Dry Eye Syndrome
IMPORTANT INFORMATION
IMPORTANT INFORMATION
Key Points
...ey Points
...ye is a common ocular condition that has a high i...
Etiology
Etiolo...
...Inflammatory Mediators in Dry Eye
...re 2. Major Etiological Causes of Dry...
...Factors for Dry EyeHaving trouble viewi...
Diagnosis
...agnosis...
...dentifying characteristics of the causative f...
...upporting clinical observations and tests are use...
...ut patient symptoms and signs, exacerba...
...s should have a comprehensive adult medical...
...luation of a patient who presents with sympt...
...external examination should pay parti...
...ion of conjunctival staining is helpful but un...
...oderate punctate staining of the cornea and/or...
...dye is NOT recommended for evaluating...
...Schirmer test can be performed to evaluate aq...
...p biomicroscopy evaluation should focus on t...
...d review of systems should be performed...
...high degree of suspicion is appropr...
...s who might have thyroid eye disease should b...
...B-scan sonogram or other imaging stud...
...opsy is appropriate for any patients...
...es have failed to correlate tear osmolarity...
...ts with moderate to severe aqueous tear deficie...
...s should be performed in this sequence because th...
...inutes should be allowed between the dye testi...
...ation should be assessed when trig...
...tory and clinical evaluation for autoimmu...
...eye conditions have a chronic course, repea...
...nostic Tests Ordered for Possible Under...
...Characteristic Findings for Dry Eye Syndr...
...e 3. Sjögren’s International Collaboration...
Management
...anagement...
...y eye who are evaluated by non-opht...
...hthalmologist should educate the patien...
...stic expectations for therapeutic goals s...
...effective treatments for evaporative tear d...
...uence and combination of therapies should be de...
...ic therapies may be chosen from any category...
...who have suggestive symptoms without signs shoul...
...with a clinical diagnosis of mild...
...sures such as lowering the computer screen to...
...ulsions, gels, and ointments can be...
...ificial tears may be increased, but th...
...rved tear substitutes are generally...
...bstitutes are used frequently and chronica...
...buting ocular factors such as blepharitis or...
...thromycin should be used with caution to treat d...
...ities resulting from blepharitis should be correc...
...lid abnormalities resulting from trichiasis shoul...
...lid abnormalities resulting from lid malposition...
...al corticosteroid therapy can be used at infre...
Patients prescribed corticosteroids f...
...mega-3 fatty acid products without ethyl es...
...emic omega-3 fatty acid supplements f...
...ith aqueous tear deficiency, punctal...
...ugs may be helpful in moderate to severe...
...ted with punctal plugs should be monitor...
The largest plug that can be inserted should b...
...benefit from having punctal plugs in p...
...therapies such as eyeglass side shields and moi...
...ts (hydroxypropyl cellulose) are occasionally help...
...locarpine and cevimeline have been...
...ne treatment has been shown to have...
...m drops have been reported to improve ocular irr...
...tologous serum drops have been reported...
Filamentary keratitis can be treated wit...
...s can be debrided with a cotton-tip a...
...atient has associated neurotrophic...
...tal occlusion can be accomplished by...
...occlusion with cautery is planned, a trial occlusi...
...epwise approach to cautery occlusion is...
...rrhaphy can be performed to decrease tear...
...rmeable scleral lenses have been e...
Counseling and Referral
...ing and Referral...
...ortant aspects of caring for patients with dry e...
...is helpful to periodically reassess the patien...
...ith pre-existing dry eye should be...
...have dry eye and are considering keratorefract...
...to severe cases that are unresponsive to treatme...
...to an internist or rheumatologist c...
...stemic disease such as primary Sjögren syndro...
...ies of Dry Eye TreatmentsHaving trou...
.... Treatment Recommendations for Dry Eye Sy...
...e 7. Summary of Evidence for the Treatment...