Dry Eye Disease Lecture Notes
64 Questions
1 Views

Dry Eye Disease Lecture Notes

Created by
@RightfulEnjambment

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary function of the mucous layer in the tear film?

  • To anchor the lacrimal gland to the ocular surface
  • To create a smooth optical surface and remain moist (correct)
  • To produce hyperosmolarity in the tear film
  • To reduce ocular surface inflammation

    • According to the TFOS DEWS II report, what is the primary characteristic of dry eye disease?

  • Inflammation of the ocular surface
  • Neurosensory abnormalities
  • Loss of homeostasis of the tear film (correct)
  • Hyperosmolarity of the tear film

    • What is the purpose of the '4th layer' in the tear film?

  • To produce glycoproteins
  • To anchor the lacrimal gland to the ocular surface
  • To reduce tear film instability
  • To allow the aqueous to spread over the eye (correct)

    • What is the primary role of the lacrimal gland in the tear film?

    <p>To produce the aqueous layer of the tear film</p> Signup and view all the answers

    What is the key feature of dry eye disease?

    <p>All of the above</p> Signup and view all the answers

    What is the recommended reading to supplement this lecture on dry eye disease?

    <p>The College of Optometrists' Clinical Management Guideline on Dry Eye</p> Signup and view all the answers

    What is the primary function of the lipid layer in the tear film?

    <p>To prevent evaporation of the aqueous layer</p> Signup and view all the answers

    What is the estimated prevalence of Dry Eye Disease (DED) in those aged 50 years or older?

    <p>5-60%</p> Signup and view all the answers

    What is a risk factor for Dry Eye Disease?

    <p>Vitamin A deficiency</p> Signup and view all the answers

    What is the name of the dry eye disease caused by a disorder of lacrimal function?

    <p>Keratoconjunctivitis Sicca</p> Signup and view all the answers

    What is the name of the test used to diagnose aqueous deficient dry eye?

    <p>Schirmer's test</p> Signup and view all the answers

    What is a complication of Sjogren's syndrome?

    <p>All of the above</p> Signup and view all the answers

    What is a cause of evaporative dry eye?

    <p>Meibomian gland dysfunction</p> Signup and view all the answers

    What is a risk factor for aqueous deficient dry eye?

    <p>All of the above</p> Signup and view all the answers

    What is the name of the questionnaire used to assess dry eye symptoms?

    <p>OSDI questionnaire</p> Signup and view all the answers

    What is a complication of dry eye disease?

    <p>Corneal ulcers</p> Signup and view all the answers

    What is the primary cause of evaporative dry eye (EDE)?

    <p>Meibomian gland dysfunction (MGD)</p> Signup and view all the answers

    Which of the following is a sign of Meibomian gland dysfunction (MGD)?

    <p>Cloudy, thickened meibum</p> Signup and view all the answers

    What is the result of incomplete blinking secondary to concentration/ near working?

    <p>Evaporative dry eye (EDE)</p> Signup and view all the answers

    What is the term for the condition characterized by terminal duct obstruction and/or qualitative/ quantitative changes in the glandular secretion?

    <p>Meibomian gland dysfunction (MGD)</p> Signup and view all the answers

    Which of the following is a symptom of dry eye?

    <p>Ocular surface discomfort</p> Signup and view all the answers

    What is the name of the muscle that helps in the secretion of meibum?

    <p>Obicularis muscle</p> Signup and view all the answers

    What is the result of the action of Riolan's/ Obicularis muscle on meibomian glands?

    <p>Continuous production of new meibocytes and lipid delivery to lid margins</p> Signup and view all the answers

    What is the system affected by the action of Meibomian glands?

    <p>Tear film</p> Signup and view all the answers

    What is the term for the folds in the conjunctiva that can produce or aggravate existing dry eye?

    <p>Conjunctivochalasis</p> Signup and view all the answers

    What is the result of the over-colonisation of commensal bacteria on lid margins in Meibomian gland dysfunction?

    <p>Release of free fatty acids from retained lipids in glands</p> Signup and view all the answers

    What is the impact of mild dry eye on QOL compared to psoriasis?

    <p>Greater effect on QOL</p> Signup and view all the answers

    What is the primary use of the OSDI questionnaire?

    <p>Evaluating the effect of treatment</p> Signup and view all the answers

    What is the cut-off value for dry eye diagnosis using Tearlab?

    <p>308mOsm/L</p> Signup and view all the answers

    What is the purpose of measuring tear break-up time?

    <p>To assess the lipid layer</p> Signup and view all the answers

    What is the sensitivity and specificity of the McMonnies dry eye questionnaire?

    <p>87%</p> Signup and view all the answers

    What is the name of the device used to measure tear osmolality?

    <p>Tearlab</p> Signup and view all the answers

    What is the primary characteristic of the tear film in dry eye disease?

    <p>Hyperosmolarity of the tear film</p> Signup and view all the answers

    What is the role of the mucous layer in the tear film?

    <p>To allow the aqueous to easily spread over the eye</p> Signup and view all the answers

    What is the name of the report that redefined dry eye disease?

    <p>The TFOS DEWS II report</p> Signup and view all the answers

    What is the primary mechanism by which the mucous layer anchors to the microvilli?

    <p>Via the action of glycoproteins</p> Signup and view all the answers

    What is the primary function of the '4th layer' in the tear film?

    <p>To create a smooth optical surface</p> Signup and view all the answers

    What is the website that provides additional information on the clinical management of dry eye disease?

    <p>www. college-optometrists.org</p> Signup and view all the answers

    What is the primary function of the aqueous layer in the tear film?

    <p>To supply oxygen to the avascular corneal epithelium</p> Signup and view all the answers

    Why do studies on the prevalence of Dry Eye Disease have varying results?

    <p>All of the above</p> Signup and view all the answers

    What is a common risk factor for Dry Eye Disease in older adults?

    <p>All of the above</p> Signup and view all the answers

    What is the primary function of the lipid layer in the tear film?

    <p>To prevent evaporation of the aqueous layer</p> Signup and view all the answers

    What is the classification of Dry Eye Disease characterized by a disorder of lacrimal function?

    <p>Aqueous Deficient Dry Eye</p> Signup and view all the answers

    What is the impact of aging on the lacrimal gland?

    <p>Decreased tear production</p> Signup and view all the answers

    What is the purpose of the immunoglobins in the aqueous layer?

    <p>To provide an antibacterial function</p> Signup and view all the answers

    What is the consequence of reduced tear volume in the eye?

    <p>Increased risk of dry eye disease</p> Signup and view all the answers

    What is the role of the nasolacrimal excretory system in the eye?

    <p>To drain excess tears</p> Signup and view all the answers

    What is the primary factor contributing to the development of evaporative dry eye?

    <p>Increased tear evaporation</p> Signup and view all the answers

    What is the impact of moderate dry eye on QOL compared to angina?

    <p>Greater than angina</p> Signup and view all the answers

    What is the advantage of using Tearlab for tear osmolality measurement?

    <p>It provides results in seconds</p> Signup and view all the answers

    What is the significance of a score of 14.5 or greater on the McMonnies dry eye questionnaire?

    <p>It is consistent with a diagnosis of dry eye</p> Signup and view all the answers

    What is the primary mechanism by which tear break-up time is affected in dry eye?

    <p>Compromised lipid layer</p> Signup and view all the answers

    What is the primary use of the OSDI questionnaire?

    <p>To assess the effect of treatment on dry eye</p> Signup and view all the answers

    What is the cut-off value for dry eye diagnosis using Tearlab?

    <p>308mOsm/L</p> Signup and view all the answers

    What is the primary cause of aqueous deficient dry eye (ADDE) in cases of Ocular cicatricial pemphigoid (OCP)?

    <p>Cicatricial disease of eyelids or lacrimal ducts</p> Signup and view all the answers

    Which of the following is a characteristic of evaporative dry eye (EDE)?

    <p>Meibomian gland dysfunction</p> Signup and view all the answers

    What is the result of incomplete blinking secondary to concentration/ near working in evaporative dry eye (EDE)?

    <p>Increased tear evaporation</p> Signup and view all the answers

    What is the term for the chronic diffuse abnormality of the Meibomian glands?

    <p>Meibomian gland dysfunction (MGD)</p> Signup and view all the answers

    What is the consequence of the action of Riolan's/ Obicularis muscle on meibomian glands?

    <p>Secretion of meibum</p> Signup and view all the answers

    Which of the following is a sign of Meibomian gland dysfunction (MGD)?

    <p>Cloudy, thickened meibum</p> Signup and view all the answers

    What is the consequence of over-colonisation of commensal bacteria on lid margins in Meibomian gland dysfunction?

    <p>Release of free fatty acids from retained lipids</p> Signup and view all the answers

    What is the effect of age on Meibomian gland dysfunction?

    <p>Increased likelihood of Meibomian gland dysfunction</p> Signup and view all the answers

    What is the term for the condition characterized by lid parallel conjunctival folds?

    <p>Conjunctivochalasis</p> Signup and view all the answers

    What is the effect of hormonal changes on Meibomian gland dysfunction?

    <p>Increased likelihood of Meibomian gland dysfunction</p> Signup and view all the answers

    Study Notes

    Definition of Dry Eye Disease (DED)

    • DED is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, accompanied by ocular symptoms, and involving tear film instability, hyperosmolarity, ocular surface inflammation, and damage, as well as neurosensory abnormalities.
    • Key features of DED include hyperosmolarity of the tear film and inflammation of the ocular surface.

    Anatomy of the Tear Film

    • The tear film is composed of three main layers: mucin, aqueous, and lipid.
    • The mucin layer is comprised of fluid and glycoproteins, anchors to microvilli, and serves to allow the aqueous to easily spread over the eye, create a smooth optical surface, and remain moist.
    • The aqueous layer is comprised of 98-99% water with electrolytes, glucose, urea, proteins, and mucins, and serves to supply oxygen to the avascular corneal epithelium, provide an antibacterial function, create a smooth regular surface, and wash away debris.
    • The lipid layer is comprised of wax, cholesterol esters, and triglycerides, and serves to prevent evaporation of the aqueous layer, increase surface tension of tears, improve stability of the tear film, lubricate the eyelids, and convert the epithelium to a hydrophilic surface.

    Epidemiology of DED

    • DED is a common disease affecting approximately 5-60% of those aged 50 years or older.
    • The wide prevalence range is due to different definitions of dry eye, varying demographics of the studied populations, and different methodologies.
    • No robust UK-based data is available.
    • Risk factors for DED include age, gender (female), systemic antihistamines, autoimmune disease, previous refractive surgery, prolonged display screen equipment use, contact lens wear, radiation therapy, vitamin A deficiency, and hepatitis C infection.

    Classification of DED

    • DED can be broadly classified into aqueous deficient and evaporative dry eye.
    • Aqueous deficient dry eye is characterized by a disorder of lacrimal function, reduced flow and volume of tears, and is known as Keratoconjunctivitis Sicca.
    • Evaporative dry eye is characterized by a normal lacrimal function, generally abnormality of an unstable tear film, and increased evaporation of tears.

    Aetiology of DED

    • Aqueous deficient dry eye can be caused by Sjogren's syndrome, lacrimal disease, lacrimal obstruction, reflex abnormalities, and certain medications.
    • Evaporative dry eye can be caused by meibomian gland dysfunction, oil deficiency, blink abnormalities, and surface abnormalities.

    Signs and Symptoms of DED

    • Clinical signs of DED include reduced tear meniscus height, reduced pre-corneal break-up time, punctate epithelial erosions, increased mucus strands and other tear debris, and reduced corneal sensitivity.
    • Symptoms of DED include ocular surface discomfort, foreign body sensation, light sensitivity, secondary reflex watering, and presence of stringy mucous discharge.
    • Symptoms are generally worse later in the day and exacerbated by smoke, wind, or heat.

    Treatment of DED

    • Questionnaires such as the Ocular Surface Disease Index (OSDI) and McMonnie's dry eye questionnaire can be used to assess symptoms and evaluate the effectiveness of treatment.
    • Tear osmolarity measurement can be used to diagnose DED and evaluate the effectiveness of treatment.
    • Tear break-up time (TBUT) can be used to diagnose DED and evaluate the effectiveness of treatment.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Description

    Understand the definition, anatomy, epidemiology, classification, aetiology, signs, symptoms, and treatment of Dry Eye Disease with this comprehensive quiz. Test your knowledge of optometry and biomedical sciences. Based on Ulster University's Biomedical Sciences lecture notes.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser