April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Prevalence, risk factors, and morbidities of eye lid laxity in a Veteran population
Author Affiliations & Notes
  • Zubair Ansari
    Marshall University School of Medicine, Huntington, WV
    University of Miami, Miami, FL
  • Roshni Singh
    University of Miami, Miami, FL
  • Stuti Dang
    University of Miami, Miami, FL
  • Chrisfouad Alabiad
    University of Miami, Miami, FL
  • Anat Galor
    University of Miami, Miami, FL
  • Footnotes
    Commercial Relationships Zubair Ansari, None; Roshni Singh, None; Stuti Dang, None; Chrisfouad Alabiad, None; Anat Galor, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 1493. doi:
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      Zubair Ansari, Roshni Singh, Stuti Dang, Chrisfouad Alabiad, Anat Galor; Prevalence, risk factors, and morbidities of eye lid laxity in a Veteran population. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1493.

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Abstract
 
Purpose
 

To study the frequency, risk factors, and morbidity of eyelid laxity in a Veteran population

 
Methods
 

150 consecutive subjects were evaluated from either an outpatient eye or a geriatric clinic at the Miami Veterans Affairs Hospital from June through August 2013. Clinical data were gathered from a questionnaire and a computerized medical record system including demographics, medical history, and ocular irritation history. Upper and lower eyelid laxity was clinically graded. The presence of lower eyelid laxity was determined by the snap back test. A grade of 0 indicated laxity within normal limits, a grade of 1 indicated a delay of one to four seconds for the lower lid to return to its native state. A grade of 2 indicated persistent separation necessitating a blink to return to the normal state. Upper eyelid laxity was determined by the lid distraction test. A grade of 0 indicated laxity within normal limits. A grade of 1 indicated 3 to 6 mm of distraction, and a grade of 2 indicated complete tarsal eversion of the upper eyelid.

 
Results
 

Fifty-four percent of participants (n=81) had laxity (grade 1 or higher) in either the upper and/or lower eyelids. Risk factors for eyelid laxity in our population included older age, higher body mass index (BMI), and a diagnosis of sleep apnea. Patients with any eyelid laxity (grade 1 or more in any eyelid) had a 2.23 fold risk of severe ocular surface symptoms (score of 12 or higher on the Dry Eye Questionnaire 5) compared to those without laxity (95% confidence interval (CI) 1.15-4.31, p=0.017). and was primarily driven by the presence of upper eyelid laxity.

 
Conclusions
 

We found a high frequency of eyelid laxity in our population, and its presence was associated with significant ocular surface morbidity. This study reinforces the need to incorporate dynamic eyelid testing into the ophthalmic exam in patients with ocular surface discomfort.

 
Keywords: 526 eyelid • 486 cornea: tears/tear film/dry eye • 464 clinical (human) or epidemiologic studies: risk factor assessment  
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