Dry eye disease secondary to bacterial, fungal or acanthamoeba keratitis

Abstract

Abstract Purpose To characterize dry eye disease after severe unilateral infectious (non‐viral) keratitis. Methods Tear break‐up time (BUT), Schirmer I test, Ocular surface disease index (OSDI) and Tear film osmolarity by means of Tearlab* (Tearlab, San Diego, CA, USA) were collected in patients admitted for severe unilateral non‐viral infectious keratitis in Ophthalmology departments of Strasbourg and Paris‐Bicetre university hospitals (France) between January and May 2010. All of these data were collected in both eyes (infected eye and non‐infected controlateral eye as a control) at least 3 month after the beginning corneal infection and 1 month after the end of topical treatment. Severity of infection was defined as a large (> 2 mm) and/or a deep corneal infiltrates (> 50% thickness). Results 21 patients (9 men, 12 women) were followed during the study. Mean age was 37 year‐old (range 19‐64). Bacteria, fungi and acanthamoeba were involved as pathogenic agents in 16, 3 and 2 cases respectively. The mean score of OSDI was 5.94+/‐3.83 in infected eyes and 2.17+/‐2.28 in control (non‐infected) eyes (p=0.0017). Tear osmolarity as 290.67+/‐7.56 mOsm/L in infected eyes as compared to 300.71+/‐6.40 in control eyes whereas tear BUT and Schirmer test were also significantly decreased in infected eye (p<0.001 p=0.0023 and 0.0011 respectively). Conclusion Secondary dry eye disease is a common finding after severe corneal infection. However, decreased tear film osmolarity has been observed in all patients. These results are in contradiction with increased tear osmolarity reported in primary mild to moderate dry eye disease. Prolonged inflammation and subsequent destruction of resident cells of the conjunctiva and lacrimal glands could be hypothetized.