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A. Tomlinson, S. Khanal, A. McFadyen, C. Diaper, K. Ramaesh; Determination of the Most Effective Tests in Differentiating Chronic Blepharitis From Dry Eye. Invest. Ophthalmol. Vis. Sci. 2007;48(13):412.
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To determine the differences in tear physiology of patients with chronic blepharitis and dry eye and identify the most effective battery of tests in the differential diagnosis of these two conditions.
Two groups of subjects, 19 patients with chronic blepharitis and 41 with dry eye had a range of tear physiology measures assessed which included tear turnover, evaporation, structure, volume and osmolarity and meibomian gland dysfunction (MGD).
No significant differences or distinct cut-offs were seen in tear turnover rate, evaporation, structure, volume and osmolarity between patients with chronic blepharitis and dry eye. MGD score (with a cut-off value of 2 dysfunctioning glands) was found to be useful to differentiate blepharitis from dry eye with sensitivity of 79%, specificity 69%, positive predictive value of 60%, negative predictive value of 85% and overall accuracy of 62%. Series and parallel combinations of tests were not found to be more effective in the differential diagnosis of these conditions. Discriminant function analysis was also applied but it removed all the parameters, except MGD scores, from the discriminant function.
There are limited differences in tear physiology in patients with chronic blepharitis and dry eye. Meibomian gland dysfunction is the most effective measure in differentiating between these two conditions.
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