Dry Eye Disease

Question 1

Which conditions are associated with ADDE?

Answer 1

Anterior blepharitis, demodex, recurrent hordeolum, conjunctivitis, and marginal corneal infiltrates.

Question 2

What conditions are associated with EDE

Answer 2

Posterior blepharitis, Acne Rosacea, MG blockage

Question 3

DED history (SAR)

what does this stand for?

Answer 3

Severity
Associated dry mouth and swollen salivary glands?
Risk factor analysis: age, smoker, CL use

Use questionnaire: OSDI (score: >13) / SPEED / DEQ-5 (score: >6)

Question 4

DED clinical diagnosis requirements

Answer 4

Questionnaire (OSDI | SPEED | DEQ-5)

AND one of
Low TBUT (<10 secs)
Ocular surface staining
Hyperosmolarity

Question 5

ADDE management

Answer 5

1. Warm compress and Lid hygiene (lid wash –Demodex: Weekly 5% scrub + daily tea tree shampoo)
2. Chloramphenicol 0.5% QID for 1 week or erythromycin (resistance cases) or FML 1% for 2 weeks (Azasite if misdirected lashes)
3. Review in 1 – 2 weeks: check compliance, infection and IOP check

Question 6

EDE management

Answer 6

1. Lipid Lubricating eyedrops
2. Warm compress or IPL treatment
3. Omega 3 supplement
4. Topical antibiotic + oral antibiotic
5. Steriods when indicated
6. Review in 4 – 6 weeks
7. Referral if symptoms persist