Dry Eye Syndrome

Publication Date: January 1, 2019

IMPORTANT INFORMATION

IMPORTANT INFORMATION

This pocket guide has been archived and is no longer updated. The information below may be outdated. Please refer to AAO website for current guidelines.

Key Points

...Key Points...

...Dry eye is a common ocular conditio...


Etiology

...Etiology

...ure 1. Inflammatory Mediators in Dry Eye...


Figure 2. Major Etiological Causes of Dry Eye


...k Factors for Dry EyeHaving trouble viewing tab...


Diagnosis

...Diagn...

...haracteristics of the causative facto...


...upporting clinical observations and...


...ut patient symptoms and signs, exacerbatin...


...uld have a comprehensive adult medi...


The initial evaluation of a patient who present...


...e external examination should pay par...


...luation of conjunctival staining is helpful but un...


...oderate punctate staining of the cornea...


...reen dye is NOT recommended for evaluating corn...


...r test can be performed to evaluate aqueous t...


...slit-lamp biomicroscopy evaluation shou...


...etailed review of systems should be performe...


...igh degree of suspicion is appropriate fo...


...o might have thyroid eye disease should...


...n sonogram or other imaging study should be order...


...tival biopsy is appropriate for any patients who...


...studies have failed to correlate tear osmolarity...


...r patients with moderate to severe aqueous tear...


...ts should be performed in this sequence bec...


...veral minutes should be allowed be...


...on should be assessed when trigeminal n...


...ratory and clinical evaluation for a...


...most dry eye conditions have a ch...


...Diagnostic Tests Ordered for Possible Unde...


...ble 4. Characteristic Findings for Dry Eye...


...re 3. Sjögren’s International Collaboration Cli...


Management

...Management

...y eye who are evaluated by non-ophthalmologist...


...ist should educate the patient about...


...istic expectations for therapeutic goals sh...


...rly effective treatments for evapor...


...d combination of therapies should be de...


...erapies may be chosen from any category regar...


...have suggestive symptoms without signs should...


...nts with a clinical diagnosis of mil...


...s lowering the computer screen to belo...


...els, and ointments can be used. (III, In ...


...e use of artificial tears may be increased...


...ed tear substitutes are generally preferabl...


...bstitutes are used frequently and chronica...


...g ocular factors such as blepharitis or meibom...


...in should be used with caution to t...


...ities resulting from blepharitis should be correc...


...elid abnormalities resulting from trichiasis sho...


...lities resulting from lid malposition should b...


...ow-dose topical corticosteroid therapy can be used...


...prescribed corticosteroids for dr...


...atty acid products without ethyl esters...


...of systemic omega-3 fatty acid supplemen...


...ents with aqueous tear deficiency, punctal oc...


...ugs may be helpful in moderate to severe case...


Patients treated with punctal plug...


...he largest plug that can be inserted should be u...


...tients who benefit from having punctal plugs...


...herapies such as eyeglass side shi...


...inserts (hydroxypropyl cellulose) are occasionally...


...pine and cevimeline have been approved...


...reatment has been shown to have short-te...


...us serum drops have been reported to improv...


...erum drops have been reported to improve oc...


...tary keratitis can be treated with...


...ents can be debrided with a cotton-tip applicato...


...atient has associated neurotrophic keratopathy,...


...ent punctal occlusion can be accomplished by...


...lusion with cautery is planned, a tri...


...approach to cautery occlusion is gen...


...arsorrhaphy can be performed to decr...


...-permeable scleral lenses have been emp...


Counseling and Referral

...Counselin...

...ost important aspects of caring for patients with...


...t is helpful to periodically reassess the patient...


...ith pre-existing dry eye should be cautioned...


...ents who have dry eye and are considering kera...


...severe cases that are unresponsive to tr...


...an internist or rheumatologist can be consid...


...ents with systemic disease such as...


...ategories of Dry Eye TreatmentsHaving...


.... Treatment Recommendations for Dry Eye Syndrome b...


...ary of Evidence for the Treatment of Dr...