Dry Eye & Schirmer’s Test

Objective and Outcome The trainee will gain knowledge about: Dry eye and its causes and treatment Symptoms and signs of dry eye Diagnostic tests of dry eye Schirmer’s Test and its procedures.

What is the Dry Eye? Deficiency of tear film due to various causes.

Signs of Dry Eye Precorneal tear -film Marginal tear Strip Conjunctiva-congestion Cornea- Punctuate epithelial erosions Abrasions Filaments Mucus discharge

Dry Eye Symptoms Burning, stinging, FBS, dryness, gritty, discomfort, tearing, decreased vision, photophobia.

Causes of Dry Eye Congenital Steven Johnson Syndrome MGD Lagopthalmos Ectropion Vitamin A deficiency Post chemical Injury Coloboma of the lid Chronic Blepharitis Computer worker Long term use of contact lens

Influential Factors of Dry Eye Foods / Drink (e.g. alcohol) Visual Tasking (e.g. PC use) Systemic Medications (e.g. anti-histamines) Arid Conditions (e.g. Midwest) Windy Environments (e.g. air conditioning, forced heat) Pollutants (e.g. exhaust, smoke)

Treatment of Dry Eye Preservation of the existing tears: Punctal Occlusion Supplementation of tears Drops Ointments Slow-releasing inserts Gel-tears

Preservation of the existing tears Lid tarsorrhaphy Moist – chamber goggles

Diagnostic Tests Staining: Tear break-up time : Rose Bengal Fluoresceine Evaluates the extent of conjunctival and corneal damage Tear break-up time : Stability of tear film Impression Cytology mapping

Schimer’s Test A 5 mm wide and 35mm long, special filter paper (whatt man no.41) is placed in lower fornix

Procedure and techniques: Schirmer’s test I , and done without anaesthesia-evaluates the reflex secretion Schirmer’s test II and done with anaesthesia-evaluates the basal secretion.

Thank you