5 - Lid Wiper Epitheliopathy

Abstract

The lid wiper is proposed to be that portion of the marginal conjunctiva of the upper eyelid that acts as a wiping mechanism for spreading the tear film over the ocular surface or over the surface of a contact lens. There is also a lid wiper in the lower lid, but its role in spreading tears is less certain. ‘Lid wiper epitheliopathy’ is the term used to describe disruption to the surface epithelium of the lid wiper, typically observed by using vital dyes. The precise anatomical location and structure of the lid wiper are still in debate. Friction between the lid wiper and the anterior surface of a contact lens over which the lid wipes is thought to be a source of discomfort, but a definitive link between lid wiper epitheliopathy and discomfort has yet to be demonstrated. There may be an inflammatory component to this condition. Corticosteroids, lubricants and fitting contact lenses of higher lubricity can alleviate this condition.