the mucocutaneous junction, never makes contact w/ the ocular surfaces, seen on lid eversion

LOM: surface tissue on margin where dry tissue meets wet, never touches ocular surface, NOT grey line

Question 4

if your patient reports they feel every blink and its painful to blink what should you suspect

Answer 4

LWE

lid wiper epitheliopathy

Question 5

what is debriding

Answer 5

w/ golf club spud- dental model of removing dead ep cells that interere w/ normal blink and closure of eyelids
-LOM and lower lid margin to provide relieve MG function

Question 6

what does schirmer’s test test for

Answer 6

aq deficiency

measures total tear volume: reflex and basal

Question 7

what restulst for schirmer’s is normal, dig DE, severe DE

Answer 7

normal > or equal to 15mm
5-10 is sig
<5mm severe

Question 8

what does the korb mb gland evaluator do

Answer 8

applies consistent and standard pressure equal to a forceful blink

Question 9

what can you predict w/ meibography

Answer 9

can’t predict gland function, only tests structure bc only images

Question 10

who are the korb-blackie light test performed on

Answer 10

pts who complain of dry eye symp in the morn or have constatn irritation and pain
-see light leakage

Question 11

what is the treatment for an incomplete lid seal

Answer 11

first line: ointment or gel drops

second line: night shields or moisture goggles

Question 12

who do we perform the goggle test on

Answer 12

pts w/ constant and chronic pain

pts w/ a high speed score (severe de)

Question 13

when testing osmolarity, when is it considered dry eye

Answer 13

high os=dry eye

Question 14

what is the prokera: amniotic membrane

Answer 14

part of the placenta

used to treat ocular surface when eye is so damaged it needs help to heal