Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • known underlying medical cause
  • use of known causative medications
  • corneal filaments

Other diagnostic factors

  • ocular irritation/foreign body sensation
  • ocular burning
  • transient blurred vision
  • tearing
  • blepharitis/meibomianitis
  • punctate epithelial erosions
  • conjunctival punctuate erosions
  • conjunctival injection
  • lagophthalmos
  • proptosis
  • presence of mites

Risk factors

  • female sex
  • older age
  • blepharitis/meibomianitis
  • connective tissue disorders
  • vitamin A deficiency
  • hepatitis C
  • HIV
  • haematopoietic stem cell transplantation
  • refractive surgery
  • contact lens use
  • diabetes mellitus
  • systemic medicines
  • preserved topical ophthalmic medicines
  • sarcoidosis
  • Parkinson's disease
  • environmental factors
  • occupational factors

Diagnostic investigations

1st investigations to order

  • tear film meniscus height
  • tear film break-up time (TFBUT)
  • Schirmer's test
Full details

Emerging tests

  • tear film osmometry
  • metalloproteinase-9 (MMP-9) detection
  • corneal topography
  • ocular surface interferometry
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Consultant Ophthalmologist

Sunderland Eye Infirmary

Sunderland

UK

Disclosures

JS declares that he has received travel and meeting costs from Novartis and Bayer.

Consultant Ophthalmologist

James Cook University Hospital

Middlesbrough

UK

Disclosures

PS declares that he has served on the advisory boards of and received a travel grants from Bayer and Novartis.

Consultant Ophthalmologist

Sunderland Eye Infirmary

Sunderland

UK

Disclosures

SG declares that he has no competing interests.

Peer reviewers VIEW ALL

Ophthalmology Resident

Wilmer Eye Institute

Baltimore

MD

Disclosures

IW declares that she has no competing interests.

Consultant Ophthalmic Surgeon

King's College Hospital

Honorary Research Fellow

Institute of Ophthalmology

London

UK

Disclosures

GG declares that he has no competing interests.

Assistant Professor

Ophthalmology

University of New Mexico Medical School

Albuquerque

NM

Disclosures

BA declares that he has no competing interests.

Co-Director

Penn Dry Eye and Ocular Surface Center

Assistant Professor

Cornea and External Disease

Scheie Eye Institute

Philadelphia

PA

Disclosures

VYB declares that she has no competing interests.

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