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Latest revision as of 21:07, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]

Overview

Other diagnostic studies for viral conjunctivitis include rapid antigen testing.^[1] Other diagnostic studies for keratoconjunctivitis sicca (dry eye syndrome) include corneal sensation, tear break up time, ocular surface staining, and Schirmer's test.^[2]^[3]

Other Diagnostic Studies

Viral Conjunctivitis

Rapid in-office Antigen Testing

Rapid in-office antigen testing for adenoviruses has been helped to identify the viral causes of conjunctivitis and prevent unnecessary antibiotic use.^[1]

Keratoconjunctivitis Sicca

Other diagnostic studies for keratoconjunctivitis sicca (dry eye syndrome) conjunctivitis include corneal sensation, tear break up time, ocular surface staining, tear film interferometry, Schirmer's test, and InflammaDry (rapid in-office test for matrix metalloproteinase 9).^[2]^[3]^[4]

Corneal Sensation

On corneal sensation test, chronic keratoconjunctivitis sicca is characterized by corneal hyperesthesia or reduced sensation.

Tear Break Up Time

On tear breakup time (TBUT), keratoconjunctivitis sicca is characterized by tear film instability and rapid evaporation. The tear film is observed under the light of a slit lamp.

Ocular Surface Staining

On ocular surface staining, keratoconjunctivitis sicca in a patients with aqueous tear deficiency may be characterized by fluorescein, Rose Bengal, or lissamine green staining on the interpalpebral conjunctiva.

Schirmer's Test

On Schirmer's test, keratoconjunctivitis sicca caused by severe aqueous deficiency is characterized by wetting under 5 mm.

Matrix Metalloproteinase 9 (InflammaDry)

On InflammaDry (rapid in-office test), keratoconjunctivitis sicca is characterized by matrix metalloproteinase 9 elevation in the tear.^[4]^[5]

Tear film interferometry

Tear film interferometry is a noninvasive method of grading tear film quality and estimating the thickness of the lipid layer.

On Tear film interferometry, keratoconjunctivitis sicca caused by mebomian gland dysfunction characterized by abnormal colored tear film.

References

↑ ^1.0 ^1.1 Jhanji V, Chan TC, Li EY, Agarwal K, Vajpayee RB (2015). "Adenoviral keratoconjunctivitis". Surv Ophthalmol. 60 (5): 435–43. doi:10.1016/j.survophthal.2015.04.001. PMID 26077630.
↑ ^2.0 ^2.1 Savini G, Prabhawasat P, Kojima T, Grueterich M, Espana E, Goto E (2008). "The challenge of dry eye diagnosis". Clin Ophthalmol. 2 (1): 31–55. PMC 2698717. PMID 19668387.
↑ ^3.0 ^3.1 Beckman KA, Luchs J, Milner MS (2016). "Making the diagnosis of Sjögren's syndrome in patients with dry eye". Clin Ophthalmol. 10: 43–53. doi:10.2147/OPTH.S80043. PMC 4699514. PMID 26766898.
↑ ^4.0 ^4.1 Lanza NL, Valenzuela F, Perez VL, Galor A (2016). "The Matrix Metalloproteinase 9 Point-of-Care Test in Dry Eye". Ocul Surf. 14 (2): 189–95. doi:10.1016/j.jtos.2015.10.004. PMID 26850527.
↑ D'Souza S, Tong L (2014). "Practical issues concerning tear protein assays in dry eye". Eye Vis (Lond). 1: 6. doi:10.1186/s40662-014-0006-y. PMC 4604107. PMID 26605353.

Template:WS Template:WH

[pmid26077630-1] 1.0 ^1.1 Jhanji V, Chan TC, Li EY, Agarwal K, Vajpayee RB (2015). "Adenoviral keratoconjunctivitis". Surv Ophthalmol. 60 (5): 435–43. doi:10.1016/j.survophthal.2015.04.001. PMID 26077630.

[pmid19668387-2] 2.0 ^2.1 Savini G, Prabhawasat P, Kojima T, Grueterich M, Espana E, Goto E (2008). "The challenge of dry eye diagnosis". Clin Ophthalmol. 2 (1): 31–55. PMC 2698717. PMID 19668387.

[pmid26766898-3] 3.0 ^3.1 Beckman KA, Luchs J, Milner MS (2016). "Making the diagnosis of Sjögren's syndrome in patients with dry eye". Clin Ophthalmol. 10: 43–53. doi:10.2147/OPTH.S80043. PMC 4699514. PMID 26766898.

[pmid26850527-4] 4.0 ^4.1 Lanza NL, Valenzuela F, Perez VL, Galor A (2016). "The Matrix Metalloproteinase 9 Point-of-Care Test in Dry Eye". Ocul Surf. 14 (2): 189–95. doi:10.1016/j.jtos.2015.10.004. PMID 26850527.

[pmid26605353-5] D'Souza S, Tong L (2014). "Practical issues concerning tear protein assays in dry eye". Eye Vis (Lond). 1: 6. doi:10.1186/s40662-014-0006-y. PMC 4604107. PMID 26605353.

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@@ Line 4: / Line 4: @@
 ==Overview==
-Additional available methods for the keratocojunctivitis diagnosis, conjunctivitis subtype, include [[corneal]] sensation, tear break up time, ocular surface staining, and schirmer’s test.<ref name="pmid19668387">{{cite journal| author=Savini G, Prabhawasat P, Kojima T, Grueterich M, Espana E, Goto E| title=The challenge of dry eye diagnosis. | journal=Clin Ophthalmol | year= 2008 | volume= 2 | issue= 1 | pages= 31-55 | pmid=19668387 | doi= | pmc=2698717 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19668387  }} </ref>
+Other diagnostic studies for '''viral conjunctivitis''' include rapid antigen testing.<ref name="pmid26077630">{{cite journal| author=Jhanji V, Chan TC, Li EY, Agarwal K, Vajpayee RB| title=Adenoviral keratoconjunctivitis. | journal=Surv Ophthalmol | year= 2015 | volume= 60 | issue= 5 | pages= 435-43 | pmid=26077630 | doi=10.1016/j.survophthal.2015.04.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26077630  }} </ref>
-==Other diagnostic studies==
+Other diagnostic studies for '''[[keratoconjunctivitis sicca|keratoconjunctivitis sicca (dry eye syndrome)]]''' include corneal sensation, tear break up time, ocular surface staining, and [[Schirmer's test]].<ref name="pmid19668387">{{cite journal| author=Savini G, Prabhawasat P, Kojima T, Grueterich M, Espana E, Goto E| title=The challenge of dry eye diagnosis. | journal=Clin Ophthalmol | year= 2008 | volume= 2 | issue= 1 | pages= 31-55 | pmid=19668387 | doi= | pmc=2698717 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19668387  }} </ref><ref name="pmid26766898">{{cite journal| author=Beckman KA, Luchs J, Milner MS| title=Making the diagnosis of Sjögren's syndrome in patients with dry eye. | journal=Clin Ophthalmol | year= 2016 | volume= 10 | issue=  | pages= 43-53 | pmid=26766898 | doi=10.2147/OPTH.S80043 | pmc=4699514 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26766898  }} </ref>
-===Corneal Sensation===
-[[Corneal]] [[hyperesthesia]] or reduced sensation may be present in severe and [[chronic]] [[dry eye]] disease. [[Sensory]] denervation may cause dry eye by reducing the [[afferent]] signaling of tear production, reducing the [[blink]] rate, and by altering [[trigeminal]] nerve influences on ocular [[epithelial]] health. Corneal sensation can be measured using a cotton tip [[applicator]] or more precisely with a Cochet-Bonnet esthesiometer.
+==Other Diagnostic Studies==
-===Tear Break Up Time===
+===Viral Conjunctivitis===
-Tear break up time (TBUT) is an indication of tear film [[stability]].  The proper method of TBUT testing is using a [[fluorescein]] impregnated strip wet with non-preserved saline solution ([[benzalkonium chloride]] can increase tear break up speed).  The dye is distributed by blinking, and the patient is then asked to stare straight ahead without blinking.  The tear film is observed under the cobalt blue light of a [[slit lamp]], and the time between the last blink and the appearance of the first dry spot or hole in the tear film is measured and equal to the TBUT.
+====Rapid in-office Antigen Testing====
-===Ocular surface staining===
+Rapid in-office antigen testing for [[adenoviruses]] has been helped to identify the [[viral]] causes of conjunctivitis and prevent unnecessary [[antibiotic]] use.<ref name="pmid26077630">{{cite journal| author=Jhanji V, Chan TC, Li EY, Agarwal K, Vajpayee RB| title=Adenoviral keratoconjunctivitis. | journal=Surv Ophthalmol | year= 2015 | volume= 60 | issue= 5 | pages= 435-43 | pmid=26077630 | doi=10.1016/j.survophthal.2015.04.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26077630  }} </ref>
-Interpretation of staining is based on intensity and location using a grading scale described by Van Bijsterveld. The [[nasal]] and [[temporal]] [[conjunctiva]] and the [[cornea]] are graded on a scale of 0-3 with a maximum possible score of 9.
-In aqueous tear deficiency, the interpalpebral conjunctiva is the most common location for rose Bengal staining. The severity of staining has been shown to correlate with the degree of aqueous deficiency, tear film instability, and reduced [[mucin]] production by conjunctival [[goblet cell]] and [[epithelial cells]]
+===Keratoconjunctivitis Sicca===
-===Schirmer’s Test===
+Other diagnostic studies for [[keratoconjunctivitis sicca|keratoconjunctivitis sicca (dry eye syndrome)]] conjunctivitis include corneal sensation, tear break up time, ocular surface staining, tear film interferometry, [[Schirmer's test]], and InflammaDry (rapid in-office test for matrix metalloproteinase 9).<ref name="pmid19668387">{{cite journal| author=Savini G, Prabhawasat P, Kojima T, Grueterich M, Espana E, Goto E| title=The challenge of dry eye diagnosis. | journal=Clin Ophthalmol | year= 2008 | volume= 2 | issue= 1 | pages= 31-55 | pmid=19668387 | doi= | pmc=2698717 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19668387  }} </ref><ref name="pmid26766898">{{cite journal| author=Beckman KA, Luchs J, Milner MS| title=Making the diagnosis of Sjögren's syndrome in patients with dry eye. | journal=Clin Ophthalmol | year= 2016 | volume= 10 | issue=  | pages= 43-53 | pmid=26766898 | doi=10.2147/OPTH.S80043 | pmc=4699514 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26766898  }} </ref><ref name="pmid26850527">{{cite journal| author=Lanza NL, Valenzuela F, Perez VL, Galor A| title=The Matrix Metalloproteinase 9 Point-of-Care Test in Dry Eye. | journal=Ocul Surf | year= 2016 | volume= 14 | issue= 2 | pages= 189-95 | pmid=26850527 | doi=10.1016/j.jtos.2015.10.004 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26850527  }} </ref>
-The Schirmer test is performed by placing a paper test strip in the lateral third of the lower eyelid after drying the [[inferior]] [[fornix]] and then measuring the length of the moistened portion of the strip after 5 minutes.
+====Corneal Sensation====
-The Schirmer I test is performed without [[anesthesia]] and, thus, measures reflex tearing. The Schirmer II test also lacks anesthesia but is done following nasal stimulation, which has been shown to be reduced more in [[Sjögren’s syndrome]] compared to non-Sjögren’s dry eye. Schirmer with anesthesia is also commonly performed and measures basal tear secretion.
+On corneal sensation test, chronic keratoconjunctivitis sicca is characterized by corneal hyperesthesia or reduced sensation.
-The Schirmer test is often criticized for its variability and poor reproducibility.  It is most useful in the diagnosis of patients with severe [[aqueous]] deficiency, but is relatively insensitive for patients with mild dry eye.
+====Tear Break Up Time====
+On tear breakup time (TBUT), keratoconjunctivitis sicca is characterized by tear film instability and rapid evaporation. The tear film is observed under the light of a [[slit lamp]].
+====Ocular Surface Staining====
+On ocular surface staining, keratoconjunctivitis sicca in a patients with [[aqueous tear]] deficiency may be characterized by [[fluorescein]], [[Rose Bengal]], or lissamine green staining on the interpalpebral conjunctiva.
+====Schirmer's Test====
+On [[Schirmer's test]], keratoconjunctivitis sicca caused by severe aqueous deficiency is characterized by wetting under 5 mm.
+====Matrix Metalloproteinase 9 (InflammaDry)====
+On InflammaDry (rapid in-office test), keratoconjunctivitis sicca is characterized by matrix metalloproteinase 9 elevation in the tear.<ref name="pmid26850527">{{cite journal| author=Lanza NL, Valenzuela F, Perez VL, Galor A| title=The Matrix Metalloproteinase 9 Point-of-Care Test in Dry Eye. | journal=Ocul Surf | year= 2016 | volume= 14 | issue= 2 | pages= 189-95 | pmid=26850527 | doi=10.1016/j.jtos.2015.10.004 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26850527  }} </ref><ref name="pmid26605353">{{cite journal| author=D'Souza S, Tong L| title=Practical issues concerning tear protein assays in dry eye. | journal=Eye Vis (Lond) | year= 2014 | volume= 1 | issue=  | pages= 6 | pmid=26605353 | doi=10.1186/s40662-014-0006-y | pmc=4604107 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26605353  }} </ref>
+====Tear film interferometry====
+Tear film interferometry is a noninvasive method of grading tear film quality and estimating the thickness of the lipid layer.
+On Tear film interferometry, keratoconjunctivitis sicca caused by [[mebomian gland]] dysfunction characterized by abnormal colored tear film.
 ==References==
 {{reflist|2}}
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 [[Category:Ophthalmology]]
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