dry eye

Question 1

what 2 conditions could dry eyes present as?

Answer 1

o Aqueous tear deficiency — reduced aqueous secretion from lacrimal glands
o Evaporative tear deficiency — increased tear film evaporation often due to a
deficient lipid layer in the tear film

Question 2

what are the symptoms of dry eyes?

Answer 2

dryness
irritation or discomfort,
intermittent blurring of vision

Question 3

what age group is dry eyes most common/

Answer 3

over 50s

Question 4

what are the red flags for dry eyes?

Answer 4

• Reduced visual clarity e.g. blurred vision
• Marked eye pain, headache or photophobia
• Red sticky eye in a neonate (within 30 days of birth)
• History of trauma (mechanical, chemical or ultraviolet) or possible foreign body
• Copious rapidly progressive discharge
• Infection with a herpes virus
• Soft contact lens use with corneal symptoms (such as photophobia and watering)
• Unilateral red eye

Question 5

what is the lifestyle advice you can give a patient for dry eyes?

Answer 5

• Warm compresses, lid hygiene and gentle eye massage — these can be especially helpful if blepharitis or Meibomian gland dysfunction are present
• Contact lens wear should be limited to shorter periods and lenses removed when dry eye symptoms appear — changing lens type or solution may help

o Avoid areas of reduced humidity
o Prolonged periods of computer use, or lengthy time spent in air-conditioned
environments
o Lower computer screens to below eye level (decreasing lid aperture), take regular breaks, and increase blink frequency with computer use and reading
o Avoid alcohol and exposure to cigarette smoke

Question 6

what are the drug treatment options for dry eyes?

Answer 6

artificial tears or lubricant eye drops

Drops are best for daytime use with ointments or gels reserved for use before bed as these are most likely to cause temporary blurring of vision.

Question 7

when would you need to consider preservative free?

Answer 7

• the person is intolerant of preservative in tear supplements
• has moderate to severe dry eye disease requiring drops more than 4 times per day
• is using multiple preserved topical medications; or uses soft or hybrid contact lens