Sterile corneal perforations in a case of severe dry eyes

Baranwal, Vinod Kumar; Satyabala, K.; Mishra, Avinash; Dutta, Ajay K.

doi:10.1016/j.mjafi.2013.04.005

Cited by 7 publications

(5 citation statements)

References 5 publications

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“…Nevertheless, due to insufficient reports on the comorbid occurrence of DED in patients with PD, initiatives to establish a multidisciplinary care system, wherein regular ocular examinations and DED screening are incorporated within the routine management of PD, are limited. Delayed DED diagnosis and intervention can eventually cause corneal perforation and scarring, leading to severe chronic ocular and visual impairments 33 , 47 . Our finding of increased DED prevalence within this population highlights the need for healthcare providers to be vigilant regarding comorbid DED and regularly offer DED screening and intervention for patients with PD.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and characteristics of dry eye disease in Parkinson’s disease: a systematic review and meta-analysis

Nagino

Sung

Oyama

et al. 2022

Sci Rep

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We investigated and characterized the prevalence of dry eye disease (DED) in Parkinson’s disease (PD). PubMed and EMBASE databases were searched for relevant studies between January 1, 1979 and March 10, 2022. Quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Study-specific estimates were combined using the DerSimonian–Laird random-effects model. Prevalence of subjective DED symptoms in patients with PD and mean differences in blink rate, corneal thickness, tear film breakup time, and tear secretion volume on Schirmer test I were compared to those in controls. Of 383 studies, 13 (1519 patients with PD) and 12 were included in qualitative and quantitative syntheses, respectively. Meta-analysis revealed a 61.1% prevalence of subjective DED symptoms in PD and that, compared with controls, patients with PD had significantly lower blink rate, thinner corneal thickness, shorter tear film breakup time, and lower tear secretion volumes on Schirmer test I, without and with anesthesia.

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Section: Discussionmentioning

confidence: 99%

Prevalence and characteristics of dry eye disease in Parkinson’s disease: a systematic review and meta-analysis

Nagino

Sung

Oyama

et al. 2022

Sci Rep

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“…Although Sjögren’s syndrome and rheumatoid arthritis are known to cause corneal perforation, these conditions are basically bilateral. 3 Further, while cases of corneal perforation caused by dry eye alone have been reported, 2 , 3 no studies have provided data on large numbers of dry eye cases allowing rough calculation of the rate of corneal perforation. Dry eye may be complicated by corneal ulceration, particularly in patients with Sjögren’s syndrome, and corneal perforation may occasionally develop in such cases.…”

Section: Discussionmentioning

confidence: 99%

“…Dry eye may be complicated by corneal ulceration, particularly in patients with Sjögren’s syndrome, and corneal perforation may occasionally develop in such cases. 2 , 3 Corneal perforation occurred in 17 of 1838 patients (0.9%) with Sjögren syndrome 4 and in 2 of 243 patients (0.8%) with ocular GVHD. 18 The incidence of corneal perforation associated with rheumatoid arthritis is estimated as 0.234–9.82/million/year.…”

Section: Discussionmentioning

confidence: 99%

Lacrimal Duct Obstruction and Infection Associated with Non-Traumatic Corneal Perforation: A Case Series

Nitta¹,

Mukai²,

Todokoro³

et al. 2022

IMCRJ

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Purpose To report a case series of lacrimal duct obstruction and infection associated with non-traumatic corneal perforation. Case Series This study included 6 eyes in 6 patients with non-traumatic corneal perforation treated between April 2019 and March 2021. All 6 cases were associated with lacrimal duct obstruction and infection. Purulent discharge caused by lacrimal duct infection was observed in all 6 patients (100%). However, three of the 6 patients (50%) did not show purulent discharge at initial examination and lacrimal duct obstruction was therefore not initially recognized. Dry eye was observed in five of the 6 patients (83%) and may have caused corneal deterioration, increasing susceptibility to perforation. Further, dry eye masks symptoms of lacrimal duct obstruction and infections, such as epiphora and regurgitation of purulent discharge, making the association with lacrimal duct obstruction and infection difficult to determine. All patients were treated for both corneal perforation and lacrimal duct disease, and conditions improved, with no recurrence of either corneal perforation or lacrimal duct disease. Conclusion In patients with a combination of lacrimal duct disease and corneal perforation, treatment of both diseases resulted in stabilization of patient condition. Dry eyes may mask symptoms of lacrimal duct diseases, such as epiphora and purulent discharge, and lacrimal duct disease may thus be underdiagnosed.

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“…The prevalence of DED increases with age and is higher in females than males [2,3]. In severe cases, DED can progress into corneal ulcers and perforations [4,5]. Hung et al recently demonstrated that patients with aqueous-deficient DED had an increased risk of corneal surface damage in a long-term follow-up of a population-based cohort [6].…”

Section: Introductionmentioning

confidence: 99%

The Association between Autoimmune Thyroid Disease and Ocular Surface Damage: A Retrospective Population-Based Cohort Study

Lai

Tai

et al. 2023

JCM

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Autoimmune thyroid diseases (ATDs) are potentially connected to lacrimal gland dysfunction and ocular surface disruption. This study aimed to evaluate the relationships between ATD, dry eye disease (DED), and corneal surface damage. In a matched nationwide cohort study, we used Taiwan’s National Health Insurance research database to compare the incidences of DED and corneal surface damage between subjects with and without ATD. Multivariable Cox proportional hazards regression models were used to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for the ophthalmological outcomes. A total of 50,251 matched pairs with 748,961 person-years of follow-up were included for analysis. The incidence of DED was 16.37 and 8.36 per 1000 person-years in the ATD and non-ATD groups, respectively. ATDs were significantly associated with increased DED (aHR: 1.81, 95% CI: 1.73–1.89, p < 0.0001). This association was generally consistent across the subgroups of age, sex, different comorbidity levels, and use of systemic corticosteroids or not. Furthermore, patients with ATD had a higher risk of corneal surface damage compared with non-ATD subjects (aHR: 1.31, 95% CI: 1.19–1.44, p < 0.0001), including recurrent corneal erosions (aHR: 2.00, 95% CI: 1.66–2.41, p < 0.0001) and corneal scars (aHR: 1.26, 95% CI: 1.01–1.59, p = 0.0432). Other independent factors for corneal surface damage were age, sex, diabetes mellitus, Charlson Comorbidity Index scores, and use of systemic corticosteroids. Our results suggested that ATDs were associated with higher risks of DED and corneal surface damage. Considering the high prevalence of ATD, prophylactic and therapeutic strategies should be further developed to prevent irreversible vision loss in this susceptible population.

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Sterile corneal perforations in a case of severe dry eyes

Cited by 7 publications

References 5 publications

Prevalence and characteristics of dry eye disease in Parkinson’s disease: a systematic review and meta-analysis

Prevalence and characteristics of dry eye disease in Parkinson’s disease: a systematic review and meta-analysis

Lacrimal Duct Obstruction and Infection Associated with Non-Traumatic Corneal Perforation: A Case Series

The Association between Autoimmune Thyroid Disease and Ocular Surface Damage: A Retrospective Population-Based Cohort Study

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