Patient selection: dry eye
Clinical symptoms of dry eye:
(1) feeling of dryness
(2) ocular fatigue
(3) blurry vision that disappears with blinking or use of artificial tears
(4) ocular itching
(5) photophobia
(6) blepharospasm
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Clinical Features
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Description
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Grade
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diminished tear secretion without symptoms of dryness unless there is a precipitating factor (see below)
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subclinical
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1 minus
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mild symptoms
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mild
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1
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symptomatic with reversible signs of ocular surface dryness
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moderate
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2
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symptomatic with permanent signs of ocular surface dryness
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severe
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3
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severe and permanent loss of vision from corneal scars, ulcerations or keratinization
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disabling
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3 plus
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Precipitating factors for symptoms of dry eye in a patient with subclinical disease:
(1) contact lens use
(2) exposure to windy weather
(3) exposure to air conditioning or a fan
(4) driving with an open car window
(5) hot weather
Reversible signs of ocular surface dryness:
(1) epithelial erosion
(2) keratopathia punctata
(3) keratopathia filamentosa
(4) ocular surface vital staining
(5) short BUT
(6) hyperemia of the exposed conjunctival trigone
Permanent signs of ocular surface dryness:
(1) corneal ulcerations
(2) nephelion
(3) leucoma
(4) corneal neovascularization
(5) epitheleal squamous metaplasia
(6) conjunctival scars
(7) retraction of the lacunar sulci
Permanent signs of ocular surface dryness
