CRU 2025: A closeup of diagnostic approaches and examination tips for DED and OSD

During their CRU 2025 presentation "The ABCs of DED and OSD," Cecelia Koetting, OD, FAAO, DipABO, and Madeline Yung, MD, focused on ocular surface disease and dry eye diagnosis, emphasizing a comprehensive approach to patient evaluation. In an exclusive interview with Optometry Times, Koetting shared the following:

Diagnostic approach

• Thoroughly examine the entire eye system, including eyelids, lid closure, conjunctiva, and tear drainage system

Diagnostic techniques

• Use vital dyes, particularly fluorescein
• Analyze staining patterns carefully
• Look beyond traditional dyes like lissamine green or rose bengal
• Observe staining location and extent

Staining pattern insights

• Different staining patterns can reveal underlying issues: - Inferior staining might indicate sleeping with eyes open - metamucosa could result from preserved eye drops

Examination recommendations

• Conduct a detailed slit lamp examination
• Pay attention to patient conversation and visual cues
• Don't rush through the initial examination

Diagnostic significance

• Staining patterns help identify: - Specific dry eye causes - Potential treatment directions - Underlying eye health issues

Holistic patient assessment

• Look beyond technical measurements
• Engage in meaningful conversation
• Observe patient's overall eye health and symptoms

Koetting emphasizes the importance of a meticulous, patient-centered approach to diagnosing ocular surface disease, highlighting that careful observation and comprehensive examination are crucial for accurate diagnosis and effective treatment.