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Dry eye
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Dry Eye
Healthy tear
film
Dry eye
Etiology
1. Aqueous tear deficiency. It is
also known as keratoconjunctivitis
sicca. It is seen in conditions like
congenital alacrimia, paralytic
hyposecretion, primary and
secondary Sjogrens syndrome, Riley
Day syndrome and idiopathic
hyposecretion.
Schirmer-I test
It measures total tear secretions. It is performed with
the help of a 5 35 mm strip of Whatman-41 filter
paper which is folded 5 mm from one end and kept in
the lower fornix at the junction of lateral one-third
and medial two-thirds. The patient is asked to look
up and not to blink or close the eyes (Fig. 15.4).
After 5 minutes wetting of the filter paper strip from
the bent end is measured.
Normal values of Schirmer-I test are more than 15
mm. Values of 5-10 mm are suggestive of moderate
to mild keratoconjunctivitis sicca (KCS) and less than
5 mm of severe KCS.
Treatment
At present, there is no cure for dry eye. The
following treatment modalities have been tried
with variable results:
1. Supplementation with tear substitutes.
Artificial tears remains the mainstay in the
treatment of dry eye. These are available as
drops, ointments and slowrelease inserts. Mostly
available artificial tear drops contain either
cellulose derivatives (e.g., 0.25 to 0.7% methyl
cellulose and 0.3% hypromellose) or polyvinyl
alcohol (1.4%).
Diagnosing
Absence of Meibomian gland.
The gland orifices are often compromised due to
stenosis or closure.
A declining quality and quantity of lipid secretion.
Treatment
Clearing
Hot fomentation on eyelids for 5~10mins.
Massaging the eyelids.
Swabbing the lid-margin with mild cleaning solution.