Dry eye

Question 1

What questions would you ask in order to confirm dry eye?

Answer 1

have you had daily/persistent troublesome dry eyes for more than 3 months?
recurrent sensation of sand or gravel in the eyes?

Question 2

What are aggravating factors of dry eyes?

Answer 2

dry air, smoke, wind, dust

Question 3

What symptoms would a pt have?

Answer 3

burn, feel tired, itch, irritated, gritty

Question 4

What are likely causes?

Answer 4

blepharitis
Sjöhrens syndrome
medicine-induced dry eyes

Question 5

What is a very unlikely cause of dry eyes?

Answer 5

Bell’s Palsy - facial paralysis often sudden onset - pt unable to close one eye which can result in decreased film tear

Question 6

When to refer?

Answer 6

if pt has Sjöhrens syndrome, outward turning eyelid

child presenting with dry eyes

Question 7

what medications cause dry eyes?

Answer 7

diuretics, anticholinergic effect, isotretinoin, HRT, androgen antagonists, cardiac arrhytmias, SSRIs

Question 8

what tx options are there for dry eyes ?

Answer 8

hypromellose 
polyvinyl alcohol (viscosity enhancer) 
carmellose 
carbomer 980 
sodium hyaluronate 
wool fats

Question 9

What is a counselling point you should give to a patient about preservative eye drops?

Answer 9

contains benzalkonium chloride can cause eye irritation so can use preservative free