Conjunctivitis other diagnostic studies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
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.[1]
Other diagnostic studies
Keratoconjunctivitis Sicca
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.
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.
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. 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
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
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.