Red Eye: Dry Eye (D&T)

Question 1

What is dry eye?

Answer 1

Keratoconjunctivitis sicca

Question 2

What problems with the eye can cause this? (3)

Answer 2

Problems with:

1. Lipid layer: stability (meibomian glands)
2. Aqueous layer: volume (lacrimal glands)
3. Mucous layer: wetability (conjunctival goblet cells)

Question 3

What causes this? (4)

Answer 3

1. Drugs (topical, oral e.g. anticholinergics)
2. Eye disease (blepharitis, conjunctivitis)
3. Autoimmune disease: Sjogrens syndrome ass. RA)
4. Mechanical problems: 7th nerve palsy, lid notches, contact lenses

Question 4

What is the function of tears?

What are they made of?

Answer 4

Lubricate and oxygenate the ocular surface

Spread over cornea by blinking
Oils, antibodies, lactoferrin, lysozyme, mucin

Question 5

What are the types of tears?

Answer 5

Basal tears (constant production)
Reflex (corneal irritation, emotional response)

Question 6

What are the symptoms of a dry eye?

Answer 6

Insidious onset
Feel 'dry', gritty, burning
Struggle to open in the morning
Watering (epiphora -  reflex to dry spots)
Blurred vision (need to blink)
Recurrent infection
Unable to wear contact lenses

Question 7

What are the signs?

Answer 7

Mildly red eye

Question 8

What is the management?

Answer 8

Drug history and stop causative medications
Contact lens wear
Explain mechanism
Frequent topical lubricants
Blinking (increase blinking)
Eye protection