The Experts below are selected from a list of 32439 Experts worldwide ranked by ideXlab platform
Kazuo Tsubota - One of the best experts on this subject based on the ideXlab platform.
-
Association of Systemic Comorbidities with Dry Eye Disease
Journal of clinical medicine, 2020Co-Authors: Motoko Kawashima, Norihiko Yokoi, Miki Uchino, Masakazu Yamada, Chika Shigeyasu, Kazuhisa Suwaki, Yoshimune Hiratsuka, Kazuo TsubotaAbstract:We investigated the association between Dry Eye disease and systemic comorbidities, including Dry Eye subtype, quality of life (QOL) and health utility among patients with Dry Eye disease. This cross-sectional, observational study enrolled 449 patients with Dry Eye disease (386 females; mean age, 62.6 ± 15.7 [range, 21–90] years). Ophthalmic examination findings included tear film break-up time (TBUT), Schirmer I value and keratoconjunctival staining score. QOL and health utility were evaluated using the Dry Eye-Related Quality-of-Life Score (DEQS) and Human Utility Index Mark 3 (HUI-3), respectively. Background information, including systemic comorbidities, was obtained. Prevalence of systemic comorbidities was 48.8% (219/449). No significant difference occurred between DEQS and systemic comorbidity. However, patients with Dry Eye disease and systemic comorbidities (depression and insomnia) exhibited significantly worse ocular surface parameters, particularly regarding TBUT, than those without. Dry Eye disease with insomnia or depression comorbidity significantly correlated with friction-related diseases (including conjunctivochalasis or lid wiper epitheliopathy). A high prevalence of several systemic comorbidities occurred in patients with Dry Eye disease. This study shows an association between ocular signs and systemic comorbidities, particularly depression and insomnia. Ophthalmologists should be aware of patients’ systemic comorbidities in the diagnosis and management of Dry Eye disease.
-
A New Perspective on Dry Eye Classification: Proposal by the Asia Dry Eye Society.
Eye & Contact Lens: Science & Clinical Practice, 2020Co-Authors: Kazuo Tsubota, Norihiko Yokoi, Murat Dogru, Hitoshi Watanabe, Masakazu Yamada, Shigeru Kinoshita, Hyo Myung Kim, Hung Won Tchah, Takashi Kojima, Joon Young HyonAbstract:The 2017 consensus report of the Asia Dry Eye Society (ADES) on the definition and diagnosis of Dry Eyes described Dry Eye disease as "Dry Eye is a multifactorial disease characterized by unstable tear film causing a variety of symptoms and/or visual impairment, potentially accompanied by ocular surface damage." The report emphasized the instability of tear film and the importance of visual dysfunction in association with Dry Eyes, highlighting the importance of the evaluation of tear film stability. This report also discussed the concept of tear film-oriented therapy, which stemmed from the definition, and which is centered on provision of insufficient components in each tear film layer and ocular surface epithelium. The current ADES report proposes a simple classification of Dry Eyes based on the concept of tear film-oriented diagnosis and suggests that there are three types of Dry Eye: aqueous-deficient, decreased wettability, and increased evaporation. It is suggested that these three types respectively coincide with the problems of each layer: aqueous, membrane-associated mucins, and lipid/secretory mucin. Although each component cannot be quantitatively evaluated with the current technology, a practical diagnosis based on the patterns of fluorescein breakup is recommended. The Asia Dry Eye Society classification report suggests that for a practical use of the definition, diagnostic criteria and classification system should be integrated and be simple to use. The classification system proposed by ADES is a straightforward tool and simple to use, only through use of fluorescein, which is available even to non-Dry Eye specialists, and which is believed to contribute to an effective diagnosis and treatment of Dry Eyes.
-
new perspectives on Dry Eye definition and diagnosis a consensus report by the asia Dry Eye society
Ocular Surface, 2017Co-Authors: Kazuo Tsubota, Norihiko Yokoi, Jun Shimazaki, Murat Dogru, Hitoshi Watanabe, Masakazu Yamada, Shigeru Kinoshita, Hyo Myung Kim, Hung Won TchahAbstract:Abstract For the last 20 years, a great amount of evidence has accumulated through epidemiological studies that most of the Dry Eye disease encountered in daily life, especially in video display terminal (VDT) workers, involves short tear film breakup time (TFBUT) type Dry Eye, a category characterized by severe symptoms but minimal clinical signs other than short TFBUT. An unstable tear film also affects the visual function, possibly due to the increase of higher order aberrations. Based on the change in the understanding of the types, symptoms, and signs of Dry Eye disease, the Asia Dry Eye Society agreed to the following definition of Dry Eye: "Dry Eye is a multifactorial disease characterized by unstable tear film causing a variety of symptoms and/or visual impairment, potentially accompanied by ocular surface damage." The definition stresses instability of the tear film as well as the importance of visual impairment, highlighting an essential role for TFBUT assessment. This paper discusses the concept of Tear Film Oriented Therapy (TFOT), which evolved from the definition of Dry Eye, emphasizing the importance of a stable tear film.
-
Evaluation of treatment for Dry Eye with 2-hydroxyestradiol using a Dry Eye rat model.
Molecular vision, 2016Co-Authors: Akihiro Higuchi, Erina Oonishi, Tetsuya Kawakita, Kazuo TsubotaAbstract:Purpose: 2-hydroxy estradiol (2-OHE2) is a catechol derivative of 17β -Estradiol (E2) and it is synthesized from E2 catalyzed by cytochrome P4501A1. Previous studies reported that 2-OHE2 is a physiologic antioxidant in lipoproteins, liver microsomes, and the brain. Catechol derivatives show an anti-inflammatory effect through the inhibition of prostaglandin endoperoxide synthase (PGS) activity. Corneal erosion caused by Dry Eye is related to an increase in oxidative stress and inflammation in ocular surface cells. We investigated the therapeutic effects of 2-OHE2 on corneal damage caused by Dry Eye. Methods: Steroidal radical scavenging activity was confirmed through the electron spin resonance (ESR) method. PGS activity was measured using the COX Fluorescent Activity Assay Kit. To evaluate the effect of 2-OHE2 on the treatment for Dry Eye, 2-OHE2 was applied as an Eye drop experiment using Dry Eye model rats. Results: 2-OHE2 scavenged tyrosyl radical and possibly suppressed oxidative stress in corneal epithelial cells. In addition, 2-OHE2 inhibited PGS activity, and 2-OHE2 is probably a competitive inhibitor of PGS. Corneal PGS activity was upregulated in the Dry Eye group. Therefore, 2-OHE2 Eye drops improved corneal erosion in Dry Eye model rats. Conclusions: 2-OHE2 is a candidate for the treatment of Dry Eye through the suppression of inflammation and oxidative stress in the cornea.
-
Dry Eye: Future Directions and Research
Dry Eye, 2014Co-Authors: Minako Kaido, Kazuo TsubotaAbstract:Dry Eye disease is prevalent with the recent environmental and lifestyle changes. Short breakup time (BUT)–type Dry Eye tends to increase recently in office workers with video display terminal (VDT) work and contact lens users. In VDT-related Dry Eye, the decreased blink frequency may induce a failure of tear secretion with an excessive secretory vesicle accumulation in the acinar epithelia. Dry Eye disease may be also regarded as an age-related disease. Oxidative stress and metabolic syndrome play a major role in the aging process. We will introduce the new strategy for the Dry Eye treatments, such as tear film–oriented therapy (TFOT) targeting at each tear layer on the ocular surface with a new preparation of Eye drops, oral supplement, and antiaging approach on “the prevention of cellular oxidation as an anti-aging strategy” and “calorie restriction as an anti-aging strategy.”
Norihiko Yokoi - One of the best experts on this subject based on the ideXlab platform.
-
Association of Systemic Comorbidities with Dry Eye Disease
Journal of clinical medicine, 2020Co-Authors: Motoko Kawashima, Norihiko Yokoi, Miki Uchino, Masakazu Yamada, Chika Shigeyasu, Kazuhisa Suwaki, Yoshimune Hiratsuka, Kazuo TsubotaAbstract:We investigated the association between Dry Eye disease and systemic comorbidities, including Dry Eye subtype, quality of life (QOL) and health utility among patients with Dry Eye disease. This cross-sectional, observational study enrolled 449 patients with Dry Eye disease (386 females; mean age, 62.6 ± 15.7 [range, 21–90] years). Ophthalmic examination findings included tear film break-up time (TBUT), Schirmer I value and keratoconjunctival staining score. QOL and health utility were evaluated using the Dry Eye-Related Quality-of-Life Score (DEQS) and Human Utility Index Mark 3 (HUI-3), respectively. Background information, including systemic comorbidities, was obtained. Prevalence of systemic comorbidities was 48.8% (219/449). No significant difference occurred between DEQS and systemic comorbidity. However, patients with Dry Eye disease and systemic comorbidities (depression and insomnia) exhibited significantly worse ocular surface parameters, particularly regarding TBUT, than those without. Dry Eye disease with insomnia or depression comorbidity significantly correlated with friction-related diseases (including conjunctivochalasis or lid wiper epitheliopathy). A high prevalence of several systemic comorbidities occurred in patients with Dry Eye disease. This study shows an association between ocular signs and systemic comorbidities, particularly depression and insomnia. Ophthalmologists should be aware of patients’ systemic comorbidities in the diagnosis and management of Dry Eye disease.
-
A New Perspective on Dry Eye Classification: Proposal by the Asia Dry Eye Society.
Eye & Contact Lens: Science & Clinical Practice, 2020Co-Authors: Kazuo Tsubota, Norihiko Yokoi, Murat Dogru, Hitoshi Watanabe, Masakazu Yamada, Shigeru Kinoshita, Hyo Myung Kim, Hung Won Tchah, Takashi Kojima, Joon Young HyonAbstract:The 2017 consensus report of the Asia Dry Eye Society (ADES) on the definition and diagnosis of Dry Eyes described Dry Eye disease as "Dry Eye is a multifactorial disease characterized by unstable tear film causing a variety of symptoms and/or visual impairment, potentially accompanied by ocular surface damage." The report emphasized the instability of tear film and the importance of visual dysfunction in association with Dry Eyes, highlighting the importance of the evaluation of tear film stability. This report also discussed the concept of tear film-oriented therapy, which stemmed from the definition, and which is centered on provision of insufficient components in each tear film layer and ocular surface epithelium. The current ADES report proposes a simple classification of Dry Eyes based on the concept of tear film-oriented diagnosis and suggests that there are three types of Dry Eye: aqueous-deficient, decreased wettability, and increased evaporation. It is suggested that these three types respectively coincide with the problems of each layer: aqueous, membrane-associated mucins, and lipid/secretory mucin. Although each component cannot be quantitatively evaluated with the current technology, a practical diagnosis based on the patterns of fluorescein breakup is recommended. The Asia Dry Eye Society classification report suggests that for a practical use of the definition, diagnostic criteria and classification system should be integrated and be simple to use. The classification system proposed by ADES is a straightforward tool and simple to use, only through use of fluorescein, which is available even to non-Dry Eye specialists, and which is believed to contribute to an effective diagnosis and treatment of Dry Eyes.
-
New Developments in Dry Eye Research
Foundations of Corneal Disease, 2020Co-Authors: Norihiko YokoiAbstract:This chapter covers recent developments in Dry Eye research, including the relationship between Dry Eye and the patient’s systemic condition, and the importance of tear-film breakup. Eye drops are the standard first line of treatment for Dry Eye, but as Dry Eye is a lifestyle disease, treatment should begin with lifestyle interventions, in which patients are provided with advice on diet, computer usage, and ways to improve their mental health. Tear stability is an important aspect of Dry Eye, and it is useful to evaluate tear-film breakup times and patterns to provide information to help clinicians stabilize the tear film. In addition, the basis of the neuropathic pain of Dry Eye has been elucidated as an unstable tear film disrupts the corneal nerving. The progress in this field is expected to lead to new treatments or prevention for Dry Eye.
-
Tear-film-oriented diagnosis for Dry Eye
Japanese Journal of Ophthalmology, 2019Co-Authors: Norihiko Yokoi, Georgi As GeorgievAbstract:Tear-film (TF) stability protects the ocular surface epithelium from desiccation and is ensured via cooperation between the ocular surface components including constituents of the TF and ocular surface epithelium. Thus, when those components are insufficient or impaired, the TF breakup that initiates Dry Eye occurs. Recently, new, commercially available Eye drops have appeared in Japan that enable TF stabilization via targeted supplementation of deficient ocular surface components. Hence, a new layer-by-layer diagnosis and treatment concept for Dry Eye, termed tear-film-oriented diagnosis and tear-film-oriented therapy (TFOD and TFOT, respectively), have emerged and become widely accepted in Asian countries and beyond. TFOD is a diagnostic method for Dry Eye based on the TF dynamics and breakup patterns (BUPs), through which Dry-Eye subtypes, including aqueous-deficient Dry Eye, decreased-wettability Dry Eye, and increased-evaporation Dry Eye, are diagnosed. BUPs and/or each diagnosed Dry-Eye subtype can, in a layer-by-layer fashion, reveal the insufficient ocular surface components responsible for the TF breakup. Using these data, the optimal topical TFOT to treat Dry Eye can be proposed by addressing the TF breakup via the supplementation of the insufficient components. In Japan, TF breakup is now regarded as a visible core mechanism of Dry Eye, and abnormal breakup time (ie, ≤ 5 seconds) and symptoms are currently considered part of the diagnostic criteria for Dry Eye. In this review, the importance of TF instability as a core manifestation of Dry Eye, the molecular mechanism of TF breakup, the concept of TFOD, and the methods for implementing TFOD for TFOT are introduced.
-
new perspectives on Dry Eye definition and diagnosis a consensus report by the asia Dry Eye society
Ocular Surface, 2017Co-Authors: Kazuo Tsubota, Norihiko Yokoi, Jun Shimazaki, Murat Dogru, Hitoshi Watanabe, Masakazu Yamada, Shigeru Kinoshita, Hyo Myung Kim, Hung Won TchahAbstract:Abstract For the last 20 years, a great amount of evidence has accumulated through epidemiological studies that most of the Dry Eye disease encountered in daily life, especially in video display terminal (VDT) workers, involves short tear film breakup time (TFBUT) type Dry Eye, a category characterized by severe symptoms but minimal clinical signs other than short TFBUT. An unstable tear film also affects the visual function, possibly due to the increase of higher order aberrations. Based on the change in the understanding of the types, symptoms, and signs of Dry Eye disease, the Asia Dry Eye Society agreed to the following definition of Dry Eye: "Dry Eye is a multifactorial disease characterized by unstable tear film causing a variety of symptoms and/or visual impairment, potentially accompanied by ocular surface damage." The definition stresses instability of the tear film as well as the importance of visual impairment, highlighting an essential role for TFBUT assessment. This paper discusses the concept of Tear Film Oriented Therapy (TFOT), which evolved from the definition of Dry Eye, emphasizing the importance of a stable tear film.
Ikuko Toda - One of the best experts on this subject based on the ideXlab platform.
-
Dry Eye After LASIK
Investigative Ophthalmology & Visual Science, 2018Co-Authors: Ikuko TodaAbstract:Post-LASIK Dry Eye is the most common postoperative Dry Eye after ophthalmic surgeries. The clinical signs of post-LASIK Dry Eye include positive vital staining of the ocular surface, decreased tear breakup time and Schirmer test values, reduced corneal sensitivity, and decreased functional visual acuity. The symptoms and signs usually last for about 1 month after LASIK. A small number of patients continue to experience symptoms more than 1 year postoperatively. It has been suggested that the loss of corneal innervation caused by flap-making is the major cause, affecting the corneal-lacrimal gland, corneal-blinking, and blinking-meibomian gland reflexes, resulting in decreased aqueous and lipid tear secretion and mucin expression. A new type of corneal refractive surgery, SMILE, which has less impact on corneal nerves, induces less postoperative Dry Eye, supporting the association between corneal denervation and postoperative Dry Eye. As LASIK enhancement by flap-lifting induces fewer Dry Eye symptoms and signs than initial surgery, factors other than neurotrophic effects may be involved in the mechanisms of post-LASIK Dry Eye. Post-LASIK ocular surface pain is a type of postoperative chronic pain and discomfort, and is thought to be a different clinical entity from Dry Eye, possibly induced by abnormal reinnervation or neural sensitization of peripheral nerves and the central nervous system after LASIK. Treatments include tear supplements, anti-inflammatory agents, meibomian gland dysfunction management, ointment and Eye patches, punctal plugs, and autologous serum Eye drops. For patients with preoperative Dry Eye, careful patient selection, and preoperative ocular surface management are mandatory.
-
LASIK and Dry Eye.
Comprehensive ophthalmology update, 2007Co-Authors: Ikuko TodaAbstract:Dry Eye is one of the most common complications after laser-assisted in situ keratomileusis (LASIK). The clinical signs of post-LASIK Dry Eye include positive vital staining of ocular surface, decreased tear film breakup time and Schirmer test, reduced corneal sensitivity, and decreased functional visual acuity. The symptoms and signs last at least 1 month after LASIK. Although the mechanisms for developing post-LASIK Dry Eye are not completely understood, loss of corneal innervation by flap-making may affect the reflex loops of the corneal-lacrimal gland, corneal-blinking, and blinking-meibomian gland, and blinking-meibomian gland, resulting in decreased aqueous and lipid tear secretion and mucin expression. As LASIK enhancement by flap-lifting induces less Dry Eye symptoms and signs than first surgery, it is suggested that other factors rather than loss of neurotrophic effect may be involved in the mechanisms of post-LASIK Dry Eye. The treatments of Dry Eye include artificial tears, topical cyclosporine, hot compress, punctal plugs, and autologous serum Eye drops. For patients with severe preoperative Dry Eye, a combination of punctal plugs and serum Eye drops is required to be used before surgery.
-
allergic conjunctivitis and Dry Eye
British Journal of Ophthalmology, 1996Co-Authors: Hiroshi Fujishima, Ikuko Toda, Jun ShimazakiAbstract:AIMS: Differential diagnosis of allergic conjunctivitis or Dry Eye is sometimes very difficult to diagnose by symptoms and clinical examination alone, especially in older patients. It was hypothesised that clinically allergic patients who were serum antigen specific IgE negative were candidates for Dry Eye. METHODS: Sixty patients were studied prospectively who were clinically diagnosed with allergic conjunctivitis by their itchy sensation and papilla formation of conjunctiva. They consisted of 30 serum antigen specific IgE positive and 30 IgE negative patients, with no significant differences in age. Dry Eye examination and serum total IgE were performed on these two groups. RESULTS: No significant differences were seen between the two groups with regard to age (p = 0.76) and sex ratio. The antibody negative group had lower Schirmer's test scores (p = 0.002), lower tear clearance (p = 0.0001), lower tear function index (p = 0.0001), and lower serum total IgE (p = 0.04) than the antibody positive group. CONCLUSION: This study suggests that the evaluation of serum antigen specific IgE and tear dynamics are important for the differential diagnosis of patients with allergic conjunctivitis and Dry Eye. Clinically diagnosed allergic conjunctivitis with negative serum antigen specific and total IgE can be one form of Dry Eye.
Stephen C Pflugfelder - One of the best experts on this subject based on the ideXlab platform.
-
Dry Eye: An Immune-Based Inflammation
Encyclopedia of the Eye, 2010Co-Authors: Michael E Stern, Stephen C PflugfelderAbstract:Dry Eye is a common and debilitating human ocular disease that has a high prevalence worldwide. Patients with Dry Eye experience ocular discomfort (e.g., scratchiness, grittiness, foreign body sensation, burning, and itching) coupled with blurred and fluctuating vision and ocular fatigue. In the most severe cases recurrent corneal ulceration experienced during chronic Dry Eye may result in reduced vision and blindness. Emerging evidence suggests that Dry Eye is an ocular surface immune-based inflammatory disease that is the result of an unstable tear film resulting from dysfunction of a complex Lacrimal Function Unit (LFU: cornea, conjunctiva, lacrimal glands, and meibomian glands). Indeed, inflammatory cell (e.g., CD4+ T cells) infiltration within the LFU tissues correlates with elevated proinflammatory cytokine levels, increased epithelial cell apoptosis, decreased tear production, and diminished goblet cell numbers in patients with Dry Eye. Recent years have provided rapid advancement in our understanding of the immunopathogenesis of Dry Eye; the combined effort of human studies and the use of a mouse model of Dry Eye, which shares similar clinical and histological disease profiles to human patients, have accelerated discovery efforts. This research is providing important insights into what (cells, cytokines, chemokines, etc.), where (regional lymph nodes, spleen and/or at the ocular surface), and how (cell-dependent and independent pathways) the immune system contributes to the development and progression of Dry Eye disease, and has proven invaluable in the development of clinically effective therapies.
-
Dry Eye and Ocular Surface Disorders - Dry Eye and ocular surface disorders
2004Co-Authors: Stephen C Pflugfelder, Roger W. Beuerman, Michael E SternAbstract:Dry Eye: The Problem. The Lacrimal Functional Unit. The Normal Tear Film and Ocular Surface. Dysfunction of the Lacrimal Functional Unit and its Impact on Tear Film Stability and Composition. The Conjunctiva and Tear Film Maintenance. Mechanisms of the Ocular Surface Immune Response. Impact of Systemic Immune Disease on the Lacrimal Functional Unit. Sex and Sex Steroid Influences on Dry Eye Syndrome
-
Inflammation in Dry Eye
Ocular Surface, 2004Co-Authors: Michael E Stern, Stephen C PflugfelderAbstract:Abstract Dry Eye is a condition of altered tear composition that results from a diseased or dysfunctional lacrimal functional unit. Evidence suggests that inflammation causes structural alterations and/or functional paralysis of the tear-secreting glands. Changes in tear composition resulting from lacrimal dysfunction, increased evaporation and/or poor clearance have pro-inflammatory effects on the ocular surface. This inflammation is responsible in part for the irritation symptoms, ocular surface epithelial disease, and altered corneal epithelial barrier function in Dry Eye. Anti-inflammatory therapies for Dry Eye target one or more of the inflammatory mediators/pathways that have been identified in Dry Eye.
-
Antiinflammatory therapy for Dry Eye.
American journal of ophthalmology, 2004Co-Authors: Stephen C PflugfelderAbstract:Abstract Purpose To present evidence establishing the relationship between inflammation and Dry Eye and supporting the use of antiinflammatory therapy for Dry Eye. Design Analysis of literature. Methods Research studies that evaluated inflammation in Dry Eye pathogenesis and clinical trials of antiinflammatory therapies for Dry Eye were reviewed. Results There is increasing evidence that decreased tear secretion, decreased tear turnover, and desiccation promote inflammation on the ocular surface. An increase in soluble mediators (cytokines and proteases) in the tear fluid, adhesion molecule expression by the conjunctival epithelium, and T-cell infiltration of the conjunctiva have been observed in Dry Eye patients. This inflammation appears to have a role in the pathogenesis of the ocular surface epithelial disease, termed keratoconjunctivitis sicca (KCS), that develops in Dry Eye. Clinical improvement of KCS has been observed after therapy with antiinflammatory agents including corticosteroids, cyclosporin and doxycycline. Cyclosporin A emulsion was approved by the Food and Drug Administration as therapy for Dry Eye. Randomized placebo-controlled FDA clinical trials showed that cyclosporine A was superior to vehicle in stimulating aqueous tear production, decreasing corneal punctuate fluorescein staining, reducing symptoms of blurred vision, and decreasing artificial tear use in patients with KCS. No ocular or systemic toxicity was observed from this medication. Conclusions Ocular surface and lacrimal gland inflammation has been identified in Dry Eye that plays a role in the pathogenesis of KCS. Antiinflammatory therapy has efficacy for treating KCS. Cyclosporin A is the first FDA approved therapy for this indication. It improved signs and symptoms of KCS, and it is safe for long-term use.
Anthony J Bron - One of the best experts on this subject based on the ideXlab platform.
-
LASIK-Dry Eye: fact or fancy
Acta Ophthalmologica Scandinavica, 2007Co-Authors: Ay Reginald, Jm Tiffany, Ph Rosen, Anthony J BronAbstract:Purpose: To review the evidence for Dry Eye after refractive surgery. Methods: A review of the literature. Results: Irritation and ocular surface staining after LASIK is termed LASIK-Dry Eye, treated with artificial tears and/or punctal plugs. Symptomatic recovery takes about 6 months. It has been attributed to a loss of afferent drive to the lacrimal gland and blink mechanism. Waking lacrimal secretion is stimulated by reflex sensory inputs from the ocular surface and nose. The rich innervation of the cornea, compared to the conjunctiva, determines that corneal incision causes significant loss of drive from the ocular surface, gradually restored by corneal re-innervation. While LASIK-Dry Eye is a true entity, LASIK patients also suffer from LASIK-induced neuroepitheliopathy or LINE, a neurotrophic state due to interruption of trophic, sensory nerves. The conditions are not mutually exclusive. The hallmark of LINE is the presence corneal staining confined to the flap and sparing the hinge region. Tear Break Up Time (TBUT) is normal or reduced and the Schirmer test is normal. The hallmark of LASIK- Dry Eye is staining of the interpalpebral conjunctiva, with or without interpalpebral corneal staining, accompanied by a reduced TBUT and Schirmer test and increased tear osmolarity. Pre-existing tear film instability is a predictor of post-LASIK Dry Eye and pre-existing Dry Eye is a predictor of a chronic, post-LASIK Dry Eye state, associated with a greater risk of refractive regression. Conclusions: Post-operative Dry Eye following LASIK or other refractive procedures is predictable and demands that all patients are assessed preoperatively for the signs of tear instability and Dry Eye. Preoperative detection permits a more accurate prognosis and the initiation of prophylactic measures.
-
Diagnosis of Dry Eye.
Survey of Ophthalmology, 2001Co-Authors: Anthony J BronAbstract:Abstract Dry Eye disease is characterized by symptoms, ocular surface damage, reduced tear film stability, and tear hyperosmolarity. There are also inflammatory components. These features can be identified by various kinds of diagnostic tests (symptom questionnaires, ocular surface staining, tear break-up time, and osmometry), although there may not be a direct correlation between the number or severity of symptoms and the degree of ocular surface damage or tear deficiency. Once the diagnosis of Dry Eye disease has been established, further tests can be used to classify the condition into tear-deficient or evaporative Dry Eye. The two forms of Dry Eye are not mutually exclusive and often co-exist. The optimal diagnosis of Dry Eye disease, therefore, depends on the results of several tests, and this article suggests an appropriate order for performing these tests at a single clinic visit.
