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Eye: Dry

Usually elderly patient complaining of a chronic gritty sensation—due to reduced tear secretion. Three main preparations for treatment:

  • lubricating drops (e.g. polyvinyl alcohol solution or hypromellose 0.5%)

  • lubricating gels or ointments (e.g. Poly Visc, Duratears)

  • tear stimulating drops (e.g. Thera Tears, Cellufresh)

Other tips:

  • Bathe regularly with clean water.

  • Use room humidifiers where there is dry heating.

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Table E7 The red and tender eye: diagnostic strategy model

Probability diagnosis

Conjunctivitis

  • bacterial

  • adenovirus

  • allergic

Serious disorders not to be missed

Acute glaucoma

Uveitis

  • acute iritis

  • choroiditis

Corneal ulcer

Herpes simplex keratitis

Microbiol keratitis, e.g. fungal, amoeba, bacteria

Herpes zoster ophthalmicus

Penetrating injury

Endophthalmitis

Orbital cellulitis

Trachoma

Pitfalls (often missed)

Scleritis/episcleritis

Foreign body

Trauma—contusion, penetrating injury

Ultraviolet light ‘keratitis’

Blepharitis

Cavernous sinus arteriovenous fistula

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