The association of vitamin D deficiency with tear break-up time and Schirmer testing in non-Sjögren dry eye

Abstract

Purpose To investigate the effect of vitamin D deficiency on tear break-up time (TBUT) and Schirmer test scores and to assess their relationship in non-Sjögren dry-eye patients. Methods Thirty-four patients with serum vitamin D deficiency and 21 control subjects with normal vitamin D levels were included in this study. The TBUT and Schirmer-1 test without topical anesthesia were performed to all patients. Results The mean TBUT were 5.18 ± 2.15 and 7.36 ± 3.10 s and Schirmer scores were 12.18 ± 6.44 and 18.57 ± 8.99 mm in the study and control groups, respectively. TBUT scores and Schirmer-1 results of the study group were significantly lower than the control group (P = 0.01 and 0.007, respectively). The mean vitamin D levels were 11.50 ± 1.8 ng/ml in the study group and 32.8 ± 8.72 ng/ml in control group (P = 0.001). Dry-eye symptoms were detected in all patients in the study group and 15% of the patients in the control group. Conclusions We demonstrated that vitamin D deficiency decreases the TBUT and Schirmer test values and may be associated with dry-eye symptoms in non-Sjögren syndrome.

Bowman Break and Subbasal Nerve Plexus Changes in a Patient With Dry Eye Presenting With Chronic Ocular Pain and Vitamin D Deficiency

“…9 Vitamin D exhibits antiinflammatory and immunoregulatory properties, and a deficiency can result in DED. 10 Because vitamin D inhibits the release of nitric oxide, a painrelated neurotransmitter, it has been shown to decrease ocular discomfort. 11 Vitamin D and its agonists have also been found to inhibit maturation and induce tolerance in dendritic cells resulting in the arrest of inflammatory processes.…”

Correlation between tear fluid and serum vitamin D levels

“…There is growing evidence regarding 25-hydroxyvitamin D status in ocular surface diseases such as allergic conjunctivitis and dry eye [13, 14, 20]. However, there has been some rather contradicting observations with regards to 25-hydroxyvitamin D and dry eye [15, 21].…”

Vitamin D in Dry Eye and Myopia

“…When observing participant in accordance with dry eye severity, it showed that people with moderate and sever dry eye were more likely to be vitamin D insufficient. A recent study reported that in their optimal vitamin D (81.8688 ± 21.77) participants, there was 15% exhibiting dry eye symptoms, while dry eye symptoms were observed in 100% in vitamin D deficient (28.70 ± 4.49 nmol/l) participants (Kurtul et al, 2015a). Of our studied population, 1/3 with optimal vitamin D levels showed at least mild dry eye symptoms (OSDI > 12), while dry eye symptoms were observed in 50% of people with vitamin D deficiency.…”

“…For example, Jee et al (2016) reported no effect, whereas Yildirim et al (2016) and Kurtul (2015b) suggested good improvements. Jin et al (2016) observed that TBUT was shorter in people with vitamin D deficiency, but did not measure a significant impact on OSDI scores or fluorescein staining (Jin et al, 2016).…”

“…In addition, it has also been demonstrated that the two commonly tests for dry eyeSchirmer score and tear break up time, were lower in vitamin D deficient people (Kurtul et al, 2015a). Yet, another recent study suggested there was no correlation between dry eye syndrome and serum vitamin D levels, thought it was found that increased serum vitamin D levels had lower odds of dry eye syndromes (Jee et al, 2016).…”