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Published in Ken Addley, MCQs, MEQs and OSPEs in Occupational Medicine, 2023
Dry eye is a condition where the surface of the eye becomes inflamed and sore due to a poor relationship between the tear film and the eyelids. This might be because the eyes are not producing enough tears or that the chemistry of the tear film is out of balance.
Sjögren's Disease
Published in Jason Liebowitz, Philip Seo, David Hellmann, Michael Zeide, Clinical Innovation in Rheumatology, 2023
The current diagnostic approach requires a multidisciplinary evaluation in most patients. The ophthalmologist seeks evidence of aqueous-deficient dry eye disease, with an assessment of the tear meniscus, tear debris, corneal filaments, ocular surface staining with vital dyes, and measurement of tear flow (generally with Schirmer test strips) and, occasionally, tear osmolarity. An oral medicine specialist or dentist measures salivary flow and examines the oral cavity for signs of salivary hypofunction, including root and incisal caries (relatively unique to salivary hypofunction) and chronic erythematous candidiasis (51). A minor salivary gland biopsy (MSGB) provides the most direct evidence for glandular involvement by SjD, with the finding of focal lymphocytic sialadenitis of sufficient severity to have one or more focal lymphocytic aggregates per 4 mm2 of glandular tissue (focus score ≥1). Finally, the rheumatologist evaluates for systemic manifestations, including serologic abnormalities, and the presence of other autoimmune diseases. Each element of the diagnostic evaluation must be interpreted in the context of the others. None has absolute specificity for the diagnosis.
Dry-Eye Disease
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
DED consistently impacts all aspects of vision-related quality of life, including physical, psychological, and emotional wellbeing, social functioning, daily living activities, and independence. The impact of symptoms associated with dry eye, including soreness, discomfort, eye irritation, itching, grittiness, watering, redness, eye strain, fatigue, heavy eyelids, blurred vision and/or fluctuating vision, higher-order aberrations, glare, and sensitivity to light and wind, and their chronicity underpin those adverse findings.
Ocular side effects of systemic isotretinoin – a systematic review and summary of case reports
Published in Journal of Dermatological Treatment, 2023
Olivia Lamberg, Arianna Strome, Foster Jones, Julia Mleczek, Adrienne Jarocki, Jonathon P. Troost, Yolanda Helfrich
It is important for clinicians to address and educate patients about the potential ophthalmologic side effects of isotretinoin. Specifically, we suggest that patients be educated on potential ocular side effects such as dry eye and signs of more serious ocular complications, such as vision alteration. Clinicians should evaluate for these symptoms while patients are taking isotretinoin. Therapeutic interventions to address dry eye include lubricating eye drops, avoidance of contact lens use, and avoidance of prolonged screen time while using isotretinoin (63). Lubricating eye drops increase tear film stability, reduce surface stress, and increase quality of life for patients. For patients experiencing persistent moderate to severe dry eye or any signs of serious ocular complications, we suggest referral for an ophthalmological examination (104).
Application of iontophoresis in ophthalmic practice: an innovative strategy to deliver drugs into the eye
Published in Drug Delivery, 2023
Dong Wei, Ning Pu, Si-Yu Li, Yan-Ge Wang, Ye Tao
Dry eye disease (DED) is one of the most common diseases of the anterior segment (Gayton, 2009). There is usually more than one factor that can cause DED. Lesions in any of the components associated with anterior segment (including the ocular surface, tear film, the interconnecting neural reflex loops, and the main lacrimal glands) can lead to the development of DED (Stern et al., 1998; Gayton, 2009). It is usually accompanied by conjunctival or corneal inflammation and increased tear film osmolarity (Anonymous, 2007). Currently, the main treatment for DED is to minimize its objective and clinical symptoms, which may improve with treatment, but cannot be cured. In addition, DED patients must use artificial tear replacement products frequently (Marshall & Roach, 2016). Therefore, a treatment that can relieve dry eye symptoms for a long time course is necessary.
Efficacy and safety of manuka honey for dry eye
Published in Clinical and Experimental Optometry, 2023
Jindong Hu, Lingwen Kong, Sixing Zhu, Mohan Ju, Qianfu Zhang
Manuka honey was administered in the experimental group as a constituent of eye drops,12,13,22,23 eye gel12 and eye creams,21 while the intervention in the control group was mainly lubricant eye drops.13,22,23 The duration of the five studies ranged from 2 weeks to 3 months; the sample sizes ranged from 20 to 120, and 288 participants with dry eye were included. The included studies examined the related indicators of dry eye from various aspects, such as symptomology, tear film quality, ocular surface characteristics, adverse events, and compliance. The outcome measures across studies are summarised in Table 2. Ocular Surface Disease Index, tear break-up time, conjunctival/eyelid margin vascularity/redness, and ocular surface staining were the most frequent tests.