Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic ocular irritation, foreign body sensation, burning, and intermittent blurred vision. Symptoms exacerbate with prolonged screen use, wind exposure, and in low-humidity environments. No history of recent ocular trauma or chemical exposure.
Clinical Examination Findings
Slit lamp examination reveals reduced tear meniscus height, rapid tear film break-up time (TBUT < 5 seconds), and punctate epithelial erosions (PEE) on the inferior cornea upon fluorescein staining. Conjunctival injection present; lids show evidence of meibomian gland dysfunction (MGD) with inspissated secretions.
Treatment Protocol
Initiate preservative-free artificial tears QID, warm compresses to eyelids BID, and lid hygiene with tea tree oil or mild soap. Consider topical cyclosporine or lifitegrast for chronic inflammation. Recommend omega-3 fatty acid supplementation and optimization of environmental humidity.