Síndrome do olho seco
Summary
Definition
History and exam
Key diagnostic factors
- causa clínica subjacente conhecida
- uso de medicamentos causadores conhecidos
- filamentos corneanos
Other diagnostic factors
- irritação ocular/sensação de corpo estranho
- ardência ocular
- visão turva transitória
- lacrimejamento
- blefarite/meibomianite
- erosões epiteliais pontuadas
- erosões conjuntivais ponteadas
- hiperemia conjuntival
- lagoftalmia
- proptose
- presença de ácaros
Risk factors
- sexo feminino
- idade avançada
- blefarite/meibomianite
- doenças do tecido conjuntivo
- deficiência de vitamina A
- hepatite C
- vírus da imunodeficiência humana (HIV)
- transplante de células-tronco hematopoéticas
- cirurgia do cristalino e das pálpebras
- uso de lentes de contato
- diabetes mellitus
- medicamentos sistêmicos
- medicamentos oftálmicos tópicos preservados
- sarcoidose
- Doença de Parkinson
- fatores ambientais
- fatores ocupacionais
- cefaleia
Diagnostic tests
1st tests to order
- altura do menisco do filme lacrimal (meniscometria)
- tempo de ruptura do filme lacrimal/fluoresceína (TRFL)
- teste de Schirmer
Emerging tests
- osmometria do filme lacrimal
- detecção da metaloproteinase-9 (MMP-9)
- topografia corneana
- interferometria da superfície ocular
- termografia infravermelha
- microscopia confocal in vivo
- marcadores imunes da superfície ocular (OSIM)
Treatment algorithm
olho seco na apresentação inicial
olho seco crônico
Contributors
Authors
Jonathan Smith, FRCOphth, MRCP
Consultant Ophthalmologist
Sunderland Eye Infirmary
Sunderland
UK
Disclosures
JS declares that he has no competing interests.
Philip Severn, FRCOphth, MRCP
Consultant Ophthalmologist
James Cook University Hospital
Middlesbrough
UK
Disclosures
PS declares that he has served on the advisory boards of and received travel grants from Bayer and Novartis. He has also received travel grants from Allergan.
Darren Shu Jeng Ting, FRCOphth, PhD
Honorary Associate Professor of Ophthalmology
School of Medicine
University of Nottingham
Consultant Ophthalmologist
Birmingham and Midland Eye Centre
UK
Disclosures
DSJT declares that he has no competing interests.
Saurabh Ghosh, FRCOphth
Consultant Ophthalmologist
Sunderland Eye Infirmary
Sunderland
UK
Disclosures
SG declares that he has no competing interests.
Peer reviewers
I-Hui Wu, MD
Ophthalmology Resident
Wilmer Eye Institute
Baltimore
MD
Disclosures
IW declares that she has no competing interests.
Gus Gazzard, MA, MBBChir, MD, FRCOphth
Consultant Ophthalmic Surgeon
King's College Hospital
Honorary Research Fellow
Institute of Ophthalmology
London
UK
Disclosures
GG declares that he has no competing interests.
Bob Avery, MD, PhD
Assistant Professor
Ophthalmology
University of New Mexico Medical School
Albuquerque
NM
Disclosures
BA declares that he has no competing interests.
Vatinee Y. Bunya, MD
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Hakim FE, Farooq AV. Dry eye disease: an update in 2022. JAMA. 2022 Feb 1;327(5):478-9. Abstract
Amescua G, Ahmad S, Cheung AY, et al. Dry eye syndrome preferred practice pattern®. Ophthalmology. 2024 Apr;131(4):P1-49.Full text Abstract
Craig JP, Nichols KK, Akpek EK, et al. TFOS DEWS II definition and classification report. Ocul Surf. 2017 Jul;15(3):276-83.Full text Abstract
Shtein RM, Shen JF, Kuo AN, et al. Autologous serum-based eye drops for treatment of ocular surface disease: a report by the American Academy of Ophthalmology. Ophthalmology. 2020 Jan;127(1):128-33.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Olho vermelho
- Síndrome de Sjögren
- Disfunção das glândulas meibomianas
More DifferentialsGuidelines
- Dry eye syndrome preferred practice pattern
- Cornea/external disease summary benchmarks - 2024
More Guidelines
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