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ABSTRACT Purpose: To investigate the association of pre--photorefractive keratectomy Schirmer-1 test value with post--photorefractive keratectomy central corneal epithelial thickness, ocular surface disease index score, and uncorrected distance visual acuity. Methods: Patients were categorized according to preoperative Schirmer-1 value: the normal Schirmer Group (n=54; Schirmer-1 test value, >10 mm) and the low Schirmer Group (n=52; Schirmer-1 test value, between 6 and 10 mm). We analyzed ablation depth, visual acuity, result of Schirmer-1 test (with anesthesia), tear film break-up time, ocular surface disease index score, central corneal epithelial thickness, and spherical equivalent refraction. Results: We found significant differences between the groups in Schirmer-1 test value, tear film break-up time, and ocular surface disease index score, both preoperatively and postoperatively (p<0.001). The preoperative central corneal epithelial thicknesses of the two groups were similar (p>0.05). After photorefractive keratectomy, the Schirmer-1 test value and spherical equivalent refraction decreased in both groups (p<0.05), and ocular surface disease index scores and central corneal epithelial thickness values increased in the low Schirmer Group (p<0.001) but not in the normal Schirmer Group (p>0.05). The postoperative central corneal epithelial thicknesses of the low Schirmer Group were significantly higher than those of the normal Schirmer Group (p<0.001). Postoperative uncorrected distance visual acuity did not differ significantly between the two groups (p>0.05). Conclusions: In patients with low Schirmer-1 test values before photorefractive keratectomy, the corneal epithelium thickened and ocular surface complaints increased during the postoperative period. However, changes in the corneal epithelium did not affect the postoperative uncorrected distance visual acuity. To reduce postoperative problems on the ocular surface in these patients, we recommend that dry eye be treated before photorefractive keratectomy.
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Purpose: This present prospective, cross-sectional study aims to comprehensively evaluate the ocular surface in asymptomatic patients with diffuse blebs after trabeculectomy versus chronic anti?glaucoma medication use and compare it with the age?matched normal population. Methods: Objective clinical evaluation was done by tear film break?up time (TBUT) and Schirmer’s test (ST) in the three groups– trabeculectomy >6 months with a diffuse bleb (Wurzburg bleb classification score ?10), chronic anti?glaucoma medication (AGM >6 months) group, and normal population. In all groups, tear film osmolarity was checked with the TearLab® device (TearLab Corp., CA, USA), and subjective evaluation was performed by administering Ocular Surface Disease Index (OSDI) questionnaire. Patients already on chronic lubricants or any other drug for the treatment of dry eyes (viz. steroids, cyclosporin) or having symptoms suggestive of an abnormal ocular surface, who had undergone refractive or intraocular surgery, and contact lens users were excluded. Results: In total, 104 subjects/eyes were recruited over 6 weeks. Thirty?six eyes recruited in the trab group were compared with 33 eyes studied in the AGM group, and both these groups were compared to 35 normal eyes. When compared to normals, TBUT and ST were significantly lower (P = 0.003 and 0.014) and osmolarity and OSDI were statistically significantly higher (P = 0.007 and 0.003) in the AGM group, whereas only TBUT was statistically significantly different (P = 0.009) when the trab group was compared to normals. Also, when the trab group was compared to the AGM group, ST was found to be higher (P = 0.003) and osmolarity was lower (P = 0.034). Conclusion: To conclude, ocular surface is affected even in asymptomatic patients on AGM but near normalcy is possible following trabeculectomy when blebs are diffuse.
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Purpose: Dry eye disease (DED) is because of a decrease in the tear film’s volume or a change in the composition of tears. Evaporative dry eye is the most common type, which is due to meibomian gland dysfunction (MGD). In this study, the morphology of meibomian glands was evaluated in all kinds of dry eyes to look for any loss of meibomian glands, assess the function of remaining glands, and investigate the relationship between anatomy, function, and severity of DED. Methods: A total of 300 patients were included in the study, with 150 eyes in the study group and 150 in the control group. Meibomian gland morphology was assessed by examining the tarsal plate after everting the eyelids. Tear film function was evaluated using tear film break?up time (TBUT) and Schirmer’s test (SCH I and II). Meibomian gland morphology was examined with a slit?lamp under magnification, a transilluminator using a small light emitting diode (LED) bulb, and non?contact meibography using an auto refracto?keratometer (ARK). Results: Females had a higher prevalence of dry eyes in our study. In all, 103 eyes (68.6%) in the study group had evaporative dry eye, making it the most prevalent type. Among the 150 controls, 104 controls with 69.3% had no dry eye symptoms, and in those with symptoms, the evaporative type was the most common, with a 28% prevalence. Conclusion: TBUT should be performed in all patients with detectable MG abnormality. Meibography has high specificity and sensitivity to diagnose MGD and in turn dry eyes and should be considered a routine screening modality.
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Background: Most Indians today own one or more mobile phones. The average time of phone usage per person per day is 4.8 h and the excess usage of mobile phone is an emerging cause of dry eye. Although some studies have established this relation, not many studies focus on South India. Our study aims to highlight the South Indian population. Aim and Objective: To study the prevalence of dry eye among medical students of 18–25 years. Materials and Methods: This is a cross-sectional study, whose participants are undergraduate medical students, both males and females, between 18 and 25 years. Schirmer’s test was done for each candidate after answering an Ocular Surface Disease Index questionnaire. Results: The most frequent symptom reported by the participants at the time of answering the questionnaire was soreness and irritation of the eye (8%). The most common long-term symptom reported was burning and watering of eyes of tolerable severity (27%). Some participants experienced uncomfortable and bothersome eye fatigue. Conclusion: Dry eye in the form of symptoms of both dryness of eye and reflex epiphora is present in the population under study. About 76% of the study population use their phones for over 3 hours a day. The soreness and irritation of eyes, watering and burning of eyes are attributed to the mobile phone usage for more than 6 hours per day.
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Aims: To compare the diagnostic values of the OSDI, the Schirmer’s and tear film breakup time test to check for dry eye in healthy adult students using computers and contact lenses.Methodology: Our sample consisted of hundred (100) eyes from fifty (50) healthy adults aged 18-24 years students at the University of West Attica (25 participants were contact lens wearers, while the remaining 25 were not). All participants were exposed to a computer screen or a mobile screen. Qualitative tear measurement was performed with Tear Break-Up Time Test (TBUT), quantitative measurement of tears with Schirmer Test and use of the Ocular Surface Disease Index (OSDI).Results: During the analysis of the results, it was found that OSDI was inversely proportional to the TBUT test and the Schirmer test. 60% did not have dry eye, 34% had a mild dry eye, 4% had moderate dry eye and 2% had severe dry eye. ? statistically significant relationship existed between OSDI and the other variables as well as the TBUT test with Schirmer test (p-value <0.05).Conclusion: The OSDI questionnaire, used in conjunction with the TBUT test, was easy to perform and could be helpful in supporting the diagnosis of dry eye syndrome.
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Purpose: A study of the association between vitamin D deficiency and dry eye syndrome (DES) in the Indian population. Methods: This was a cross?sectional, hospital?based observational study. Sixty patients diagnosed with vitamin D deficiency (<20 ng/dl) who met the inclusion criteria were sent to the Eye OPD from the Endocrinology OPD (case) were compared to 60 subjects with normal vitamin D levels (?20 ng/dl) who attended the Eye OPD (controls). The examination of the tear film was done using Whatman filter paper in Schirmer test I and Schirmer test I (with anesthesia). The tear film break?up time (TFBUT) was determined by slit?lamp examination using the fluorescein stain, and scoring using the ocular surface disease index (OSDI) was done. Results: A significant difference in the mean values of Schirmer I and Schirmer I test (with anesthesia) (P < 0.001) was seen between the case and control groups. A significant difference in the mean values of TFBUT (P < 0.001) and OSDI scores (P < 0.01) was also seen between the two groups. Conclusion: A positive association was found between vitamin D deficiency and dry eye on comparing the above parameters.
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Background: Dry eye is recognized as a growing public health problem and one of the most frequent reasons for visiting an ophthalmologist in middle and old age people. Objectives: To the best of our knowledge, very less study has been undertaken in central India on dry eye. The present study was designed to study clinical profile and to evaluate the true prevalence and risk factors of dry eye in central India. Materials and Methods: A total of 1562 participants aged 30 years or more visiting ophthalmology department in a tertiary care rural hospital enrolled in a study. Study duration was 18 months. The study design was a prospective, cross-sectional, and observational study. An ocular surface disease index (OSDI) questionnaire was administered to all participants and individuals with OSDI score greater than 12 were further evaluated with dry eye tests in sequence of tear break-up time, lissamine green staining, Schirmer-1 test, and slit-lamp examination for meibomian gland dysfunction. The participants with OSDI Score ≥13 were diagnosed to be having dry eye. The data were compiled and subjected to statistical analysis using SPSS v.17.0 software (SPSS Inc., Chicago, Illinois, USA). P < 0.05 was considered to be statistically significant. Results: Prevalence of dry eye in our study was 24.7%. Prevalence of lipid layer, aqueous layer, and mucin layer deficiency dry eye was 13.8%, 5.2%, and 7.8%, respectively. Increasing age, illiteracy, and menopause were the significant risk factors and female sex, urban habitat, and laborer and factory worker were insignificant risk factors for dry eye. Conclusion: Prevalence of dry eye in our study is higher than reported in literature in central India. Lipid anomaly dry eye was the most prevalent, followed by mucin layer deficiency and lastly aqueous tear deficiency.
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Introduction: Cataract is the major cause of blindness inthe developing world. Study aimed at evaluation of tearfilm stability and tear secretion after phacoemulsificationcompared with MSICS.Material and methods: This prospective comparativerandomized study was performed in a tertiary centre ofJharkhand between June 2018 to March 2019. 187 patientswith senile cataract were included in this study. Group A had110 patients undergoing MSICS and group B 77 patientsundergoing phacoemulsification. Dry eye symptoms(DES)characterizedby redness, burning, stinging, foreign bodysensation, photophobia. Corneal fluorescein staining wasperformed. Basal Schirmer test was performed for assessmentof aqueous tear production. Patients were examined postoperatively on 1st week, 4th week and 3rd month.Results: Out of 187 patients 103(55.08%) were male and84(44.91%) were female. Grade of DES increased significantly1 week after each procedure compared to pre-operative dataand remained increased after 4 weeks of surgery. After 3months the symptoms decreased and returned to baseline data.Conclusion: MSICS is as effective as phacoemulsificationwith no difference between both techniques regarding tearfilm stability and tear secretion.
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Introduction: Cataract is the major cause of blindness inthe developing world. Study aimed at evaluation of tearfilm stability and tear secretion after phacoemulsificationcompared with MSICS.Material and methods: This prospective comparativerandomized study was performed in a tertiary centre ofJharkhand between June 2018 to March 2019. 187 patientswith senile cataract were included in this study. Group A had110 patients undergoing MSICS and group B 77 patientsundergoing phacoemulsification. Dry eye symptoms(DES)characterizedby redness, burning, stinging, foreign bodysensation, photophobia. Corneal fluorescein staining wasperformed. Basal Schirmer test was performed for assessmentof aqueous tear production. Patients were examined postoperatively on 1st week, 4th week and 3rd month.Results: Out of 187 patients 103(55.08%) were male and84(44.91%) were female. Grade of DES increased significantly1 week after each procedure compared to pre-operative dataand remained increased after 4 weeks of surgery. After 3months the symptoms decreased and returned to baseline data.Conclusion: MSICS is as effective as phacoemulsificationwith no difference between both techniques regarding tearfilm stability and tear secretion.
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Objective: The objective of the study was to find the occurrence of meibomian gland dysfunction (MGD) and dry eye disorder in patients with type 2 diabetes mellitus (DM) and to assess the profile of MGD in type 2 DM patients.Materials and Methods: An observational case-control study was conducted on 100 type 2 diabetes patients and 100 controls who are attending ophthalmology outpatient department with distinct complaints, for example, correction of refractive error. Age and gender matching was done. Tear film evaluation was done for both the groups, lid margin abnormalities were noted under slit lamp biomicroscope, fluorescein staining of ocular surface performed, and pre-corneal tear film was observed for debris. Schirmer’s test as well as tear breakup time test was performed.Results: Of 100 diabetic patients, dry eye disorder was found in 56 (56%) cases, among which 24 patients had MGD. Twenty-four of 56 that is 42% of dry eye is credited to MGD. Of 100 non-diabetics, 15% had dry eye disorder, among which 6 cases had MGD.Conclusions: Diabetes can cause changes in ocular surface with respect to both qualitative and quantitative parameters. Diabetic patients are more susceptible for dry eye disorders when compared to normal subjects. In diabetics, the frequency of MGD is considerably more when compared to nondiabetic group. As the duration of DM increases prevalence and severity of MGD also increases proportionately.
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Background: The aim was to study the demographic profile and analyze risk factor associated with dry eye disease in North West Rajasthan, India.Methods: This was a hospital-based study conducted in Department of Ophthalmology, Sardar Patel Medical College, Bikaner, Rajasthan. Sample size of this study was 100 patients. All participants underwent a general ophthalmic assessment including history of any previous ocular and systemic illness along with ocular examination on slit lamp and specific tests for dry eye (Schirmer's test and Tear film break up time) were performed.Results: Dry eye were seen maximum in age group 46 to 60 years (41%), followed by 61-75 years (23%). Female’s preponderance was seen compared with male. Dry eye patients belong from rural areas were (57%) while remaining (43%) from urban areas and among these highest were farmer/labourers (32%). Several known risk factors were found in this study which include post-menopause. Climatic condition like excessive wind, high temperature and computers users had strong association with dry eye. In Systemic disease rheumatoid arthritis was commonly associated with dry eye were. Smoking contact lens use were also associated with increased risk of developing dry eye.Conclusions: Dry eye disease are more common in older age group patients. Female’s preponderance were found in the study especially postmeopausal women. Dry eye disease are more common in patients belongs to rural areas. Risk factor associated with dry eye were Climatic condition like excessive wind, high temperature and computers users, systemic disease like rheumatoid arthritis Smoking, contact lens users.
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Background: Ocular surface disease is the most common, underdiagnosed comorbidity of glaucoma. Ocular surface diseaseaffects the quality of life of glaucoma patients apart from causing visual disturbances. Evaluation of ocular surface disease isimportant for complete management of glaucoma.Aims and Objectives: This study aims to evaluate the subjective and objective measures of ocular surface disease in patientswith glaucoma.Materials and Methods: A cross-sectional study was carried out on 108 eyes of 54 glaucoma patients on topical antiglaucomamedications for >6 months at the department of ophthalmology from January 2018 to January 2019. Subjective evaluation withocular surface disease index (OSDI) score and objective evaluation with tear breakup time (TBUT) and Schirmer test werecarried in all patients.Results: The subjective measure with OSDI score >12 was observed in 55.6% of glaucoma patients. The objective measures withTBUT <10 s and Schirmer test <10 mm in 5 min were observed, respectively, in 64.8% and 53.7% of glaucoma patients. Patientson longer duration (>15 months) of topical antiglaucoma medications and patients on multiple topical antiglaucoma drugs had higherOSDI score, lesser TBUT, and lesser Schirmer test values. OSDI score had strong positive correlation with TBUT and Schirmer test.Conclusion: Prompt evaluation of ocular surface disease, use of fixed-drug combinations, use of preservative-free antiglaucomaeye drops, and supplementation with lubricants will improve the compliance of patients and outcome of glaucoma management.
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The aim of the study is to find the frequency of dry eye in type 2 diabetes mellitus patients in a tertiary care centre in Western Uttar Pradesh region. Methods: A cross sectional observational study, conducted in the Department of Ophthalmology, Teerthankar Mahaveer Medical College and Hospital. A Total of 200 patients were enrolled, 100 in Type 2 diabetes mellitus group and 100 in non-diabetic group. Detailed ocular and diabetic history was recorded and clinical examination with slit-lamp for anterior segment was done. Schirmer’s test (SchT), Tear breakup time (TBUT) were performed, and results noted. The stage of diabetic retinopathy was determined using direct and indirect ophthalmoscopy. Results: According to the present study, frequency of dry eye was more in diabetics (68%) as compared to non-diabetic patients (32%). Frequency of dry eye was maximum among the patients of above 60 years of age with 48.5% and 48.1% in diabetic and non-diabetic group respectively. Dry eye was more common in females in both the groups, 54.5% and 51.8% respectively. Dry eye was seen in 75% patients having diabetic retinopathy. Dryness (68%) and watering(21%) was the most common ocular symptom in diabetics and non-diabetics respectively. Conclusion: Dry eye have high frequency with diabetics and diagnosis for dry eye by TBUT and Schirmer’s along with history of ocular symptoms can be utilized as screening tool. Dry eye appears more in higher age group and in females as compared to middle or younger age group. Frequency of dry eye is much higher in diabetics having diabetic retinopathy as compared to the other diabetic patients without diabetic retinopathy.
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Purpose: The purpose was to study dry eye following manual small-incision cataract surgery (SICS) by analyzing the changesin tear film and diagnostic tear film tests following cataract surgery.Study Design: This is a prospective study.Material and Methods: The present study is a hospital-based study which was carried out over a period of 1 year starting fromApril 2018 to March 2019. In this study, 50 patients of age group 31–80 years, who were diagnosed with senile cataract wereobserved. All underwent uncomplicated manual SICS and followed up for the period of 3 months. All selected patients werestudied for any abnormalities in tear film before and after manual SICS. The various tear film tests done were tear meniscusheight (TMH), tear film breakup time (TBUT), Schirmer’s test 1 (ST1), and rose bengal staining (RB). The tests were done onall the patients 1 day before and 1 day, 1 month, and 3 months post-cataract surgery.Results: In the present study, majority (50%) of the study participants were aged between 61 and 70 (years) and 18%were aged between 71 and 80 (years). In the present study, 70% of the participants were males and 30% were females. Alldry eye test values were significantly worse post-cataract surgery in the 3-month follow-up period; TMH analysis showedthat 22 (44%), 38 (76%), and 31 (62%) had low TMH at post-operative 1 week, 1 month, and 3 months, respectively,which was statistically significant. The TBUT analysis showed that at post-operative 1 week, 1 month, and 3 months,18 (36%), 23 (46%), and 18 (36%) had low TBUT values. 21 (42%), 26 (52%), and 9 (18%) had low ST1 values at postoperative 1 week, 1 month, and 3 months, respectively. RB stain analysis showed at 1 week, 1 month, and 3 months,post-operatively 21 (42%), 26 (52%), and 9 (18%), respectively, patients had abnormal value. Statistically significantdifference in TMH, ST1, TBUT, and RB staining between pre-operative, post-operative 1 week, 1 month, and 3 monthshas been seen.Conclusion: Manual SICS is capable of inducing dry eye, and patients should be educated about the dry eyes after cataractsurgery and be assessed for dry eyes pre-operatively
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Background: Dry eye syndrome arises due to chronic lack of sufficient lubrication and moisture on the surface of the eye. Symptoms of dry eye syndrome includes burning sensation, itchy eyes, blurred vision, and fatigued eyes, redness of eyes, gritty and dry eye sensation / foreign body sensation. Studies reveal that post-menopausal women are at greater risk of developing dry eyes than men of same age. Aims and objectives were to determine the prevalence of dry eye syndrome among post-menopausal women at tertiary care center, Hyderabad and to assess the socio-demographic factors related to dry eye syndrome among study population.Methods: A cross sectional study was carried out from March to June 2017 among post-menopausal women attending Gandhi Hospital, in Hyderabad, Telangana. A convenient sample of 200 post-menopausal women was taken. Schirmer’s test was used to determine presence of dry eyes.Results: The mean age of study population was found to be 51.66±5.8 years. The mean age of onset of menopause in study subjects was 45.63±1.8 years. The prevalence of dry eye syndrome was found to be 39.5%. Mild dryness of eyes was most common among study subjects (20.5%). Prevalence of dry eyes increased with age and had significant association.Conclusions:Dry eye syndrome is not a life threatening disease, but causes ocular discomfort and compromises quality of life. If neglected, can even lead to blindness and debility due to complications arising due to dry eye.
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@#AIM: To observe the clinical efficacy of Xiaoyao Powder combined with tobramycin dexamethasone in treating dry eye syndrome caused by Meibomian gland dysfunction(MGD). <p>METHODS: Totally 134 eyes of 106 dry eye patients with MGD in the First People's Hospital of Wolong District, Nanyang City from November 2015 to November 2017. They were randomly divided into the control group and the observation group, each with 53 cases(67 eyes). The two groups were all given hot compress massage, and other basic treatment. The control group was given tobramycin dexamethasone treatment, while the observation group was treated with Xiaoyao Powder on the basis of the control group. The clinical effect of two groups of patients, the symptoms of dry eye, corneal fluorescence staining(FL), the scale of quality of life for diseases with visual impairment(SQOL DVI), tear film break-up time(BUT)and the Schirmer test(SⅠT)were observed. <p>RESULTS: After treatment, the total effective rate of treatment in the observation group(86.6%)was significantly higher than that of the control group(67.2%). The symptoms of dry eye, corneal FL and SQOL DVI scores were significantly lower than those in the control group, and the values of BUT and SⅠT were significantly higher than those in the control group, the difference was statistically significant(<i>P</i><0.01). During the treatment period, the incidence of intraocular pressure elevation in the observation group was significantly lower than that in the control group, the difference was statistically significant(<i>P</i><0.05). <p>CONCLUSION: The Xiaoyao Powder combined with tobramycin dexamethasone in the treatment of MGD dry eye can significantly improve the curative effect and improve the prognosis of the patients.
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PURPOSE: To evaluate the diagnostic value of tear film osmolarity for non-Sjogren dry eye syndrome through measuring the correlation between tear osmolarity and several conventional dry eye parameters. METHODS: In this observational cross-sectional study, 274 patients (274 eyes) with non-Sjogren dry eye syndrome were examined using tear film osmolarity and the following conventional dry eye parameters: Schirmer's test, tear film break-up time, ocular surface disease index (OSDI), and corneal staining score. The correlations between tear film osmolarity and each conventional dry eye parameter were assessed using Spearman's correlation coefficients. RESULTS: The mean tear film osmolarity of the study population was 296.34 ± 21.08 mOsm/L. The tear film osmolarity was significantly negatively correlated with the Schirmer's test value (r = -0.431, p < 0.001) and tear break-up time (r = -0.131, p = 0.031), while it was significantly positively correlated with the OSDI scores (r = 0.191, p = 0.001) and corneal staining scores (r = 0.150, p = 0.013). CONCLUSIONS: Tear film instability was significantly correlated with other conventional dry eye parameters. However, additional studies are required to determine its feasibility as a stand-alone diagnostic tool.
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Humans , Cross-Sectional Studies , Diagnosis , Dry Eye Syndromes , Osmolar Concentration , TearsABSTRACT
PURPOSE: To evaluate the efficacy of strip meniscometry test for dye eye syndrome (DES) by measuring the correlation between strip meniscometry and conventional test measurements. METHODS: All subjects were examined using the Schirmer test, tear breakup time (TBUT) and strip meniscometry using SMTube (Echo Electricity Co., Ltd., Fukushima, Japan). Tear meniscus height (TMH), tear meniscus depth (TMD) and tear meniscus area (TMA) were measured using Fourier-domain optical coherence tomography. The DES group (n = 46 eyes) was compared with the normal group (n = 30 eyes) and correlation was assessed using Spearman's correlation coefficient. RESULTS: Strip meniscometry measurement was significantly correlated with Schirmer score (r = 0.6080, p < 0.01), TBUT (r = 0.5980, p < 0.01), TMH (r = 0.6210, p < 0.01), TMD (r = 0.6080, p < 0.01) and TMA (r = 0.6370, p < 0.01). Strip meniscometry was significantly lower in the DES group (4.58 ± 1.94 mm) than the normal group (7.07 ± 2.61 mm, p < 0.05). CONCLUSIONS: Strip meniscometry was significantly correlated with other conventional test measurements for dry eye syndrome. Strip meniscometry is less time consuming and a less invasive method than the Schirmer test. Strip meniscometry could be an efficient tool to evaluate patients with dry eye syndrome in a clinical setting.
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Humans , Diagnosis , Dry Eye Syndromes , Electricity , Methods , Tears , Tomography, Optical CoherenceABSTRACT
?AlM: To investigate the clinical characteristics and influencing factors of chronic renal failure ( CRF) patients with dry eye, and to provide clinical reference.?METHODS:Sixty-one cases (122 eyes) of patients with CRF ( CRF group ) and 61 cases ( 122 eyes ) of healthy persons ( control group) were carried out on Schirmer ▏test ( S▏t ) , break-up time of tear film ( BUT ) , corneal fluorescein staining ( FL) , test results of two groups were compared and related factors of dry eye in CRF patients were analyzed.?RESULTS: The results of S▏t and BUT in CRF group were lower than that in the control group (P<0. 05). The proportion of tear secretion reduce in CRF group ( S▏t<10mm/5min) was 49. 2% ( 60/122 ), which was higher than that in the control group ( 10. 0%, 12/122 ), the difference was statistically significant ( X2 = 45. 39, P <0. 05). The percentage of instability of tear film in CRF group (BUT≤10s) was 75. 4% (92/122), which was significantly higher than that in the control group (27. 0%, 33/122) (X2=57. 1, P<0. 05). The positive rate of corneal FL was 37. 7% (46/122), which was higher than that of the control group (10. 7%, 13/122), there was a statistically significant difference (X2= 24. 34, P<0. 05).?CONCLUSlON:CRF patients with a decrease in tear film stability and tear secretion are susceptible population to dry eye, clinically should be paid attention to the treatment.
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PURPOSE: To compare the response of dry eye treatment in patients divided by the degree of lower lid laxity. METHODS: Thirty patients were classified into three groups - normal, moderate and severe, according to the degree of lower lid laxity. Tear break-up time (TBUT), Schirmer test (ST), ocular surface disease index (OSDI) scores and changes in OSDI score in each group were compared before and at 3 months after the treatment. RESULTS: TBUT, ST and OSDI scores were not different among the three groups at baseline. TBUT improved to 6.60 +/- 1.43, 6.0 +/- 2.54 and 6.0 +/- 1.45 sec in normal, moderate and severe lower lid laxity group, respectively at 3 months after the treatment and no difference among the groups was found. ST scores did not increase after the treatment, while OSDI scores improved to 12.20 +/- 1.40, 16.10 +/- 4.63 and 20.80 +/- 4.52 in each group, respectively and they were significantly different (p = 0.029, 0.029, <0.001, respectively). The response to the dry eye treatment as assessed by changes in OSDI scores was poorer in patients in the severe lower lid laxity group (p = 0.019 vs. moderate laxity group, <0.01 vs. normal group). CONCLUSIONS: As the degree of lower lid laxity increases, the response to dry eye treatment becomes poorer even when TBUT increases.