Wydanie 3/2014
str. 30

Ciężki zespół suchego oka – algorytm diagnostyczny w praktyce klinicznej

The Diagnostic Algorithm of the Severity of Dry Eye Syndrome in Clinical Practice

Marta Kita-Mosek1, Anna M. Ambroziak1,2, Wojciech Kołodziejczyk1, Ewa Langwińska-Wośko1,3

1 Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie
Dyrektor: prof. dr hab. n. med. Jerzy Szaflik
2 Zakład Optyki Informacyjnej Instytutu Geofizyki Wydziału Fizyki Uniwersytetu Warszawskiego
Kierownik: dr hab. Rafał Kotyński
3 Katedra i Klinika Okulistyki I Wydziału Lekarskiego Warszawskiego Uniwersytetu Medycznego
Kierownik: prof. dr hab. n. med. Jerzy Szaflik

Summary: Despite the fact that dry eye syndrome is a very common disorder, there is still no gold-standard model for determining its severity. The Odissey Algorithm is based on clear and practical sequence of trials in diagnosing dry eye disease severity, established by the multinational European Consensus Group. There are just two primary criteria confirming the diagnosis of severe dry eye in the majority of patients, symptom – based assessment and corneal fluorescein staining. In discordance between signs and symptoms there is a need to identify additional criteria to evaluate the severity of dry eye.
Summarizing, it should be emphasized, that such great number of diagnostic test characterized by different sensitivity, repeatability and specifity prooves heterogenicity of the disorder itself and diagnostics imperfection. Many above presented tests is used only in advanced clinical studies.
Therefore, in ophthalmological practice, according to capabilities, we use our own basic diagnostic set, in which following factors would be included: detailed history, lid margins evaluation, conjunctival folds evaluation, tear break-up time and corneal staining. Tear osmolarity evaluation using new and easy devices is highly sensitive and specific method, which maybe will soon become basic test used both in clinical trials and in every-day practice.
However, beside that, it is definitely the best clinical test, it does not meet „Gold Standard” criteria, in economical aspect it withdraw us from using that test in everyday practice.

Słowa kluczowe: ciężki zespół suchego oka, wskaźnik zaburzeń powierzchni oka, skala stopniująca barwienie powierzchni oka, europejski konsensus dotyczący diagnostyki zespołu suchego oka.

Keywords: severe dry eye syndrome, Ocular Surface Disease Index (OSDI), Corneal Fluorescein Staining (CSF), ODISSEY algorithm.