Dry Eye - Evaluation & Work up

Dry eyes can usually be diagnosed by {the} symptoms alone.Tests can determine both {the} quantity and {the} quality of {the} tears.

A slit lamp examination can be performed to diagnose dry eyes and to document any damage to {the} eye.


Dry eyes can usually be diagnosed by {the} symptoms alone.Tests can determine both {the} quantity and {the} quality of {the} tears.

A slit lamp examination can be performed to diagnose dry eyes and to document any damage to {the} eye

Diagnosis of Dry Eye 

  • Dry eyes can usually be diagnosed by {the} symptoms alone.Tests can determine both {the} quantity and {the} quality of {the} tears.A slit lamp examination can be performed to diagnose dry eyes and to document any damage to {the} eye.
  • A Schirmers test can measure {the} amount of moisture bathing {the} eye. This test is useful for determining {the} severity of {the} condition. A five-minute Schirmer's test with and without anesthesia using a Whatman #41 filter paper 5 mm wide by 35 mm long is performed.For this test, wetting under 5 mm with or without anesthesia is considered diagnostic for dry eyes.
  • If {the} results for {the} Schirmers test are abnormal, a Schirmer II test can be performed to measure reflex secretion. In this test, {the} nasal mucosa is irritated with a cotton-tipped applicator, after which tear production is measured with a Whatman #41 filter paper.For this test, wetting under 15 mm after five minutes is considered abnormal.
  • A tear breakup time (TBUT) test measures {the} time it takes for tears to break up in {the} eye.The tear breakup time can be determined after placing a drop of fluorescein in {the} cul-de-sac.
  • A tear protein analysis test measures {the} lysozyme contained within tears.In tears, lysozyme accounts for approximately 20 to 40 percent of total protein content.
  • A lactoferrin analysis test provides good correlation with other tests.
  • The presence of {the} recently described molecule Ap4A, naturally occurring in tears, is abnormally high in different states of ocular dryness. This molecule can be quantified biochemically simply by taking a tear sample with a plain Schirmer test. Utilizing this technique it is possible to determine {the} concentrations of Ap4A in {the} tears of patients and in such way diagnose objectively if {the} samples are indicative of dry eye.

Anatomy of {the} Tear Film

 

Mucin Tear Deficiency

  • may possibly be due to decreased Vitamin A, alkali burns, Cicatricial pemphigoid, SJS
  • increased tear break-up time

Lipid Tear Deficiency

Dry Eye Tests

Tests for evaluation of dryness

  • basic secretion test
  • Schirmer I
  • Schirmer I
  • Tear meniscus
  • Tear breakup time

    As part of our eyes' normal function, tear film is produced, spread over {the} eyeball, and continually washed out through tiny holes on {the} edges of {the} upper and lower eyelids. Our impulse to blink is due to {the} tear film thinning out and evaporating, giving us {the} automatic impulse to blink and refresh {the} tear film. The process of {the} tear film thinning out is called tear film break-up.

    When not enough tear film is being produced to keep {the} eye moist between blinks, or when {the} tear film composition is abnormal, tear film break-up can occur too quickly—before our impulse to blink. This causes dry spots to appear on {the} eye's surface (cornea).

    Even if tear film is fairly normal, dry spots can still appear if {the} cornea has been compromised in some way. The cells on {the} corneal surface have very delicate structures that allow {the} tear film to stick to {the} eye, and if compromised, tear film can break-up too quickly

 

Images related to dry eye disease

 

 

 

 

Videos about Dry Eye and its treatment

 

 

 

 

 
 
 
 
 




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