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(To be filled only by physician)
A. >10
B. 11-20
C. 21-40
D. 41-60
E. More than 60
A. >18 yrs
B. >18 yrs to ≤ 30 yrs
C. ≥31 yrs to ≤ 45 yrs
D. ≥45yrs to ≤ 60 yrs
E. More than 60 yrs
A. Less than 10%
B. 10%-25%
C. 26%-50%
D. More than 50%
A. Patient history and symptoms assessment
B. Tear film break-up time test
C. Schirmer's test
D. Corneal staining with fluorescein
A. Meibomian gland evaluation
B. Osmolarity testing
C. Tear meniscus height measurement
D. Tear cytokine analysis
A. Every visit
B. Every two weeks
C. Monthly
D. Quarterly
A. Dietary changes
B. Limiting screen time
C. Stress reduction techniques
D. Sleep hygiene
A. Humidification
B. Avoiding ceiling fans
C. Limiting screen time
D. Sunglasses outdoor
A. Significant impact
B. Moderate impact
C. Minimal impact
D. No impact
A. Only if they have a history of MGD
B. During the initial evaluation
C. After one month of artificial tear use
D. Before initiating oral tetracyclines
A. Warm compresses and lid massage
B. Pulsed-dye laser therapy
C. Amniotic membrane transplantation
D. Punctal cautery
A. Preservative-free lubricant eye drops
B. Lubricant eye drops with preservatives
C. Gel drops
D. High viscosity ointments
A. Carboxymethylcellulose
B. Hydroxypropyl methylcellulose
C. PEG/PG
D. Sodium hyaluronate
E. Others
A. Adjust glaucoma medication dosage
B. Change glaucoma medication type
C. Use preservative-free glaucoma drops
D. Refer to a glaucoma specialist
A. Restoring tear production
B. Reducing inflammation
C. Alleviating symptoms
D. Preventing corneal damage
A. Before trying artificial tears
B. After a trial of cyclosporine A
C. If symptoms persist despite treatment
D. As part of the initial evaluation
A. Frequently
B. Occasionally
C. Rarely
D. Never
A. Less than 25%
B. 25%-50%
C. 51%-75%
D. More than 75%
A. As part of the initial evaluation
B. After 4 weeks of artificial tear use
C. Before starting cyclosporine A therapy
D. If they do not respond to topical cyclosporine
A. Preservative free Artificial tears
B. Topical Cyclosporine
C. Topical Steroids
D. IPL
E. Punctal plugs
A. Yes, frequently
B. Yes, occasionally
C. No, never
A. Scleral lenses
C. Autologous serum eye drops
D. Punctal occlusion
A. Cyclosporine A
B. Topical corticosteroids
D. Lipid-based artificial tears
A. Improving tear film stability
B. Reducing ocular surface inflammation
C. Alleviating symptoms and improving quality of life
D. Promoting meibomian gland function
A. Topical corticosteroids
B. Artificial tears with preservatives
C. Intense pulsed light (IPL) therapy
D. Cyclosporine A
A. If punctal plugs are not effective
B. For patients with significant eyelid abnormalities
C. When meibomian gland dysfunction is present
D. For any case of dry eye disease
A. Symptom questionnaires
B. Objective clinical signs
C. Tear osmolarity measurement
D. Combination of above methods
A. Over-the-counter artificial tears
B. Prescription eye drops
C. In-office procedures
D. Lid hygiene products