A clinical study on dry eye

The purpose of this study is to evaluate prevalence risk factors, symptoms, signs, objective tests of dry eye diagnosis in patients attending to Out Patient Department of Mamata General Hospital, Khammam.All patients presenting with dry eye symptoms to ophthalmology outpatient department, Mamata Medical College over a period of one and half year. A prospective study was conducted for a period of 18 months from June 2018 to Jan 2021 among patients attending ophthalmology Out Patient Department unit with symptoms of dry eye. Among the 100 patients studied, prevalence of dry eye was found to be as high as 23%.The prevalence of dry eye increased with increase in age and was significantly higher among people more than 40 years of age. Prevalence was higher among females when compared to males. Conjunctival congestion was found to be reliable sign of dry eye with a strong positive association. Foreign body sensation was found to be the most common symptom associated with dry eye. People with refractive errors, with or without history of spectacle use, had a higher incidence of dry eye compared to emmetropes. OSDI was found to be reliable measure of dry eye symptoms. Higher, scores of OSDI, indicating severe dry eye, correlated well with diagnostic tests for dry eye. TBUT test showed a high sensitivity and specificity, followed by Schirmers test and impression cytology. Impression cytology was a reliable measure for detecting ocular surface changes. Many patients showed grade 2 or 3 changes. These changes were more among those with schirmer less than 5mm. Dry eye evaluation with an appropriate and standard questionnaire along with standard tests for dry eye helps in diagnosis and treatment. This will go a long way in the effective and successful management of patients with dry eye, specially so as the disease is chronic and needs long term treatment. Early and appropriate management will provideocular comfort and satisfaction with a better quality of life.

Impression Cytology Screening for Ocular Surface changes in various forms of Vernal Keratoconjunctivitis in Subtropical Central Zone in India

Introduction: Vernal keratoconjunctivitis (VKC) is a chronic recurrent allergic disorder of the eye more common in warm and dry climates like central India. Chronic and recurrent nature of disease requires long duration of treatment which leads to changes in ocular surface leading to cytomorphological distortion of goblet cells, that can be evaluated by impression cytology. Clinical presentation and impact of disease on cytomorphology of ocular surface was analysed in various forms of the VKC. The objective of this study was to find correlation of clinical profile and cytomorphological changes in ocular surface in patients with various forms of vernal keratoconjunctivitis. Materials and methods: This cross sectional study analysed 120 eyes of 60 patients of various forms of vernal keratoconjunctivitis. Detailed history was taken along with complete ophthalmic examination. Vernal keratoconjunctivitis was graded as per Gokhale et al classification. Impression cytology for goblet cell morphology and metaplasia according to classification given by Saini et al was done. Cytological changes were noted for different age groups, duration of disease, and severity of disease. Results: Vernal keratoconjunctivitis was seen more commonly in males and in the second decade of life which shows a changing trend towards higher age. Milder forms were more commonly present than moderate and severe forms. Mostly Grade 2 changes were seen on impression cytology. Conclusion: Increasing severity, duration of disease and age of presentation was directly proportionate to greater cytological changes on ocular surface.