Eye Symptoms In Patients Research Articles

Photophobia and sensations of dryness in patients with migraine occur independent of baseline tear volume and improve following botulinum toxin A injections

BackgroundTo evaluate the efficacy of botulinum toxin A (BoNT-A) in reducing photophobia and dry eye symptoms in individuals with chronic migraine. Additionally, we aimed to evaluate tear film volume as...

Changes in Contrast Sensitivity in Young Adults with Diabetes

Background: This study compared contrast sensitivity and visual acuity of young adults with diabetes to that of controls and attempted to identify predictors of dry eye symptoms in patients with diabetes. Methods: This cross-sectional study, which included 37 patients with diabetes and 37 age-matched controls, was conducted in the Optometry Clinic of Kulliyyah Allied Health Science. All participants were aged between 19 and 39 years. Inclusion criteria were a diagnosis of diabetes without any evidence of ocular disease, abnormalities in colour vision or media opacity. Results: The contrast sensitivity significantly differed between patients and controls (p = 0.045). A multiple regression analysis showed that contrast sensitivity was a significant predictor of ocular symptoms in patients with diabetes, and this was statistically significant (p = 0.002). Conclusions: Contrast sensitivity may be affected during early ocular changes among young adults with diabetes. It may also predict the occurrence of dry eye symptoms in such patients.

Plasma Rich in Growth Factors for the Treatment of Dry Eye after LASIK Surgery

Purpose: The aim of this study was to evaluate the use of plasma rich in growth factors (PRGF) eye drops in patients with dry eye disease after laser-assisted in situ keratomileusis (LASIK) surgery. Material and Methods: This is a longitudinal, retrospective, comparative, and descriptive study of 77 eyes of 42 patients with dry eye disease following LASIK surgery. This study was designed to evaluate the efficacy of PRGF treatment compared to conventional therapy (control group). Outcome measures including signs and symptoms of dry eye disease were evaluated before and after treatment. The percentage of change before and after treatment for each clinical variable measured was compared between both groups. Results: There were 1–4 treatment cycles with PRGF eye drops (1 cycle = 6 weeks). Results showed a statistically significant improvement in the Ocular Surface Disease Index (38.12%), visual analogue scale scores for frequency (41.89%) and severity (42.47%), and the Schirmer test scores (88.98%) after PRGF treatment (p < 0.05). No adverse events were reported after PRGF treatment. Conclusions: These results suggest that PRGF eye drops are effective for the improvement of dry eye symptoms in patients who underwent LASIK surgery in comparison to the conventional therapy. The treatment with PRGF is an alternative for patients who suffer from postoperative dry eye.

Evaluation of the Relationship Between Thyroid Functions and Dry Eye Symptoms in Patients with Hashimoto Thyroiditis

Evaluation of the Relationship Between Thyroid Functions and Dry Eye Symptoms in Patients with Hashimoto Thyroiditis

The sustained effect (12 months) of a single-dose vectored thermal pulsation procedure for meibomian gland dysfunction and evaporative dry eye

PurposeTo evaluate the sustained effect (up to 1 year) of a single, 12-minute vectored thermal pulsation (VTP) treatment in improving meibomian gland function and dry eye symptoms in patients with meibomian gland dysfunction and evaporative dry eye.MethodsThe prospective, multicenter, open-label clinical trial included 200 subjects (400 eyes) who were randomized to a single VTP treatment (treatment group) or twice-daily, 3-month, conventional warm compress and eyelid hygiene therapy (control group). Control group subjects received crossover VTP treatment at 3 months (crossover group). Effectiveness measures of meibomian gland secretion (MGS) and dry eye symptoms were evaluated at baseline and 1, 3, 6, 9, and 12 months. Subjects with inadequate symptom relief could receive additional meibomian gland dysfunction therapy after 3 (treatment group) and 6 months (crossover group).ResultsAt 3 months, the treatment group had greater mean improvement in MGS (P<0.0001) and dry eye symptoms (P=0.0068), compared to controls. At 12 months, 86% of the treatment group had received only one VTP treatment, and sustained a mean improvement in MGS from 6.4±3.7 (baseline) to 17.3±9.1 (P<0.0001) and dry eye symptoms from 44.1±20.4 to 21.6±21.3 (P<0.0001); 89% of the crossover group had received only one VTP treatment with sustained mean improvement in MGS from 6.3±3.6 to 18.4±11.1 (P<0.0001) and dry eye symptoms from 49.1±21.0 to 24.0±23.2 (P<0.0001). Greater mean improvement in MGS was associated with less severe baseline MGS (P=0.0017) and shorter duration of time between diagnosis and treatment (P=0.0378).ConclusionA single VTP treatment can deliver a sustained mean improvement in meibomian gland function and mean reduction in dry eye symptoms, over 12 months. A single VTP treatment provides significantly greater mean improvement in meibomian gland function and dry eye symptoms as compared to a conventional, twice-daily, 3-month regimen. Early VTP intervention for meibomian gland dysfunction is associated with improved treatment outcomes.

Omega-3 fatty acid supplementation improves dry eye symptoms in patients with glaucoma: results of a prospective multicenter study.

Omega-3 fatty acid supplementation improves dry eye symptoms in patients with glaucoma: results of a prospective multicenter study Abdullah Kaya,1 Yakup Aksoy2 1Department of Ophthalmology, Anittepe Military Dispensary, Ankara, Turkey; 2Department of Ophthalmology, Girne Military Hospital, Girne, CyprusWe read the article entitled “Omega-3 fatty acid supplementation improves dry eye symptoms in patients with glaucoma: results of a prospective multicenter study” by Tellez-Vazquez, with great interest.1 The authors found omega-3 fatty acid supplementation to have very beneficial effects on symptoms and clinical findings of dry eye. We appreciate the authors’ well-organized study that contained a large number of participants.Findings in this study show the importance of diet in dry eye syndrome. As a result of industrialization, natural eating habits have changed. Refined foods make up a large part of the diet. Thus, deficiency of essential molecules such as omega-3 is unavoidable. Elderly people especially, may have more deficiency because of potential absorption problems. Omega-3 is important for cell membrane stabilization and health of neural cells.2 Deficiency of omega-3 may have a significant role in dry eye, more than estimated. We suggest that supplementation of omega-3 should be recommended to chronic dry eye patients.View original paper by Tellez-Vazquez.

Omega-3 fatty acid supplementation improves dry eye symptoms in patients with glaucoma: results of a prospective multicenter study.

PurposeThe purpose of this study is to assess the effectiveness and tolerability of a dietary supplement with a combination of omega-3 fatty acids and antioxidants on dry eye symptoms caused by chronic instillation of antihypertensive eye drops in patients with glaucoma.Patients and methodsA total of 1,255 patients with glaucoma and dry eye symptoms related to antiglaucoma topical medication participated in an open-label, uncontrolled, prospective, and multicenter study and were instructed to take three capsules a day of the nutraceutical formulation (Brudypio® 1.5 g) for 12 weeks. Dry eye symptoms (graded as 0–3 [none to severe, respectively]), conjunctival hyperemia, tear breakup time, Schirmer I test, Oxford grading scheme, and intraocular pressure were assessed.ResultsAfter 12 weeks of administration of the dietary supplement, all dry eye symptoms improved significantly (P<0.001) (mean 1.3 vs 0.6 for scratching, 1.4 vs 0.7 for stinging sensation, 1.6 vs 0.7 for grittiness, 1.0 vs 0.4 for tired eyes, 1.1 vs 0.5 for grating sensation, and 0.8 vs 0.3 for blurry vision). The Schirmer test scores and the tear breakup time also increased significantly. There was an increase in the percentage of patients grading 0–I in the Oxford scale and a decrease in those grading IV–V. Compliance was recorded in 62.5% of patients. In compliant patients, the mean differences at 12 weeks vs baseline of dry eye symptoms were statistically significant as compared to noncompliant patients.ConclusionDietary supplementation with Brudypio® may be a clinically valuable additional option for the treatment of dry eye syndrome in patients with glaucoma using antiglaucoma eye drops. These results require confirmation with an appropriately designed randomized controlled study.

Combination Therapy of Intense Pulsed Light Therapy and Meibomian Gland Expression (IPL/MGX) Can Improve Dry Eye Symptoms and Meibomian Gland Function in Patients With Refractory Dry Eye: A Retrospective Analysis.

To assess the improvement in meibomian gland function and dry eye symptoms in patients with refractory dry eye treated with a combination therapy of intense pulsed light (IPL) and meibomian gland expression (MGX). Medical records of 81 consecutive patients with dry eye treated with serial IPL/MGX were retrospectively examined to determine the outcome. All patients had a minimum of 6 months of follow-up after the first IPL/MGX treatment. Patients typically received 1 to 4 IPL treatments spaced 4 to 6 weeks apart. Each IPL session included MGX. Thirty-five charts had complete data for inclusion in analysis. We reviewed demographics, ocular histories, Standard Patient Evaluation of Eye Dryness 2 (SPEED2) symptom survey scores, slit-lamp examinations, and meibomian gland evaluations (MGE) at baseline and at each visit before IPL/MGX treatments. The paired t test showed a significant (P < 0.0001) decrease in SPEED2 with IPL/MGX therapy. Of the 35 patients, 8 (23%) had a ≥50% decrease in SPEED2, 23 (66%) had a 1% to 49% decrease in SPEED2, 1 (3%) had no change in SPEED2, and 3 (9%) had an increase in SPEED2. The Paired t test showed a significant increase in MGE in the left eye but not in the right eye (OD P = 0.163 and OS P = 0.0002). Thirteen patients (37%) had improved MGE bilaterally. Eight patients (23%) had either a decrease in MGE bilaterally or a decrease in 1 eye with no change in the other eye. This retrospective analysis shows that the combination of IPL and MGX can significantly improve dry eye symptoms (in 89% of patients) and meibomian gland function (in 77% of patients in at least 1 eye).

Cyanocobalamin-containing lubricant for topical therapy of LASIK-associated dry eye

to study the effect of topical treatment with Artelac Balance, a cyanocobalamin-containing lubricant, in patients with post-LASIK corneal neuropathy and LASIK-associated dry eye. Patients scheduled for LASIK were enrolled. Inclusion criteria were contact lens wear for 5 years or longer and more than 6 diopters of myopia. The patients were divided into 3 groups. Group 1 was prescribed the cyanocobalamin-containing topical lubricant for 3 months before and 1 month after surgery, group 2 - the same cyanocobalamin-containing lubricant, but only for the first month after surgery, and group 3 received a standard preservative-free lubricant for the first month after surgery. Tear osmolarity and production as well as corneal sensitivity were assessed 90±10 days before and 30±3 days after surgery. The percentage of patients with dry eye symptoms and those who required prolonged use of lubricants were also estimated at day 30±3. Preoperatively, there were no statistically significant differences in demographic characteristics, tear osmolarity, tear production, or corneal sensitivity between the three study groups. At day 30±3 after surgery, tear production and corneal sensitivity were both significantly higher in group 1 than in group 3 (16.8 mm vs. 13.2 mm, p=0.003 and 37.7±3.1 mm vs. 32.4±2.2 mm, p=0.023, respectively). As to the percentage of patients with dry eye symptoms and those who required prolonged use of lubricants, it was lower in group 1 than in group 3 (51.3% vs. 76.3%, p=0.03 and 38.5% vs. 63.2%, p=0.03, respectively). Between the groups 2 and 3, none of the studied parameters differed significantly. Combined pre- and postoperative use of Artelac Balance, a cyanocobalamin-containing lubricant, has been proved effective in restoring corneal sensitivity and reducing dry eye symptoms in patients at high risk for developing LASIK-associated dry eye.

Association of Psoriatic Disease With Uveitis: A Danish Nationwide Cohort Study.

Psoriasis, psoriatic arthritis, and uveitis are inflammatory disorders with significant overlap in their inflammatory pathways. Limited evidence is available about the relationship between psoriatic disease and uveitis. To investigate the potential bidirectional relationship between psoriatic disease, including psoriasis and psoriatic arthritis, and uveitis. We performed a nationwide cohort study of the Danish population from January 1, 1997, through December 31, 2011. We included 74,129 Danish patients with psoriasis who were 18 years or older during the study period. Patients were identified through administrative registries, and information on age, sex, socioeconomic status, medication, and comorbidity was obtained using individual-level linkage of administrative registers. We performed data analysis from January 27 through March 4, 2015. Diagnosis of mild or severe psoriasis or psoriatic arthritis for uveitis risk and diagnosis of uveitis for the risk for psoriasis or psoriatic arthritis. Diagnosis of uveitis, mild psoriasis, severe psoriasis, or psoriatic arthritis. We calculated incidence rates (IRs) and estimated IR ratios adjusted for potential confounders using Poisson regression. We identified 74,129 cases of psoriasis and psoriatic arthritis and 13,114 cases of uveitis. The IRs (95% CIs) for uveitis were 2.02 (1.99-2.06), 2.88 (2.33-3.56), 4.23 (2.40-7.45), and 5.49 (3.36-8.96) for the reference population and those with mild psoriasis, severe psoriasis, and psoriatic arthritis, respectively. In the reference population, these IRs (95% CIs) were 9.37 (9.30-9.45), 1.12 (1.10-1.15), and 1.04 (1.01-1.06), and in patients with uveitis, these statistics were 15.51 (12.92-18.62), 2.66 (1.72-4.13), and 4.25 (3.00-6.01) for mild psoriasis, severe psoriasis, and psoriatic arthritis, respectively. Adjusted IR ratios (95% CIs) for uveitis were 1.38 (1.11-1.70 [P = .02]), 1.40 (0.70-2.81 [P = .34]), and 2.50 (1.53-4.08 [P < .001]) for patients with mild psoriasis, severe psoriasis, and psoriatic arthritis, respectively. For patients with uveitis, IR ratios (95% CIs) were 1.59 (1.32-1.91 [P < .001]) for mild psoriasis, 2.17 (1.40-3.38 [P < .001]) for severe psoriasis, and 3.77 (2.66-5.34 [P < .001]) for psoriatic arthritis, respectively. We found a bidirectional association between psoriatic disease and uveitis. Increased focus on eye symptoms in patients with psoriasis and psoriatic arthritis and on skin and joint symptoms in patients with prior or current uveitis may be appropriate.

Corneal Sensitivity and Dry Eye Symptoms in Patients with Keratoconus.

PurposeTo investigate corneal sensitivity to selective mechanical, chemical, and thermal stimulation and to evaluate their relation to dry eye symptoms in patients with keratoconus.MethodsCorneal sensitivity to mechanical, chemical, and thermal thresholds were determined using a gas esthesiometer in 19 patients with keratoconus (KC group) and in 20 age-matched healthy subjects (control group). Tear film dynamics was assessed by Schirmer I test and by the non-invasive tear film breakup time (NI-BUT). All eyes were examined with a rotating Scheimpflug camera to assess keratoconus severity.ResultsKC patients had significatly decreased tear secretion and significantly higher ocular surface disease index (OSDI) scores compared to controls (5.3±2.2 vs. 13.2±2.0 mm and 26.8±15.8 vs. 8.1±2.3; p<0.001). There was no significant difference in NI-BUT between the two groups (KC: 9.8±4.8 vs. control: 10.7±3.8; p>0.05). The mean threshold for selective mechanical (KC: 139.2±25.8 vs. control: 109.1±24.0 ml/min), chemical (KC: 39.4±3.9 vs. control: 35.2±1.9%CO2), heat (KC: 0.91±0.32 vs. control: 0.54±0.26 Δ°C) and cold (KC: 1.28±0.27 vs. control: 0.98±0.25 Δ°C) stimulation in the KC patients were significantly higher than in the control subjects (p<0.001, for all parameters). No correlation was found between age and mechanical, chemical, heat or cold thresholds in the patients with KC (p>0.05), whereas in the control subjects both mechanical (r = 0.52, p = 0.02), chemical (r = 0.47, p = 0.04), heat (r = 0.26, p = 0.04) and cold threshold (r = 0.40, p = 0.03) increased with age. In the KC group, neither corneal thickness nor tear flow, NI-BUT or OSDI correlated significantly with mechanical, chemical, heat or cold thresholds (p>0.05 for all variables).ConclusionsCorneal sensitivity to different types of stimuli is decreased in patients with keratoconus independently of age and disease severity. The reduction of the sensory input from corneal nerves may contribute to the onset of unpleasant sensations in these patients and might lead to the impaired tear film dynamics.

Tear osmolarity and dry eye symptoms in diabetics

PurposeTo assess the relationship between tear osmolarity and dry eye symptoms in patients with diabetes.Patients and methodsFifty patients with diabetes were enrolled. Demographic information and past medical history were recorded. Symptoms were assessed using the ocular surface disease index (OSDI). Tear osmolarity of each eye was measured with the TearLab® Osmolarity System.ResultsThe majority of the subjects were female (76%), African American (56%), and/or had a diagnosis of type 2 diabetes (82%). The mean ± standard deviation (SD) for age was 54.6±13.4, and maximum tear osmolarity was 304.6±12.7 mOsm/L. Men had higher osmolarity than women (mean ± standard error (SE) 311.8±4.0 mOsm/L versus 302.3±1.9 mOsm/L, P=0.02). Age, race, use of artificial tears, years of diabetes, and hemoglobin A1c did not have a statistically significant association with tear osmolarity. Longer duration of diabetes was associated with lower (less severe) OSDI scores (r=−0.35, P=0.01). Higher tear osmolarity was associated with lower (less severe) OSDI scores (r=−0.29, P=0.04).ConclusionApproximately half of the diabetic subjects in our study had elevated tear osmolarity, and half of our population also reported symptoms consistent with dry eye disease. However, the two were slightly inversely related in that those with higher osmolarity reported fewer symptoms. Subjects with a longer duration of diabetes also reported fewer dry eye symptoms. Therefore, health care providers should be aware that patients who are most likely to have ocular surface disease, including those with long-standing diabetes, may not experience symptoms and seek care in a timely manner.

Combination Therapy With Diquafosol Tetrasodium and Sodium Hyaluronate in Patients With Dry Eye After Laser In Situ Keratomileusis

To evaluate the possible advantages of combination therapy with diquafosol tetrasodium and sodium hyaluronate for dry eye after laser in situ keratomileusis (LASIK). Prospective randomized comparative trial. A total of 206 eyes of 105 patients who underwent LASIK were enrolled in this study. Patients were randomly assigned to 1 of 4 treatment groups according to the postoperative treatment: artificial tears, sodium hyaluronate, diquafosol tetrasodium, and a combination of hyaluronate and diquafosol. Questionnaire responses reflecting subjective dry eye symptoms, uncorrected and corrected visual acuity, functional visual acuity, manifest refraction, tear break-up time, fluorescein corneal staining, Schirmer test, and corneal sensitivity were examined before and 1 week and 1 month after LASIK. Distance uncorrected visual acuity was significantly better in the combination group than in the hyaluronate group 1 week and 1 month after LASIK. Near uncorrected visual acuity was significantly better in the combination group than in the artificial tear and diquafosol groups 1 week and 1 month after LASIK. Distance functional visual acuity improved significantly only in the combination group 1 month after LASIK. The Schirmer value in the combination group was significantly higher than that in the hyaluronate group at 1 month after LASIK. Subjective dry eye symptoms in the combination group improved significantly compared with those in the other groups 1 week after surgery. Our results suggest that hyaluronate and diquafosol combination therapy is beneficial for early stabilization of visual performance and improvement of subjective dry eye symptoms in patients after LASIK.

Evaluation of Ocular Surface Temperature in Patients with Pterygium

Purpose: To investigate ocular surface temperature in eyes with pterygium and dry eye disease.Methods: Eighteen eyes of 18 patients with pterygium (group 1), 18 eyes of 18 patients diagnosed with dry eye disease (group 2), and 22 eyes of 22 healthy subjects with no signs of dry eye (group 3), were included in this prospective study. Schirmer's test I and II, and tear film break up time (BUT) were evaluated. Infrared thermal imaging (Tomey TG 1000, Tomey Corp, Nagoya, Japan) was used to study the temperature of the ocular surface. All measurements were performed by one examiner only.Results: No significant difference in temperature course over ten seconds of eye opening was present between groups 1 and 2 (p = 0.551). However, a significant difference was present between groups 1 and 3 (p = 0.001) and between groups 2 and 3 (p = 0.003). Comparing group 1 and group 2, statistically significant differences in Schirmer’s test I (p < 0.001) and II (p < 0.001) and BUT (p = 0.04) were present. There were also significant differences in Schirmer`s test I (p < 0.001) and II (p < 0.001) and BUT (p < 0.001) between group 2 and group 3. No significant difference in Schirmer’s test I (p = 0.785) and II (p = 0.871) was present between group 1 and group 3. However, a statistically significant difference in BUT was noted (p < 0.001).Conclusion: During sustained eye opening, a significant decrease in corneal surface temperature occurred in eyes with pterygium and dry eye disease. Thermography, in addition to other investigations, might be used to objectively identify dry eye symptoms in patients with pterygium. In addition to cosmetic appearance, increasing astigmatism, and expanding growth towards the center of the cornea, this new supplementary data may help to determine the proper time for intervention.

Contact lenses and the rate of evaporation measured in vitro; the influence of wear, squalene and wax

Accelerated evaporation of tears may contribute to dry eye symptoms. It is not clear whether contact lenses decrease or increase the rate of evaporation of tears. In this study, the rates of evaporation through contact lenses (ERTCL) were measured in vitro to gain insight to this question. Contact lenses were equilibrated with various solutions to determine if they influenced ERTCL in vitro. ERTCL was measured gravimetrically. ERTCL measured in vitro for used contact lenses was about 20% faster than for buffer alone suggesting that natural tear components bound to the lenses changed the ERTCL. One natural tear component that binds to contact lenses is waxes. Equilibration of contact lenses with wax increased the ERTCL by about 30% suggesting that waxes might potentially increase ERTCL in vivo. Squalene, found in sebum and possibly meibum was infused into the contact lenses as a step toward decreasing the ERTCL. Squalene decreased ERTCL by over 60% in vitro. Soaking a contact lens in DuraSite(®) with benzalkonium chloride (BAK) did not alter the ERTCL. ERTCL were about 40% higher than the evaporation rate of DuraSite(®) alone or without BAK. In addition to lowering the ERTCL, the squalene in contact lenses could be a source of terpenoids to replace the terpenoids deficient in patients with MGD. If the ERTCL could be minimized in vivo, contact lenses could potentially be used to relieve dry eye symptoms in patients with evaporative dry eye.

눈피로(안구건조) 환자에 대한 임상적 고찰

Objectives : The purpose of this report was to examine the relation between ocular fatigue and dry eye symptoms in patients with ocular fatigue. Methods : 115 patients with ocular fatigue disease were included in this analyses. The study examination included a symptom interview that assessed stiff sense, foreign body sense, pain, soreness, redness, etc. and ocular fatigue. Results : The survey showed in subjective ocular fatigue in all subjects. All patients(115) reported symptoms of ocular fatigue and 25.2% (29/115) were diagnosed as having dry eye with symptoms. Conclusions : These findings suggest that there is a strong between ocular fatigue and dry eye.

Correlation between eye and ear symptoms and lack of teeth, bruxism and other parafunctions in a population of 1006 patients in 2003-2008

IntroductionParafunctions (harmful habits) play a crucial role in the formation of temporo-mandibular joint (TMJ) dysfunction syndrome with disc displacement. Disorder symptoms in temporo-mandibular joints manifest themselves in the eye and ear but are usually not associated with the dysfunction of temporo-mandibular joints and that might lead to errors in diagnosis. The aim of the study was to examine the influence of missing teeth and parafunctions on the occurrence of ear and eye symptoms in patients treated in the Department of Prosthodontics of the Medical University of Lublin.Material and methodsThe patient group consisted of 753 women and 253 men aged 10 to 82 years who had been treated in the Department of Prosthodontics, Medical University of Lublin in the years 2003-2008 due to various symptoms associated with temporo-mandibular joint dysfunction.ResultsEye (24.84%, n = 785) and ear (33.38%, n = 785) syndromes occur on average more often in patients with parafunctions than without them (15.98%, n = 219 and 23.29%, n = 219). However, only parafunctions involving tooth contact should be taken into consideration when diagnosing eye and ear syndromes. The data presented here show that the number of missing teeth does not have a significant influence on the frequency of occurrence of parafunctions. Parafunctions have become a very important factor in the diagnosis of diseases and pathological symptoms of eye and ear as the rate at which they occur is growing.ConclusionsThe kind of parafunction is very important. Only those involving tooth contact should be taken into consideration when diagnosing eye and ear syndromes.

Dry Eye Symptoms in Patients after Eyelid Reconstruction with Full-Thickness Eyelid Defects: Using the Tomey TG-1000 Thermographer

Background: Large full-thickness eyelid defects are conventionally reconstructed by either a Hughes flap or Cutler-Beard bridge flap. Since the structure of the eyelid and its components are necessary for the tear film production and stability, we investigated the outcome after eyelid reconstruction focusing on dry eye symptoms using a new thermographic device, the TG-1000. Methods: Seventeen eyes of patients formerly treated with Hughes flaps (n = 16) and a Cutler-Beard bridge flap (n = 1) were compared to untreated healthy eyes (n = 17) regarding the functional and aesthetic outcome. The follow-up ranged from 3 to 63 months (mean 24.88 ± 17.86). Results: There was no significant difference in Schirmer’s test, break-up time and ocular surface temperature (p > 0.05) between patients after full-thickness eyelid reconstruction and a control group. Eleven patients had minor postoperative complications such as notching of the lid margin (11/17), epiphora (1/17), superficial punctate keratitis (6/17), trichiasis (2/17) and a mild tendency to eversion of the lid margin (6/17). More than 75% of the patients rated their postoperative aesthetic outcome as good or even excellent. Conclusion: The new TG-1000 device is a simple and quick tool for screening of dry eye. This study shows that tarsoconjunctival grafts offer good aesthetic and functional outcome with sufficient tear film composition and stability.

Correlation of non‐contact Meibography to dry eye symptoms and signs in Sjögren`s syndrome and graft‐versus‐host disease

AbstractPurpose Severe dry eye is often observed in patients suffering from Sjögren’s syndrome (SS) or chronic graft‐versus‐host‐disease (cGVHD). Although the underlying pathomechanisms differ, deficient tear production, as well as meibomian gland dysfunction (MGD) are present in both. Non‐contact Meibography can achieve a non‐invasive investigation of the meibomian glands inside the tarsal plates of the eyelids. The purpose of this study was to evaluate the correlation of non‐contact Meibography to dry eye symptoms in patients suffering from SS or cGVHD.Methods We examined 37 patients suffering from SS and 11 patients with cGVHD of our dry eye unit. Subjective dry eye symptoms were evaluated with a visual analogue scale and the Ocular Surface Disease Index© (OSDI). Clinical signs of MGD were graded from 0 to 3 according to the Report of the TFOS Workshop on MGD. Non‐contact Meibography was performed by a Heidelberg Retina Angiograph 1, featuring two infrared diode lasers. Partial or complete loss of the meibomian glands was scored according to the meiboscore of Arita and colleagues.Results The mean age of the study population was 55.3 ± 13.4 years and 91.7% were women. The Meiboscore correlated significantly with the subjective symptoms assessed by visual analogue scale. The grading of the lid margins correlated significantly with the Meiboscore.Conclusion Non‐contact Meibography is a valuable tool in the diagnosis of MGD. Standard ophthalmic angiography cameras equipped with infrared diodes can easily perform it. The meiboscore correlates with the intensity of subjective symptoms and lid margin changes in patients suffering from SS or cGVHD.

Influência da toxina botulínica tipo A na função lacrimal de pacientes com distonias faciais

To analyze the influence of botulinum toxin on the lacrimal function of patients with facial dystonias. Patients with the diagnosis of hemifacial spasm or benign essential blepharospasm were evaluated and invited to answer the Ocular Surface Index Disease (OSID) questionnaire. All patients underwent Schirmer I and basal tests; break-up time (BUT) test and lacrimal clearance evaluation. On the following day, the patients were treated with botulinum toxin. The Ocular Surface Index Disease questionnaire and all the initial tests were reapplied 30 days after the treatment by the same examiner. Twenty-six patients were enrolled in this study, 15 (57.7%) with hemifacial spasm and 11 (42.3%) with benign essential blepharospasm. The mean age of patients with hemifacial spasm was 70.9 ± 13.3 years and the male:female ratio was 1:1.5. In the group of patients with benign essential blepharospasm, the mean age was 68.9 ± 8.4 years with a female preponderance (90.0%). After the treatment, the Ocular Surface Index Disease score, Schirmer I and basal tests score decreased in both groups. The mean of Break-up time test increased significantly in both groups. The lacrimal clearance evaluation showed a greater number of eyes that achieved a complete drainage of the tears after the treatment in both groups. The treatment with botulinum toxin improved dry eye symptoms in patients with facial dystonia. Despite of the aqueous portion of tear have decreased, blink modifications improved the tear stability and drainage.