Molecular analysis revealed a diverse ocular surface bacterial population. In addition to the normal flora, various potentially pathogenic bacteria were identified. The detection of known pathogens in both normal and dry eyes, with minimal signs of infection, presents a diagnostic dilemma. It remains unknown whether their presence is associated with inflammation and reduced goblet cell density or whether they adversely affect the ocular surface predisposing it to abnormal microbial colonization. In the absence of overt clinical infection, it is unknown whether such results should prompt intervention with therapy.
Purpose
Large variations in results of diagnostic tests for mild to moderate dry eye are widely recognised. The purpose of this study was to assess if there was concordance between common dry eye diagnostic tests.
Methods
A total of 91 subjects were recruited to the study. The tear film and ocular surface were evaluated using the phenol red thread test, tear break up time (TBUT), biomicroscopic examination and impression cytological (IC) assessment of conjunctival goblet cells. Dry eye symptoms were assessed using McMonnies questionnaire and statistical correlations between all tests were assessed.
Results
This study cohort did not include severe aqueous deficient dry eye patients as determined by the phenol red thread test (PRT). A statistically significant difference was noted between PRT results and all other tests (***P ≤ 0.001). Only meibomian gland pathology, McMonnies questionnaire, reduced goblet cell density and TBUT (≤7 seconds) demonstrated correlation determined by McNemar’s test.
Conclusion
A correlation was only found between tests assessing lipid/mucous deficiency (meibomian gland evaluation, goblet cells density, TBUT, and McMonnies questionnaire).
Aim: The purpose of this study was to survey the attitudes of optometrists and ophthalmologists, located in a number of different countries, towards diagnostic tests and therapies for dry eye disease. Methods: A web-based questionnaire was used to survey attitudes using forced-choice questions and Likert scales. Results: Sixty-one respondents (23 ophthalmologists and 38 optometrists) reported a wide range of patient dry eye symptoms. A large variation in use of diagnostic tests was noted. Patient symptoms and fluorescein staining were reported to be significantly more valuable and more frequently performed than any other test. Artificial tear supplements and improved lid hygiene were the preferred therapeutic options selected by the entire group. The results demonstrated a wide variation in attitudes in relation to satisfaction with the range of available diagnostic and therapeutic options. Conclusions: This study indicates that the interest for the issue of dry eye is relatively limited amongst eye professionals, as demonstrated by the poor participation in the questionnaire.
In this study we report the first gel based proteomic analysis of an inflammed dry eye utilising a clinically-based non-invasive methodology for collection of a specimen from the posterior lid and inferior conjunctival mucosa of the subject. This multidimensional technique allowed the identification of 592 proteins, having a MOWSE score of greater than 40, using the heuristic tool PROVALT. Automated curation of this list using an inbuilt randomised database searching tool with false discovery rate set at 1% significantly reduced this list to 86 proteins. Additional manual curation resulted in the final positive identification of 75 proteins. These identified proteins were functionally classified and physiochemically characterised. This led to the identification of a number of proteins involved in cell structure, inflammation, and the innate immune response. Contained within these proteins were a number of potential biomarkers of not only dry eye syndrome but also lacrimal gland acinar cell function such as lacritin, calgranulin A and lacrimal proline-rich protein 4.
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