Ocular Surface Disease : A Case-Based Guide.

Intro -- Preface -- Contents -- Contributors -- Chapter 1: Aqueous-Deficient Dry Eye Disease: Evaluation and Management -- Case 1 -- What Additional Questions Do You Want to Ask This Patient to Further Understand the Possible Etiology of Her Complaints? -- What Should You Look for on Physical Exam to Aid in Diagnosis of the Patient? -- What Additional Ancillary Testing Would Be Appropriate? -- What Treatment Should Be Initiated? -- Case 2 -- What Are the Patient's Risk Factors for Dry Eye Disease, and How Can These Be Addressed? -- What Additional Treatments May Be Initiated? -- Case 3 -- What Additional Treatment Options Might You Offer to This Patient? -- References -- Chapter 2: Update in the Diagnosis and Management of Meibomian Gland Dysfunction -- Case 1 -- What Diagnosis Do These Findings Suggest? -- How Do You Approach Symptoms of Dry Eye? -- What Other Testing Should Be Performed? -- What Newer Technologies Can Be Helpful in Evaluating and Quantifying Meibomian Gland Dysfunction? -- Looking at the Tear Film Interferometry Gives Part of the Picture, but Looking Directly at the Glands Would Help Determine If the Meibomian Glands Are Still Viable. What Technology Can Help Look at Meibomian Glands? -- The Patient Reported Tearing with His Work. How Do You Evaluate This? -- What Do You Recommend for This Patient? -- How Are Patients Instructed To Do Hot Compresses? Is Eyelid Massage Recommended? -- What Other Treatment Can Be Offered? -- His Exam Is Unchanged After 4 weeks. What Additional Treatment Option Can You Offer? -- What Are Blink Exercises? -- Some Patients Do Not Respond to LipiFlow. What Else Can Be Offered If There Is Not Significant Meibomian Gland Atrophy? -- Case 2 -- What Diagnosis Do These Findings Suggest? -- What Additional Testing Is Helpful? -- What Is Your Conclusion From These Additional Tests?.

What Caused Her Meibomian Gland Atrophy? -- Final Thoughts -- What Is the Role of Eyelid Hygiene (Cleaning the Lids/Lashes) in Meibomian Gland Disease? -- What Can Be Done About Demodex Infestation? -- What Is the Role of Topical Corticosteroids in MGD? -- References -- Chapter 3: Image-Guided Evaluation and Monitoring of Treatment Response in Patients with Ocular Surface Disease -- Introduction -- Case 1 -- What Diagnosis Do These Symptoms Suggest? -- What Are Your Next Diagnostic Steps? -- What Diagnosis Do These Findings Suggest? -- What Are Your MGD Treatment Recommendations? -- Case 2 -- How Would You Proceed at This Stage? -- What Are Your Next Diagnostic Steps? -- What Are Your Treatment Recommendations? -- Case 3 -- What Is Your Examination Approach to Chronic Dry Eye? -- What Are Your Ocular Treatment Recommendations? -- References -- Chapter 4: Management of Ocular Surface Disease in Cataract and Refractive Surgery Patients -- Introduction -- Case 1 -- What Risks Does Cataract Surgery Pose to Individuals with OSD? -- What Testing Should Be Performed to Evaluate This Patient's OSD? -- What Treatments Should Be Initiated in This Patient? -- Before Cataract Surgery, What Preoperative Testing Should Be Performed in This Patient to Ensure Improvement and Stability in the Ocular Surface? -- What Intraoperative Considerations Should Be Taken into Account in a Patient with a History of OSD? -- What Postoperative Measures Will Promote Ocular Surface Health? -- Case 2 -- For a Chronic CTL Wearer with CTL-Related Discomfort, What Preoperative Considerations Should Be Taken into Account? -- What Symptoms in This Patient Elevate Your Suspicion for Limbal Stem Cell Strain or Deficiency? -- How Do You Diagnose OSD in a Chronic CTL Wearer? -- How Do You Treat OSD in a Chronic CTL Wearer?.

Once Treatment Has Been Initiated and the Limbal Stem Cell Deficiency Has Improved, What Preoperative Testing and Imaging Is Required? -- Case 3 -- What Other Testing Should Be Performed on This Patient? -- What Factors Likely Promote Dry Eye in This Patient? -- How Should This Patient's Dry Eye Be Managed? -- How Should This Patient Be Counseled Regarding Eventual Cataract Surgery? -- References -- Chapter 5: Diagnosis and Management of Ocular Involvement in Sjögren's Syndrome -- Introduction -- Case 1 -- What Are Your Initial Thoughts? -- What Additional Questions Should You Ask? -- What Components Are Important to Include on the Exam? -- What Is Your Assessment? What Is the Ocular Staining Score (OSS) and How Is It Interpreted? -- How Would You Manage the Patient at This Point? -- What Is Your Assessment and What Are Your Next Steps? -- What Are Your Next Management Steps? -- Can You Have SS with Negative Bloodwork? -- What Are the Current Classification Criteria for SS? -- What Is the Role of Punctal Occlusion in SS? -- What Are Other Treatment Options for This Patient? -- Case 2 -- What Are Important Preoperative Considerations When Planning Cataract Surgery for Patients with Sjögren's Syndrome? -- What Role Do In-office Tests Such as MMP-9 Testing and Tear Osmolarity Play in Preoperative Surgical Planning for SS Patients? -- How Would You Change her Treatment Regimen Prior to Cataract Surgery Based on These Findings? -- How Do You Manage Postoperative Cataract Patients with Severe Dry Eye and/or SS? -- Case 3 [30] -- What Is the Initial Approach to This Patient? What Diagnosis Do These Findings Suggest? -- What Are Your Next Diagnostic Steps? -- What Is the Pathophysiology of Corneal Melts in SS Patients? -- What Is the Approach to Corneal Ulcerations with Corneal Perforation or Threatened Corneal Perforation in SS Patients?.

How Would Your Management Change at This Point? -- References -- Chapter 6: Diagnosis and Management of Ocular Graft-­Versus-­Host Disease -- Case 1 -- What Is Your Examination Approach to Ocular GVHD? -- Is There a Diagnostic Criterion for Chronic Ocular GVHD? -- Can You Perform Any Other Tests to Determine If He Has Any Signs of Ocular Inflammation? -- How Do These Laboratory Tests Help You in Counseling and Treating This Patient? -- Case 2 -- Why Are Her Ocular Symptoms Asymmetric? -- How Do You Treat This Patient, Given She Has Minimal Symptoms (OSDI = 2.08)? -- What Is the Role of Autologous Serum Tears in the Management of Chronic Ocular GVHD? -- Case 3 -- Why Did He Have Fluorescein Staining of the Superior Cornea? -- Is SLK Seen in Chronic Ocular GVHD? -- How Do You Treat SLK in Patients with Dry Eyes? -- Why Does He Have LSCD in the Left Eye? -- References -- Chapter 7: Management of Ocular Surface Allergic Diseases -- Case 1 -- What Is Seasonal Allergic Conjunctivitis, and How Does It Typically Present? -- Is Any Further Diagnostic Testing Needed? How Would You Manage This Patient? -- Case 2 -- What Is the Typical Clinical History of VKC? How Can the History Help to Differentiate Between VKC and Other Forms of Allergic Eye Disease, Specifically AKC? -- What Are Common Examination Findings in VKC? What Are the Long-Term Sequelae of VKC? -- What Is the Pathophysiology of VKC? What Is Appropriate Medical Management for These Patients? -- Case 3 -- Is There Any Further History You Would Like to Elicit from the child's family? What Is the Differential Diagnosis of a Chronic Corneal Ulcer in This Patient? -- What Is the Pathogenesis of a Shield Ulcer? -- How Should Shield Ulcers Initially Be Managed? -- What Are Some Other Treatment Options for Recalcitrant Shield Ulcers? -- Case 4.

What Is the Typical Clinical History of Patients with AKC? What Are Common Skin and Eyelid Findings in AKC? -- How Does AKC Affect the Conjunctiva and Cornea? What Are Other Ocular Associations Seen in AKC? -- What Is the Treatment Approach to AKC? -- What Are Some Considerations When Planning Penetrating Keratoplasty in AKC Patients? -- Summary -- References -- Chapter 8: Neuropathic Corneal Pain -- Case 1: Corneal Neuropathy and Light Sensitivity (Photoallodynia) -- What Is Causing Her Pain? Given the Normal Eye Exam, Could the Patient Be Malingering? -- How Do We Approach This Patient? -- What Is the Difference Between Peripheral vs. Central Neuropathic Pain? What Is the Proparacaine (Anesthetic) Challenge Test? -- What Can Aid in Definitive Diagnosis? -- Case 2: Corneal Neuropathy After LASIK Surgery (Post-­LASIK Neuralgia) -- Which Patients Are Susceptible to Corneal Pain? -- What Is the Social Impact of Corneal Pain? -- What Should We Do Next for This Patient? -- Case 3: Ocular Pain and Centralized Pain -- Case 4: Corneal Neuropathy and Inflammation -- Summary of the Management of Neuropathic Corneal Pain -- Anti-inflammatory Agents -- Neuro-regenerative Therapy -- Protective Contact Lenses -- Systemic Pharmacotherapy for Pain -- Complementary and Alternative Medical Approaches -- References -- Chapter 9: Management of Glaucoma in Patients with Ocular Surface Disease -- Case 1: Ocular Surface Toxicity/Allergy from Glaucoma Medications -- What Diagnosis Do These Findings Suggest? -- What Is the Basic Pathophysiology of the Ocular Surface Disease in the Setting of Glaucoma? -- What Is the Next Step in the Management of This Patient? -- What About the Long-Term Management of This Patient's Glaucoma and OSD? -- Case 2: Glaucoma Patient with Chronic Conjunctivitis and Scarring -- What Is Your Diagnosis? What Else Do You Recommend?.

How Was This Patient Managed?.

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