scholarly journals An investigation of the relationship between tear meniscus height and the subjective severity of ocular symptoms in keratoconus

2015 ◽  
Vol 74 (1) ◽  
Author(s):  
Deanne L. Nicholas ◽  
Wayne D.H. Gillan

Keratoconus is a debilitating disease in which the cornea does not develop its characteristic round shape but develops into a conical form affecting both functional vision as well as ocular comfort. Depending on the severity of the keratoconus as well as the presence of any associated conditions, keratoconic individuals may complain of various symptoms that include discomfort, irritation, dryness, reflex tearing and foreign body sensation. There are various subjective and objective measures that can be used to determine the severity of these symptoms. A subjective method that is widely used is the ocular surface disease index (OSDI) which has been shown to be fairly accurate when diagnosing dry eye disease; however, these symptoms do not correlate with objective measures of dry eye. Research has revealed the various structural and biochemical changes that take place within a keratoconic cornea; however, the tear dimensions of keratoconic subjects have not been extensively investigated. It is possible that the symptoms experienced by many keratoconic individuals might be linked to alterations within the quantity of the tears of these patients. The present study compared the symptoms experienced by keratoconic individuals with the symptoms of control patients. The differences in tear meniscus heights between keratoconic individuals and those of control individuals were also compared using the Oculus Keratograph 4 (OK4). The results of the study show the absence of a relationship between the subjective symptoms experienced and the height of the tear meniscus.

2021 ◽  
pp. 24-24
Author(s):  
Bojana Dacic-Krnjaja ◽  
Milan Hadzi-Milic ◽  
Jelena Potic ◽  
Danijela Raonic ◽  
Milenko Stojkovic

Introduction/Objective. The objective of this paper was to assess the diagnostic value of three simple dry eye (DE) tests: lid parallel conjunctival folds (LIPCOF), tear meniscus height (TMH), and tear ferning (TF). Methods. Diagnostic DE tests LIPCOF, TMH and TF tests were performed in 100 patients. Eighty of them were referred to us by rheumatologists and general practitioners either during evaluation for Sj?gren?s syndrome, or because of DE symptoms. Control group was made of 20 patients, with no DE relating symptoms. Ocular Surface Disease Index (OSDI) questionnaire was used for DE symptoms? evaluation. Results of LIPCOF, TMH and TF tests were compared with results of Copenhagen criteria (CC) DE tests i.e., tear fluorescein break up time, Schirmer I and Rose Bengal tests. Ability of tests to recognize DE in various grades according to Dry Eye Work Shop (DEWS) report score system was assessed. Results. Compared to CC, sensitivity of LIPCOF and TMH was high: 92.8% and 83.5%, while specificity was low: 34.4% and 49.2%, respectively. TF had low sensitivity of 59.1% but high specificity of 82.7%. Mean values of both LIPCOF and TMH differed significantly (F = 7.222, p < 0.001 and F = 11.802, p < 0.001) between control group and all DEWS DE grades, but not among different grades of DE. Conclusions. Diagnostic tests TMH and LIPCOF showed high sensitivity which makes them excellent screening DE tests. Low sensitivity of TF suggests that it is not truly a good screening test on its own, but its high specificity is of definite value.


2021 ◽  
pp. 23-25
Author(s):  
Vepa Meenakshi ◽  
Maridi Aparna ◽  
Tammana v

AIM: To screen for dry eye among type 2 diabetic patients ,determine the prevalence and correlate with blood sugar levels. METHODS: 100 patients who were diagnosed cases of type 2 diabetes were included in the study .Detailed history regarding ocular symptoms, diabetes and its duration was taken. A thorough ocular examination using Slit lamp bio microscopy was done and visual acuity tested with Snellen's chart.Tear lm status evaluated by Schirmer's I test, Tear lm break up time(TBUT),Tear meniscus height. Two or all of the above performed tests was positive in a given patient, the patient was deemed to be suffering from dry eye. RESULTS:Out of 100 patients, males were 48 and females were 52. 39 patients were found to show positive screening tests for dry eye.38% (out of 39 patients) had major symptom of foreign body sensation. 23 out of 39 patients were females. 14 out of 39 patients were in age group 51 to 60 years.Most of the diabetics with dry eye had duration of disease 5 to 10 years .39 patients had Tear Break Up time <10 sec, 25 patients had Tear Meniscus Height <0.25mm and 36 patients had Schirmers I test<10mm.Diabetics with dry eyes had average RBS of 179.63+57.28 and PPBS of 247.75+88.39 mg/dl. These values were more when compared to diabetics with no dry eye. CONCLUSION: Early ocular examination in Diabetic patients and good glycemic control should be done considering increased incidence of dry eyes.This should be an integral part of the assessment of diabetic eye disease so as to improve the patient's comfort and to prevent or minimize further structural damage to the ocular surface.


2018 ◽  
Vol 29 (6) ◽  
pp. 645-653 ◽  
Author(s):  
Ammar El Ameen ◽  
Guillaume Vandermeer ◽  
Raoul K Khanna ◽  
Pierre-Jean Pisella

Purpose: Preservatives in glaucoma medications have been associated with ocular toxicity. We compared ocular signs and symptoms in patients with open-angle glaucoma or ocular hypertension treated in monotherapy with preserved or preservative-free prostaglandin analogues. Methods: Observational cross-sectional clinical study in real life. 82 patients treated for at least 6 months with prostaglandin analogue were assessed for intraocular pressure, ocular symptoms and ocular signs including conjunctival hyperaemia, tear break-up time and tear meniscus height measured using objective and non-invasive methods (OCULUS Keratograph 5M). Patients presenting with symptoms of ocular toxicity with preserved prostaglandin analogues were switched to preservative-free latanoprost, and a second assessment was processed 6 months after. Results: At inclusion, 30 (36.6%) patients were treated with preservative-free latanoprost, 25 (30.5%) with preserved latanoprost, 16 (19.5%) with preserved travoprost and 11 (13.4%) with preserved bimatoprost. Patients treated with preservative-free latanoprost reported significantly less ocular symptoms upon instillation (mainly burning) and between instillations than patients treated with preserved prostaglandin analogues. The mean conjunctival hyperaemia (limbal + bulbar) was significantly lower with preservative-free latanoprost (2.08 ± 0.55) compared to preserved latanoprost (2.50 ± 0.7, p = 0.0085), preserved travoprost (2.67 ± 0.82, p = 0.0083) and preserved bimatoprost (2.68 ± 0.67, p = 0.0041). There were no relevant between-group differences in mean tear meniscus height and break-up time. Ocular symptoms and conjunctival hyperaemia improved when preserved prostaglandin analogues were switched to preservative-free latanoprost for 6 months while intraocular pressure reduction was maintained. Conclusion: Overall, this study suggests a better subjective and objective ocular tolerance when patients were treated with preservative-free latanoprost than with other preserved prostaglandin analogues monotherapy. Switching to preservative-free latanoprost maintained intraocular pressure at the same level as preservative prostaglandin analogue, but improved ocular surface tolerance.


2018 ◽  
Vol 28 (6) ◽  
pp. 670-676
Author(s):  
Ilkay Kilic Muftuoglu ◽  
Maria Laura Gomez ◽  
Natalie Afshari ◽  
Dirk-Bartsch Uwe ◽  
Amit Meshi ◽  
...  

Purpose: Herein, we describe a novel finding which appears as a reticular pattern on multicolor confocal scanning laser ophthalmoscopy image during routine imaging of retina and we aim to show whether there is an association between this pattern and dry eye findings. Materials and methods: A total of 162 eyes of 81 patients that were scheduled for a routine retinal imaging by scanning laser ophthalmoscopy at a vitreoretinal practice underwent dry eye evaluation including corneal and conjunctival lissamine green staining, fluorescein staining, tear break-up time, and tear meniscus height measurement before acquiring any images. Then, multicolor images were taken and graded for the severity of reticular pattern. Results: Among 150 eyes of 81 patients with gradable multicolor imaging, 45 eyes (30%) had some reticular pattern on multicolor image. Severity of reticular pattern on multicolor imaging was significantly correlated with total lissamine score (rho = 0.378, p = 0.007) and tear meniscus height (rho = −0.408, p = 0.011). Furthermore, they were found to be the best set of predictors for the severity pattern on multicolor imaging (odds ratio = 1.30, 95% confidence interval = 1.01–1.37, p = 0.027 and odds ratio = 0.25, 95% confidence interval = 0.128–0.342, p < 0.001, respectively). Conclusion: Reticular pattern seen on multicolor image while acquiring retinal images using scanning laser ophthalmoscopy may be related to tear film instability. Further modulations of the scanning laser ophthalmoscopy instrument will likely improve this indicator of dry eye syndrome.


2021 ◽  
pp. 22-24
Author(s):  
V. Meenakshi ◽  
Saswathi Bhushan ◽  
T. Jyothirmayi

AIM: To evaluate tear lm status in cases of Parkinson's Disease and compare with a study group METHODS:50 patients of Parkinson's Disease and 50 age-gender matched controls were included in this study. Both groups underwent detailed history regarding dry eye symptoms,tear lm evaluation using slit-lamp bio-microscopy, uorescein staining, tear meniscus height, tear breakup time, Schirmer test, blink rate. Statistical analysis was done with Statistical Package for Social Sciences [SPSS] - Version 22.0 Released 2013 version RESULTS: There was a signicant difference between the various groups in terms of distribution of Meibomian Gland Disease 72.0% of the Case group as compared to 40% of control group had Meibomian Gland Disease,There was a signicant difference between the various groups in terms of distribution of Tear Meniscus Height <0.25Mm , Case group had the larger proportion of Tear Meniscus Height of <0.25Mm .There was a signicant difference between the various groups in terms of distribution of Tear Breakup Time <5 Sec, Schirmer's Test <5Mm in 5Min and Blink Rate <10 .There was no signicant difference between the various groups in terms of distribution of corneal Staining and dry eye symptoms. CONCLUSION: The study concluded that patient of Parkinson's disease had higher dry eye symptoms and Meibomian gland disease Also they have reduced Tear miniscus height,Tear lm break up time,Schirmer test I and Blink rate


2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Tong Lin ◽  
Lan Gong ◽  
Xiaoxu Liu ◽  
Xiaopeng Ma

Dry eye is highly prevalent and has a significant impact on quality of life. Acupuncture was found to be effective to treat dry eye. However, little was known about the effect of acupuncture on different subtypes of dry eye. The objective of this study was to investigate the applicability of tear meniscus assessment by Fourier-domain optical coherence tomography in the evaluation of acupuncture treatment response in dry eye patients and to explore the effect of acupuncture on different subtypes of dry eye compared with artificial tear treatment. A total of 108 dry eye patients were randomized into acupuncture or artificial tear group. Each group was divided into three subgroups including lipid tear deficiency (LTD), Sjögren syndrome dry eye (SSDE), and non-Sjögren syndrome dry eye (Non-SSDE) for data analysis. After 4-week treatment, the low tear meniscus parameters including tear meniscus height (TMH), tear meniscus depth (TMD), and tear meniscus area (TMA) in the acupuncture group increased significantly for the LTD and Non-SSDE subgroups compared with both the baseline and the control groups (allPvalues < 0.05), but not for the SSDE. Acupuncture provided a measurable improvement of the tear meniscus dimensions for the Non-SSDE and LTD patients, but not for the SSDE patients.


2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Mohd Hafidz Ithnin ◽  
Azrin Esmady Ariffin ◽  
Khairidzan Mohd Kama

Introduction: The clinical evaluation of the three layers of tear film is still poorly described. The purpose of this study is to evaluate the value of aqueous assessment in diagnosing dry eye. Materials and method: Schirmer test with anaesthesia (STA) and tear meniscus height (TMH) measurement were conducted on non-dry eye (NDE) and dry eye (DE) subjects in this cross-sectional study. The NDE and DE subjects were classified using two types of classification; classification 1 and classification 2. Results: 321 subjects with 642 eyes were recruited in the study. STA was significantly correlated with TMH (r = 0.24, p < 0.001) in all 642 eyes. The comparison between nondry and dry eye subjects in STA and TMH were not significantly different (p > 0.05) if the Classification 1 was used to define dry eye. In Classification 2, there were significantly different between NDE (12.5 ± 8.2 mm) and DE (3.4 ± 0.8 mm) subjects in STA (p < 0.001). Similar trend was also depicted in TMH based on the definition of dry eye stated in Classification 2 (NDE = 0.45 ± 0.20 mm, DE = 0.39 ± 0.14 mm; p < 0.05). Conclusion: The value of STA and TMH were lower significantly in dry eye subjects. However, the significant outcomes were only demonstrated if the clinical signs of dryness were used in the definition of dry eye.


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