Eyeworld

SPRING 2024 | EYEWORLD | 59 C Relevant disclosures Kim: None Sayegh: None Contact Kim: docdbk100@gmail.com Sayegh: rrs109@case.edu sponge has been used to touch the corneal surface to identify areas of loose epithelium, but the dry sponge can stick to the cornea and induce an abrasion. "As a result, I developed the Kim Corneal Sweeper [Corza Medical], which is a handheld instrument with a straight handle and fusiform shape tip with rounded edges," he said. "The smooth texture enables safe use on the corneal surface. Fluorescein dye is instilled, and the cornea is examined under the slit lamp with cobalt blue light. The sweeper is held like a pencil and pressed tangentially against the cornea with steady indentation pressure along the entire corneal surface. The tear film enables it to glide over the cornea atraumatically. When an area of loose epithelium is encountered, it ripples up, which creates a visible fold easily continued from page 57 Dry eye syndrome: Dry eye is a broad term that includes any condition in which tears are impacted, in quantity, quality, composition, or distribution on the ocular surface. Blepharitis, meibomian gland dysfunction, and conjunc- tivochalasis are very common conditions that are part of the dry eye syndrome, and a gritty or sandy feeling in the eyes is commonly re- ported by patients with these conditions. Conjunctivitis: This includes allergies, which are very common, as well as viral conjuncti- vitis. Patients often report itching, irritation, redness, and the sensation of a foreign body in the eye. Everting the eyelids can be helpful in the diagnosis of these conditions to look for follicles and papillae, Dr. Sayegh said. Contact lens issues: FBS can be a symptom of a poor fit or contact lens spoilage or related to a complication of contact lens wear, such as a corneal abrasion or ulcer. It is also important to ask if wearing the contact lens helps with the FBS, which can occur in some patients, such as those with limbal stem cell deficiency. Foreign body: Sometimes a small foreign object can actually get stuck in the eye or under the eyelid, leading to FBS. "We have seen contact lenses retained for decades. One should not forget conjunctival concretions are common and can sometime break through the surface and cause FBS," he said. Environmental factors: Wind, smoke, dust, and other environmental factors can cause foreign body sensation. "Some of my patients who work long hours outdoors or at the grill have benefited from protective goggles," he said. Eye strain: Prolonged periods of reading or using digital screens can cause eye strain, leading to discomfort which may include FBS. Corneal erosions: These are also a common cause of FBS and include epithelial basement membrane dystrophy and recurrent erosion syndrome. It is important to look carefully for patterns of negative staining that is indicative of these conditions, he said. Other dystrophies are often easier to diagnose based on corneal appearance. Certain systemic drugs such as novel cancer treatments can also cause corne- al changes and FBS. Persistent foreign body sensation in the eye can be caused by a variety of conditions and factors, Dr. Sayegh said. Some of the most common ones include: Certain systemic drugs can also cause corneal changes and FBS. The slit lamp photograph shows microcyst-like epithelial changes in a patient on mirvetuximab soravtansine, an antibody drug conjugate used for the treatment of ovarian cancer. Source: Rony Sayegh, MD continued on page 61

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