Question 1

A patient experiencing chronically dry eyes reports having a foreign body sensation, burning, and itching. A Schirmer test is abnormal. What is the suspected cause of this patient's symptoms based on this test finding?

A) Aqueous deficiency
B) Corneal abrasion
C) Evaporative disorder
D) Poor eyelid closure

A

Accepted Answer

An abnormal Schirmer test indicates a deficiency in the quantity or quality of tears, specifically the aqueous component. This is consistent with the patient's report of chronically dry eyes and foreign body sensation. Corneal abrasion would have been noted on examination and may contribute to the symptoms, but it is not the cause. Evaporative disorder is associated with a deficiency of the lipid component of tears, which is not reflected in the Schirmer test. Poor eyelid closure may contribute to dry eye symptoms, but it is not the primary cause indicated by the abnormal Schirmer test.

Question 2

A patient has evaporative dry eye syndrome with eyelid inflammation. What are some pharmacologic and nonpharmacologic measures the provider can recommend? (Select all that apply.)&#10;A) Apply over-the-counter artificial tears as needed.&#10;B) Avoid direct exposure to air conditioning.&#10;C) Topical steroid eye drops as a maintenance medication.&#10;D) Use nontearing baby shampoo to gently scrub the eyelids.&#10;E) Use tetrahydrozoline drops for discomfort

Accepted Answer

The provider can recommend applying over-the-counter artificial tears as needed to alleviate dryness and avoiding direct exposure to air conditioning to decrease evaporation. The provider can also suggest using nontearing baby shampoo to gently scrub the eyelids to help with the inflammation. While topical steroid eye drops may be considered for severe cases, they are not typically used as maintenance medication. Tetrahydrozoline drops are not recommended as they can cause rebound redness and increased irritation.

Deck 57: Dry Eye Syndrome