Continuing education CET
Figure 6 Inferior dessication staining
instructions with brochures or links to websites where patients can get accurate information. Design a treatment plan, emphasise the importance of adhering to this plan and schedule a follow-up visit in 3-4 weeks. This gives the patient time to form the habit of using the drops or performing the lid hygiene routine but does not give them time hopefully to fall off the wagon or run out of the product you advised. Nowadays, patients can find out anything they want on the web, so it is
Figure 7 Staining pattern related to poor blink
Figure 8 Checking the meibomian gland patency
Multiple-choice questions – take part at opticianonline.net
1
According to the Dry Eye Workshop Report (DEWS), which of the following is NOT TRUE of dry eye? A There is a decreased osmolarity of the tear film B There is potential for damage to the ocular surface C Symptoms include discomfort and visual disturbance D Dry eye is a multifactorial disease
2
What are the three key question areas required to ascertain the grade for the level of dryness? A Frequency, presence of discomfort and blurred vision B Frequency, presence of discomfort and interference with activity C Frequency, presence of discomfort and discharge D Presence of discomfort, blurred vision and discharge
4
Which of the following is not a symptom of MGD? A Burning sensation B Blurred vision C Discomfort D Itching
5
For patients with moderate to severe dry eyes, what should be avoided when selecting a dry eye product? A High viscosity polymers B Hypotonic agents C Preservatives D Electrolytes
6
What is the optimal temperature for a lid warming device to reach and maintain to melt inspissated meibum from the lid margin? A 25°C B 37°C C 40°C D 50°C
3
Which of the following is NOT TRUE of an ideal blink pattern? A Full and complete B Relaxed and light C Slow and precise D Confident and natural Successful participation in this module counts as one credit towards the GOC CET scheme administered by Vantage and one towards the Association of Optometrists Ireland’s scheme. Deadline for responses is December 22 2011
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even more critical that their practitioner leads them in the proper direction to informative sites rather than leave them to Google poorly referenced or, worse still, pure ‘selling’ sites. A dedicated member of staff, ‘the optical hygienist’ trained in dealing with dry eye management – the insertion of drops, lid hygiene techniques and associated products – is a major asset to the practice both in time management and patient improved compliance and satisfaction. Ensure that the patient understands that this is a dynamic process and that the required management may change as mentioned at the beginning of this article. They need to understand what to do if circumstances worsen and symptoms return. In summary, dry eye disease is commonly encountered in everyday practice. We must use a thorough case history of symptoms in conjunction with a variety of clinical and diagnostic tests to diagnose the condition and its severity. Approach management and treatment options in a systematic way based on symptoms and clinical signs of severity Dry eye is a chronic disease and one that can be frustrating for both patient and practitioner. In our ‘quick fix’ society, this is one disease process that does not play by those rules. ● References 1 The Dry Eye Workshop (DEWS). The Ocular Surface; April 2007, Vol 5, No 2. 2 Simpson et al. Dry Eye Symptoms Assessed by Four Questionnaires. OVS, 2008; 85:8 692-698. 3 McMonnies CW, Incomplete Blinking, Contact Lens & Anterior Eye, 30 (2007) 37-51. 4 Nicholls K et al. International Workshop on MGD. Invest Ophthalmol Vis Sci; March 30, 2011 vol 52 no 4 1917-1921.
● Caroline Christie is associate director for contact lens teaching, City University 25.11.11 | Optician | 33