1. Dry Eye & Schirmer’s Test

2. 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.

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

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

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

6. 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

7. 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)

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

9. Preservation of the existing tears
Lid tarsorrhaphy
Moist – chamber goggles

10. 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

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

12. 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.

13. Thank you