Keratoconus and Dry Eye
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This document discusses dry eye syndrome in patients with keratoconus. It notes that keratoconus patients are more susceptible to developing dry eye due to changes on the ocular surface from high keratometric values and other factors like scratching and contact lens use. The document outlines tests for diagnosing dry eye like break up time tests and staining of the cornea and conjunctiva. It recommends a multidisciplinary treatment approach including managing risk factors, preventative care, anti-inflammatory treatment if needed, and considers intracorneal ring segments which may improve keratometry and reduce dry eye symptoms. The conclusion reiterates that keratoconus patients are more prone to dry eye and emphasizes the importance of a healthy
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Keratoconus and Dry Eye
- 2. World Keratoconus Congress DRY EYE SYNDROME IN KERATOCONUS PATIENTS Guilherme Ferrara
- 3. Introduction Changes on the ocular surface • High keratometric values • Scratching & Atopy • Contact lens • Corneal sensation / Innervation Changes in tears Inflammation Dry eye syndrome & Keratoconus
- 4. Introduction Changes on the ocular surface • High keratometric values • Scratching & Atopy • Contact lens • Corneal sensation / Innervation Changes in tears Inflammation Dry eye syndrome & Keratoconus
- 5. Break up Time 0 seconds 1 second 2 seconds 3 seconds 4 seconds 5 seconds 6 seconds 16 seconds Must be higher than blink frequency.
- 6. Introduction Changes on the ocular surface • High keratometric values • Scratching & Atopy • Contact lens • Corneal sensation / Innervation Changes in tears Inflammation Dry eye syndrome & Keratoconus
- 7. Introduction Changes on the ocular surface • High keratometric values • Scratching & Atopy • Contact lens • Corneal sensation / Inervation Changes in tears Inflamation Dry eye syndrome & Keratoconus
- 8. Blepharitis and Contact Lens Evaporative Dry Eye Dry eye syndrome & Keratoconus
- 9. Introduction Changes on the ocular surface • High keratometric values • Scratching & Atopy • Contact lens • Corneal sensation / Inervation Changes in tears Inflamation Dry eye syndrome & Keratoconus
- 10. Cornea and Conjunctiva staining
- 11. Dry eye syndrome & Keratoconus
- 12. Lipid component: Osmolarity 368 mOsm /l 303 mOsm/l 368 mOsm /l tratamiento
- 13. Hiperosmolarity 368 mOsm /l 303 mOsm /l Dry eye syndrome & Keratoconus
- 14. Lachrymal Functional Unit Innervation Aferente Eferente Parasimpático Eferente Simpático Dry eye syndrome & Keratoconus
- 15. Psicometría Escala Visual Analógica 1. Frecuencia de los síntomas: Por favor, ponga una X en la línea para indicar lo frecuente que normalmente siente sus ojos secos y / o irritados Raramente _______________________________________Siempre 2. Gravedad de los síntomas: Por favor, ponga una X en la línea para indicar la gravedad que normalmente siente sus ojos secos y / o irritados Muy leve_______________________________________Muy Grave SANDE: Symptom Assessment iN Dry Eye Schaumberg DA et al. Development and Validation of a Short Global Dry Eye Symptom Index The Ocular Surface 2007;5:50-57 Dry eye syndrome & Keratoconus
- 16. Psicometría Escala Visual Analógica 1. Frecuencia de los síntomas: Por favor, ponga una X en la línea para indicar lo frecuente que normalmente siente sus ojos secos y / o irritados comparado con su visita de hace dos meses Raramente _______________________________________Siempre Ultima visita 2. Gravedad de los síntomas: Por favor, ponga una X en la línea para indicar la gravedad que normalmente siente sus ojos secos y / o irritados comparado con su visita de hace dos meses Muy leve_______________________________________Muy Grave Ultima Visita Schaumberg DA et al. Development and Validation of a Short Global Dry Eye Symptom Index The Ocular Surface 2007;5:50-57 Dry eye syndrome & Keratoconus
- 17. Treatment Multidisciplinary approach. Multiple and Protracted Avoid risk factors Scratch Contact lens Hygiene Preventive treatment Education of the patient Avoid tear evaporation Anti-inflammatory if evidence of inflammation Dry eye syndrome & Keratoconus
- 18. Treatment Intra corneal ring segments Improvement of keratometry Reduction of dry eye symptoms Reduction of scratch Reduction of use of the contact lens Dry eye syndrome & Keratoconus
- 19. Conclusions • Keratoconus patients are more susceptible to develop a dry eye syndrome • BUT & mucus thin layer healthy are good markers of a normal function of the epithelium of the ocular surface. • Treatment Protocol of DES in Keratoconus patients. Dry eye syndrome & Keratoconus
- 20. Thank you