Lid Wiper Epitheliopathy and Dry Eye Symptoms

Abstract

Lid wiper epitheliopathy, diagnosed by staining with fluorescein and rose bengal dyes, is a frequent finding when symptoms of dry eye are experienced in the absence of routine clinical dry eye findings.

Mechanical Complications Induced by Silicone Hydrogel Contact Lenses

“…97,[100][101][102][103] It has been widely reported that CL-induced dryness symptoms often do not correlate with clinical signs. However, Korb et al 94 observed LWE in 80% of symptomatic patients but in only 13% of asymptomatic patients. Another group of investigators reported similar findings.…”

“…94 Some clinicians speculate that LWE occurs more often with lenses of high coefficient of friction (e.g., GP, some SiHy CLs). 105 Theoretically, the coefficient of friction is not strongly dependent on the lens material surface properties as long as the lens surface is well lubricated.…”

“…93,94 This wiping effect is believed to be essential for spreading the tear film over the ocular surface or the surface of a CL. It is postulated that when the tear film is thinned or becomes unstable or a lens surface does not provide a stable and wettable surface, there might be a more mechanical/frictional effect on the lid wiper as the lid travels across the ocular or lens surface during blinking.…”

“…It is postulated that when the tear film is thinned or becomes unstable or a lens surface does not provide a stable and wettable surface, there might be a more mechanical/frictional effect on the lid wiper as the lid travels across the ocular or lens surface during blinking. 94 As a result of insufficient boundary lubrication, the lid wiper is traumatized and develops into LWE that can be viewed clinically when the epithelium of the marginal conjunctiva is stained with commonly used ophthalmic dyes (Fig. 9).…”

“…9). 84,95,96 To diagnose LWE, Korb et al recommend 1 application of sodium fluorescein or lissamine green dye and waiting for 60 sec before observing the everted eyelid. Alternatively, 30 to 60 sec after 1 application of Rose Bengal dye will also facilitate the examination of LWE.…”