Thorough exam and an open mind needed to identify dry eye masqueraders
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KOLOA, Hawaii — Specialists must be thorough in their examinations of patients with dry eye symptoms in order to catch dry eye masqueraders, according to a presenter here.
“There is a laundry list of dry eye masqueraders,” Richard S. Davidson, MD, said at Hawaiian Eye 2023.
For example, conjunctivochalasis is often an overlooked cause of foreign body sensation.
“It's really important to take a look at these patients and really look at their conjunctiva,” he said.
Eyelid laxity, subepithelial corneal infiltrates, convergence insufficiency and presbyopia are other conditions that commonly present with symptoms associated with dry eye disease.
“It’s very common for patients as they are becoming presbyopic ... to not really be able to describe their symptoms, and they come in with this diagnosis of dry eyes,” but it is the strain of not being able to accommodate that masquerades as a diagnosis of dry eye, he said.
“It is more common than we think,” he said.
Being thorough, listening to the patient and taking patient history all play into being able to identify when these patients have something else going on in the cornea, he said.
“These are just a few of the laundry list of things that masquerade as dry eye, so just keep an open mind and really take a good look at the patient,” he said.
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Davidson RS. No, this is not dry eye: Masqueraders of dry eye syndrome. Presented at: Hawaiian Eye 2023; Jan. 14-20, 2023; Koloa, Hawaii.
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