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News|Videos|March 31, 2025

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

Author(s)Cecelia Koetting, OD, FAAO, DipABO, Jordana Joy, Associate Editor

Cecelia Koetting, OD, FAAO, DipABO, weighs in on patient assessments, staining pattern insights, and diagnostic tips for patients who may have dry eye disease.

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.

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