<p>Impact of Improper Approach to Identify Lid Wiper Epitheliopathy (LWE)</p>

Abstract

Purpose: Variability in the use of ophthalmic dyes to diagnose lid wiper epitheliopathy (LWE) has led to division in the literature and clinical practice. The principal aim of this study was to evaluate whether the use of a non-optimal methodology to identify LWE had a potential for false negatives; in which LWE was overlooked. Patients and Methods: A total of 20 participants were initially categorized to not have LWE and were enrolled in this study. The protocol examined whether or not LWE would later be revealed through the use of optimized methodology. Semi-automated analysis was performed of images taken after two different drop instillations with varying post-dye viewing times for both lissamine green (LG) and sodium fluorescein (NaFl). Results: There was a significant increase in area of staining revealed when an optimal methodology for LWE identification was used. Comparisons for every non-optimal condition were statistically significantly different against the optimal condition (all p<0.01). The use of a non-optimal methodology resulted in a 70% false-negative rate when using LG and a 95% false-negative rate when using NaFl. Conclusion: The study demonstrated that using a double instillation of dye was statistically different from a single-dose, even with extended wait time for clinical observation. A single instillation did not offer adequate volume of dye for adequate lid margin uptake. A careful adherence to volume as well as a repeat administration is key to revealing the full area of LWE. A non-optimal approach to diagnose LWE can lead to false negatives.

Natural course of lid wiper epitheliopathy (LWE) in symptomatic contact lens wearers

“…As LWE may have different presentations (continuous and noncontinuous staining), the calculated area of lid wiper staining (mm 2 ) used for analysis includes all stained regions as well as the Line of Marx. This approach is consistent with previous studies using alternative semi-automated methodologies [19,23,25,26]. LWE area was calculated with the ADCIS software and the Korb score calculated using Protocol B [18].…”

“…The VAS questions used were average daily dryness at all visits (V1, V2, V3, V4) and end-of-day dryness and frequency of end-of-day dryness on visits 3 and 4 (V3, V4). [19,23,24]. Images of the everted lid (resolution of 2000*1000 digitized on 8 bits, 12x magnification, Haag-Streit BI900 LED Slit Lamp system and Canon EOS 60D digital camera) were captured in raw mode, and then converted into tiff-format images.…”

Artificial Intelligence Models Utilize Lifestyle Factors to Predict Dry Eye-Related Outcomes

“…There is evidence to suggest that the LoM can shift due to aging, and due to the presence of DE. 14,18 Eyelid margin irregularities such as notching are frequently observed in cases of blepharitis and MGD, 19,20 both conditions known to be related to aging. [21][22][23][24] It has been well documented that symptoms of DE and MGD are on average more severe, frequent, and prevalent among older populations.…”

“…Some outcomes have natural predicted classes, such as a diagnosis of blepharitis (Yes/No) or eyelid notching (Present/Absent). The predicted classes for continuous and ordinal outcomes were de ned based on published thresholds where available, [9][10][11][12][13][14] and on clinical expertise and standard practice where not. Details of all clinical assessments, symptomatology instruments, and clinician diagnoses are provided in Appendix 1.…”