Observation of precorneal tear film in patients with Sjögren's syndrome.

Abstract

The present study was designed to examine whether the lipid layer of the precorneal tear film has a role in the pathogenesis of dry eye. The study involved 104 eyes of 52 patients with primary Sjögren's syndrome. The lipid layer of the precorneal tear film was observed by non-contact specular microscopy, and relationships between grade of interference color and the tear function parameters were examined. The lipid layer was classified from Grade 1, with no interference color, to Grade 4, of most intense interference color. In addition to these four grades, an oil droplet type not previously described was characterized. The grade of interference color was closely related to the intensity of vital staining. The oil droplet type was associated with more severe ocular surface damage than were Grades 1 through 4. The findings of this study suggest that the state of the lipid layer of the tear film may have some involvement in the pathogenesis of dry eye.