Download Dry Eye Assessment

Dry Eye Assessment
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Dry Eye Questionnaire (record score for comparison with post Tx) and/or POHx (inc past
dry eye Tx), PMHx and meds and symptoms inc ‘onion test’. Remember symptoms along
with SL/staining signs are the drivers to your decision to Tx,
Measure Tear Film Osmolarity (if equipment available)
Keratometer/Topographer
o NIBUT
Tearscope (currently out of production)
SLIT LAMP
o Tear Quality & Meniscus Height
Tearflo/Schirmer test
o Tear Quantity
SLIT LAMP
o Grade conjunctival hyperaemia/LIPCOF?
o Insert BioGlo/NaFl along with Lissamine Green
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Observe tear mixing
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FTBUT
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Record / Grade - Corneal stain of NaFl
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Record / Grade - Conjunctival/corneal stain of Lissamine Green
o Evert Lid
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Record / Grade - Tarsal conjunctival status- papillae/hyperaemia.
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Lid Wiper Epitheliopathy
o Examine Lid Margin Status
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Use of Guillon grading scales for lid contamination, MG blockage and
expression are worth consideration (simple, straightforward and not time
consuming)
DISCUSS thoroughly your findings
o If they understand why they are doing things they are more likely to do them!
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Create a Personalised Management Plan: Heat application, lid massage, lid hygiene, nonpreserved drops and blink exercises.
o Write it down in clear simple steps
o Demonstrate procedures and products/hand over to ocular hygienist
o Sell products as complete package (Tx less effective if parts of management plan
not used) or include in global fee for appointments
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Reinforce message: Not a cure, this is management of condition, effects of treatment
not instant, do not take shortcuts (no flannels, no baby shampoo, no other Tx other than
prescribed), if symptoms worsen stop Tx and call. This Tx is successful in greater than
95% of cases of evaporative dry eye with good compliance.
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Arrange follow up appointment with intermediate phone check at 3-4 days