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Diseases
http://www.virtualcancercentre.com
Roles and Characteristics of the eyelids
Eye protection
Regular blink: protection and stability of the tear
film
Rich of glands
Adequate blood supply
No venous valve
Conception
Corneal epithelium
Conjunctival epithelium
Tear film
Clinical ocular surface consist of
conjunctiva
cornea
eyelids
lacrimal gland
lacrimal passages
Tear and the Tear Film
Function :
1.Cleaning
2.Wetting ocular surface
3.Bacteriostasis
4.Supporting the cornea
(oxygen supply)
http://www.drmalcolmmckellar.co.nz
Origin of Epithelium
Stem cells, SC
Corneal epithelium derived from the
Limbal stem cells.
Conjunctival epithelium derived from
forniceal and palpebral regions.
Ocular Surface Disease
Conception
The ocular surface is a complex biological
continuum responsible for the maintenance of
corneal clarity, elaboration of a stable tear film for
clear vision, as well as protection of the eye
against microbial and mechanical insults.
Comprising a variety of disorders on cornea,
eyelid, conjunctiva, lacrimal apparatus and tear
film.
Classification
Reconstruction
Epithelium, limbal stem cells
Lacrimal secretion, tear film
Innervation (nerve restore)
Structure and function of eyelid
Surgical operation
To re-establish conjunctiva, cornea,
tear film and eyelid.
Dry Eye
Healthy tear film Dry eye
http://www.chronicdryeye.com
Conception
www.virtualmedicalcentre.com
Etiological factor & Classification
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Clinical Manifestation
Dry eye symptoms
asthenopia
irritation, grittiness
dryness
burning
ophthalmalgia
light sensitivity
pink-eye
Do you regularly experience one or several symptoms above?
Some diseases and conditions (like rheumatoid
arthritis, lupus and Sjgrens Syndrome) also cause
chronic Dry Eye in many patients.
On the other hand, activities like reading, Wearing contact lenses or
working at the computer may cause Dry Eye.
Diagnostic Tests for Dry Eye
Dry Eye questionnaire
Lacrimal river width
Schirmer test uses paper strips under eyelid to
measure the wetness that collects over a specific period of
time.
Break-up time of tear film (BUT)
Staining uses special dyes to highlight areas of possible
damage to the eye surface.
Tear ferning test
Lactoferrin contents
Tear penetration pressure test
Corneal tonographic map
Impression cytology
Diagnosing
http://www.dryeyezone.com
Etiological Factor
Failure of the glands to produce or secrete lipids.
Wax ester declining and cholesterol increasing
make the symptoms worse .
Lack of tears and tear penetration pressure
increasing.
Lupus, brandy nose etc.
http://www.revophth.com
Clinical Manifestation
Common in aged people and who lived in cold
region.
No specific symptoms.
Lid-margin mostly thickening; abnormal secretion
while pressurizing.
Disorder in Meibomian
gland, eyelid, conjunctiva.
http://www.eyehealthnutrition.com
Diagnosing
Absence of Meibomian gland.
The gland orifices are often compromised due to stenosis or
closure.
A declining quality and quantity of lipid secretion.
Anyone of the physical signs can make the
diagnosis of Meibomian gland dysfunction if the patient
has clinical symptoms.
http://www.ophmanagement.com
Treatment
Clearing
Hot fomentation on eyelids for 5~10mins.
Massaging the eyelids.
Swabbing the lid-margin with mild
cleaning solution.
Treatment
Antibiotics oral administration.
Local Medication
Antibiotic eye drops
Glucocorticoid eye drops (short term)
Artificial tears
The End
Lacrimal river width
Schirmer Test
Normal 10mm/5min
Tear break-up time, BUT
Staining
Using special dyes to highlight areas of
possible damage to the eye surface.
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