Blepharoplasty
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in Head & Neck Surgery Plastic Surgery, 2018
Keratoconjunctivitis sicca (dry eye syndrome) is most often seen in patients who have a pre-existing tear film insufficiency. This should be specifically examined for pre-operatively and the patient counselled accordingly. This can be particularly important in patients who have undergone corneal refractive procedures (e.g. LASIK) or who wear contact lenses. The consistent continued use of frequent artificial tears is imperative in these patients who may also require additional procedures at a later date (e.g. punctal plug placement or punctal cautery). Patients who require artificial tears more frequently than three or four times per day should use a preservative free preparation.
Rheumatic Disease
John S. Axford, Chris A. O'Callaghan in Medicine for Finals and Beyond, 2023
Keratoconjunctivitis sicca causes various ocular symptoms, including the sensation of a foreign body, burning, tiredness, dryness, redness, blurred vision, itchiness, soreness, pain, photosensitivity and excessive secretion.
Assessment of Corneal and Tear Film Parameters in Rheumatoid Arthritis Patients Using Anterior Segment Spectral Domain Optical Coherence Tomography
Published in Ocular Immunology and Inflammation, 2018
Dina El-Fayoumi, Maha Mohamed Youssef, Mohamed Mahmoud Khafagy, Nashwa Badr El Dine, Wafaa Gaber
Rheumatoid arthritis (RA) is a chronic, multisystem, autoimmune disease sustained by environmental and genetic factors.1 Women are nearly three times more likely to have the disease than men.2 The disease principally affects the joints and is usually accompanied by one or more extra-articular manifestations.3 The eye is an important extra-articular target organ for this disease and the ocular surface, in particular, is one of the most frequently affected areas.3 The most common form of ocular involvement is dry eye (DE), affecting most RA patients.4 Dry eye may present either as keratoconjunctivitis sicca (KCS) or secretory deficiency.5 According to Fox et al.,6 KCS is an important clinical sign of secondary Sjogren syndrome (SSII), as well as primary Sjogren, and approximately 20% of patients with RA have SSII.7 The type of collagen affected, the amount of corneal hydration, and the involvement of the extracellular matrix of the cornea may vary in different types of autoimmune diseases with corneal involvement.8 This may be reflected on different corneal parameters, including pre-corneal tear film, corneal, and epithelial thickness.
A Review of Ocular Graft-versus-Host Disease: Pathophysiology, Clinical Presentation and Management
Published in Ocular Immunology and Inflammation, 2021
Jimena Tatiana Carreno-Galeano, Thomas H. Dohlman, Stella Kim, Jia Yin, Reza Dana
Ocular GVHD (oGVHD) arises in 30 to 60% of patients who undergo HSCT and in 60 to 90% of patients with systemic GVHD.6,7 oGVHD is characterized by involvement of the lacrimal glands, eyelids and ocular surface, with resulting inflammation and fibrosis in these tissues. These changes produce symptoms of dry, painful eyes and signs of keratoconjunctivitis sicca (dry eye) and sometimes even cicatricial conjunctivitis. These changes have the potential to lead to severe visual impairment and a significant reduction in patient quality of life.8 The management of oGVHD can be challenging due to the persistence and severity of patient systems, and a multidisciplinary approach is critical to improving patient outcomes. Here, we present a comprehensive review of oGVHD, including disease pathophysiology, clinical presentation and current management strategies.
Clinical practice guidance for Sjögren’s syndrome in pediatric patients (2018) – summarized and updated
Published in Modern Rheumatology, 2021
Minako Tomiita, Ichiro Kobayashi, Yasuhiko Itoh, Yuzaburo Inoue, Naomi Iwata, Hiroaki Umebayashi, Nami Okamoto, Yukiko Nonaka, Ryoki Hara, Masaaki Mori
While 98% of adult SS patients complain of sicca symptoms, pediatric patients rarely complain of dryness [3,5,6]. Approximately 30% of cases present with sicca symptoms, which are detected by detailed medical interviews and examinations [24]. To assess dryness of the mouth (xerostomia), medical interviews should be conducted using specific close-ended questions as follows: ‘Do you need to drink water when eating dry foods like bread?’; ‘Are you worried about bad breath?’; ‘Have you ever experienced pain and/or enlargement of the parotid gland?’; ‘Do you have dental caries/stomatitis/ranula?’; ‘Have you noticed a change in your sense of taste?’. Parotid gland enlargement is frequently reported as the earliest symptom of SS [3–5,25]. Dry eye (xerophthalmia or keratoconjunctivitis sicca) symptoms, such as a feeling of dryness, red eyes, sensation of a foreign body, pain, and itchiness, should be checked, in addition to a condition where the patient cannot produce tears even when they might normally cry.
Related Knowledge Centers
- Contact Lens
- Eye
- Meibomian Gland Dysfunction
- Vitamin A Deficiency
- Antihypertensive Drug
- Pregnancy
- Dryness
- Tears
- Sjögren Syndrome
- Antihistamine