3 steps to improve ocular health of dry eye patients
Diagnosis, treatment, patient communication help achieve improved results more efficiently
Warwick, RI—Clinicians today have a variety of diagnostic and therapeutic measures for their patients with dry eye.
At one time, the only available treatment was artificial tears—many of which contained the preservative, benzalkonium chloride, an agent that has been well documented as detrimental to ocular health.1
Diagnostic methods were also similarly lacking. In the past, clinicians were limited to fluorescein staining and Schirmer strips. Without a reliable diagnosis, a beneficial therapy could not be provided.
As a whole, diagnosing properly, following specific treatment plans, and providing excellent communication can keep patients happy and ensure the best ocular health.
When it comes to diagnosing dry eye, the first and most important tool remains patient history. Improved questionnaires better elicit what is happening with the ocular surface and provide an excellent starting point. Tear osmolarity should be determined next, along with an examination to discover any possible concurrent issues.
Though osmolarity has been difficult to determine in the past, the advent of devices (such as the TearLab Osmolarity System, TearLab Corp.) have made the process easier. Determining osmolarity is vital, as it will be higher in a number of dry eye etiologies. If tear concentration is normal, the problem will be fairly minor. With a high osmolarity, tears are too concentrated.
Classic dry eye (without meibomian gland disease) is a condition of high tear concentration. Eyes become irritated because what amounts to “scum on a pond” is sitting on the ocular surface. Patients may have trouble seeing because their tears are too thick, or their eyes may tear frequently in an effort to dilute the tear film. Normal concentration is 280 to 300. A concentration of 310 or higher requires intervention, at which point drop therapy tpically is started.