An Objective Approach to Dry Eye Disease Severity

Sullivan, Benjamin D.; Whitmer, Diane; Nichols, Kelly K.; Tomlinson, Alan; Foulks, Gary N.; Geerling, Gerd; Pepose, Jay S.; Kosheleff, Valerie P; Porreco, Allison; Lemp, Michael A.

doi:10.1167/iovs.10-5390

Cited by 460 publications

(396 citation statements)

References 29 publications

Supporting

Mentioning

368

Contrasting

Unclassified

Order By: Relevance

“…These findings are in accordance with current literature, where the poor relationships between ocular signs and dry eye symptoms are criticised. [8][9][10][11]19 However, the use of a composite index might have shown a stronger relationship between staining and dry eye severity, as reported by Sullivan et al 63 The classic tests TMH, NIBUT, and PRTT, as well as the new LIPCOF (nasal and temporal) and LWE tests were significant correlated to dry eye symptoms (Table 2), although these correlations varied in their strengths. The relationship between LWE and dry eye symptoms investigated in this study confirms the findings of Korb et al, 15 where LWE was reported to correlate to symptoms as determined by the total Standard Patient Evaluation of Eye Dryness (SPEED) score.…”

Section: Discussionmentioning

confidence: 75%

“…This is in accordance with clinical experience and the published Using a combination of tests has been recommended to improve the predictive ability for dry eye. 9,[12][13][14]63 However, there is no agreement on which tests should be combined and, to our knowledge, it was unknown before this study whether LWE and LIPCOF would be able to help such a combination of tests in non-contact lens wearers. Since a combination of LIPCOF Sum and NIBUT showed an improved predictive ability for later contact lens related dry eye symptoms in naive contact lens wearers, 13 a comparable combination appeared to be obvious in non-contact lens wearers.…”

Section: Discussionmentioning

confidence: 90%

See 1 more Smart Citation

The relationship between clinical signs and dry eye symptoms

Pult

Purslow

Murphy

2011

Eye

145

View full text Add to dashboard Cite

Purpose To evaluate (i) the relationship between traditional and new clinical tests (lid-wiper epitheliopathy (LWE), lid-parallel conjunctival folds (LIPCOF)) and dry eye symptoms in non-contact lens wearers, and (ii) that a combination of these tests can improve predictive ability for the development of dry eye symptoms. Methods Tear meniscus height (TMH), non-invasive break-up time (NIBUT), ocular hyperaemia, LIPCOF, phenol red thread test (PRTT), corneal and conjunctival staining, and LWE grades were observed in a cohort of 47 healthy, non-lens wearers (male ¼ 17, female ¼ 30, median age ¼ 35 years, range ¼ 19-70). Symptoms were assessed using the Ocular Surface Disease Index (OSDI). Results LWE was significantly correlated to both temporal and nasal LIPCOF (0.537or o0.607, Po0.05). LIPCOF and LWE were significantly correlated to NIBUT and PRTT (r4À0.248, Po0.001). Significant correlations were found between NIBUT and TMH (r ¼ 0.461, P ¼ 0.001) and PRTT (r ¼ 0.640, Po0.001). OSDI scores were significant correlated to NIBUT, TMH, PRTT, LIPCOF, and LWE (r4|0.31|; Po0.05). Significant discriminators of OSDI þ /À were NIBUT (area under the receiver operative characteristic curve (AUC) ¼ 0.895), TMH (0.715), PRTT (0.781), LIPCOF (temporal/nasal/Sum 0.748/0.828/0.816), and LWE (0.749). Best predictive ability was achieved by combining NIBUT with nasal LIPCOF (AUC ¼ 0.944). Conclusions The individual tests NIBUT, TMH, PRTT, LIPCOF, and LWE were significantly, but moderately, related to OSDI scores. The strongest relationship appeared by combining NIBUT with nasal LIPCOF.

show abstract

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 90%

The relationship between clinical signs and dry eye symptoms

Pult

Purslow

Murphy

2011

Eye

145

View full text Add to dashboard Cite

show abstract

“…Participants were individuals with a normal ocular surface by history and examination, according to defined criteria. Following a preliminary visit subjects were screened for the following inclusion criteria: tear osmolarity <308 mOsm/L; 19 OSDI score <20; TBUT >10 seconds and corneal staining < grade 2 using the Oxford clinical grading scale. 20 Subjects were excluded if they had any active ocular disease, any clinically significant lid or conjunctival abnormalities (corneal scars or opacities), any clinically significant limbal or bulbar injection or conjunctival staining, any eye surgery or injury within the previous 6 months, any systemic disease affecting ocular health, had nasolacrimal occlusion or were using any topical medications.…”

Section: Subjectsmentioning

confidence: 99%

Central Connections of the Lacrimal Functional Unit

Willshire

Buckley

Bron

2017

Cornea

View full text Add to dashboard Cite

2 ABSTRACTPurpose To study the contribution of each eye to the reflex tear response, after unilateral and bilateral topical anaesthesia.Method A closed eye, modified Schirmer test was performed bilaterally in 8 normal subjects, in a controlled environment chamber set to 23°C, 45% relative humidity and 0.08m/s airflow. Eye drops were instilled into each eye 10 minutes before the Schirmer test. Experiments were: a) bilateral saline (control) b) unilateral anaesthesia (ipsilateral anaesthetic; contralateral saline) and c) bilateral anaesthesia.Results There was no difference in between-eye wetting lengths in the saline control eyes (p = 0.394) or the bilaterally anaesthetised eyes (p = 0.171). Wetting length was reduced in both eyes after bilateral anaesthesia compared to saline controls (p = 0.001; p = <0.0005). After unilateral anaesthesia, wetting length was reduced in the anaesthetised eye compared to its saline control by 51.4% (p = <0.0005) and compared to its fellow, unanaesthetised eye (p = 0.005). The fellow eye value was also reduced compared to its saline control (p = 0.06).Conclusions Wetting length was reduced by topical anaesthesia, when instilled bilaterally and ipsilaterally. The latter response implies an ipsilateral, reflex sensory drive to lacrimal secretion. In the unanaesthetised fellow eye the reduction compared to its saline control was not quite significant. This implies a relative lack of central, sensory, reflex cross-innervation, although the possibility cannot entirely be ruled out. These results are relevant to the possibility of reflex lacrimal compensation from a normal, fellow eye, in cases of unilateral corneal anaesthesia.3

show abstract

“…20,31 However, because not all glaucoma patients would be treated on both eyes, only the treated eye was included in the study. In patients where both eyes were eligible, both eyes were included in the study.…”

Section: Clinical Evaluationmentioning

confidence: 99%

“…Measurements of TFO have been demonstrated to be suitable, and even superior to other forms of tests, in terms of dry eye diagnosis. [17][18][19] Sullivan et al 20 found that TFO measurements are the best indication of dry eye severity, with a correlation coefficient of 0.55, as compared with other clinical tests.…”

Section: Introductionmentioning

confidence: 99%

Effect of chronic anti-glaucoma medications and trabeculectomy on tear osmolarity

Lee

Wong

Chua

et al. 2013

Eye

View full text Add to dashboard Cite

Purpose To evaluate the tear film osmolarity (TFO) and ocular surface clinical signs and symptoms in chronically medicated glaucoma patients and post-trabeculectomy patients. Methods This is a single-center, prospective case-controlled study. One-hundred and thirty eyes of 130 participants aged Z45 years were included (49 normal controls, 50 glaucoma patients on chronic preserved antiglaucoma medication Z6 months, and 31 post-trabeculectomy patients not on medication Z6 months). TFO, tear break-up time (TBUT), Schirmer's test I and dry eye symptoms were evaluated. Data from both groups of glaucoma patients were compared with age and sex-matched controls. Logistic regression was performed to calculate the odds ratios. Results Mean TFO in the three groups were 301.4 ± 7.7, 307.0 ± 9.3, and 307.4 ± 11.6 mOsm/l, respectively. Compared with normal controls, chronically medicated glaucoma patients and post-trabeculectomy patients were more likely to have a raised TFO, with odds ratios (95% CI) of 4.43 (1.74-11.32) and 2.76 (1.02-7.94), respectively. Both groups of glaucoma patients were also more likely to experience dry eye symptoms, with ORs of 4.72 (1.92-11.59) and 4.24 (1.54-11.72). There was no significant difference in TFO and symptoms between both groups of glaucoma patients, and in TBUT and Schirmer's test across all three groups. Conclusions Patients on chronic topical antiglaucoma medication and posttrabeculectomy patients were more likely to have raised TFO and dry eye symptoms, suggesting significant ocular surface disease. Glaucoma practitioners should be aware that dry eye symptoms and raised TFO may occur in the absence of TBUT and Schirmer's test abnormality.

show abstract

An Objective Approach to Dry Eye Disease Severity

Cited by 460 publications

References 29 publications

The relationship between clinical signs and dry eye symptoms

The relationship between clinical signs and dry eye symptoms

Central Connections of the Lacrimal Functional Unit

Effect of chronic anti-glaucoma medications and trabeculectomy on tear osmolarity

Contact Info

Product

Resources

About