Clinical Analysis of Dry Eye Syndrome According to Anterior Displacement of the Marx Line

Purpose: To evaluate the clinical characteristics of patients with dry eye syndrome according to anterior displacement of the Marx line.Methods: This retrospective study involved 127 eyes in 127 patients with dry eye, who were divided into three groups: group 1, aqueous-deficient, including Sjögren syndrome; group 2, meibomian gland dysfunction (MGD) dry eye; and group 3, other tear layer instability. A detailed assessment was conducted, involving the Ocular Surface Disease Index, corneal fluorescein staining (score: 0-15), conjunctival Lissamine green staining (score: 0-12), measurement of tear breakup time, and Schirmer’s test.Results: The proportion of patients with MGD was highest in the group with anterior displacement of the Marx line (p < 0.05). The correlation between anterior dislocation of the Marx line and Schirmer’s test, an objective indicator of dry eye syndrome, was significantly weaker when there was anterior displacement of the Marx line.Conclusions: Anterior dislocation of the Marx line was more common in patients with MGD. The Marx line is a useful marker for diagnosing MGD.

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Dry eye and Meibomian gland dysfunction evaluation in sarcoidosis patients

European Journal of Ophthalmology ◽

10.1177/11206721211006579 ◽

2021 ◽

pp. 112067212110065

Author(s):

Pelin Kiyat ◽

Melis Palamar ◽

Bengu Gerceker Turk

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Tear Film ◽

Surface Damage ◽

Meibomian Gland ◽

Drop Out ◽

Meibomian Gland Dysfunction ◽

Ocular Surface Disease Index ◽

Group 2 ◽

Group 1

Purpose: To analyze the relation between Meibomian gland dysfunction, dry eye, and sarcoidosis. Materials and Methods: Twenty eyes of 10 sarcoidosis patients (Group 1) and 20 left eyes of 20 age-sex matched healthy volunteers (Group 2) were included. Presence of dry eye was evaluated with Schirmer 1 test, tear film break-up time (T-BUT), Oxford scale scoring, Ocular Surface Disease Index (OSDI) score assessments. A slit-lamp biomicroscope infrared filter (Topcon, SL-D701, IJssel, The Netherlands) was used to evaluate Meibomian glands. The drop-out ratio according to meibography was scored for each eyelid from grade 0 (no loss) through grade 3 (lost area >2/3 of the total Meibomian gland area). Results: Among dry eye tests mean Schirmer 1 and T-BUT values were lower and OSDI score was higher in Group 1 compared to Group 2 and the differences were statistically significant ( p = 0.017, p = 0.039, p = 0.003, respectively). In addition, the upper, lower and total meiboscores were statistically significantly higher in Group 1 ( p = 0.047, p = 0.003, p = 0.005, respectively). Conclusion: A significantly higher presence of dry eye and Meibomian gland drop out ratios was detected in sarcoidosis patients. It is important to monitor sarcoidosis patients for dry eye and Meibomian gland dysfunction and when detected, to treat adequately to prevent ocular surface damage.

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The assessment of lacrimal film condition in patients with dry eye syndrome during therapy

Russian Ophthalmological Journal ◽

10.21516/2072-0076-2019-12-4-13-18 ◽

2019 ◽

Vol 12 (4) ◽

pp. 13-18

Author(s):

F. A. Bakhritdinova ◽

E. N. Bilalov ◽

B. A. Oralov ◽

S. Sh. Mirrakhimova ◽

J. O. Safarov ◽

...

Keyword(s):

Dry Eye ◽

Treatment Process ◽

Comparison Group ◽

Tear Film ◽

Meibomian Gland ◽

Dry Eye Syndrome ◽

Control Group ◽

Ocular Surface Disease Index ◽

Meibomian Glands ◽

Quality Imaging

To evaluate the efficiency of modern imaging methods of meibomian gland ducts and determine the tear film break-up time (TFBUT) during therapy in patients with the secondary dry eye syndrome (SDES) of allergic etiology.Material and methods. 66 patients aged 38.0 ± 1.5 with SDES after allergic conjunctivitis were examined. The patients were divided into 2 groups depending on the therapy administered. The main group (n = 33) received Oftalron as tear replacement therapy for 20 days, 2 drops, 2 times a day. The patients of the comparison group (n = 33) used Super Optic HydroBalance for 20 days, 2 drops 2 times a day. The control group consisted of 25 healthy subjects without eye pathology. All subjects underwent Schirmer’s tests I and II, as well as TFBUT and meibography on an automatic refractokeratometer HRK-9000A (Huvitz, Korea).Results. In both SDES groups, a significant decrease of the OSDI (Ocular Surface Disease Index) in the treatment process was observed (p ≤ 0.05), which corresponded to low intensity of SDES symptoms. In both groups morphofunctional changes of meibomian glands of 1 and 2 stages prevailed. The most significant dynamics was observed in TFBUT results, they were significantly lower in comparison with the similar indexes in the patients of the control group.Conclusion. Specific modes of autorefractokeratometer HRK-9000A allow receiving objective information about the condition of the tear film and high-quality imaging of meibomian glands, which allow expanding possibilities of complex diagnostics of various forms of DES.

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Evaluation of Dry Eye after Implantable Collamer Lens Surgery

Ophthalmic Research ◽

10.1159/000511197 ◽

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

Objectives: To evaluate dry eye (DE) and associated meibomian gland dysfunction parameters after Implantable Collamer Lens (ICL) surgery. Methods: 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. Results: 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. Conclusions: ICL implantation has a bad influence on the ocular surface and MG functions. The influence may be more obvious in patients with existing DE.

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Dry Eye Syndrome-Related Quality of Life in Glaucoma Patients

European Journal of Ophthalmology ◽

10.1177/112067210901900409 ◽

2009 ◽

Vol 19 (4) ◽

pp. 572-579 ◽

Cited By ~ 78

Author(s):

Gemma Caterina Maria Rossi ◽

Carmine Tinelli ◽

Gian Maria Pasinetti ◽

Giovanni Milano ◽

Paolo Emilio Bianchi

Keyword(s):

Quality Of Life ◽

Dry Eye ◽

Ocular Surface ◽

Cross Sectional Study ◽

Dry Eye Syndrome ◽

Control Group ◽

Ocular Surface Disease Index ◽

Symptom Scale ◽

Cross Sectional

Purpose To verify the presence of dry eye syndrome (DES) in treated patients with glaucoma and to analyze DES's impact on the patients' quality of life (QOL) versus the control group. Methods In this observational cross-sectional study, 61 patients were enrolled at a clinical practice. Patients were divided into three groups by number of glaucoma drops instilled per day (G1=1 drop/day, G2=2 drops/day, G3=3 drops/day). A control group of 20 subjects was also selected (G0). All subjects were submitted to a complete ocular examination (including tear function and ocular surface status) and completed the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ), Glaucoma Symptom Scale (GSS) questionnaire, and Ocular Surface Disease Index (OSDI). DES was defined as presence of punctate keratitis and decreased break-up time. Statistical analysis was performed applying the Kruskal-Wallis analysis of variance and Mann-Whitney U tests (to compare median values between groups) as well as the χ2 and Fisher test (to verify significant differences). Results A total of 40% of G3 and 39% of G2 patients presented DES versus 11% of G1 and 5% of G0 (p=0.01). QOL was significantly influenced and altered (NEI-VFQ 25 total mean and GSS total mean and symptoms average: p=0.0085, p=0.006, and p=0.03, respectively). OSDI pointed out differences by group: 26% of G2 and 15% of G3 presented moderate OSDI and 15% of G3 and 8.7% of G2 severe OSDI (p>0.05). Conclusions Patients with topically treated glaucoma present DES more often than a similar control group (p=0.01). The presence of DES negatively influences the patient's QOL. The patients with glaucoma's ocular surface status should be evaluated regularly to ensure the timely detection and treatment of pathologic signs on the ocular surface.

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Massive Demodicosis of the Eyes in a Patient with Sjögren Syndrome: A Case Report

Acta Parasitologica ◽

10.1007/s11686-020-00297-w ◽

2020 ◽

Author(s):

Marta Ziaja-Sołtys ◽

Magdalena Kołodziejczyk ◽

Beata Rymgayłło-Jankowska ◽

Dominika Wróbel-Dudzińska ◽

Ewa Suchodoła-Ratajewicz ◽

...

Keyword(s):

Dry Eye ◽

Meibomian Gland ◽

Sjögren Syndrome ◽

Dry Eye Syndrome ◽

Ocular Infection ◽

Sjogren Syndrome ◽

Corneal Perforation ◽

Therapeutic Success ◽

Immune Systems

Abstract Purpose Demodex mites infestation, typically asymptomatic, is a problem for patients with weakened immune systems because it often takes the form of symptomatic, massive infection. The Demodex mites play an important role in the occurrence of a range of eye surface diseases such as Demodex blepharitis, Meibomian gland dysfunctions, conjunctivitis and corneal changes. The ocular infection is closely related to the systemic invasion. Our goal was to minimize infestation and alleviate the symptoms of massive demodicosis so as to prevent further damage to the cornea. Methods Our research note involves a 61-year old woman diagnosed with secondary Sjögren syndrome due to rheumatoid arthritis. On the background of the autoimmune disease, corneal perforation of the left eye occurred that was cured by surgery. Then during the follow-up visit the patient was found (microscopically) massively infected with Demodex mites and the developed symptoms were particularly severe. Results Adequate dry eye syndrome and massive demodicosis therapy significantly reduced the number of Demodex mites and improved the patient’s condition. Conclusion We would like to draw the attention of the physicians of different specialties that special care should be taken with respect to the therapy of dry eye syndrome and ocular demodicosis in patients with immunological disorders to achieve therapeutic success and avoid particularly dangerous consequences of these diseases.

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Intense pulsed light plus meibomian gland expression versus intense pulsed light alone for meibomian gland dysfunction: A randomized crossover study

PLoS ONE ◽

10.1371/journal.pone.0246245 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0246245

Author(s):

Kyoung Yoon Shin ◽

Dong Hui Lim ◽

Chan Hee Moon ◽

Byung Jin Kim ◽

Tae-Young Chung

Keyword(s):

Meibomian Gland ◽

Treatment Session ◽

Intense Pulsed Light ◽

Meibomian Gland Dysfunction ◽

P Value ◽

Pulsed Light ◽

Ocular Surface Disease Index ◽

P Values ◽

Group 2 ◽

Group 1

Purpose To investigate the comparative efficacy of intense pulsed light (IPL) therapy alone with that of IPL plus meibomian gland expression (MGX) for meibomian gland dysfunction (MGD). Methods This is a prospective randomized crossover clinical trial. Sixty patients were enrolled and randomly assigned to two groups. All of patients underwent four treatment sessions in total, which were two weeks apart. Group 1 underwent two sessions of IPL therapy with MGX, as well as two sessions of IPL alone. Group 2 received two sessions of IPL therapy alone, and two sessions of IPL therapy with MGX. The following parameters were measured at baseline (BL), 2 weeks after the second treatment session (FU1), and 2 weeks after the fourth treatment session (FU2): tearfilm break-up time (BUT), Oxford grade for corneal staining, meibomian gland expressibility (MGE), meibum quality (MQ), and ocular surface disease index (OSDI). The separate effect of MGX on improvement of MGD parameters was evaluated using generalized estimating equation (GEE). Results The mean age of the participants was 57.52 ± 10.50 years. The BUT, Oxford grade, MGE, MQ, and OSDI of both groups improved significantly (from baseline) by the end of four treatment sessions (FU2 compared to BL; all p-values <0.05). The MGE and MQ significantly improved after the first and second treatment sessions (FU1 compare to BL; all p-values < 0.001). However, the improvement was not statistically significant after the third and fourth treatment sessions (FU2 compared to FU1; p-value of 0.388 for MGE and 0.645 for MQ in group 1, 0.333 for MGE and 0.333 for MQ in group 2). The IPL plus MGX therapy produced greater improvements in the BUT scores than did IPL therapy alone (p = 0.003 by GEE). In contrast, the Oxford grade, MGE, MQ, and OSDI were not influenced by the addition of MGX to IPL (p = 0.642, 0.663, 0.731, and 0.840, respectively by GEE). Conclusion IPL therapy effectively improves the subjective symptoms and objective ocular findings of MGD. MGX enhanced the improvement of BUT driven by IPL therapy. The meibomian gland function (MGE and MQ) recovers faster in response to IPL therapy than did the other parameters.

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Efficacy of Self-Administration of a Personal Mechanical Eyelid Device for the Treatment of Dry Eye Disease, Blepharitis and Meibomian Gland Disease

Journal of Dry Eye Disease ◽

10.22374/jded.v3i1.25 ◽

2020 ◽

Vol 3 (1) ◽

pp. e1-e5

Author(s):

David Schanzlin ◽

John Olkowski ◽

John Coble ◽

Wendy Gross ◽

Michael Dash

Keyword(s):

Adverse Events ◽

Dry Eye ◽

Training Session ◽

Meibomian Gland ◽

Dry Eye Disease ◽

Eye Disease ◽

Self Administration ◽

Staining Score ◽

Meibomian Gland Disease ◽

At Home

PurposeA prospective study to evaluate the safety and efficacy of a novel mechanical eyelid device (NuLidsTM by NuSight Medical, LLC, Rancho Santa Fe, CA) used at home for the treatment of dry eye disease (DED), blepharitis (anterior and posterior) and meibomian gland disease (MGD). MethodsSeventy-four (74) eyes of thirty-seven (37) patients were self-treated with the NuLidsTM device at home. Inclusion criteria included blepharitis, MGD and/or DED. After an initial training session, each eyelid was treated for 15 seconds (total of 1 minute per treatment session per day). The following tests were collected before the first treatment and after the final treatment: OSDI survey, BCVA, Tear Osmolarity Test (Tear Lab), Tear Break Up Time (TBUT), Meibomian Gland Score (MGS), Meibomian Glands Yielding Liquid Secre-tions (MGYLS), Sicca Ocular Staining Score. Satisfaction with treatment survey was taken after treatment. ResultsAll measured parameters had a statistically significant improvement. Symptoms improved based on an average decrease in OSDI score from 54.2 ± 19.5 (mean ± SD) to 26.7 ± 18.4 (P < 0.001). Tear osmolarity improved from 315 ± 15.7 to 306 ± 13.9 (P = 0.002). TBUT was noted to improve from pre-treatment of 4.8 ± 1.7 seconds to post-treatment of 7.9 ± 4.1 seconds (P < 0.001). MGS improved from 8.9 ± 5.1 to 7.0 ± 5.9 (P = 0.01). MGYLS improved from 8.7 ± 6.2 to 15.8 ± 6.9 (P = 0.002). Sicca Ocular Staining Score improved from 2.7 ± 2.1 to 1.4 ± 1.5 (P = 0.002).There were no adverse events. No corneal or conjunctival trauma. No patients dropped out of the trial due to discomfort. 91% of participants agreed or strongly agreed that the device was easy and convenient to use. Of those previously using manual lid scrubs, 82% felt the NuLids device was easier and more comfortable to use. 89% described little or no discomfort. 95% were satisfied or very satisfied with the overall treatment. ConclusionsA mechanical device was safely used by patients at home for 1 minute daily for 30 days to treat DED, blepharitis, and MGD. There was a statistically significant improvement in signs and symptoms of DED as shown by improved OSDI, tear osmolarity, TBUT, MGS, MGYLS, and Ocular Staining Score. High patient satisfaction along with the low risk of adverse events supports the use of this device as a valid tool to treat DED, blepharitis, and MGD.

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Pellevé™ vs Lipiflow™ MGD-Related Dry Eye Treatment Study: The ThermaLid™ Procedure

Journal of Dry Eye Disease ◽

10.22374/jded.v1i1.2 ◽

2018 ◽

Vol 1 (1) ◽

pp. e11-e21

Author(s):

Edward Hall Jaccoma ◽

Craig Litherland ◽

Andrew Jaccoma ◽

Aseef Ahmed

Keyword(s):

Dry Eye ◽

Randomized Study ◽

Meibomian Gland ◽

Treatment Modalities ◽

Ocular Surface Disease Index ◽

Non Invasive ◽

Standard Patient ◽

Significant Difference ◽

Surface Staining ◽

Time Point

Objective: To assess the safety and efficacy of the Pellevé Wrinkle Treatment System as compared to LipiFlow, for treatment of dry eye syndrome due to meibomian gland dysfunction (MGD). Materials and Methods: In this split face, randomized study, ten patients who met specific criteria for inclusion were followed after treatment with the Pellevé Wrinkle Reduction System (what the authors have dubbed the "thermaLid Procedure") and a standard LipiFlow procedure performed the same day, with 1 and 3 months follow-up. Pre- and post- treatment MGD was assessed using a variety of subjective and objective measurements. Results: The function of the meibomian glands improved significantly from baseline to 3 months for both thermaLid and Lipiflow treated eyes, with no significant difference between them, as measured by MGE grading, wax plug scoring, Standard Patient Evaluation of Eye Dryness (SPEED) and Ocular Surface Disease Index (OSDI) scoring. A significant change in conjunctival staining was found after both treatments at the 1-month time point but not the 3-month time point. thermaLid but not Lipiflow treatment, significantly decreased MARX line measurements at 3-months. Lipiview, Non-Invasive Tear Breakup Time (NITBUT), corneal surface staining, Tear Osmolarity, and anesthetic Schirmer's testing did not show statistically significant improvement, nor differences between treatment modalities. Conclusions: thermaLid treatment of the eyelids appears to show efficacy similar to Lipiflow treatment in reducing symptoms, reducing wax plugging and improving the number of functioning MGs as well as reducing conjunctival staining in MGD related dry eye disease.

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Crosslinked hyaluronic acid with liposomes and crocin for management symptoms of dry eye disease caused by moderate meibomian gland dysfunction

10.21203/rs.2.17536/v1 ◽

2019 ◽

Author(s):

José-María Sánchez-González ◽

Concepción De-Hita-Cantalejo ◽

María Carmen Sánchez-González

Keyword(s):

Hyaluronic Acid ◽

Dry Eye ◽

Meibomian Gland ◽

Dry Eye Disease ◽

Eye Disease ◽

Schirmer Test ◽

Ocular Surface Disease Index ◽

Artificial Tear ◽

Before And After ◽

Contralateral Eye

Abstract Background: To study the effect of uncrosslinked and crosslinked hyaluronic acid combined with other artificial tear components in patients with dry eye caused by moderate meibomian gland dysfunction.Method: Prospective, single-blind, contralateral eye study. Fifty eyes were analyzed (25 patients). Eye selection for each tear type was random, and the eye drop formulations Aquoral Forte® (artificial tear A) and Aquoral Lipo® (artificial tear B) were used. The determined dosing schedule was three times a day for six weeks, and the study participants underwent a clinical examination before and 45 days after lubricant treatment. The Schirmer test, tear breakup time (TBUT) test, and Ocular Surface Disease Index (OSDI) questionnaire were applied before and after instillation period with both types of artificial tears. Results: On the Schirmer test, a significant improvement was obtained with both tear A (p < 0.01) and tear B (p < 0.01). On the TBUT test, a significant improvement was obtained with tear A (p < 0.01) and tear B (p < 0.01). The OSDI score significantly decreased after instillation period with both artificial tear types (p < 0.01). Conclusion: Uncrosslinked hyaluronic acid combined with other components, such as tamarind seed polysaccharide, and crosslinked hyaluronic acid combined with liposomes and crocin are effective for management symptoms of dry eye disease.

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