Term
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Definition
lumphocyic infilatrationa & atrophy of the main lacrimal galnd, acessory lacrimal gland and salivary gland.
autoimmune disorder
common in post menopause women
Higher frequeccy of meibomian Gland Dysfunction |
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Term
| Sjogren's syndrome triad of findings |
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Definition
| Kcs, xerostomia, connective tissue disease (need 2 of 3 to call it) |
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Term
| Primary Sjogren's: cause of aqueous deficiency |
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Definition
KCS and xerostomia (plus autoantibodies,
focus score minor salivary galnd biopsy. |
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Term
| Secondary Sjogrens Syndrome (cause of aqueous deficiency) |
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Definition
| Connective tissue disease with KCS and xerostomia |
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Term
| Non-sjogren syndrome Dry Eye |
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Definition
Lcarimal dysfunction
age-related dry eye
KCS (Keratoconjunctivitis Sicca) |
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Term
| non-sjogren syndrome dry eye: Primary lacrimal Gland deficiencies |
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Definition
congenital alaccrima
familial dysautonomia ( rilery-day syndrome) |
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Term
| Familial dysautonomia (riley-day syndrome) = primary lacrimal gland defiencies |
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Definition
- Caused by autonomic dysfunction like instability of blood pressure, sweating, vasomotor control.
- Generalized insensitivity to pain accompanied by marked lack of emotional & reflex tearing.
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Term
| Secondary lacrimal gland deficiencies: lacrimal gland infiltration |
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Definition
| Sarcoidosis, lymphoma, AIDS, graft vs host disease, lacrimal gland ablation, lacrimal gland denervation |
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Term
| Non-sjogren syndrome dry eye involving obstruction sof the lacrimal gland ducts (may cause cicatricial obstructive MGD) |
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Definition
- Trachoma
- Cicatricial pemphigoid & mucous membrane pemphigoid
- Erythema multiforme
- Chemical & thermal burns
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Term
| Non-sjogren syndrome dry eye that obstructs the lacrimal gland ducts: 1. ocular pempighoid |
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Definition
- Bilateral progressive shrinking of the conjuctiva, entropion (inversion of eyelids), trichiasis (inward turning of hair inward causing irritation), xerosis (dry skin), and visual loss by corneal opacification
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Term
- Non-sjogren syndrome dry eye featuring obstruction of the lacrimal gland ducts: Ocular Pemphigoid
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Definition
- Inflammatory disease of an autoimmune process.
- More women ~58 onset,
chronic blistering disease (affects eye, oral mucoaa, skin, vagina, &rectum |
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Term
- Non-sjogren syndrome dry eye featuring obstruction of the lacrimal gland ducts: Erythema Multiforme
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Definition
Acute, self limited mucocutaneous disorder
Immune complex mediated hypersensitivity
3-15% severe may die |
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Term
| How Erthema Multiforme begins (a non-sjogren syndrome dry eye cause) |
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Definition
Upper respiratory tract infxn
1-14 days: fever, sorethroat, chills.. malaise
- Mucocutanous lesions deverlop abraubptly.
- Cannot eat or drink if oral and or mucous membranes are severe
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Term
- Non-sjogren syndrome dry eye featuring obstruction of the lacrimal gland ducts: Erythema Multiforme
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Definition
skin vessicles, bullae, maculopapular lesions concentrated on the hands and feet.
Erythematous patches on hands, arms, face &neck.
"bulls eye" lesions
hemorrhagic crusting of the lips
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Term
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Definition
| CL wear, diabetes, neurotrophic keratitis can cause what ? |
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Term
| Reflex motor block which leads to reflex hyposecretion |
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Definition
| VII cranial nerve damage, multiple neuromatosis, exposure to systemic drugs can cause what? |
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Term
| how reflex sensory block works? |
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Definition
when eyes open, there is increased reflex sensory drive from exposed ocular surface.
- You can favor dry eye when sensory drive is reduced which causes: decreasing reflex-indued lacrimal secretion, reducing blink rate & increasing evaporative loss
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Term
| They are causes of ocular sensory loss |
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Definition
All of these cause what?Infective (herpes simplex & herpes zoster opthalmicus),
Corneal Surgery,
Neurotrophic Keratitis,
Topical agents (topical anaesthesia decreases tear secrtion- 60-75% and blink rate - 30%.
Systemic medications (betal blockers, atropine-like drugs)
Chronic CL wear- reduction in corneal sensitivity of GP and EW CL's.
Diabetes mellitus.
Neurotrophic keratitis. |
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Term
| They cause Reflex Motor Block |
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Definition
The following cause what?
- facial CN VII damage (causes lacrimal hyposecretion)
- Multiple Neuromatosis
- Exposure to systemic drugs causing decreased lacrimal secretion (e.g. psychotropic)
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Term
| Major Etiologic causes of Dry eye |
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Definition
Intrinsic Evaporative(lids affected)
Extrinsic Evaporative (due to extrinsic exposure) |
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Term
| Examples of Intrinsic Evaporative Causes of Dry Eye |
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Definition
- Meibomian Gland Dysfunction or "posterior blepharitis"
- Disorders of lid Aperture &lid/Globe dynamic
- Low Blink rate
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Term
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Definition
- Absorbed into conjuntival capillaries
evaporation (10-25%)
- Drainage through puncta ( and down lacrimal canals)
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Term
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Definition
Intermittent Burning and Tearing, grittiness, foreign body sensation, itching
redness,
intermittent blurred vision ( a film over the eyes)
photophobia,
mattering of lids and lashes. |
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Term
| The clinical signs of DRY EYE |
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Definition
- Reduction in the height of the inferior tear meniscus (average = 0.2mm)
- Cellular debris in the tear film
Abnormal accumulation of mucus that tends to settle in the inferior cul-de-sac.
Conjunctival Injection
- Dull appearance of the eye
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Term
| Test of Aqueous Deficiency in Dry Eyes |
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Definition
| Tear menicus lower than average height of 0.2mm |
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Term
| Test of Moderate to severe Dry Eyes |
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Definition
Increased Tear debris and mucus strands (1+,2+,3+,4+)
Mucus Strands = early change in dry eye |
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Term
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Definition
This layer of the tear film when smooth and thick shows bright colors
This layer when smooth and thin, or iregular appears gray |
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Term
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Definition
This condition is caused by bacterila (staphlococcaal) infxn or unknown factors
It exhibits scaly exudate around eyelash bases; matted, hard crusts around cilium,
ulcers of the hair follicles;
corneal staining
- Dilated blood vessels on the lid margin
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