Clinical Scorecard: Dry Eye Dx and Tx: Preserving the Periphery

At a Glance

Key Highlights

• Custom specialty soft lenses are beneficial for patients requiring non-standard lens powers.
• LSCD can occur due to contact lens wear, with 16.8% of cases attributed to this.
• Monitoring the limbal region under slit lamp is crucial for early detection of LSCD.
• Silicone hydrogel materials improve oxygen transmission to the cornea.
• Early LSCD treatment may involve cessation of lens wear and topical therapies.

Guideline-Based Recommendations

Diagnosis

• Clinical identification of LSCD through corneal neovascularization and fluorescein staining.

Management

• Use silicone hydrogel materials and preservative-free disinfection.
• Consider amniotic membranes, limbal transplants, and scleral lenses for advanced cases.

Monitoring & Follow-up

• Perform slit lamp exams at least annually to assess corneal health and staining.

Risks

• Higher risk of LSCD in patients with custom specialty soft lenses due to lower Dk/t values.

Patient & Prescribing Data

Patients with high prescriptions requiring custom soft lenses.

Monitor oxygen transmissibility (Dk/t) to prevent corneal edema.

Clinical Best Practices

• Remove contact lenses at every office visit for fluorescein staining tests.
• Educate patients on the importance of monitoring for symptoms of LSCD.

References

• Jeng et al, 2011
• Rossen et al, 2016
• Cheung et al, 2021
• Kim and Mian, 2017
• Holden and Mertz, 1984
• Papas, 1998
• Fonn and Bruce, 2005
• Yeung et al, 2018