11. TEAR FILM BREAK UP TIME
• Interval b/w complete blink and
appearance of dry spot on cornea
• F-stain > observed in slit lamp
• Normal: >/= 10 seconds
22. Grading
Stage 0: Normal cellular structure
Stage 1: Early loss of goblet cells
Stage 2: Total loss of goblet cells
Stage 3: Early and mild keratinisation
Stage 4: Moderate keratinisation
Stage 5: Severe keratinisation
23. WATERING EYE
• ROPLAS test
• FDDT
• Lacrimal syringing test
• Jones tests
• DCG
• Lacrimal scintillography
25. Fluorescein Dye Disappearance test
• Drop instilled in conjunctival sac
• Observed after 5 mins
• Color intensity after 5 mins: 0 to +4
• +2 to +4 > Inadequate drainage
26. Lacrimal syringing test
• TA - 2 to 4% xylocaine
Result Inference
Free passage No obstruction
Passes with considerable
pressure on syringe
Partial obstruction
Reflux through same punctum Obstruction in same canaliculus
Reflux through other punctum
Obstruction in common
canaliculus, lacrimal sac, NLD
27. Primary Jone’s test
• 1% fluorescein dye placed in
conjunctival sac
• Cotton bud dipped in xylocaine +
epinephrine is placed in inferior
meatus
28. Inference
• Stained bud - Adequate drainage:
Watering is due to hypersecretion
• Unstained bud - Inadequate drainage:
Obstruction
Failure of lacrimal pump
29. Secondary Jone’s test
• Residual fluorescein is flushed from
conjunctival sacs
• Lacrimal syringing done with clear
saline
32. Dacryocystography
• Exact site,extent and nature of block
• Information about mucosa about sac,
fistula, diverticula, stone or tumor of
lacrimal passage
