Lid wiper epitheliopathy in symptomatic and asymptomatic dry eye subjects

Abstract

Purpose: Lid wiper epithliopathy (LWE) was stuided in symptomatic and asymptomatic dry eye subjects. This is the first such study to be conducted in the Indian population. LWE is a clinical condition associated with vital staining in the lower and upper eyelids on increased friction of the lid margin over to the cornea. Our aim was to study LWE in symptomatic and asymptomatic (control) dry eye subjects. Methods: Out of 96 subjects screened, 60 subjects were enrolled in the study and were divided into two groups, symptomatic and asymptomatic dry eye subjects, based on the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire and the Ocular Surface Disease Index (OSDI) scores. The subjects were examined to rule out clinical dry eye findings and assessed for LWE with two different dyes (fluorescein and lissamine green). Descriptive analysis was done and Chi-square test was used for statistical analysis. Results: A total of 60 subjects were enrolled in a study with a mean age of 21.33 ± 1.88 years, out of which the majority of LWE patients (99.8%) was seen in the symptomatic group than the asymptomatic group (73.3%); the difference was statistically significant (p = 0.00) and also clinically significant. LWE was found to be significantly higher in symptomatic dry eye subjects (99.8%) compared to asymptomatic dry eye subjects (73.3%). LWE severity was also found to be more (56.6% of grade 3) among symptomatic dry eye subjects compared to asymptomatic subjects (40% of grade 2). Conclusion: It is important to assess the lid wiper region (LWR) and treat LWE in routine clinical practice.

Morphological features of the eyelid margin in relation to conjunctival goblet cells and MUC5AC in tear film and clinical tests of dry eye

“…Kamath et al [11] reported that individuals with symptomatic dry eye disease had signi cantly more LWE (99.8%) than those without symptoms (73.3%), and symptomatic dry eye subjects had more severe LWE (56.6% of grade 3) than asymptomatic subjects (40% of grade 2) after grading the stained LWE, these percentages were greater than those of Korb's study, in which the prevalence of 76% of LWE among symptomatic dry eye subjects and the severity of Grade I and II were only 8% and 4%, respectively [26]. These results suggest that LWE may occur before the development of dry eye symptoms.…”

“…Each portion was evaluated separately from 0 to 3 points according to the following criteria: 0, entirely on the conjunctival side of the meibomian ori ces (MOs); 1, part of the ML touches the MOs; 2, the ML runs through all of the MOs; and 3, the ML runs on the eyelid margin side of the MOs [10]. Moreover, LWE was also evaluated by staining the lid wiper as previously described [11]. Staining as positive, and vice versa as negative.…”