Dry Eye Syndrome in Elderly Tibetans at High Altitude

Lü, Peng; Xiao-ming, Chen; Liu, Xuyang; Yu, Ling; Kong, Ying; Xie, Quanhua; Lang, Ke; Wei, Xiaoyan

doi:10.1097/ico.0b013e318165b1b7

Cited by 88 publications

(52 citation statements)

References 38 publications

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“…This number suggests a higher burden of symptoms in our hospital-based population compared with previously reported populationbased studies in Salisbury, Maryland (where 13% of men had ‡1 symptoms often or all the time) 14 and Shihpai, Taiwan (where 30% of men had ‡1 symptoms often or all the time). 11 Our numbers were more in line with that of Lu et al, 12 who found that 52% of 1031 Tibetans living in Zeku, China, reported one or more symptoms often or all the time. Using cutoff definitions for various tear parameters, we also found many objective abnormalities in various tear function measurements, with most patients displaying a lipid tear deficiency or a mixed pattern.…”

Section: Discussionsupporting

confidence: 80%

“…Using cutoff definitions for various tear parameters, we also found many objective abnormalities in various tear function measurements, with most patients displaying a lipid tear deficiency or a mixed pattern. These findings have been supported by previous hospital and population-based studies [11][12][13][14][23][24][25][26] (Table 6). When considering the parameters in combination or individually, we could not find good correlation between measured signs and symptoms, despite the inclusion of newer tear film variables, such as osmolarity and meibomian gland parameters.…”

Section: Discussionsupporting

confidence: 80%

“…* More severe value of the two eyes. (12) to 0.072 (discomfort). Examining correlations between the various objective measures revealed that only two had an R 2 greater than 5%: TBUT with Schirmer test (r ¼ 0.38) and TBUT with conjunctival and corneal staining (r ¼ À0.27).…”

Section: Correlation Between Symptoms and Signs Of Desmentioning

confidence: 99%

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Ocular Surface Parameters in Older Male Veterans

Galor

Feuer

Lee³

et al. 2013

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To characterize ocular surface discomfort and tear film parameters in a veteran population.METHODS. Male patients seen in the Miami Veterans Affairs eye clinic aged 50 years or older were recruited to participate in the study. All patients had normal eyelid, corneal, and conjunctival anatomy. Patients filled out the Dry Eye Questionnaire 5 (DEQ5) and underwent measurement of tear film parameters. The main outcome measures were the frequency of ocular surface symptoms and the correlation between symptoms and global, aqueous, and meibomian gland parameters. RESULTS.A total of 263 men participated in the study; 48% had DES based on the presence of severe symptoms. Many men had objective abnormalities in tear function measurements. Using Schirmer information, lid plugging, and meibomian quality to define objective DES, 176 patients (68%) had one or more abnormalities. Of these, 22 (8%) had aqueous tear deficiency, 124 (47%) lipid tear deficiency, and 30 (11%) a mixed pattern. When examining associations between individual clinical parameters and DEQ5 score, the only significant, but weak, correlations were with the global parameters conjunctival and corneal staining (r ¼ 0.16) and TBUT (r ¼ À0.15). Neither specific aqueous nor meibomian gland measurements were significantly correlated with the presence of symptoms. When considering all measured parameters in a regression model, 8% of the variability in symptoms was explained by the tear parameters.CONCLUSIONS. We found that ocular surface symptoms were prevalent in our population. Measurement of standard tear film parameters could not explain the degree of symptoms. This study highlights the need for future research regarding the mechanisms behind ocular surface discomfort in patients with tear film disturbances. (Invest Ophthalmol Vis Sci.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 80%

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Ocular Surface Parameters in Older Male Veterans

Galor

Feuer

Lee³

et al. 2013

Invest. Ophthalmol. Vis. Sci.

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“…Similarly, an association was found between fluorescein staining and pterygium but, in contrast with other studies, 28 not with symptoms or with other signs of dry eye despite the fact that chronic inflammation has been postulated as a contributing factor for the development of pterygium. Meibomian gland dysfunction was also examined but no significant association was found with this ocular surface disorder either.…”

Section: Discussioncontrasting

confidence: 49%

Prevalence of pinguecula and pterygium in a general population in Spain

Viso

Gudé

Rodríguez‐Ares

2010

Eye

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Purpose To determine the prevalence of pinguecula and pterygium and to investigate their associations in a general adult population in North-Western Spain. Methods An age-stratified random sample of 1155 subjects Z40 years was selected in O Salnés (Spain). From 937 eligible subjects, 619 (66.1%) participated (mean age (SD): 63.4 (14.5) years, range: 40-96 years, 37.0% males). An interview to collect history of systemic diseases and lifestyle details and a comprehensive ophthalmic evaluation in which pinguecula and pterygium were recorded was carried out. The prevalence of pinguecula and pterygium and their relationship with lifestyle factors and ocular and systemic diseases was investigated. Results The prevalence of pinguecula was 47.9% (95% confidence interval (CI): 43.9-51.9). This prevalence increased significantly with aging (P ¼ 0.002) and was higher in men (56.4%; 95% CI: 50.0-62.7) than in women (42.7%; 95% CI: 37.8-47.8) (P ¼ 0.001). The prevalence of pterygium was 5.9% (95% CI: 4.3-7.9). This prevalence also increased significantly with aging (P ¼ 0.005) and was 4.8% (95% CI: 2.6-8.4) in men and 6.5% (95% CI: 4.5-9.3) in women (P ¼ 0.346). After controlling for age and sex, pinguecula was associated with alcohol intake (adjusted odds ratio (OR a ): 3.08; 95% CI: 1.60-5.95), pterygium with fluorescein staining (OR a : 2.64; 95% CI: 1.08-6.46) and both disorders with outer activity (OR a : 2.07; 95% CI: 1.36-3.15 and 2.28; 95% CI: 1.04-4.98, respectively). Conclusions Pinguecula is far more common than pterygium. Alcohol consumption is strongly associated with pinguecula. Fluorescein staining is highly prevalent in subjects with pterygium. Both disorders increase with age and are associated with outer activity.

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“…26 Eye metalloproteinase-9 (MMP-9) tear levels. 41 In another study by the same group, similar findings were seen after 20 dry eye patients were exposed to a CAE simulating an in-flight airplane cabin for 2 h. 42 Environmental factors such as high altitude, 43 wind, 15 air pollution, 15,44 volcanic eruption, 45 dust, 46 and chemicals 47,48 have also been associated with transient and/or chronic dry eye. In our study of 3.41 million patients seen in 394 Veteran Affairs (VA) eye clinics within the continental United States, we found that several environmental factors were significantly associated with the risk of a dry eye diagnosis.…”

Section: Environmental Conditionssupporting

confidence: 55%

Neuropathic ocular pain: an important yet underevaluated feature of dry eye

Galor

Levitt

Felix

et al. 2014

Eye

177

175

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Dry eye has gained recognition as a public health problem given its prevalence, morbidity, and cost implications. Dry eye can have a variety of symptoms including blurred vision, irritation, and ocular pain. Within dry eyeassociated ocular pain, some patients report transient pain whereas others complain of chronic pain. In this review, we will summarize the evidence that chronicity is more likely to occur in patients with dysfunction in their ocular sensory apparatus (ie, neuropathic ocular pain). Clinical evidence of dysfunction includes the presence of spontaneous dysesthesias, allodynia, hyperalgesia, and corneal nerve morphologic and functional abnormalities. Both peripheral and central sensitizations likely play a role in generating the noted clinical characteristics. We will further discuss how evaluating for neuropathic ocular pain may affect the treatment of dry eye-associated chronic pain.

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Dry Eye Syndrome in Elderly Tibetans at High Altitude

Abstract: This study shows a high prevalence rate of dry eye syndrome in elderly Tibetans, representing an important health problem.

Cited by 88 publications

References 38 publications

Ocular Surface Parameters in Older Male Veterans

Ocular Surface Parameters in Older Male Veterans

Prevalence of pinguecula and pterygium in a general population in Spain

Neuropathic ocular pain: an important yet underevaluated feature of dry eye

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