The Wet Eye

Question 1

What’s are the two overall issues associated with a wet eye?

Answer 1

Increased tearing

Draining issues

Question 2

What are the three components of tears, where are they produced from and what are their functions?

Answer 2

1. Lipid
   - From: meibomian and tarsal glands
   - Function: Reduces evaporation
2. Aqueous
   - From: Lacrimal and accessory lacrimal gland (TE)
   - Function: Nourishes ocular surface
3. Mucin
   - From: Goblet cells
   - Function: adheres aqueous part to corneal surface

Question 3

What are the causes of increase tearing?

Answer 3

• Trigeminal irritation
• Distichiasis: abnormal growth of lashes from meibomian glands
• Ectopic cillium: distichiasis where lashes exits through conjunctiva intro eye
• Trichiasis: I growing lashes
• LPI of cornea
• LPI of nicitans membrane
• Foreign body
• Corneal ulcer
• Eyelid mass

Question 4

What are the causes of impaired draining?

Answer 4

• Cherry eye
• Eyelid abnormality
  > Entropion (inwards folding eyelid)
  >Ectropon (outwards folding eyelid)
  >Euryblepharon (Sagging lower eyelid)
  > Diamond eye (St Bernard’s!)
  > Ageneis (Holes in parts of eye
• Nasocrimal blockage
• Dacrocysitis (Inflammation o the nasolacrimal sac
• Retrobulbar/nasal disease

Question 5

How would you diagnosis impaired drainage?

Answer 5

Jones test

Question 6

What is the treatment for congenital entropion?

Answer 6

Surgery - tacking sutures

Question 7

What is the treatment for acquired entropion?

Answer 7

Proxymetacaine application - if it solves then the source is optic pain. Surgery if persistent after proxymetacaine.