Abstract
Purpose. To determine which subjective assessments and objective tests have clinical utility as diagnostic tools in ocular irritation associated with Sjogren's syndrome-related aqueous tear deficiency (ATD), non-Sjogren ATD, inflammatory meibomian gland disease (MGD) associated with rosacea, and atrophic MGD. Methods. Forty adults with ocular irritation and 10 with normal ocular surfaces were enrolled in a nonrandomized, nonblinded clinical trial. Symptoms were evaluated. Tests included biomicroscopy; evaluation of tear- film integrity, production, and clearance; fluorescein and rose bengal staining; and serum autoantibody screening. Results. Symptoms were similar among groups and most severe in the Sjogren's group. Fluorescein tear break- up time was significantly faster in the ATD and MGD groups than that in controls. Schirmer scores were significantly lower in the ATD group than those in MGD and control groups. Tear clearance was delayed in the ATD and atrophic MGD groups. Xeroscope grid distortion was noted only with ATD. The Sjogren's group had greater loss of nasolacrimal reflex, slower fluorescein clearance, and greater ocular-surface fluorescein and rose bengal staining than did the others. More MGD subjects had meibomian gland orifice metaplasia and acinar dropout than did those with Sjogren-related ATD and controls. Schirmer scores correlated inversely with rose bengal staining, corneal fluorescein staining, and grid distortion. Rose bengal staining correlated with grid distortion and loss of nasal-lacrimal reflex, but not with MGD. Conclusion. Subjective assessments and objective diagnostic tests have clinical utility as diagnostic tools in tear-film disorders. ATD is correlated with ocular-surface disease. An algorithm summarizing the diagnostic utility of these tests is included.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 38-56 |
| Number of pages | 19 |
| Journal | Cornea |
| Volume | 17 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1998 |
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Keywords
- Aqueous tear deficiency
- Meibomian gland disease
- Ocular irritation
- Ocular surface disease
- Rosacea
- Sjogren's syndrome
- Tear break-up time
- Tear-film disorder
ASJC Scopus subject areas
- Ophthalmology
Cite this
Evaluation of subjective assessments and objective diagnostic tests for diagnosing tear-film disorders known to cause ocular irritation. / Pflugfelder, Stephen C.; Tseng, Scheffer C G; Sanabria, Olga; Kell, Hans; Garcia, Carlos G.; Felix, Carlos; Feuer, William J; Reis, Brenda L.
In: Cornea, Vol. 17, No. 1, 01.1998, p. 38-56.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Evaluation of subjective assessments and objective diagnostic tests for diagnosing tear-film disorders known to cause ocular irritation
AU - Pflugfelder, Stephen C.
AU - Tseng, Scheffer C G
AU - Sanabria, Olga
AU - Kell, Hans
AU - Garcia, Carlos G.
AU - Felix, Carlos
AU - Feuer, William J
AU - Reis, Brenda L.
PY - 1998/1
Y1 - 1998/1
N2 - Purpose. To determine which subjective assessments and objective tests have clinical utility as diagnostic tools in ocular irritation associated with Sjogren's syndrome-related aqueous tear deficiency (ATD), non-Sjogren ATD, inflammatory meibomian gland disease (MGD) associated with rosacea, and atrophic MGD. Methods. Forty adults with ocular irritation and 10 with normal ocular surfaces were enrolled in a nonrandomized, nonblinded clinical trial. Symptoms were evaluated. Tests included biomicroscopy; evaluation of tear- film integrity, production, and clearance; fluorescein and rose bengal staining; and serum autoantibody screening. Results. Symptoms were similar among groups and most severe in the Sjogren's group. Fluorescein tear break- up time was significantly faster in the ATD and MGD groups than that in controls. Schirmer scores were significantly lower in the ATD group than those in MGD and control groups. Tear clearance was delayed in the ATD and atrophic MGD groups. Xeroscope grid distortion was noted only with ATD. The Sjogren's group had greater loss of nasolacrimal reflex, slower fluorescein clearance, and greater ocular-surface fluorescein and rose bengal staining than did the others. More MGD subjects had meibomian gland orifice metaplasia and acinar dropout than did those with Sjogren-related ATD and controls. Schirmer scores correlated inversely with rose bengal staining, corneal fluorescein staining, and grid distortion. Rose bengal staining correlated with grid distortion and loss of nasal-lacrimal reflex, but not with MGD. Conclusion. Subjective assessments and objective diagnostic tests have clinical utility as diagnostic tools in tear-film disorders. ATD is correlated with ocular-surface disease. An algorithm summarizing the diagnostic utility of these tests is included.
AB - Purpose. To determine which subjective assessments and objective tests have clinical utility as diagnostic tools in ocular irritation associated with Sjogren's syndrome-related aqueous tear deficiency (ATD), non-Sjogren ATD, inflammatory meibomian gland disease (MGD) associated with rosacea, and atrophic MGD. Methods. Forty adults with ocular irritation and 10 with normal ocular surfaces were enrolled in a nonrandomized, nonblinded clinical trial. Symptoms were evaluated. Tests included biomicroscopy; evaluation of tear- film integrity, production, and clearance; fluorescein and rose bengal staining; and serum autoantibody screening. Results. Symptoms were similar among groups and most severe in the Sjogren's group. Fluorescein tear break- up time was significantly faster in the ATD and MGD groups than that in controls. Schirmer scores were significantly lower in the ATD group than those in MGD and control groups. Tear clearance was delayed in the ATD and atrophic MGD groups. Xeroscope grid distortion was noted only with ATD. The Sjogren's group had greater loss of nasolacrimal reflex, slower fluorescein clearance, and greater ocular-surface fluorescein and rose bengal staining than did the others. More MGD subjects had meibomian gland orifice metaplasia and acinar dropout than did those with Sjogren-related ATD and controls. Schirmer scores correlated inversely with rose bengal staining, corneal fluorescein staining, and grid distortion. Rose bengal staining correlated with grid distortion and loss of nasal-lacrimal reflex, but not with MGD. Conclusion. Subjective assessments and objective diagnostic tests have clinical utility as diagnostic tools in tear-film disorders. ATD is correlated with ocular-surface disease. An algorithm summarizing the diagnostic utility of these tests is included.
KW - Aqueous tear deficiency
KW - Meibomian gland disease
KW - Ocular irritation
KW - Ocular surface disease
KW - Rosacea
KW - Sjogren's syndrome
KW - Tear break-up time
KW - Tear-film disorder
UR - http://www.scopus.com/inward/record.url?scp=0031984088&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0031984088&partnerID=8YFLogxK
U2 - 10.1097/00003226-199801000-00007
DO - 10.1097/00003226-199801000-00007
M3 - Article
VL - 17
SP - 38
EP - 56
JO - Cornea
JF - Cornea
SN - 0277-3740
IS - 1
ER -