ASSESSMENT OF DRY EYE

History: 

Prolong visual work like computers etc. Sand in eye like feeling

SLIT LAMP EXAMINATION:

Look for tear film and foam like deposits over lids. Blepharitis can result in dry eye.

1. Stability of the tear film as related to its break-up time (BUT).

2. Tear production (Schirmer, fluorescein clearance and tear osmolarity).

3. Ocular surface disease (corneal stains and impression cytology).

TEAR FILM BREAK UP TIME:

Fluorescein dye is instilled into eye and patient is asked to blink several time. Patient is seen with cobalt blue filter over slit lamp.  Appearance of dye free spots on cornea before 10 sec is indicative of dry eye.

SHIRMIR TEST:

A watman paper or filter paper 5x40mm is turned at 5mm from one end and placed in lower fornix. It is done with anesthesia without anesthesia. With anesthesia basic secretion and without anesthesia basic plus reflex secretion is recorded. Less than 10 mm of wetting after 5 minutes without anaesthesia or less than 6 mm with anesthesia is considered abnormal.

Ocular surface staining;  fluorescen and rose bengal