Ocular Lubricants Flashcards
82% of dry eye pts wished there was
There was something more than ATs to treat their dry eyes
Common visual complaints in dry eye
Fluctuating vision w blinking
Glare
Blurred vision
Eye fatigue
Dry eye, caused by unstable tear film can result in
Reduced vision, inflammation and discomfort
Factors that can disrupt homeostatic control and destabilize the tear film
Rosacea
MGD
Accurate (can kill MG)
CLs
Certain conditions can cause an inflammation driven dry eye
Sjorgrens
RA, Lupus
Fibromyalgia
Inflammation effect on MG
In the resolution phase, fibroblasts come in and re- keratinize the glands stopping the oil from coming out
Conj and cornea wont be as healthy in dry eye because
Inflammation causes apoptosis
CL intolerance is a big clue for
Dry eye
Can be resolved by using peroxide based systems to get rid of build up
It’s common for dry eye pt’s to also complain of
Dry skin
Paying attention might be essential for the early detection and relief of ocular or skin dryness
Brimonidine
Used as a cream to help rosacea
Although dry eye is a heterogenous disorder of the ocular surface, the common denominator is
Inflammation
Difference between time when pt with irritated eye symptoms are worse
End of the day - dry eye
Morning- bleph
Almost exclusive for bleph, free fatty acids and soaps released after bacterial lipases break down the MG secretions
Burning eyes
What kind of pain seen in dry eye
Neuropathic pain, dry eye is constantly irritating the tear film and cornea causing damaged nerves
Dry eye symptomsare due to over reacting nerves
Dry eye questionnaires are helpful because
They can document improvement that they usually don’t notice
First line of defense of the tear film
Lipid layer
Protects the tear film, against desiccation and protects corneal noniceptors
Why is blinking important?
It’s how the glans releases it’s oil
A function of a healthy tear film is a tropic environment
Growth factors for corneal epithelium
Tears when you have a dry eye change by
Increase in osmolarity which is what causes the irritation
Age related dry eye
The most common form
Immunologic change in dry eye
Once T cells are activated, inflammatory cytokines are released causing more inflammation
Testosterone treatment for dry eye can
Bind to corticosteroid and can have some anti inflammatory effect
What happens if you dont treat MGD
Lipid changes
Eyelid inflammation
Bacterial overpopulation
Lipase release toxins
All dry eye has increased
Osmolarity and inflammation
MGD pathophysiology
Increased evaporation
Increased osmolarity
Visual issues in dry eyes are caused by
Tear film instability - glare
Corneal SPK - blurred vision
ATs lack
Complex mixture of growth factors
Dry eye pts blink
More bc there no stable tear film
Gels are better because of
Increased viscosity increases retention time
Natural lubricant
HA is added to ATs
Try to avoid a certain persevative in ATs
BAK, it builds up
Cell changes in dry eye
Junction between cells start to break down, increase in corneal turnover
Theratears and saline help with dry eye because
Used to rinse eye, and helps with inflammation because cytokines are being diluted
ATS dont contain specific anti inflammaoptry, lysozyme, lactoferrin, immunoglobulin a, lipid binding proteins and growth factors.
MGP pts should use
Lipid supplemented tears
Blink has
HA
Rash is a sign of
Inflammation
Discontinuing steroids will cause
Inflammation to come back
Filamentary keratitis
Is caused when you have you dont have enough tears to dissolve mucous
Filamentary keratitis is a condition with
strands composed of degenerated epithelial cells and mucus develop on and adhere to the corneal surface causing pain and FBS
Vigamox is a
Non preserve topical antibiotic
Démodé treatement
Only tea treat oils can kill it
It’s messy, smelly and it stings
MGD obstruction
Cant fix itself
Glands become more
Asymmetric when they start to get plugged
