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Ophthalmology · Conjunctiva and cornea: evaporative dry eye
Sample itemA 50-year-old man has gritty eyes with a tear break-up time of 4 seconds, normal Schirmer test, telangiectatic lid margins and toothpaste-like plugs in the gland orifices. What is the type of dry eye?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Evaporative dry eye from gland dysfunction
A short tear break-up time with normal aqueous production and obstructed lid glands points to meibomian gland dysfunction, where the lipid layer fails and tears evaporate. Treatment includes warm compresses, lid hygiene and oral tetracyclines.
Option by option
A. Aqueous-deficient dry eye of Sjogren syndrome
Aqueous deficiency would give a low Schirmer value.
B. Neurotrophic dry eye
Neurotrophic disease causes reduced corneal sensation and epithelial defects.
C. Mucin-deficient dry eye from vitamin A lack
Mucin deficiency from vitamin A lack gives xerosis and Bitot spots with a systemic history.
D. Evaporative dry eye from gland dysfunction (correct)
Correct. Lipid layer failure causes evaporative dry eye with a normal Schirmer value.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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