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ABSTRACT Purpose: To compare strip meniscometry and Schirmer tear test 1 results and tear film breakup time between dogs with normal eyes and dogs diagnosed with keratoconjunctivitis sicca. Methods: One-hundred fifty-six eyes of 78 dogs, 88 normal eyes, and 68 eyes diagnosed with keratoconjunctivitis sicca were included in the study. The tests were performed in the following sequence: Schirmer tear test 1 was used to allocate the dogs to the normal or keratoconjunctivitis sicca group, followed by the strip meniscometry test and tear film breakup time measurement. Results: The results (mean ± standard deviation) of the tests in the normal group were as follows: Schirmer tear test 1, 22.75 ± 3.88 mm/min; strip meniscometry test, 10.01 ± 2.35 mm/5 sec; and tear film breakup time, 25.82 ± 5.47 sec. In the keratoconjunctivitis sicca group, the results were as follows: Schirmer tear test 1, 6.10 ± 4.44 mm/min; strip meniscometry test, 3.03 ± 2.62 mm/5 sec; and tear film breakup time, 10.78 ± 4.23 sec. The Spearman correlation coefficient in the keratoconjunctivitis sicca group was very high, with a significant difference between the strip meniscometry test and Schirmer tear test 1 (r=0.848, p<0.001), and moderate and significant between the strip meniscometry test and tear film breakup time (r=0.773, p<0.001). The cutoff for the strip meniscometry test for keratoconjunctivitis sicca was 7.0 mm/5 sec. Keratoconjunctivitis sicca was suspected when the values were <10 mm/5 sec. Conclusions: This study provided strip meniscometry test values from dogs with normal eyes and eyes with keratoconjunctivitis sicca, with high sensitivity and specificity compared with those of the Schirmer tear test 1. In the future, the strip meniscometry test may be another important quantitative test and could complement the gold standard Schirmer tear test for the diagnosis of keratoconjunctivitis sicca in dogs, an excellent animal model for the study of the disease.
RESUMO Objetivo: Comparar o teste de meniscometria em tira com o teste lacrimal de Schirmer 1 e o tempo de ruptura do filme lacrimal, em cães com olhos normais e cães com diagnóstico de ceratoconjuntivite seca. Métodos: Cento e cinquenta e seis olhos de 78 cães, 88 olhos normais e 68 olhos com diagnóstico de ceratoconjuntivite seca. Os testes foram realizados na seguinte sequência: o teste lacrimal de Schirmer 1 foi utilizado para alocar os cães no grupo normal ou no grupo ceratoconjuntivite seca, seguido pelo teste de meniscometria em tira e tempo de ruptura do filme lacrimal. Resultados: As médias e desvios-padrão para os olhos normais foram: teste lacrimal de Schirmer 1 = 22,75 ± 3,88 mm / min; teste de meniscometria em tira = 10,01 ± 2,35 mm / 5 seg; tempo de ruptura do filme lacrimal = 25,82 ± 5,47 seg; e para os olhos do grupo ceratoconjuntivite seca foram: teste lacrimal de Schirmer 1 = 6,10 ± 4,44 mm / min; teste de meniscometria em tira = 3,03 ± 2,62 mm / 5 seg; tempo de ruptura do filme lacrimal = 10,78 ± 4,23 seg. O teste de correlação de Spearman no grupo ceratoconjuntivite seca foi muito alto, com diferença significativa entre teste de meniscometria em tira e teste lacrimal de Schirmer 1 (r=0,848, p<0,001), moderada e significativa entre teste de meniscometria em tira e tempo de ruptura do filme lacrimal (r=0,773, p<0,001). O cut-off para teste de meniscometria em tira para ceratoconjuntivite seca foi identificado em 7,0 mm / 5 seg, valores abaixo de 10 mm / 5 seg podem ser considerados suspeitos para KCS. Conclusões: Este estudo forneceu valores de teste de meniscometria em tira em olhos normais e com ceratoconjuntivite seca em cães, revelando alta sensibilidade e especificidade em comparação com o teste lacrimal de Schirmer 1. No futuro, o teste de meniscometria em tira pode ser outro teste quantitativo importante e pode complementar o teste lacrimal de Schirmer padrão ouro para o diagnóstico de ceratoconjuntivite seca em cães, um excelente modelo animal para o estudo de ceratoconjuntivite seca.
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Purpose: Aim of this study was to compare the efficacy of sodium hyaluronate (SH) and carboxymethyl cellulose (CMC) eye drops in treating mild to moderate dry eye disease in terms of relief of symptoms, mean change in tear film breakup time, Schirmer’s test, and impression cytology of conjunctiva from baseline. Methods: An observational study was carried out during a 2?year period in our tertiary referral hospital. The study consisted of 60 patients randomly allotted to two groups to receive SH and CMC eye drops for an 8?week period. Ocular surface disease index, tear film breakup time, and Schirmer’s test were performed at baseline visit and 4 and 8 weeks of treatment, and impression cytology of conjunctiva was performed at baseline and 8 weeks. Results: Significant improvement in patient symptoms, tear film breakup time, and Schirmer’s test from baseline was seen in both SH and CMC groups at 8 weeks posttreatment, whereas impression cytology of conjunctiva in both groups did not show significant improvement at 8 weeks of treatment. Data analysis using unpaired t?test showed comparable results. Conclusion: Both CMC and SH demonstrated equal efficacy in treating mild to moderate dry eye disease.
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Purpose: Ocular manifestations in psoriasis are due to direct eye involvement with psoriatic plaques or psoriasis?related, immune?mediated inflammatory processes. The commonly reported pathologies are blepharitis, conjunctivitis, keratitis, dry eyes, and uveitis. Limited data is available on the ocular findings in psoriasis patients in India. In this study, we evaluated various ocular changes associated with moderate-to-severe psoriasis. Methods: In this prospective cohort study, treatment?naive psoriasis patients with Psoriasis Area Severity Index (PASI) score of more than 10 were included. The Ocular Surface Disease Index (OSDI) score, Schirmer’s score, tear film breakup time (TBUT), corneal and conjunctival staining score, and meibomian gland dysfunction score were noted. All these parameters were re?evaluated at 8 weeks of follow?up after systemic treatment. Results: Sixty-eight patients were enrolled in the study. The most common ocular pathologies observed in this study were tarsal hyperemia and anterior blepharitis in 128 (94.1%) and 64 (47%) eyes, respectively. Mild, moderate, and severe dry eyes were seen in 26 (19.1%), 14 (10.2%), and 34 (25%) eyes, respectively. Thirty?nine (57.3%) patients complained of significant difficulty watching television or digital screen. In 21 patients evaluated on follow?up at 8 weeks, cornea and conjunctiva’s ocular surface staining score increased and TBUT decreased significantly. Conclusion: The most common ocular pathologies observed in this study were anterior blepharitis and moderate dry eye, which significantly affected most patients’ daily routines. Screening patients with greater severity of psoriasis would help in early management of such problems.
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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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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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@#AIM: To observe the influence of the overnight orthokeratology(OK)on the ocular surface and tear film, and to assess the discomfort caused by OK wearing in adolescent myopic patients.<p>METHODS: This is a prospective study included 69 myopic adolescents(138 eyes)aged 12-18 years old. 31 subjects were fitted with spectacles and 38 underwent OK treatment for 12mo. All subjects were measured with the ocular surface disease index(OSDI), the corneal and conjunctival fluorescein staining(the Oxford Scheme), tear film breakup time(TBUT), noninvasive tear break-up time(NIBUT)and the Schirmer I test before wearing and at 1, 3, 6, and 12mo after wearing.<p>RESULTS: Compared with the spectacle group and baseline, the OSDI scores were significantly higher at all recording time, the Oxford scores were significantly higher at 6 and 12mo, and TBUT and NIBUT were significantly lower at all recording time in the OK group(all <i>P</i><0.05). Conversely, no statistically differences were observed in the Schirmer I test comparing the two groups(<i>P</i>>0.05)while no statistically differences were observed in the Schirmer I test comparing the two groups(<i>P</i>>0.05).<p>CONCLUSION: OK wearing may increase the OSDI and the Oxford scores mildly, and decrease the stability of tear film. Special attention must be paid to the OK wearers with baseline and follow-up ocular surface, tear film condition, and discomfort symptoms.
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Purpose: The purpose is to study the correlation between dry eye and refractive errors in young adults using noninvasive Keratograph. Methods: In this cross sectional study, a total of 126 participants in the age range of 19� years and who were free of ocular surface disease, were recruited from King Saud University Campus. Refraction was defined by the spherical equivalent (SE) as the following: 49 emmetropic eyes (�50 SE), 48 myopic eyes (??0.75 SE and above), and 31 hyperopic eyes (>+0.75 SE). All participants underwent full ophthalmic examinations assessing their refractive status and dryness level including noninvasive breakup time (NIBUT) and tear meniscus height using Keratograph 4. Results: The prevalence of dry eye was 24.6%, 36.5%, and 17.4% in emmetropes, myopes, and hypermetropes, respectively. NIBUT has a negative correlation with hyperopia and a positive correlation with myopia with a significant reduction in the average NIBUT in myopes and hypermetropes in comparison to emmetropes. Conclusion: The current results succeeded to demonstrate a correlation between refractive errors and dryness level.
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Background There are two types of different questionnaires in dry eye diagnosis.But the associations about two questionnaires or questionnaire and clinical examination are still unclear.To effectively quantize the symptoms is helpful for a correct diagnosis of dry eye disease.Objective This survey was to evaluate the Standard Patient Evaluation of Eye Dryness (SPEED) and Ocular Surface Disease Index(OSDI) questionnaire for the diagnosis of dry eye and investigate the correlation between the clinical examinations and questionnaires. Methods A perspective cohort study was designed.Sixty-six patients were enrolled in this study.This study was approved by the Ethic Committee of Peking University First Hospital,and written informed consent was obtained from each subject before any ocular examination.SPEED-based and OSDI-based questionnaires were used to score the dry eye symptom and grouped according to severity of complains.Corneal fluorescence staining,tear film breakup time(BUT),Schirmer I test and tear film interferometry were performed in all patients.The correlations between two questionnaires scores and their association with clinical examinations were evaluated.Results The negative correlations were found between the SPEED-based score or OSDI-based score with BUT value(r=0.390,P=0.001 ;r=-0.395,P=0.001 ),but no significant correlations were seen between the SPEED-based score or OSDI-based score with Schirmer test( r=-0.081,P=0.515; r=-0.080,P=0.525)and tear film interferometry score(r=0.158,P=0.204;r=0.219,P=0.077).The BUT was significantly prolonged in mild symptom group compared with serious group(t=2.339,P=0.022),but no significant difference was seen in Schirmer Ⅰ test and tear film interferometry scores using SPEED-based questionnaire ( t =0.404,P =0.687 ; t =- 0.947,P =0.347 ) ; while the positive fluorescence staining rate between two groups was significantly different (x2 =0.164,P =0.685 ).When using OSDI-based questionnaire,significant difference in BUT was seen among mild,moderate and serious symptom groups ( F =11.871,P =0.000 ),and BUT in mild symptom group was delayed in comparison with moderat and serious groups( P=0.000,0.000).No significant differences were found in Schirmer Ⅰ test,tear film interferometry scores and fluorescence staining rate among three groups(F=1.432,P =0.246; F =2.799,P =0.068; x2 =6.026,P =0.050).SPEED score showed a positive correlation with OSDI score ( r =0.697,P =0.000 ). Conclusions Both OSDI and SPEED are effective tools for the evaluation of symptoms of dry eye.The two types of questionnaires are consistent in symptoms evaluation.
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The authors evaluated whether cataract surgery developed ocular surface changes or not. Fifty three cataract patients were divided into 2 groups according to the method of subconjunctival injection at the end of the operation. In the first group, betamethason was injected in the lower nasal quadrant and gentamicin was injected in the lower temporal quadrant. In the second group, both betamethason and gentamicin were injected together in the lower nasal quadrant. The tear film break-up time and Schirmer test results were reduced significantly after cataract surgery in both groups. Goblet cell numbers were reduced significantly on the 12 o'clock, lower temporal quadrant and lower nasal quadrant conjunctiva, and especially that of the lower quadrant, in which gentamicin was injected, was reduced more. Instilled drug before and after the operation, electric cauterization, conjunctival incision, and subconjunctival injection of drugs, such as gentamicin and betamethason, may induce the precorneal tear film instability.