Update in office managementDry Eye Syndrome: An Update in Office Management
Section snippets
History and Physical Examination
Patients with dry eye syndrome commonly present with ocular pain, foreign body sensation, and redness. It is necessary to take a thorough social and medical history to help identify any factors contributing to their symptoms. A social history helps identify any environmental factors, such as low humidity, that can worsen a low aqueous tear production state. Several systemic medications also can cause dry eyes (Table). Finally, a review of systemic symptoms positive for joint pains, dry mouth,
Diagnostic Modalities
Diagnostic tests supplement the physical examination and include tear break-up time, rose bengal, lissamine green, or fluorescein stains, and a Schirmer test.
The tear break-up time test consists of placing fluorescein dye onto the eye. Once the dye is evenly distributed on the ocular surface, the time is measured until there is a dry spot appearing in the fluorescein-stained tear film. A time <5 seconds (normal >10 seconds) will signify an unstable tear film with increased tear evaporation.
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Management
Dry eye syndrome is a chronic condition, and treatment is directed at minimizing the symptoms and improving the quality of life for the individuals. One of the first treatment options involves making simple environmental modifications to reduce evaporation of the tear film. These measures include increasing ambient humidity with humidifiers, avoiding air currents, and taking frequent breaks from visually demanding tasks. Additionally, changes in systemic medications that may be causing dry eye
Conclusion
Dry eye syndrome is a disorder of the tear film, leading to excess dryness of the cornea and conjunctiva that leads to ocular discomfort, blurred vision, and damage to the ocular surface. It is diagnosed by obtaining a thorough history, including a review of symptoms, medications, social history, and a comprehensive eye examination with diagnostic testing. There are several treatment options that range from artificial tears to autologous blood serum drops. The best treatment option for each
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Conflict of Interest: None.
Authorship: All authors listed had access to the data and a role in writing the manuscript.