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Results for “ocular surface disease”

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PubMed2015

Dry eye symptoms align more closely to non-ocular conditions than to tear film parameters.

OBJECTIVE: To evaluate the relationship between dry eye symptoms, non-ocular conditions and tear film parameters. DESIGN: Cross-sectional study. PARTICIPANTS/SETTING: The study population consisted of patients who were seen in the Miami Veterans Affairs eye clinic. Patients filled out standardised questionnaires assessing dry eye symptoms (dry eye questionnaire 5 (DEQ5) and ocular surface disease index (OSDI)), non-ocular pain, depression and post-traumatic stress disorder (PTSD), and also underwent measurement of tear film parameters. MAIN OUTCOME MEASURES: Correlations between dry eye symptoms and non-ocular conditions as compared with tear film parameters. RESULTS: 136 patients with a mean age of 65 (SD 11) years participated in the study. All correlations between the dry eye questionnaire scores (DEQ5 and OSDI) and (A) self-reported non-ocular pain measures (numerical rating scale and pain history), (B) depression and (C) PTSD were significant and moderate in strength (Pearson's coefficient 0.24 to 0.60, p<0.01 for all). All correlations between the dry eye questionnaires and tear film measures were weak (Pearson's coefficient -0.10 to 0.18) and most were not significant. Multivariable linear regression analyses revealed that PTSD and non-ocular pain more closely associated with dry eye symptoms than did tear film parameters. Specifically, non-ocular pain and PTSD accounted for approximately 36% of the variability in DEQ5 scores (R=0.60) and approximately 40% of variability in OSDI scores (R=0.64). Of note, none of the tear parameters remained significantly associated with dry eye symptoms in either model. CONCLUSIONS: Dry eye symptoms more closely align to non-ocular pain, depression and PTSD than to tear film parameters.

Aged↗

PubMed2005

CCR 4 and CCR 5 expression in conjunctival specimens as differential markers of T(H)1/ T(H)2 in ocular surface disorders.

BACKGROUND: Accurate inflammatory mechanisms in chronic ocular surface diseases (OSDs) cannot routinely be assessed. New techniques for investigating ocular surface inflammatory pathways are of major importance. OBJECTIVE: To investigate the expressions of CCR 4 and CCR 5, known to be related to the T(H)2 and T(H)1 systems, respectively, and HLA-DR in conjunctival impression cytology specimens from patients with chronic OSDs. METHODS: In this case-controlled study, impression cytology specimens were taken in a series of patients with vernal keratoconjunctivitis (n=21), giant papillary conjunctivitis (n=6), or keratoconjunctivitis sicca (KCS; n=17), or receiving topical antiglaucoma treatments (n=31), and from 20 normal subjects. Conjunctival cells were incubated with mAbs to CCR 4, CCR 5, CD45, and HLA-DR to quantify conjunctival inflammation in a masked manner using flow cytometry. RESULTS: HLA-DR was higher in the glaucoma and KCS groups than in allergic and normal eyes. CCR 4 was overexpressed in allergy and glaucoma, whereas CCR 5 was higher in the KCS and glaucomatous groups. CD45 was expressed by only few cells in all groups, with almost no significant differences. CCR 4 expression was negatively correlated with CCR 5 and HLA-DR, whereas CCR 5 was positively correlated with HLA-DR. CONCLUSION: This study confirms the overexpression of chemokine receptors by the conjunctival epithelium in OSDs. CCR 4 and CCR 5 expression may vary according to the immune pathway involved. Accurate mechanisms in ocular surface inflammatory reactions-that is, those related to the T(H)1 or T(H)2 systems-could be differentiated by CCR 4/CCR 5 profiles. Our results also suggest that long-term use of topical treatments may stimulate both systems.

Adolescent↗

PubMed1990

Tear film and ocular surface changes in a rabbit model of neurotrophic keratitis.

The authors studied the tear film and ocular surface in a rabbit model of neurotrophic keratitis to determine the extent to which the surface disease of neurotrophic keratitis resembled keratoconjunctivitis sicca. After denervation, tear film osmolarity increased and remained significantly elevated for 14 weeks. The ocular surface developed decreased conjunctival goblet cell density, decreased corneal epithelial glycogen, and morphologic changes similar to those seen in keratoconjunctivitis sicca. Although the conjunctival changes were consistent with the increases in tear film osmolarity and the surface disease of keratoconjunctivitis sicca, the corneal changes observed with denervation, including slit-lamp findings, morphologic changes, and decreases in glycogen, were too severe and rapid in onset to be accounted for by osmolarity alone. Neurotrophic "keratitis" is an ocular surface disease composed in part of the surface disease of keratoconjunctivitis sicca. However, the data also support an additional mechanism for corneal disease that could be due to the trophic influence of the trigeminal nerve.

Animals↗

PubMed2002

Cataract surgery in allogeneic bone marrow transplant recipients with graft-versus-host disease(1).

PURPOSE: To study the outcomes of cataract surgery in allogeneic bone marrow transplant recipients with documented graft-versus-host disease (GVHD) and to elucidate the concomitant ocular surface problems often encountered in these patients. SETTING: W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA. METHODS: This retrospective study comprised 12 cataract surgeries in 7 patients with GVHD) after allogeneic bone marrow transplantation. In particular, visual acuity improvement, surgical complications, and problems associated with concomitant ocular surface disease were reviewed. RESULTS: The mean visual acuity improved significantly from 20/46 (logMAR 0.32) preoperatively to 20/21 (logMAR 0.02) postoperatively (P <.005). The mean postoperative follow-up was 23 months (range 3 to 48 months). All patients had dry eyes, and 3 had conjunctival cicatrization with mild keratinization. No patient had postoperative corneal breakdown. CONCLUSION: With aggressive management of dry eyes and other ocular surface problems, cataract surgery had excellent outcomes in patients with GVHD.

Adult↗

PubMed1998

The meibomian glands and tear film lipids. Structure, function, and control.

Meibomian gland disease--and, in particular, obstructive meibomian gland disease--makes an important contribution to ocular surface disease, in the form of meibomian keratoconjunctivitis. With improved methods for the study of meibomian oil composition and function, we are moving closer to the possibility of distinguishing the contribution of meibomian deficiency, as opposed to inflammatory events, to this disorder. More importantly, where aqueous tear deficiency and meibomian gland disease coincide in patients with dry eye, we are closer to the possibility of distinguishing their relative contributions to the dry eye state. This has implications for future therapies.

Androgens↗

PubMed1997

Inflammatory cytokines in the tears of patients with ocular rosacea.

OBJECTIVE: The purpose of the study is to compare tear fluid concentrations of interleukin-1alpha (IL-1alpha), tumor necrosis factor-alpha (TNF-alpha), and epidermal growth factor (EGF) in ocular rosacea with those in control subjects and to examine the relation between tear functions, such as production and clearance rate, and the concentrations of cytokines in tear fluid. PARTICIPANTS AND INTERVENTION: Fourteen patients with severe meibomian gland disease, facial rosacea, and symptoms of ocular irritation were examined for ocular surface disease, tear production, and tear clearance rate (TCR). Twelve control subjects, frequency-matched for age, and 15 ideal normal subjects with no ocular symptoms and normal tear function were assessed using the same parameters. Minimally stimulated tear samples (20 microl) were drawn from each subject and analyzed using a sandwich enzyme-linked immunosorbent assay to detect IL-1alpha, TNF-alpha, and EGF. RESULTS: Tear IL-1alpha concentration was significantly higher in patients with rosacea than in age-matched (P = 0.003) and ideal control subjects (P < 0.001). Tumor necrosis factor-alpha was not detected in patients or control subjects, indicating levels of less than 10 pg/ml. Epidermal growth factor was not significantly higher in patients with rosacea than in age-matched control subjects. Tear turnover LN(TCR) was lower in patients with rosacea than in both age-matched (P = 0.048) and ideal control subjects (P = 0.002). Schirmer I scores were statistically lower in patients with rosacea than in ideal control subjects (P = 0.013), but not age-matched control subjects. Interleukin-1alpha was correlated inversely with LN(TCR) (r= -0.58, P < 0.0001) and Schirmer I (r = -0.39, P = 0.012). CONCLUSIONS: Concentrations of IL-1alpha are present in normal tears but are elevated in ocular rosacea, whereas TNF-alpha is not present in either case. The reduced tear turnover, LN(TCR), its inverse correlation with IL-1alpha, and the absence of TNF-alpha in the tears of these patients suggest that the increased concentration of IL-1alpha observed may be largely because of clearance failure of cytokine normally produced at the ocular surface.

Adult↗

PubMed1995

Diseases of the eyelid-conjunctival complex and corneal complications of lid disease.

The vascular anatomy of the eyelids has been studied in more detail with regard to possible applications in eyelid surgery. The recognition of different subtypes of eyelid laxity, eg, floppy eyelid, lax eyelid, and eyelid imbrication syndromes, as underlying causes of conjunctival and corneal irritation will contribute to their successful management. Involvement of eyelid, conjunctiva, or cornea has been reported in association with systemic diseases such as Wegener's granulomatosis, xeroderma pigmentosum, scleromyxedema, sarcoidosis, and abnormalities of mitochondrial DNA. The ocular manifestations may be the presenting feature of the underlying disease. Results in two series of patients with ocular surface diseases such as chemical and thermal eye burns suggest that the use of autologous nasal mucosa transplantation is promising for the management of this disorder. Clinical features and results of cryotherapy are reviewed in two series of patients with congenital distichiasis and trichiasis due to ocular cicatricial pemphigoid.

Conjunctiva↗

PubMed1999

Population-based cohort study of microbial keratitis in Scotland: incidence and features.

OBJECTIVE: To investigate the incidence and features of bacterial, fungal and protozoal keratitis in Scotland. DESIGN: Prospective, population-based cohort study of all persons who developed culture proven microbial keratitis over an 8 month period. SETTING: West of Scotland, UK. SUBJECTS: Approximately 3,000,000 population. MAIN OUTCOME MEASURES: Incidence and risk factors for microbial keratitis. METHODS: All patients were included who had presumed microbial keratitis from which bacteria, fungi or Acanthamoeba was isolated from the corneal scraping by the hospital laboratory using a standardised protocol. In addition, contact lens wearing patients with pathognomonic features of Acanthamoeba keratitis, who yielded a negative culture result when referred on chlorhexidine therapy, were included if Acanthamoeba could be cultured from their lens storage case. RESULTS: The overall annual incidence of culture-proven microbial keratitis was 0.26 per 10,000 with a rate of 1.8 per 10,000 for contact lens wearers (all types, soft and rigid). Based on a previous pilot study of 'presumed' microbial keratitis in Glasgow, it was possible to estimate the incidence of expected 'presumed' microbial keratitis as 0.36 per 10,000 overall and 2.44 per 10,000 for contact lens wearers (all types). The incidence for Acanthamoeba keratitis was 1.49 per 10,000 soft contact lens wearers; this infection was not detected in the absence of contact lens wear nor with use of gas permeable or rigid contact lenses. CONCLUSIONS: 'Presumed' microbial keratitis from all causes, in the adult population, was approximately three times less common in the West of Scotland (0.36 per 10,000) than would be expected from a comparable retrospective study from Minnesota, USA for the years 1980-1988 (1.1 per 10,000). It was rare (approximately one case expected in 2 million per year) in the absence of pre-existing corneal disease, cosmetic contact lens wear or trauma. Ocular surface disease was the underlying cause predisposing to infection in 58% of cases, with an incidence of 'presumed' keratitis of 0.21 per 10,000 population; the highest incidence was found in the elderly population. Contact lens wear was responsible for 38% of cases, emphasising the importance of preventive hygiene and effective disinfection in this group. The estimated incidence of 'presumed' microbial keratitis in the West of Scotland associated with cosmetic wear (daily and extended use) of soft contact lenses was significantly less (P<0.05) than that expected from a prospective study in New England, America in 1985 (266 per 10,000, rather than 8.05 per 10,000). However, the estimated incidence for presumed microbial keratitis for the West of Scotland associated with wearing soft contact lenses for cosmetic purposes in the daily wear modality (266 per 10,000) was less, but not significantly less, than that found in the prospective American study (4.20 per 10,000). The daily wear mode for contact lenses is almost universal in the West of Scotland, where extended wear has never been recommended. Extended wear has been shown in the USA to be associated with an incidence of presumed microbial keratitis between five and ten times higher than that associated with daily wear. This explains the lower incidence we have observed and a difference with the US study for overall infection rates but not when associated with daily wear alone. The incidence of proven Acanthamoeba keratitis found in the Scottish study among wearers of soft contact lenses for daily wear cosmetic purposes was exceptionally high at 1.49 per 10,000.

Journal Article↗

PubMed2000

[Advancement in the study of embryonic stem cells and the emerging potential promising future of ocular tissue engineering].

The advancement of the study in embryonic stem cells and tissue engineering makes it promising to effectively solve the intractable problems in the present ophthalmic practice. The problems include: no effective measures to regain the visual function of the patients with late stage glaucoma or retinal diseases, shortage of appropriate biocompatible donor tissues in treating ocular surface diseases.

Animals↗

PubMed1992

Ocular surface lesions due to keratoconjunctivitis sicca: in primary Sjögren's syndrome.

Keratoconjunctivitis sicca is usually part of Sjögren's syndrome (SS) which is systemic disease. Ocular surface lesions are ascribed either to the reduction, or to to the low quality of tears. To address this question, ocular surface lesions were evaluated in 20 SS patients by the rose bengal test (RBT). The results were compared to those obtained in 20 normal volunteers and collated with the quality (estimated by the break-up-time) and the quantity of tears (estimated by the shirmer's I test and the level of lacrimal lactoferrin, LF). The RBT scores did not correlate with the shirmer's test results, neither did they with the break-up times. This is consistent with the view that Schirmer's I Test and break-up-time cannot make any distinction between patients from controls. In contrast, the RBT scores correlated well with the levels lacrimal LF and paralleled to serological abnormalities.

Adult↗

PubMed2003

Corneal toxicity: the epithelium and stroma in iatrogenic and factitious disease.

Corneal toxicity is caused by chemical trauma and by iatrogenic and factitious disease, which are often overlooked, and which are reviewed here. The clinical signs of iatrogenic disease are usually nonspecific and identical to those resulting from other causes of surface disease. Factitious disease is either the result of mechanical trauma or the abuse of toxic eye drops. One epidemiological study, in a tertiary setting, identified 13% of keratoconjunctivitis cases as iatrogenic. Healing was prolonged taking 7-93 (median 28.5) days. Pathogenic mechanisms vary widely with different drugs and include subclinical scarring, pseudopemphigoid, drug-induced ocular cicatricial pemphigoid, and toxic follicular reactions. There is little readily available data either on the probability of the development of adverse reactions or for the comparison of different drugs. The assessment of the toxicity of topical drugs is currently by the Draize test in rabbits. New in vitro tests on human corneal epithelial cell cultures include ATP assays for cell viability, scanning EM of epithelial microvilli, and vital staining to assess cell membrane permeability and intracellular esterase. Despite their simplicity, these test systems can correlate well with clinical toxicity and provide a toxicity index for drug comparisons. Treatment requires drug withdrawal or substitution by non-preserved and less toxic preparations. Factitious injury is rare, difficult to diagnose, and should only be considered when all other diagnoses have been excluded. Prevention requires a high level of awareness of the potential for iatrogenic disease, particularly in the high-risk setting of chronic ocular surface disease.

Corneal Diseases↗

PubMed2006

Mucin characteristics of human corneal-limbal epithelial cells that exclude the rose bengal anionic dye.

PURPOSE: Rose bengal is an organic anionic dye used to assess damage of the ocular surface epithelium in ocular surface disease. It has been proposed that mucins have a protective role, preventing rose bengal staining of normal ocular surface epithelial cells. The current study was undertaken to evaluate rose bengal staining in a human corneal-limbal epithelial (HCLE) cell line known to produce and glycosylate membrane-associated mucins. METHODS: HCLE cells were grown to confluence in serum-free medium and switched to DMEM/F12 with 10% serum to promote differentiation. Immunolocalization of the membrane-associated mucins MUC1 and MUC16 and the T-antigen carbohydrate epitope was performed with the monoclonal antibodies HMFG-2 and OC125 and jacalin lectin, respectively. To assess dye uptake, cultures were incubated for 5 minutes with 0.1% rose bengal and photographed. To determine whether exclusion of negatively charged rose bengal requires a negative charge at the cell surface, cells were incubated with fluoresceinated cationized ferritin. The effect of hyperosmotic stress on rose bengal staining in vitro was evaluated by increasing the ion concentration (Ca+2 and Mg+2) in the rose bengal uptake assay. RESULTS: The cytoplasm and nucleus of confluent HCLE cells cultured in media without serum, lacking the expression of MUC16 but not MUC1, as well as human corneal fibroblasts, which do not express mucins, stained with rose bengal. Culture of HCLE cells in medium containing serum resulted in the formation of islands of stratified cells that excluded rose bengal. Apical cells of the stratified islands produced MUC16 and the T-antigen carbohydrate epitope on their apical surfaces. Colocalization experiments demonstrated that fluoresceinated cationized ferritin did not bind to these stratified cells, indicating that rose bengal is excluded from cells that lack negative charges. Increasing the amounts of divalent cations in the media reduced the cellular area protected against rose bengal uptake. CONCLUSIONS: These results indicate that stratification and differentiation of corneal epithelial cells, as measured by the capacity to produce the membrane-associated mucin MUC16 and the mucin-associated T-antigen carbohydrate on their apical surfaces provide protection against rose bengal penetrance in vitro and suggest a role for membrane-associated mucins and their oligosaccharides in the protection of ocular surface epithelia.

Antibodies, Monoclonal↗

PubMed1988

The significance of ophthalmological symptoms in idiopathic blepharospasm.

Two hundred and seventy-two patients with idiopathic blepharospasm were reviewed to establish the role of local eye disease in their illness. The majority of patients (57%) had symptoms at the onset of their illness such as dryness of the eyes, grittiness, irritation or photophobia suggesting eye lid or ocular surface disease. Detailed ophthalmological examination at the time of presentation had been carried out in 170 of the 272 cases; 64% of these patients had ocular symptoms, and 40% had demonstrable ocular surface or eye lid pathology. Such pathology was usually bilateral, chronic and resistant to local treatment. Blepharospasm developed in these patients after a long latent period, often of many years. Unilateral pathology was acute, normally responded well to local treatment, but was followed by the development of bilateral blepharospasm usually within six months. Amongst all 272 patients, those without ocular symptoms at presentation rarely developed them subsequently; if they did, there were no abnormal signs. The data suggest that ophthalmological disorders may trigger idiopathic blepharospasm in a substantial proportion of cases predisposed to develop this condition.

Adolescent↗

PubMed1988

Quantitative rose bengal staining technique for external ocular diseases.

A new technique for quantitative assessment of rose bengal staining in ocular surface disorders is described. The globe is divided into 16 quadrants which represent clinically important regions of the eye. Each quadrant is graded numerically for intensity and area of rose bengal staining. This simple grading system facilitates mathematical study and computer analysis of ocular surface disease.

Diagnosis, Computer-Assisted↗

PubMed2006

[Pathology of the ocular surface].

The ocular surface is a new concept including the cornea, the conjunctiva, the lids and the lachrymal tear film in a new approach as an anatomic, physiologic and physiopathologic entity. The goal of the ocular surface, in a functional approach, is the maintenance of the corneal transparency. Ocular surface diseases are very frequent with numerous aspects and aetiologies and with no specificity for functional or clinical signs, particularly in chronical forms. Inflammation is most frequently associated in chronical diseases, subclinically as in keratoconjunctivitis sicca or, predominantly in allergy or immunologic dysfunction. Ocular surface is also involved in several kinds of subspecialties as iatrogenic toxicity, contactologia, and, on a surgical way, corneal refractive surgery, ocular surface reconstruction with graft and also filtering surgery for glaucoma.

Conjunctivitis↗

PubMedDate not supplied

Cicatricial pemphigoid and dry eye.

Cicatricial pemphigoid is the most common of the immunobullous disorders causing conjunctival cicatrization and is an autoimmune disease in which the ocular component of the immunopathology is directed at the conjunctival basement membrane. The disease is usually bilateral and more common in females, with most cases occurring between 30-90 years, and most often in the seventh decade. The disease occasionally occurs in children. Tear deficiency is a major cause of symptoms, although loss of vision is usually due to surface failure before the onset of aqueous tear deficiency, which occurs late in the progression of the disease. Management of the dry eye must be integrated with the management of the other components of both the ocular surface disease and inflammation. Management requires plastic surgery for the lid and lash malposition, tetracyclines and lid hygiene for the accompanying blepharitis. For the dry eye, the use of lubricants without preservatives is important, to avoid toxicity, and lubricant ointment is helpful for the relief of symptoms in terminally dry eyes without the capacity for surface wetting. Contact lenses, either large limbal diameter rigid gas permeable or gas permeable scleral lenses, are useful for treating dry eye and improving vision in some patients. Control of the conjunctival inflammation is mandatory to prevent disease progression and usually requires systemic immunosuppressive therapy.

Adult↗

PubMed2006

Argon laser photodynamic therapy of human corneal neovascularization after intravenous administration of dihematoporphyrin ether.

PURPOSE: Long-term evaluation of dihematoporphyrin ether (DHE) safety and efficacy as photodynamic therapy (PDT) for patients with corneal neovascularization (KNV). DESIGN: Prospective multi-center interventional case series. METHODS: Seven patients were enrolled after Institutional Review Board approval and a detailed informed consent were obtained. Eligible patients presented with clinically stable KNV without active vessel progression or inflammation. All patients with severe hypertension, history of renal or hepatic disease, or sensitivity to porphyrins, and those with active keratitis or uncontrolled ocular surface disease were excluded. DHE was administered as an intravenous bolus (2 mg/kg). Seventy-two hours later, PDT was carried out using argon green laser (514 nm). The main outcome measure, extent of vascular thrombosis, was estimated during postoperative follow-up examinations performed at day 1, 1 week, 6 months, and up to 12 years postoperative. RESULTS: All patients obtained an immediate reduction in measurable corneal vascularization. With at least 6 months of follow-up, six of seven patients maintained a significant reduction (52.5% +/- 19.6%, P < .01) in KNV. The mean length of followup was 5.4 years (Range = 6 months to 12 years) during which time there were no other ocular changes attributable to laser treatment. Three patients suffered significant systemic short-term phototoxicity reactions. CONCLUSIONS: Intravenous DHE followed by photodynamic treatment in humans is effective for the reduction of inactive, established KNV. However, the significant short-term adverse effects related to systemic administration of this drug are of particular concern and warrant further investigation.

Adult↗

PubMed2000

A standardized visual scale for evaluation of tear fluorescein clearance.

OBJECTIVE: To evaluate the correlation and the agreement between a validated fluorometric technique (fluorescein clearance test) and a newly developed, clinically practical standardized visual scale to evaluate tear fluorescein clearance. Also, the ability of this new method to distinguish healthy persons from patients reporting ocular irritation associated with meibomian gland disease (MGD), aqueous tear deficiency (ATD), or both was tested. DESIGN: Case-controlled study. PARTICIPANTS: Healthy persons (n = 32), patients with MGD associated with rosacea (n = 30), patients with noninflammatory atrophic MGD (n = 24), and patients with ATD (n = 39) were evaluated. There was a similar age and gender distribution in each group. METHODS: Each subject completed a symptom questionnaire and had the following tests performed: fluorescein clearance test (FCT), standardized visual scale test (SVST), corneal fluorescein staining, Schirmer 1 test, corneal and conjunctiva sensitivity, and eyelid margin and meibomian gland examination. MAIN OUTCOME MEASURES: The FCT was performed with a CytoFluor II fluorophotometer by measuring the fluorescein concentration in minimally stimulated tear samples collected from the inferior tear meniscus 15 minutes after instillation of 5 microl of 2% sodium fluorescein. The SVST score, ranging from 0 to 6, was obtained by comparing the colors of the standardized visual scale with the color of the lateral inferior tear meniscus immediately before tear collection for the FCT. Severity of ocular irritation was assessed with a symptom questionnaire. Schirmer 1 test (without anesthesia), biomicroscopic meibomian gland evaluation, and corneal fluorescein staining were performed. Corneal and conjunctival sensitivity scores were assessed with the Cochet-Bonnet aesthesiometer. The correlation and the agreement between FCT, FCT corrected for Schirmer test (corrected FCT), SVST, and SVST corrected for Schirmer test (corrected SVST) in separating healthy persons from patients with ATD, MGD, or both were studied. Furthermore, the correlations of FCT, corrected FCT, SVST and corrected SVST, corneal fluorescein staining score, corneal and conjunctiva sensitivity, meibomian gland and eyelid evaluation, and questionnaire score were studied. RESULTS: The FCT, the corrected FCT, the SVST, and the corrected SVST all showed strong correlation with irritation symptoms, corneal fluorescein staining, Schirmer 1 test score, cornea and conjunctiva sensitivity, and meibomian gland and eyelid pathologic characteristics. The FCT, the corrected FCT, the SVST, and the corrected SVST had a sensitivity in diagnosing MGD, respectively, of 67%, 72%, 69%, and 76%, and of 95%, 97%, 97%, and 97% in diagnosing ATD. The specificity was, respectively, 97%, 96%, 97%, and 94%. CONCLUSIONS: The new standardized visual scale test was equivalent to fluorometric assessment of tear clearance in its correlation with irritation symptoms, ocular surface and eyelid disease, and ocular surface sensitivity. Its ability to separate healthy persons from patients with MGD and ATD was improved by applying a correction factor based on Schirmer test score. The new standardized visual scale test is an accurate and practical method for clinical assessment of fluorescein tear clearance.

Case-Control Studies↗