scholarly journals Examination for Dry Eyes

2021 ◽  
Author(s):  
Tri Wahyu
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Signs And Symptoms ◽  
Eye Disease ◽  
Initial Examination ◽  
Laboratory Equipment ◽  
Dry Eyes ◽  
Potential Damage

Dry eye disease (DED) is a multifactorial disease of tears and ocular surface that results in various symptoms with the potential damage to the ocular surface. It can range from mild to severe signs and symptoms and may affect patient’s quality of life. Various techniques and methods have been developed to evaluate DED for initial examination or regular follow up. The simple evaluations that can be performed in clinic include eyelid examination, tear break-up time, and ocular surface stainings; while the advanced ones may require certain devices or laboratory equipment. Careful and thorough examinations are important to guide the clinician to assess and evaluate dry eye.

scholarly journals Dry eye disease among Glaucoma patients on topical hypotensive medications, in a tertiary hospital, Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Miraf Sahlu ◽  
Abeba T. Giorgis
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Signs And Symptoms ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Eye Drops ◽  
Schirmer Test ◽  
Ocular Surface Disease Index ◽  
Cross Sectional ◽  
Corneal Staining

Abstract Background Dry eye disease is a multifactorial disease; causing various ocular symptoms with potential damage to the ocular surface. Applying hypotensive eye drops are presumed to initiate or exacerbate existing dry eye disease. The purpose of this study was to determine the frequency of signs and symptoms and severity of dry eye disease among glaucoma patients on topical hypotensive medications and controls. Methods A cross-sectional comparative study, involving 320 glaucoma patients and controls. Ocular Surface Disease Index (OSDI) symptoms score and Schirmer, tear breakup time and corneal staining tests were used to assess dry eye disease. Data was analyzed using SPSS version 24 software; p-value less than 0.05 was considered as statistically significant. Results Among the 160 study glaucoma patients, the mean duration of topical hypotensive medication use was 5.2 ± 5.21 years (range, 4 months - 32 years). Mild to severe level of OSDI score was found in 122 (76%) glaucoma patients and in 137 (86%) controls (p = 0.033). Mild to sever abnormal clinical tests in the glaucoma patients and control, respectively, were 106 (66%) vs 80 (50%) corneal staining (p = 0.045), 79 (49%) vs 72 (45%) TBUT (p = 0.021), and 91 (57%) vs 83 (52%) Schirmer test (p = 0.242). Test results at the level of sever: 2 (1%) vs 0 (0%) corneal staining, 50 (31%) vs 39 (24%) TBUT and 65 (41%) vs 60 (38%) Schirmer test in the glaucoma patents and controls, respectively. Corneal staining and TBUT had correlation with the number of drugs (p = 0.004 and 0.031, respectively), and more relationship of the two tests with total number of drops applied per day (p = 0.01 and p <  0.001, respectively). Patients on pilocarpine and timolol had more corneal staining and lower TBUT [(p = 0.011 and p <  0.001) and (p = 0.04 and 0.012), respectively]. Conclusions The study has identified glaucoma patients to be more affected by dry eye disease than non-glaucoma patients, and presence of significantly lower TBUT and higher corneal staining in the glaucoma patients on multidrops and multidose per day. We recommend consideration of evaluation and management of DED for glaucoma patients on multidrops and multidose hypotensive medications.

Updated definition and classification of dry eye disease: Renewed proposals using the nominal group and Delphi techniques

2020 ◽  
pp. 112067212096058
Author(s):  
Stefano Barabino ◽  
Pasquale Aragona ◽  
Antonio di Zazzo ◽  
Maurizio Rolando ◽  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Dry Eye Disease ◽  
Nominal Group ◽  
Eye Disease ◽  
Type I ◽  
Disease Definition ◽  
Quality Of Vision

The aim of our research was to obtain expert consensus for updated definition and classification of dry eye disease using formal methodology. The nominal group technique (NGT) involved a steering committee of four ophthalmologists began with collection of ideas followed by group discussion. The ideas were collated, refined, and voted upon. The main characteristics considered, each with different degrees of severity in types I, II, and III, were the ability or not of the ocular surface to re-equilibrate itself, frequency of symptoms, presence of inflammation, epithelial alterations, and possible alterations in the quality of vision. This was followed by three rounds of a “mini-Delphi” involving an expert panel of 13 ophthalmologists, with the last round including all 17 ophthalmologists. Consensus in the final round of voting (⩾75% of votes) was reached on the definition of dry eye disease and on criteria for its classification in three forms. Type I is a transient and reversible form with subclinical inflammation, possible epithelial alterations, and occasional alterations in vision. Type II is a recurrent form characterized by a reduced ability to re-equilibrate the ocular surface, frequent symptoms and alterations in vision with clinically-evident inflammation, and clear evidence of epithelial alterations. Type III is a chronic form with inability to re-equilibrate the ocular surface and accompanied by clinically-evident and chronic inflammation, persistent epithelial alterations, and frequent alterations in quality of vision. The vast majority of patients with dry eye disease can be easily classified into one of these three forms. Dry eye disease definition was updated accordingly.

scholarly journals Effect of Hyaluronic Acid/Trehalose in Two Different Formulations on Signs and Symptoms in Patients with Moderate to Severe Dry Eye Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Klemens Fondi ◽  
Piotr A. Wozniak ◽  
Doreen Schmidl ◽  
Ahmed M. Bata ◽  
Katarzyna J. Witkowska ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Dry Eye ◽  
Sodium Hyaluronate ◽  
Signs And Symptoms ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Quality Of Sleep ◽  
Pro Re Nata ◽  
Breakup Time

Purpose. This randomized, observer-masked, crossover study investigated the effect of two hyaluronic acid/trehalose-based containing formulations, with different physical properties, on the signs and symptoms in patients with moderate to severe dry eye disease (DED). Methods. In one group, patients received a mixture of sodium hyaluronate and trehalose (HT, Thealoz Duo®) for use during the day. In the other group, patients received a more viscous formulation consisting of hyaluronic acid, trehalose, and carbomer (HTC-gel, Thealoz Duo Gel) to use pro re nata. Both groups used HTC-gel before going to bed. Clinical standard tests for DED were performed at the beginning and end of each one-week period. Further, patient satisfaction including quality of sleep was assessed using a visual analogue scale. Results. Corneal fluorescein and conjunctival lissamine green staining scores decreased, and tear breakup time (BUT) increased for both groups (p<0.001 each). Mean instillation frequency was 3.1 ± 2.6 drops/day when using HT and 1.9 ± 2.2 drops/day when using HTC-gel (p=0.02). A significant improvement in the quality of sleep was observed with both treatments (p=0.01). Conclusions. Our results show improvement in signs and symptoms of DED in both groups. While instillation of HTC-gel resulted in a lower instillation frequency, both formulations of trehalose showed good clinical efficacy. This trial is registered with NCT02980913.

scholarly journals Diagnostic Procedures and Management of Dry Eye

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Snježana Kaštelan ◽  
Martina Tomić ◽  
Jasminka Salopek-Rabatić ◽  
Branko Novak
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Diagnostic Procedures ◽  
Female Gender ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Systematic Classification ◽  
Contact Lens Wear ◽  
Potential Damage

Dry eye disease or dysfunctional tear syndrome is among the most frequent diagnoses in ophthalmology. It is a multifactorial disease of the ocular surface and tear film which results in ocular discomfort, visual disturbances, and tear instability with potential damage to the cornea and conjunctiva. Risk factors for dry eye syndrome include age, sex (female gender), race, contact lens wear, environment with low humidity, systemic medications, and autoimmune disorders. The aim of this paper is to present the systematic classification, epidemiology, diagnostic procedures, and advances in the management of dry eye disease. The recent improvements in comprehending the underlying etiologic factors will inevitably improve future classifications and diagnostic abilities leading to more effective therapeutic options. Treatment of this highly prevalent condition can drastically improve the quality of life of individuals and prevent damage to the ocular surface.

scholarly journals Zdravljenje glavkoma in suho oko

2016 ◽  
Vol 85 (4) ◽  
Author(s):  
Barbara Cvenkel
Keyword(s):  
Ocular Surface ◽  
Clinical Signs ◽  
Tear Film ◽  
Signs And Symptoms ◽  
Surface Damage ◽  
Eye Drops ◽  
Film Instability ◽  
Asymptomatic Patients

Patients with glaucoma have increased prevalence of dry eye (DE) compared to age-matched population without glaucoma. Clinical presentation of DE varies among individuals and may significantly reduce quality of life. The onset and deterioration of DE is caused by the toxic-inflammatory effects of preservatives in eye drops, active substance itself, and added, pharmacologically inactive substances or excipients. Ocular surface changes most frequently include superficial punctate keratitis, tear film instability, and allergic reactions. Despite the lack of symptoms, clinical signs may indicate ocular surface damage. Discordance between signs and symptoms is partly caused by decreased corneal sensitivity induced by neurotoxicity of the preservative benzalkonium chloride (BAK). Therefore, it is important to evaluate ocular surface before initiating glaucoma therapy and during follow-up also in asymptomatic patients. Preservative-free and/or BAK-free therapy is indicated in patients with severe DE and allergy to preservatives, and recommended in patients with DE of moderate severity, blepharitis, in symptomatic patients, before filtering surgery to reduce preoperative inflammation, in those with moderate fluorescein staining of grade 2 on Oxford scheme, and reduced tear film break-up time.

scholarly journals Meibomian Gland Dysfunction

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Sameera Irfan
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Treatment Strategies ◽  
Tear Film ◽  
Meibomian Gland ◽  
Dry Eye Disease ◽  
Meibomian Gland Dysfunction ◽  
Eye Disease ◽  
Treatment Protocols ◽  
Dry Eyes

Dry eyes is a common, chronic condition that has a prevalence of about 5- 50%.1 According to the Dry Eye Workshop II report (DEWS II report), published in 2017, the updated definition of Dry Eye Disease is, “a multifactorial disease of the ocular surface characterised by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyper-osmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.” The Tear Film & Ocular Surface Society (TFOS) released their report on the international work on Meibomian Gland Dysfunction (MGD)2 in 2011, which defined MGD, classified it and considered it as the primary cause of dry eye disease worldwide. Previously dry eye disease was considered as an aqueous deficiency problem, but after this report by TFOS, there is a paradigm shift towards “not producing enough lipids to retain the tears that are being produced”. This has led to a huge impact on the treatment protocols which were previously focused on managing the sequelae and symptoms of dry eyes rather than targeting directly on the underlying cause, the MGD. It has now been accepted worldwide that dry eye occurs when the ocular surface system cannot adequately protect itself from the desiccating stress due to the lack of a healthy meibomian gland secretion. This article is mainly focussed on the Meibomian Gland Dysfunction, discussing the normal anatomy of the glands, how they are affected by disease, its implications on the ocular surface and finally, the various treatment strategies. Key words: Blepharitis, Dry eyes, Meibomian gland dysfunction, blepharospasm.

scholarly journals LASIK and Dry Eye Disease: A Case Report

2021 ◽  
Vol 4 (3) ◽  
Author(s):  
Priyancaa Jeyabaladevan ◽  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Case Reports ◽  
Significant Risk ◽  
Vital Staining ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Patient Centered ◽  
Dry Eyes ◽  
Use Of Resources

Background: Post- Laser- assisted in situ keratomileusis (LASIK) dry eye is one of the most common postoperative dry eyes after ophthalmic surgeries. Clinically, patients have positive vital staining of the ocular surface, decreased tear breakup times, reduced corneal sensitivity, and decreased visual acuity. In majority of patients, symptoms last about one month, but some patients can experience these symptoms for more than a year. Case presentation: A 29-year-old female with Dry Eye Disease (DED) secondary to isotretinoin use wanted to undergo LASIK for refractive improvement. Ophthalmologists were thorough in informing the patient of the significant risk of post-operative dry eyes, especially in patients with pre-operative DED. A cautious approach was taken by the ophthalmologist, and the patient’s opinion and needs considered. Post-operatively, the patient continues to have DED but reports it is not worse than pre-LASIK and continues to be complaint with dry eye disease treatment. Conclusions: In patients with existing DED, clinicians are vigilant in progressing with LASIK, due to post-operative dry eye symptoms. Careful patient selection and preoperative ocular surface management is recommended for such patient groups. This case reports highlights the importance of clinicians allowing patients to come to an informed decision regarding their care. This patient-centered approach is a model of care that respects patients’ experiences, values, needs and preferences, whilst improving clinical outcomes, better use of resources and increased satisfaction with care.

scholarly journals TREATMENT FOR CONJUNCTIVOCHALASIS: A COMBINED APPROACH UTILIZING RADIOFREQUENCY CAUTERIZATION AND THERMALIDTM PROCEDURE

2021 ◽  
Vol 4 (1) ◽  
pp. e1-e10
Author(s):  
Liem Nguyen ◽  
Edward Jaccoma
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Symptomatic Relief ◽  
Retrospective Chart Review ◽  
Signs And Symptoms ◽  
Meibomian Gland ◽  
Significant Clinical Improvement ◽  
Pre Treatment ◽  
Tear Meniscus Height

BackgroundDry Eye Disease (DED) and related ocular surface diseases have multiple etiologies, but two of the most prevalent are Meibomian Gland Dysfunction (MGD) and Conjunctivochalasis (CCH). This study examines a customizable two-step approach utilizing radiofrequency to treat these two commonly coexisting condi-tions and provide patients with relief from DED signs and symptoms. Study DesignAn IRB approved retrospective chart review of 25 consecutively treated patients was conducted. Patients were included if they presented with DED symptoms and were treated with a combination treatment approach to improve both MGD and CCH, with pre- and post-treatment dry eye metrics outlined below. Follow-up visit information was compared to pre-treatment baseline to evaluate the efficacy and safety of treatment. ResultsStatistically significant results were observed in a decrease in symptoms as evaluated by the primary endpoints of the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire and an increase in the number of Meibomian Glands Yielding Liquid Secretion (MGYLS). Tear Meniscus Height also saw statistically significant improvement while Non-invasive Tear Break-Up Time (NTBUT) and Schirmer’s saw minor progress. Clinical evaluation and ocular surface photographs showed marked improvement in CCH with minimal observed side effects during post-operative follow-up visits. ConclusionA two-step approach utilizing a radiofrequency device to treat dry eye symptoms provides significant clinical improvement and symptomatic relief for a broad spectrum of patients who had received a variety of prior treatments for DED.

scholarly journals Aging: A Predisposition to Dry Eyes

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Anushree Sharma ◽  
Holly B. Hindman
Keyword(s):  
Older Adults ◽  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Aging Population ◽  
Well Being ◽  
Dry Eyes ◽  
Visual Status ◽  
Visual Acuity Loss

Dry eye syndrome is a disease of the ocular surface and tear film that is prevalent in older adults. Even though the degree of visual acuity loss in dry eye patients is commonly mild-to-moderate, in the aging population, this minimal change in visual status can lead to a significant decrease in visual function and quality of life. A healthy ocular surface is maintained by appropriate tear production and tear drainage, and deficiencies in this delicate balance can lead to dryness. In the aging eye, risk factors such as polypharmacy, androgen deficiency, decreased blink rates, and oxidative stress can predispose the patient to developing dry eye that is frequently more severe, has higher economic costs, and leads to worse consequences to the well-being of the patient. Understanding why elderly patients are at higher risk for developing dry eyes can provide insights into the diagnosis and management of the growing number of older adults struggling with dry eye and minimize the burden of disease on our aging population.

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