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
Other diagnostic studies for viral conjunctivitis include rapid antigen testing.[1] Other diagnostic studies for keratoconjunctivitis sicca (dry eye syndrome) Conjunctivitis 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 protein analysis test, Schirmer's test, and InflammaDry (rapid in-office test for matrix metalloproteinase 9).[2][3]
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 is performed, and wetting under 5 mm 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, and may be useful for selection of treatment or following up the patient for response to treatment.[4]
Matrix Metalloproteinase 9
Rapid in-office test, InflammaDry (matrix metalloproteinase 9), has been shown to be elevated in the tears of patients with dry eye disease.
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.
- ↑ 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.