Evaluation of dry eye subtypes and characteristics using conventional assessments and dynamic tear interferometry

2021 ◽  
pp. bjophthalmol-2020-318624
Author(s):  
Yong Woo Ji ◽  
Hyojin Seong ◽  
Jeong Gi Seo ◽  
Si Yoon Park ◽  
Mutlaq Alotaibi ◽  
...  
Keyword(s):  
Dry Eye ◽  
Meibomian Gland ◽  
Disease Index ◽  
Healthy Controls ◽  
Lipid Layer ◽  
Ocular Surface Disease Index ◽  
Schirmer’S Test ◽  
Appropriate Treatment ◽  
Conventional Tests ◽  
Tear Analysis

Background/aimsTo evaluate subtypes and characteristics of dry eye (DE) using conventional tests and dynamic tear interferometry, and to investigate determinants of disease severity in each DE subtype.Methods309 patients diagnosed with DE and 69 healthy controls were prospectively enrolled. All eyes were evaluated using Ocular Surface Disease Index (OSDI), Schirmer’s test I (ST1) and Meibomian gland dysfunction (MGD) grade were analysed. The tear interferometric pattern and lipid layer thickness were determined using DR-1α and LipiView II, respectively.ResultsDynamic interferometric analysis revealed 56.6% of patients with DE exhibited Jupiter patterns, indicative of aqueous-deficiency, while 43.4% exhibited crystal patterns, indicative of lipid deficiency. These findings were in accordance with classification based on ST1 scores and MGD grade. Conventional assessment indicated 286 patients exhibited evidence of evaporative DE (EDE) due to MGD, while only 11 exhibited signs of pure aqueous-deficient DE (pure ADDE, only ST1 ≤5 mm). Interestingly, of 286 patients with EDE, 144 were categorised into the mixed-ADDE/EDE group, in which ST1 was identified as a strong negative determinant of OSDI. In contrast, 72.2% of patients with mixed-ADDE/EDE exhibited Jupiter patterns (Jupiter mixed), while 27.8% exhibited crystal patterns (crystal mixed). OSDI values were significantly higher in the crystal-mixed group than in the Jupiter mixed, in which OSDI scores were independently associated with ST1 values only.ConclusionsOur findings indicate that majority of EDE patients also exhibit aqueous deficiency, which can aggravate symptoms even in patients with lipid-deficient mixed-ADDE/EDE. Conventional assessments should be combined with interferometric tear analysis to determine the most appropriate treatment for each DE patient.

scholarly journals Multicenter Study of Intense Pulsed Light for Patients with Refractory Aqueous-Deficient Dry Eye Accompanied by Mild Meibomian Gland Dysfunction

2020 ◽  
Vol 9 (11) ◽  
pp. 3467
Author(s):  
Reiko Arita ◽  
Shima Fukuoka ◽  
Takanori Mizoguchi ◽  
Naoyuki Morishige
Keyword(s):  
Dry Eye ◽  
Tear Film ◽  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Meibomian Gland Dysfunction ◽  
Control Group ◽  
Pulsed Light ◽  
Lipid Layer ◽  
Film Stability ◽  
Schirmer’S Test

Aqueous-deficient dry eye (ADDE) and meibomian gland dysfunction (MGD) can be refractory to therapy. Intense pulsed light (IPL) was recently introduced as an effective treatment for MGD. We here evaluated the efficacy of IPL combined with MG expression (MGX) compared with MGX alone (n = 23 and 20, respectively) for patients with refractory ADDE with mild MGD at three sites. Symptom score, visual acuity (VA), noninvasive breakup time (NIBUT) and lipid layer thickness (LLT) of the tear film, lid margin abnormalities, fluorescein BUT (FBUT), fluorescein staining, tear meniscus height (TMH), meibum grade, meiboscore, and Schirmer’s test value were assessed at baseline and 1 and 3 months after treatment. LLT, plugging, vascularity, FBUT and NIBUT were improved only in the IPL-MGX group at three months compared with baseline. All parameters with the exception of VA, meiboscore, TMH, Schirmer’s test value were also improved in the IPL-MGX group compared with the control group at three months, as was VA in patients with central corneal epitheliopathy. Although IPL-MGX does not affect aqueous layer, the induced improvement in quality and quantity of the lipid layer may increase tear film stability and ameliorate symptoms not only for evaporative dry eye but for ADDE.

scholarly journals Assessment of Dry Eye Syndrome among Computer Programmers in Computer Training Institutes in Benin City

2021 ◽  
Vol 23 (1) ◽  
pp. 18-24
Author(s):  
Ayishetu Oshoke Shuaibu ◽  
Sarah Ikhuemose Ebuwa ◽  
Abimbola Esther Ikuemonisan Ikuemonisan
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Computer Training ◽  
Disease Index ◽  
Dry Eye Syndrome ◽  
Ocular Surface Disease ◽  
Ocular Surface Disease Index ◽  
Benin City ◽  
Schirmer’S Test ◽  
Break Up

Purpose: The purpose of this study was to evaluate dry eye syndrome among computer programmers in computer training institutes in Benin City.Methods: This cross-sectional study was carried out using 250 participants of 18 years and above who were computer instructors and students of various computer training institutes in Benin City. Sociodemographic data and relevant ocular history were obtained from the participants. External and Internal examinations of the eyes were carried out to check for the presence of any ocular abnormalities. Dryeye disease was assessed subjectively with the Ocular Surface Disease Index (OSDI) questionnaire and objectively by performing  Schirmer’s test and Tear Break-up Time (TBUT). Participants with an OSDI score of ≥35 and who had < 10mm to Schirmer’s I test or < 10secs in Tear break-up Time (TBUT) test were considered to have dry eye.Results: The mean age of the participants was 25.32 ± 7.38 years and 68% were males. The prevalence of dry eye among the computer programmers was found to be 30.8%. Mean TBUT and Mean Schirmer’s Test value for those with dry eye was 10.21s±3.44s and 12.46 ± 7.27mm respectively. This study showed that age (p=0.213), gender (p=0.243) and duration of time spent on computer display units (p=0.124) were not statistically significant determinants of dry eye among the computer programmers.Conclusion: Computer programmers are predisposed to developing dry eye diseases. It is therefore imperative for them to go for regular eye examination to prevent ocular surface disorders and therefore maintain comfortable vision. Keywords: Dry Eye, Schirmer Test, Tear Break-up Time, Ocular Surface Disease Index, Computer Programmer.

scholarly journals Tear Film Instability and Meibomian Gland Dysfunction Correlate with the Pterygium Size and Thickness Pre- and Postexcision in Patients with Pterygium

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Ning Li ◽  
Tao Wang ◽  
Ruixue Wang ◽  
Xuanchu Duan
Keyword(s):  
Dry Eye ◽  
Anterior Segment ◽  
Tear Film ◽  
Multivariate Regression Analysis ◽  
Meibomian Gland ◽  
Meibomian Gland Dysfunction ◽  
Clinical Implementation ◽  
Lipid Layer ◽  
Ocular Surface Disease Index ◽  
Pterygium Excision

Purpose. This study aimed to evaluate the effects of excision on dry eye and meibomian gland dysfunction (MGD) in individuals with pterygium, before and after surgery. It also aimed to investigate how these effects correlate with the size and thickness of the pterygium. Subjects and Methods. 63 eyes from 63 patients with primary nasal pterygium and 45 eyes from 45 healthy volunteers without ocular pathologies were enrolled in this study. 63 eyes from 63 patients underwent pterygium surgery. ImageJ software was used to calculate the pterygium size based on images of the anterior segments. Anterior segment spectral domain optical coherence tomography (SD-OCT) was performed preoperatively to measure the thickness of the pterygium 1 mm anterior to the nasal scleral spur. The ocular surface disease index (OSDI), Schirmer I Test (SIT), and MGD grade were used to evaluate the eyes, and the eyes were imaged using the noninvasive keratograph average tear film breakup time (NIBUTav), tear meniscus height (TMH), meiboscore, and lipid layer grading tools of the Oculus® Keratograph 5M, preoperatively and at 1, 3, and 6 months postoperatively. Results. The OSDI, NIBUTav, lid margin abnormality, meiboscore, and lipid layer grading values differed significantly in the pterygium patients in comparison with the controls (p<0.01 for all scores). However, the SIT and TMH values were unchanged between the two groups (all p>0.05). Multivariate regression analysis demonstrated that the NIBUTav, meiboscore, and lipid layer grading score was significantly correlated with the pterygium parameters, such as size and thickness. The postoperative OSDI, NIBUTav, lid margin abnormality, and lipid layer grading values improved significantly (p<0.05 for all scores). The SIT, TMH, and meiboscore results did not differ significantly between the pre- and postoperative values (p>0.05). Among the conventional and automated indexes, at 1 month postoperatively, SIT and TMH were significantly correlated with the pterygium parameters, but no correlation was observed at 3 and 6 months postoperatively. The OSDI, NIBUTav, meiboscore, and lipid layer grading values at 1, 3, and 6 months postoperatively were significantly correlated with the pterygium parameters. Conclusion. Abnormal tear film and meibomian gland (MG) function improved following pterygium excision in the patients with primary pterygium, which was associated with uncomfortable ocular symptoms. Pterygium parameters, such as size and thickness, correlated with the dry eye and MGD indexes in patients pre- and postoperatively, potentially offering a novel strategy for clinical implementation of pterygium excision surgery.

scholarly journals Comparison of Clinical Use of Ocular-surface Disease Index Questionnaire, Tear Film Break-up time, and Schirmer Tests in Diagnosing Dry-eye

2019 ◽  
pp. 1-7
Author(s):  
Suwarna Suman ◽  
Prachi Goyal
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Dry Eye Disease ◽  
Disease Index ◽  
Ocular Surface Disease ◽  
Eye Disease ◽  
Ocular Surface Disease Index ◽  
Schirmer’S Test ◽  
The Mean

Aims:  To evaluate and compare the diagnostic values and clinical utility of the Ocular Surface Disease Index (OSDI) questionnaire, the tear film break-up time test (TBUT), and the Schirmer’s test in diagnosing dry eye disease in patients presenting with dry eye symptoms. Study Design: A prospective observational study. Place and Duration of Study: Department of Ophthalmology, AIIMS Jodhpur, Rajasthan, India. Two-month period between July 2016 and September 2016. Methodology: We have included 100 patients aged >20 years having foreign body sensations, burning sensations, pain, dryness, blurred vision, photophobia, redness in the study. Routine ophthalmological examination was performed after OSDI questionnaire, followed by TBUT and Schirmer’s test and outcomes were evaluated. Results: The mean age of 100 participants was 43 ± 15.97years (range 20–78 years). The mean OSDI, TBUT, and Schirmer’s test scores were 58.67± 12.12 (range 30.0–88.9), 5.77 ± 3.49 seconds (range 0–17 seconds), and 09.78 ± 7.93 mm (range 0–32.5 mm), respectively. There was a statistically highly significant inverse correlation between the OSDI and TBUT (r = −0.597, P = <0.0001), statistically significant correlation between TBUT and Schirmer test (r= -0.227, p= 0.023), whereas no significant correlation noted between the OSDI and Schirmer’s test (r= -0.142, p= 0.158).  Conclusion: The prevalence of dry eye disease (DED) is increasing these days. For early recognition and treatment, we need rapid, reliable and less invasive diagnostic test in daily practice. The OSDI together with the TBUT is less time consuming, easy to perform and can be useful in diagnosis of DED.

scholarly journals Evaluation of Dry Eye after Implantable Collamer Lens Surgery

2020 ◽  
Author(s):  
Haiting Chen ◽  
Xueyan Feng ◽  
Guangzeng Niu ◽  
Yuxiang Fan
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Case Series ◽  
Meibomian Gland ◽  
Quality Score ◽  
Control Group ◽  
Ocular Surface Disease Index ◽  
Implantable Collamer Lens ◽  
Lens Surgery ◽  
Breakup Time

<b><i>Objectives:</i></b> To evaluate dry eye (DE) and associated meibomian gland dysfunction parameters after Implantable Collamer Lens (ICL) surgery. <b><i>Methods:</i></b> This is a prospective observational case series. Patients who underwent ICL implantation without previous ocular diseases or ophthalmic treatments were enrolled. Their Ocular Surface Disease Index (OSDI), noninvasive breakup time (NIBUT), meibography, slit-lamp examination of the lid margin, corneal fluorescein staining (CFS), and Schirmer test I were examined preoperatively and at 1 and 3 months postoperatively. <b><i>Results:</i></b> A total of 117 eyes of 60 patients were enrolled, and 107 eyes completed 3-month follow-up period. OSDI, lid marginal abnormality, and meibomian gland (MG) secretion, and meibum quality score were significantly higher at 1 month postoperatively and recovered partially at 3 months after surgeries, while NIBUT was significantly decreased all the time. Patients with previous DE symptoms (OSDI score ≥12) showed not only lower Schirmer and TBUT values but also higher CFS, lid margin score, MG loss, MG secretion, and meibum quality scores compared with those in the control group after operations. Low Schirmer, NIBUT values, and high meibum quality score were determined as risk factors for DE symptoms after ICL surgery. <b><i>Conclusions:</i></b> ICL implantation has a bad influence on the ocular surface and MG functions. The influence may be more obvious in patients with existing DE.

scholarly journals A comparative assessment of dry eye disease among outdoor street sweepers and indoor office cleaners

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chigozie I. Echieh ◽  
Bassey A. Etim ◽  
Chidiebere Peter Echieh ◽  
Taiwo Oyeniyi ◽  
Jeff Ajewole
Keyword(s):  
Dry Eye ◽  
Cross Sectional Study ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Ocular Surface Disease Index ◽  
Simultaneous Exposure ◽  
Cross Sectional ◽  
Systematic Random Sampling ◽  
Schirmer’S Test ◽  
Multi Stage

Abstract Background Occupational predisposition to dry eye disease is known. Simultaneous exposure to multiple factors may pose more risk. Street sweepers are exposed to sunlight in addition to dust which all sweepers are exposed to. Tropical climate predisposes to significant exposure to sunlight. Combined exposure to dust and sunlight may lead to a synergy of factors. This study aims to assess the prevalence of dry eye disease (DED) amongst Street sweepers and Office cleaners in Calabar metropolis. Methods A cross-sectional study was conducted among street sweepers and office cleaners. A systematic random sampling and multi-stage sampling method were used to select street sweepers (n = 115) and office cleaners (n = 115) respectively for the study. A pretested semi-structured interviewer-administered questionnaire was used to obtain information after which the respondents had an ophthalmic examination. An assessment of DED was done with Ocular Surface Disease Index (OSDI) questionnaire, Schirmer’s test, and tear break up time (TBUT). OSDI scores of 33 and above; Schirmer’s test readings of < 10 mm wetting in 5 min and a TBUT of less than 10s in either eye were considered as positive dry eye disease. Results The majority of respondents were females 215(93.5%) compared to males 15 (6.5%). The overall mean age of respondents was 40.96 ± 9.8 years. The average OSDI score, Schirmer’s test as well as TBUT among participants was 26.4 ± 16.0, 16.44 ± 9.52 mm, and 12.38 ± 4.53 s respectively. The prevalence of DED among Street sweepers was 35.7% compared to 20% among office cleaners using the OSDI questionnaire (p = 0.352). The prevalence of DED among street sweepers was 32.2% compared to 30.4% among Office cleaners using the Schirmer’s test. (p = 0.73) The TBUT reported a prevalence of 38.3% of DED among Street sweepers compared to 32.2% in office cleaners. (p = 0.48) Overall; the prevalence of dry eye disease among Street sweepers and office cleaners using OSDI score, Schirmers test, as well as TBUT were not statistically significant (> 0.05) Street Sweepers had higher odds of developing dry eye disease compared to office cleaners (OR = 2.085; C.I. =1.106–3.929; p = 0.02). Negative correlation coefficient was observed between TBUT and OSDI (rs = − 0.102; p = 0.125). This was not statistically significant. Conclusion Street sweepers had a higher prevalence of dry eye disease compared to office cleaners due to a higher risk of increased exposure to environmental factors such as dust, smoke, and sunlight. This effect is possibly due to a synergy of factors. Studies on dose-response are warranted.

scholarly journals Reliability and validity of the Japanese version of the Ocular Surface Disease Index for dry eye disease

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033940 ◽  
Author(s):  
Akie Midorikawa-Inomata ◽  
Takenori Inomata ◽  
Shuko Nojiri ◽  
Masahiro Nakamura ◽  
Masao Iwagami ◽  
...  
Keyword(s):  
Internal Consistency ◽  
Dry Eye ◽  
Ocular Surface ◽  
Discriminant Validity ◽  
Reliability And Validity ◽  
Japanese Version ◽  
Disease Index ◽  
Eye Disease ◽  
Ocular Surface Disease Index ◽  
Test Retest Reliability

ObjectivesThe Ocular Surface Disease Index (OSDI) questionnaire is widely used to evaluate subjective symptoms of dry eye disease (DED) as a primary diagnostic criterion. This study aimed to develop a Japanese version of the OSDI (J-OSDI) and assess its reliability and validity.Design and settingHospital-based cross-sectional observational study.ParticipantsA total of 209 patients recruited from the Department of Ophthalmology at Juntendo University Hospital.MethodsWe translated and culturally adapted the OSDI into Japanese. The J-OSDI was then assessed for internal consistency, reliability and validity. We also evaluated the optimal cut-off value to suspect DED using an area under the receiver operating characteristic curve (AUC) analysis.Primary outcome measuresInternal consistency, test–retest reliability and discriminant validity of the J-OSDI as well as the optimal cut-off value to suspect DED.ResultsOf the participants, 152 had DED and 57 did not. The J-OSDI total score showed good internal consistency (Cronbach's alpha=0.884), test–retest reliability (interclass correlation coefficient=0.910) and discriminant validity by known-group comparisons (non-DED, 19.4±16.0; DED, 37.7±22.2; p<0.001). Factor validity was used to confirm three subscales within the J-OSDI according to the original version of the questionnaire. Concurrent validity was assessed by Pearson correlation analysis, and the J-OSDI total score showed a strong positive correlation with the Dry Eye-Related Quality-of-Life Score (γ=0.829). The optimal cut-off value of the J-OSDI total score was 36.3 (AUC=0.744).ConclusionsThe J-OSDI was developed and validated in terms of reliability and validity as an effective tool for DED assessment and monitoring in the Japanese population.

The Effect of Low-Dose Aspirin on Dry Eye Parameters and Ocular Surface Disease Index Questionnaire

2018 ◽  
Vol 34 (3) ◽  
pp. 256-259 ◽  
Author(s):  
Alper Yazıcı ◽  
Esin Sarı ◽  
Erkan Ayhan ◽  
Gözde Şahin ◽  
Nesime Setge Tıskaoğlu ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Low Dose ◽  
Disease Index ◽  
Ocular Surface Disease ◽  
Ocular Surface Disease Index ◽  
Dose Aspirin ◽  
Low Dose Aspirin

Efficacy of cyclic therapy with terpinen-4-ol in Demodex blepharitis

2020 ◽  
pp. 112067212091908 ◽  
Author(s):  
Özlem Evren Kemer ◽  
Emine Esra Karaca ◽  
Dilay Özek
Keyword(s):  
Ocular Surface ◽  
Meibomian Gland ◽  
Disease Index ◽  
Ocular Surface Disease ◽  
Schirmer Test ◽  
Ocular Surface Disease Index ◽  
Tea Tree ◽  
Cyclic Treatment ◽  
Pre Treatment ◽  
Breakup Time

Purpose To describe the effectiveness of cyclic treatment with terpinen-4-ol, a tea tree oil component, on Demodex blepharitis. Methods The presence of Demodex was determined by eyelash rotation as proposed by Mastrota. Schirmer test, tear breakup time, ocular surface disease index, lid margin score, meibomian gland expressibility score, and Oxford grade were performed. Patients were advised to apply heat followed by terpinen-4-ol soaked wipes to eyelids twice a day for 2 weeks. At the end of 2 weeks, treatment was interrupted for 7–10 days. The same treatment was repeated once again. The patients were examined after the first and second cycle of treatment and after 1 year. Results There was a statistically significant improvement in Schirmer test (10.37 ± 4.73 and 13.13 ± 3.44 mm/5 min), tear breakup time (6.47 ± 3.31 and 7.6 ± 2.89 s), ocular surface disease index (47.94 ± 19.77 and 34.28 ± 13.40), lid margin score (3.2 ± 0.7 and 2.63 ± 0.71), meibomian gland expressibility scores (1.93 ± 0.64 and 1.4 ± 0.67), and Oxford grade (0.9 ± 0.8 and 0.5 ± 0.63) after the first cycle of treatment ( p < 0.05). The improvement in symptoms and tear function tests of the patients after the second cycle was significantly better than in pre-treatment levels. At 12-month follow-up, symptoms of two patients (93%) relapsed. Conclusion The administration of terpinen-4-ol to the eyelid margins in a cyclic manner in Demodex blepharitis is effective against adult and hatching Demodex and breaks the vicious cycle.

Meibomian gland loss area and its relationship with age and ocular surface disease index

2019 ◽  
Author(s):  
Jacobo Garcia-Queiruga ◽  
Hugo Pena-Verdeal ◽  
Dolores Ferreiro ◽  
Carlos García-Resúa ◽  
Eva Yebra-Pimentel
Keyword(s):  
Ocular Surface ◽  
Meibomian Gland ◽  
Disease Index ◽  
Ocular Surface Disease ◽  
Ocular Surface Disease Index
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