Lect 1

Question 1

Ocular Surface Diease

Answer 1

Dry eye disease and blepharitis

Question 2

Main components of ocular surface

Answer 2

Eyelids, conjunctiva, tear film, cornea

Question 3

Eyelid

Answer 3

Skin, muscles, tarsal plate (fibrous and elastic tissue), meibomian glands, and principal accessory lacrimal glands

Question 4

Principal accessory lacrimal glands

Answer 4

Glands of: Zeiss, Moll, Krause and Wolfring, Manz and Henle

Question 5

Glands of Krause and Wolfring function

Answer 5

Secrete aqueous layer of tear film

Question 6

Glands of Manz and Henle function

Answer 6

Secrete mucous layer of tear film

Question 7

Glands of Zeis function

Answer 7

Sebaceous

Question 8

Glands of Mol function

Answer 8

Sweat

Question 9

Eyelid function

Answer 9

Protection of corneal and conjunctival surface. From infection, foreign bodies, and light.

Question 10

Blinking process is important for…

Answer 10

Tear film by supporting: meibum/lipids secretion, spreading uniform tear film, and drainage of the tears.

Question 11

Types of blinking

Answer 11

Voluntary, spontaneous, and reflex

Question 12

Blinking phases

Answer 12

Closing/occulsion: gland compression, excretion of glands, drainage of old tears through lacrimal puncta, and closing of lacrimal puncta.
Opening: homogenous spreading of new tears and lacrimal puncta opening.

Question 13

Tear film function

Answer 13

Protects from infection and hydrates cornea and conjunctiva.
Provides O2 to reach cornea.
70% of eye’s refractive power through the cornea and polishes its surfaces.

Question 14

Tear film layers

Answer 14

Lipid layer (meibomian glands)
Aqueous layer (lacrimal glands)
Mucin layer (epithelial cells)

Question 15

Corneal layers

Answer 15

Epithelium, Bowman’s layer, Stroma, Descemet’s memebrane, Endothelium.

Question 16

Conjunctiva function

Answer 16

Produces mucous layer through goblet cells. Protects the cornea and interior of the eye from the external environment. Allows independent movement of the eye and eyelids.

Question 17

Cornea function

Answer 17

Refracts incoming light, helps shield eye from foreign bodies, and serves as a filter, screening UV wavelengths in sunlight

Question 18

Dry eye risk factors

Answer 18

Asians, Females, Menopause, Certain meds, Systemic autoimmune and inflammatory disease, long term glaucoma meds, CL wear, Eye surgeries, Life style (smoke, low humidity, prolonged comp, dec essential fatty acids).

Question 19

Dry eye symptoms

Answer 19

Burning, Itching, Redness, Soreness, Dryness, FBS, Grit/sand sensation, CL intolerance, Fluctuating or transicent blurred vision, photophobia

Question 20

Dry eye lifestyle modifications

Answer 20

Avoid allergens, Humidify environment, Quit smoking, Limit screens: Reduces blink rate and increased evaporative tear loss. Lower display terminals to decrease inter palpebral aperture. Frequent breaks and A.T.s

Question 21

Dry Eye Therapeutic Management

Answer 21

Lifestyle changes, dietary mods, eyelid hygiene, eye lubricants, anti inflammatory eye drops: steroids, non steroids, antibiotics and/or cyclosproine A. Punctual plugs (retain moisture on ocular surface). Treatment of other coexisting conditions.

Question 22

Artificial Tears benefits

Answer 22

Inc volume of tears, moist and lubrication of ocular surface, stabilizing tear film, formation of functional film and preserving visual function.

Question 23

Prefer properties of A.T.

Answer 23

Very high tolerance, high affinity for the ocular surface, prolonged contact time, acceptable viscosity, appropriate osmolarity, non preservative.

Question 24

Blepharitis

Answer 24

Chronic inflammation of the eyelids.

Question 25

Anterior Bleph

Answer 25

Outside front edge of the eyelids, at the base of the lashes

Question 26

Posterior bleph

Answer 26

Innermost edge of the lids where it contacts the eyeball.. Affects meibomian glands. MGD

Question 27

Bleph common signs

Answer 27

Palpebral edema, eyelid margin inflammation, crusting and scaling of eyelid margin, eyelash changes (loss, breaking, turn inwards), conjunctival and corneal lesions.

Question 28

Bleph symptoms

Answer 28

Eyelid irritation, redness, swollen lids, eyes stuck together (mornings), increased blinking rate, burning sensation, irritation, tearing, and red eyes, photophobia.

Question 29

Eyelid hygiene goals

Answer 29

Remove crusts from eyelashes and lids, promote meibomian glands secretions, and reduce bacterial colonization.

Question 30

Benefits of eyelid hygiene

Answer 30

Avoids eyelid irritation, infection and inflammation. Preserves integrity of ocular surface. Stabilizes lipid layer of tear film.

Question 31

Eyelid hygiene components

Answer 31

Eyelid warming, massaging, and cleansing

Question 32

Goals of eyelid warming

Answer 32

Melt meibomian secretions from blocker or partly blocked ducts. Reduce it’s waxiness, and increase fluidity of meibomian secretions.