Optometry Continuing Education

Dry Eye

    • CE credits 2 hours
    • COPE code 52179-AS / 113755
    • Available until Jan 5, 2020

Introduction

Learning Objectives

  • To review the pathogenesis and classification of dry eye
  • To discuss treatment options for dry eye
  • To review the process of FDA drug approval

Case

A 43 year old male presents to your clinic complaining of a six month history of increasing ocular irritation. He complains of intermittent burning and grittiness for years, but says the symptoms have become much worse lately.

On exam visual acuities are 20/25 bilaterally with normal intraocular pressures. On slit lamp examination whitish strands are seen on the surface of the cornea:

Question

The patient's presentation is consistent with which of the following?

  • Herpes zoster keratitis

    The appearance in the photo is not in keeping with pseudodendrites.

  • Contact lens overwear

    There is no history of contact lens wear. In addition, there are no signs on anterior segment exam of contact lens overwear such as peripheral neovascularization or subepithelial infiltrates.

  • Meibomian gland dysfunction

    Although meibomian gland dysfunction is a major cause of dry eye, it would not be responsible for the patient's subacute presentation with corneal filaments.

  • Filamentary keratitis
    CORRECT

Introduction

Dry eye, also known as keratoconjunctivitis sicca, is an extremely common condition encountered by eye care professionals. Its official NEI Workshop definition is a disorder of the tear film due to tear deficiency or excessive tear evaporation which causes damage to the interpalpebral ocular surface and is associated with symptoms of ocular discomfort.1 Likely underdiagnosed, its reported prevalence ranges from 5–30%, increasing with age.2, 3 It affects roughly 15% of those over the age of 65.

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