Conjunctivitis other diagnostic studies: Difference between revisions

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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 sicca''' 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>
+==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.<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>
 ===Keratoconjunctivitis Sicca===
+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>
 ====Corneal Sensation====
-[[Corneal]] [[hyperesthesia]] or reduced sensation may be present in severe and [[chronic]] [[dry eye]] disease. [[Corneal]] sensation can be measured using a cotton tip applicator.
+On corneal sensation test, chronic keratoconjunctivitis sicca is characterized by corneal hyperesthesia or reduced sensation.
 ====Tear Break Up Time====
-A tear breakup time (TBUT) test measures the time it takes for tears to break up in the eye. The proper method of TBUT testing is using a [[fluorescein]] impregnated strip. 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 light of a [[slit lamp]].
+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====
-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.
+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.
-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]]
+====Schirmer's Test====
-====Schirmer’s Test====
+On [[Schirmer's test]], keratoconjunctivitis sicca caused by severe aqueous deficiency is characterized by wetting under 5 mm.
-A [[Schirmer's test]] can measure the amount of moisture bathing the eye. A five-minute Schirmer's test with and without anesthesia using a Whatman #41 filter paper 5 mm wide by 35 mm long is performed. For this test, wetting under 5 mm with or without anesthesia is considered diagnostic for dry eyes. It is most useful in the diagnosis of patients with severe [[aqueous]] deficiency, but is relatively insensitive for patients with mild dry eye.
-====Tear Protein Analysis====
+====Matrix Metalloproteinase 9 (InflammaDry)====
-A tear protein analysis test measures the [[lysozyme]] contained within tears. In tears, lysozyme accounts for approximately 20 to 40 percent of total protein content.
+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==
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 [[Category:Ophthalmology]]
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