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II. Anterior Segment Disease > Ocular Surface Disease (M1) > Flashcards

Ocular Surface Disease (M1) Flashcards

1
Q

What percentage of people in North America will have dry eye?

A

20%

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2
Q

Who are the people most likely to get dry eye?

A
  1. females (esp menopausal and postmenopausal)
  2. Autoimmune disease pts
  3. Systemic medications (antihistamines, antidepressants, Hormone Replacement Therapy)
  4. Contact lens wearers
  5. Refractive surgery patients
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3
Q

When there is dry eye, is there an increase or decrease in tear osmolarity?

A

increase

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4
Q

What are the four most common symptoms of dry eye?

A
  1. grittiness
  2. foreign body sensation
  3. tearing
  4. transient blur
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5
Q

What are the enlarged sebaceous glands posterior to the eyelashes called? 1. What do they secrete? 2

A
  1. meibomian glands

2. lipid

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6
Q

What percentage of meibomian glands are active at one time? 1. How can these glands be viewed? 2

A
  1. 45%

2. transillumination

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7
Q

What are the signs of Seborrheic MGD?

A
  1. hypersecretion

2. normal gland morphology

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8
Q

What are the signs of obstructive MGD?

A
  1. low secretion and gland drop-out (stenosis)

2. Increased osmolarity

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9
Q

What are the signs of obstructive with sicca MGD?

A
  1. low secretion and gland drop-out (stenosis)
  2. Increased osmolarity
  3. Decreased Schimer
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10
Q

What are the non-Rx treatments for dry eye?

A
  1. environment control
  2. Tear substitutes
  3. Nutriceutical (Omega fatty acid supplementation)
  4. Treat concurrent lid disease
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11
Q

What are the products given to dry eye patients that require anti-inflammatory treatment (and how long are each taken)?

A
  1. topical steroids (immediate relief, not taken long)

2. topical cyclosporine, Restasis (after steroids and taken for rest of life)

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12
Q

What treatment for dry eye increases mucin production and is not available in the U.S.?

A

secretagogs

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13
Q

What is given to the patient if they are unresponsive to topical immunosuppressive agents for dry eye? 1. What does it contain? 2

A
  1. autologous serum

2. neutrotrophic growth factor, epidermal growth factor, vit A, fibronectin, and lysozyme

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14
Q

What promotes an anti-inflammatory environment in dry eye and is in flax seed oil and fish oil?

A

omega fatty acids

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15
Q

What is a type of punctal plug that has the rim rest on the lid margin and has a tapered shaft?

A

Eagle Flex Plug

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16
Q

What are the plugs that require irrigation and dilation for removal and transillumination for viewing?

A

Herrick Lacrimal Plugs (Intracannicular)

17
Q

What is the semi-permanent punctal plug that requires no sizing? 1 What is it made of? 2

A
  1. SmartPlug

2. Medennium

18
Q

What is the semi-permanent punctal plug that Alcon makes?

A

Intelleport

19
Q

What are the ways to tell if a punctal plug is still in place?

A
  1. transilluminate
  2. tear meniscus height before and after
  3. Jones test (will be negative)
  4. Chronic canaliculitis, dacryocystitis as SE
20
Q

What is the cryopreserved human amniotic membrane used to promote corneal surface healing in neurotrophic disease and ocular disease?

A

Prokera

21
Q

What is the proper order for testing determined by DEWS?

A
  1. symptom questionnaire and Ocular Surface Disease Index
  2. Tear osmolarity
  3. Ocular surface evaluation
  4. TBUT
  5. Ocular Surface staining
  6. Schirmer test/Phenyl Red
22
Q

What are the treatments involved in Level 1 Dry Eye?

A
  1. Environmental and dietary changes
  2. Eliminate systemic meds
  3. Artificial tears
  4. Eyelid therapy
23
Q

What are the treatments involved in Level 2 Dry Eye?

A
  1. All Level 1
  2. Anti-inflammatories
  3. Tetracyclines
  4. Punctal plugs
  5. Secretogogues
  6. Moisture chamber spectacles
24
Q

What are the treatments involved in Level 3 Dry Eye?

A
  1. All level 2
  2. Serum
  3. Scleral or mini-scleral CL
  4. Permanent punctal occlusion
25
Q

What are the treatments involved in Level 4 Dry Eye?

A
  1. All level 3
  2. Systemic anti-inflammatory agents
  3. surgery
26
Q

What are the treatments involved in Level 1 MGD?

A
  1. pt eduction

2. lid hygiene

27
Q

What are the treatments involved in Level 2 MGD?

A
  1. Omega-3 fatty intake
  2. lid hygiene
  3. artificial tears
  4. topical emollient
  5. topical azithromycin
  6. tetracyclines
28
Q

What are the treatments involved in Level 3 MGD?

A
  1. All level 2
  2. lubrication ointment
  3. anti-inflammatory therapy for dry eye
29
Q

What is the most common parasite that lives on the skin?

A

Demodex

30
Q

What is the difference between Demodex folliculorum and Demodex brevis?

A

brevis is a little smaller

II. Anterior Segment Disease (11 decks)

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