DRY EYE.pptx

8/10/2019 DRY EYE.pptx

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Dwi Yunia Ningsih

DRY EYE


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AnatomyLacrimal

The lacrimaldrainagesystem

consists ofthe: punta, canaliculi, lacrimal sac nasolacrimalduct (NLD


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Tear Tears form a thinlayerappro!imately "#$%m thic& that co'ersthe corneal andcon uncti'alepithelium)

The functions of this ultrathin layer are:

($ to ma&e the cornea a smoothoptical surface *y a*olishing minute

surface epithelial irregularities+

( to wet and protect the delicatesurface of the corneal and

con uncti'al epithelium+

(- to inhi*it the growth ofmicroorganisms *y mechanical

.ushing and antimicro*ial action+and

(/ to pro'ide the cornea withnecessary nutrient su*stances


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Tear 0roduction

The tears are produced *ythe lacrimal gland and theaccessory lacrimal tissue(glands of 1rause and2olfring and are swept o'erthe eye surface with each*lin&)


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Methods of Tears Product3low, steady (*asal rate#responsi*le fornormal eye lu*rication)E!cessi'e (re.e! rate#producing large4uantities of tears in response to eyeirritation or emotions)


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5omposition of Tears The normal tear 'olume isestimated to *e " 6 ul ineach eye)Al*umin accounts for 7%8 ofthe total protein in tear .uid)

9mmunoglo*ulins 9gA, 9g ,and 9gE Tear lyso;ymes form $# , Na > , and 5l # occur in higherconcentrations in tears than in

plasma

Tears also contain a small amount ofglucose (< mg?dL and urea (%)%/

mg?dL , and changes in *loodconcentration parallel changes in

tear glucose and urea le'els)

The a'erage p@ of tears is ")-


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Dry Eye 3yndromes(1eratocon uncti'itis 3icca

Dryness of the eye may result from anydisease associated with deBciency of thetear Blm components (a4ueous, mucin, orlipid , lid surface a*normalities, or epitheliala*normalities)Although there are many forms of&eratocon uncti'itis sicca, those connectedwith rheumatoid arthritis and otherautoimmune diseases are commonlyreferred to as 3 grenFs syndrome)


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Epidemiology 0re'alensi:

$"8 of 2omen $$8 of Gen

9ncreasing 9ncidence 2ith Age


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5lassiBcation


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Tear deBcient dry eye1eratocon uncti'itis sicca (153

Sjogrens syndrome :Autoimmune disease in which the *odyFs immune systemmista&enly attac&s its own moisture producing glandsAutoimmune disorder with a triad of dry mouth, dry eyeand arthritis

Non-SjogrensAgeing # radual deterioration of lacrimal gland tissueoccurs with ageingMenopause # At the time of menopause, le'els ofandrogens drop downNeurotrophic keratitis # 5orneal sensiti'ity decreasesafter LA391, contact lens wear and dia*etesMedicamentosa # Anti histamines, anti depressantsCicatricial Diseases # Trachoma, chemical *urns,3te'ens Iohnson syndrome


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Gechanism of ocularsurface in.ammation in dry eye


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EJA0HRAT9JE DRY D93EA3EGei*omian gland disease: Gost pre'alent(7


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5hronic AllergyDry eye is commonly associated withchronic allergic con uncti'itis)An allergic history has *een reported *y

-78 of dry eye patients)5hronic allergy results in loss of go*letcells, desta*ili;ation of the tear Blm damage to ocular surface)


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En'ironmental 9n.uencesHcular irritation, poor tear Blm sta*ility andocular surface desiccation is associated

with poor indoor air 4uality in temperature

controlled oMce en'ironments-< / 8 of indi'iduals wor&ing in such

en'ironments are aKected)

Dry climate

rowing air pollution


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3ymptomsrednessdryness*urning

rittinesstired eyes*lurry 'isionsensiti'ity to light


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Diagnostic5ase @istory 3lit LampE'aluation Hther Tests

3chirmer s test


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3chirmer Test This test in'ol'esplacing a strip ofBlter paper o'erpart of the eye(con uncti'al sacfor up to B'eminutesLess than thenormal amount ofwetting, onrepeatede!aminations,indicates


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2ithout AnesthesiaGeasures Re.e!

Tear 3ecretion (dryeye O P 7mmwetting

2ith AnesthesiaGeasures Qasal

Tear 3ecretion (dryeye OP -mmwetting


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TreatmentEyedrops arti!cial

tears"ArtiBcial tears, similarto your own tears,

lu*ricate the eyesand help replace thenatural moisturelayer of the tear Blm)

A'aila*le without aprescription+ can *eused as often asnecessary)


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Treatment9f the pro*lem isen'ironmental, wearsunglasses whenoutdoors, to reduce

e!posure to sun,wind and dust2hen indoor heat ison, &eep a humidiBer

or pan of water inthe room to addmoisture to dry air


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TreatmentLacrimal plugs or punctal plugs plugs inthe lacrimal (tear ducts &eep tears in youreye from draining away as 4uic&ly


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Than& You


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Documents

DRY EYE.pptx