Dr Au Eong Kah Guan Shares His Experience on Treating Dry Eye and Blepharitis with Doctors at Farrer Park Hospital

By Goh Jiah Ying, IECRC

A Continuing Medical Education lecture for medical doctors was given by Dr Au Eong Kah Guan, Medical Director & Senior Consultant Ophthalmologist from International Eye Cataract Retina Centre at the TK Low Academic Specialist Centre in Farrer Park Hospital on 27 April 2017. The lecture, titled “Diagnosis and Management of Dry Eye and Blepharitis”, was part of a series of educational activities for general practitioners and medical specialists organised by Farrer Park Hospital. The event was chaired by Dr S. M. Tahir, Senior Consultant Ophthalmologist from Tahir Eye Surgery & Clinic.

Although dry eye syndrome is one of the most common reasons patients visit their ophthalmologists, it is one of the most under-diagnosed and frustrating condition to treat since there are a wide range of causes or conditions that can produce similar symptoms.

There are two types of dry eye: (1) aqueous-deficient dry eye and (2) evaporative dry eye. Aqueous-deficient dry eye is caused by insufficient production of tears. Evaporative dry eye results from rapid evaporation of tears in the exposed eye surface although the structures that are responsible for producing tears are working fine.

The tear film that covers the front portion of the eye is known as the pre-corneal tear film. It has three different layers: (1) the deepest layer is the mucin or mucous layer, (2) the middle watery layer is the aqueous layer and (3) the most superficial layer is the oily or lipid layer. Each of these layers is important for tear film stability. Compromise to any of these layers can lead to dry eye syndrome. Dry eye symptoms can be caused by a wide range of factors and often, it is easy to mistake dry eye for something else as its symptoms are non-specific.

Dr Au Eong highlighted some common clinical dry eye tests such as Schirmer test, tear break-up time test, ocular surface disease index questionnaire and ocular surface dye test that health care professionals can use to help in their diagnosis and management of patients. There are many ways to manage this disease depending on its severity, starting with the use of lubricating eye drops in mild cases to intervention such as partial or permanent punctal occlusion in severe cases.

Blepharitis is a common inflammatory condition that affects the eyelids. It is often associated with oily flakes and accumulation of bacteria at the base of the eye lashes. Dr Au Eong elaborated on the two types of blepharitis which are best diagnosed with the slit lamp, a commonly used clinical equipment that magnifies the eye during examination. Blepharitis often occurs along with dry eye. Like dry eye, it is often under-diagnosed. Both dry eye and blepharitis, if left untreated, can cause a decrease in one’s quality of life.

Unfortunately, the underlying causes of dry eye and blepharitis are usually irreversible. As these conditions are chronic in nature, their symptoms tend to recur once the treatment ceases. Dr Au Eong emphasized that educating patients about these conditions is very important to encourage them to be more compliant with treatment, thereby fulfilling the management aim of controlling the symptoms and preventing eye surface damage.