Prevalence of dry eye disease in an urban community

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To determine the prevalence of dry eye disease in an urban community in the Philippines.</p> <p style="text-align: justify;"><strong>METHODS:</strong> This was a community-based cross-sectional study. Convenience sampling was conducted on residents of Barangay 733, Sampaloc, Manila, Philippines. One hundred fifty-seven participants, 19 years old and above, underwent investigator-led interview using a dry-eye questionnaire, followed by dry-eye examination consisting fluorescein tear break-up time (TBUT), corneal staining with fluorescein, conjunctival and posterior lid margin staining (PLM) with lissamine green, and Schirmer I test with and without anesthesia.</p> <p style="text-align: justify;"><strong>RESULTS:</strong> Of the 157 participants recruited, 148 (94%) fulfilled the inclusion criteria. The mean age was 52.35 years; 95 (64.2%) were females and 53 (35.8%) males. Thirty-four (22.9%) were diagnosed with dry eye disease, and the most common symptom reported was itching (76%). Those with dry eye had significantly higher ocular surface disease index score and subjective grading of ocular discomfort compared with those without the disease. Mean TBUT for those without dry eye was 12.74 seconds compared with 8.84 seconds for the dry eye group. The mean fluorescein corneal staining scores were 2 and 20 for the none and the dry eye groups respectively. The mean lissamine green conjunctival staining scores were 14 and 55 respectively. A positive PLM sign was present in 67.6% with dry eye vs. 5.6% in the none dry eye group. Mean Schirmer I test without anesthesia was 18.53 mm and 17.09 mm in the none and dry eye groups respectively. Mean Schirmer I test with anesthesia was 13.36 mm vs. 11.94 mm respectively.</p> <p style="text-align: justify;"><strong>CONCLUSION:</strong> The prevalence rate of dry eye disease in an urban community in Manila was 22.9%. This figure was similar to those reported by neighboring Asian countries.</p>

Dry eye after clear cornea phacoemulsification

Objective@#To determine the incidence of dry eye in patients undergoing clear cornea phacoemulsification and to investigate its effects on dry eye symptoms and tear function. @*Methods@#This was a single-center, prospective, non-randomized study involving forty-nine (49) eyes from fortyfour (44) patients without preoperative dry eye, who underwent clear cornea phacoemulsification for age-related cataract. Main outcome measures were subjective grading of ocular discomfort, ocular surface disease index (OSDI), fluorescein tear break-up time (FTBUT), and Schirmer tests without anesthesia and with anesthesia. They were measured before surgery and 1 week, 1 month, and 3 months after surgery. @*Results@#None of the patients qualified for the definition of dry eye disease before and after clear cornea phacoemulsification. Preoperative FTBUT (14.01 ± 0.56 seconds) decreased at 1 week (3.97 ± 0.21 seconds; p<0.001) and at 1 month (5.82 ± 0.32 seconds; p<0.001) after the surgery and gradually improved by 3 months (8.26 ± 0.54 seconds; p<0.001) after surgery. Preoperative Schirmer test without anesthesia (18.78 ± 1.17 mm) decreased at 1 week (14.02 ± 1.52 mm; p<0.001) and subsequently recovered by 3 months (16.31 ± 1.34 mm; p>0.05). Preoperative Schirmer test with anesthesia (14.24 ± 0.94 mm) decreased at 1 week (11.98 ± 1.00 mm; p=0.046) after surgery and went back to baseline levels by 3 months (13.80 ± 1.12 mm; p>0.05). @*Conclusion@#Patients without dry eye disease, who underwent clear cornea phacoemulsification, did not develop dry eye disease after the surgery. Temporary reduction in physiologic tear levels seen one week postsurgery gradually returned to near-normal baseline levels by the third postoperative month.

Current Trends in the Recognition and Treatment of Dry Eye: A Survey of Ophthalmologists

PURPOSE: Based on the questionnaires for dry eyes in 2006, we have investigated the current status and new trends in the recognition and management of the dry eye. METHODS: We ask the 15 questionnaires to 197 ophthalmologists. After reorganizing the data based on each questions, we compared the result with the most current studies in Korea and other countries as well. Then, we report the current trends in the diagnosis and treatment of dry eye. RESULTS: Dry eye patients account for take up about 20-30% of total outpatients and it is currently accepted etiology that dry eye inflammation is related to the function of the immune system. Patient's symptoms and slit lamp examination are important for diagnosis. An anti-inflammatory therapy is needed for patients with moderate to severe dry eye. CONCLUSIONS: Increasingly, there are positive attitudes toward accepting that persistent dry eye is an inflammatory disease; therefore, there are increases in use of an anti-inflammatory agent for treatment.

Current Concepts and Therapeutic Management of Dry Eye

The majority of dry eye symptoms are due to a chronic inflammation of the lacrimal functional unit resulting in a loss of tear film integrity and normal function. The tear secretion is controlled by the lacrimal functional unit consisting of the ocular surface (cornea, conjunctiva, and meibomian glands), the main lacrimal gland, and the interconnecting innervation. A lack of systemic androgen support to the lacrimal gland has been shown to be a facilitating factor in the initiation of ocular inflammation. If any portion of this functional unit is compromised, lacrimal gland support to the ocular surface is impeded. In this review, the classification and treatment of dry eye syndrome will be presented according to the A Delphi approach.