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NIKA BELLARINATASARI
DEFINITION
TEAR-FILM EVALUATION
Inspection
Signs of associated systemic disease (rheumatoid arthritis)
Indications of personal habits (smoking)
Signs of associated ocular disease (pseudoptosis,
blepharospasm)
Characteristic facial telangiectasia & eyelid margin
hyperemia associated with ocular rosacea
Tear meniscus between the globe and the lower eyelid
(normally 1.0 mm in height and convex)
Tear breakup is a functional measure of tear stability; if
stability is perturbed (as in lipid or mucin deficiency), the
tear breakup time (TBUT) can become more rapid
The time lapse between the last blink and the appearance
of the first randomly distributed dry spot on the cornea is
the tear breakup time.
Dry spots appearing in less than 10 seconds are considered
abnormal.
Signs :
Conjunctival hyperemia, conjunctivochalasis, decreased tear
meniscus, iregular corneal surface, debreis in tear-film
Epithelial keratopathy
Filaments & mucous plaques , filamentary keratopathy,
marginal or paracentral thinning & perforation corneal
(more severe dry eye states)
EVAPORATIVE TEAR
DYSFUNCTION
Increased tear-film evaporation is most commonly
caused by MGD but may also be caused by disease of
the meibomian glands, poor apposition of the eyelids to
the ocular surface, increase of the palpebral aperture,
and contact lens wear.
Symptoms consist of burning, foreign-body sensation,
redness ofthe eyelids and conjunctiva, filmy vision, and
recurrent chalazia.
Signs of ETD include decreased TBUT, MGD, abnormal
aqueous tear production, and a characteristic linear
pattern of rose bengal/lissamine green staining of the
inferior conjunctiva and cornea and eyelid margin.
Patogenesis
Tjd obstr/hiposekresi akibat penyakit blefaritis anterior,
rosacea acne, pemfigoid
Non obstr/ hipersekresi akibat meibomian seborrhea
Management
Eyelid hygiene (1-2x/hari), dengan cara :
kompres hangat beberapa menit dilanjutkan dg
Gentle massage dengan menekan sekresi
meibom, diikuti dengan membersihkan dengan
washcloth, cotton ball, atau pad
TERIMA KASIH