Ocular Surface Disease (M1) Flashcards Preview

II. Anterior Segment Disease > Ocular Surface Disease (M1) > Flashcards

Flashcards in Ocular Surface Disease (M1) Deck (30)
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1

What percentage of people in North America will have dry eye?

20%

2

Who are the people most likely to get dry eye?

1. females (esp menopausal and postmenopausal)
2. Autoimmune disease pts
3. Systemic medications (antihistamines, antidepressants, Hormone Replacement Therapy)
4. Contact lens wearers
5. Refractive surgery patients

3

When there is dry eye, is there an increase or decrease in tear osmolarity?

increase

4

What are the four most common symptoms of dry eye?

1. grittiness
2. foreign body sensation
3. tearing
4. transient blur

5

What are the enlarged sebaceous glands posterior to the eyelashes called? 1. What do they secrete? 2

1. meibomian glands
2. lipid

6

What percentage of meibomian glands are active at one time? 1. How can these glands be viewed? 2

1. 45%
2. transillumination

7

What are the signs of Seborrheic MGD?

1. hypersecretion
2. normal gland morphology

8

What are the signs of obstructive MGD?

1. low secretion and gland drop-out (stenosis)
2. Increased osmolarity

9

What are the signs of obstructive with sicca MGD?

1. low secretion and gland drop-out (stenosis)
2. Increased osmolarity
3. Decreased Schimer

10

What are the non-Rx treatments for dry eye?

1. environment control
2. Tear substitutes
3. Nutriceutical (Omega fatty acid supplementation)
4. Treat concurrent lid disease

11

What are the products given to dry eye patients that require anti-inflammatory treatment (and how long are each taken)?

1. topical steroids (immediate relief, not taken long)
2. topical cyclosporine, Restasis (after steroids and taken for rest of life)

12

What treatment for dry eye increases mucin production and is not available in the U.S.?

secretagogs

13

What is given to the patient if they are unresponsive to topical immunosuppressive agents for dry eye? 1. What does it contain? 2

1. autologous serum
2. neutrotrophic growth factor, epidermal growth factor, vit A, fibronectin, and lysozyme

14

What promotes an anti-inflammatory environment in dry eye and is in flax seed oil and fish oil?

omega fatty acids

15

What is a type of punctal plug that has the rim rest on the lid margin and has a tapered shaft?

Eagle Flex Plug

16

What are the plugs that require irrigation and dilation for removal and transillumination for viewing?

Herrick Lacrimal Plugs (Intracannicular)

17

What is the semi-permanent punctal plug that requires no sizing? 1 What is it made of? 2

1. SmartPlug
2. Medennium

18

What is the semi-permanent punctal plug that Alcon makes?

Intelleport

19

What are the ways to tell if a punctal plug is still in place?

1. transilluminate
2. tear meniscus height before and after
3. Jones test (will be negative)
4. Chronic canaliculitis, dacryocystitis as SE

20

What is the cryopreserved human amniotic membrane used to promote corneal surface healing in neurotrophic disease and ocular disease?

Prokera

21

What is the proper order for testing determined by DEWS?

1. symptom questionnaire and Ocular Surface Disease Index
2. Tear osmolarity
3. Ocular surface evaluation
4. TBUT
5. Ocular Surface staining
6. Schirmer test/Phenyl Red

22

What are the treatments involved in Level 1 Dry Eye?

1. Environmental and dietary changes
2. Eliminate systemic meds
3. Artificial tears
4. Eyelid therapy

23

What are the treatments involved in Level 2 Dry Eye?

1. All Level 1
2. Anti-inflammatories
3. Tetracyclines
4. Punctal plugs
5. Secretogogues
6. Moisture chamber spectacles

24

What are the treatments involved in Level 3 Dry Eye?

1. All level 2
2. Serum
3. Scleral or mini-scleral CL
4. Permanent punctal occlusion

25

What are the treatments involved in Level 4 Dry Eye?

1. All level 3
2. Systemic anti-inflammatory agents
3. surgery

26

What are the treatments involved in Level 1 MGD?

1. pt eduction
2. lid hygiene

27

What are the treatments involved in Level 2 MGD?

1. Omega-3 fatty intake
2. lid hygiene
3. artificial tears
4. topical emollient
5. topical azithromycin
6. tetracyclines

28

What are the treatments involved in Level 3 MGD?

1. All level 2
2. lubrication ointment
3. anti-inflammatory therapy for dry eye

29

What is the most common parasite that lives on the skin?

Demodex

30

What is the difference between Demodex folliculorum and Demodex brevis?

brevis is a little smaller