September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Treating inadequate lid seal in patients with dry eye using an overnight ointment reduces discomfort upon awakening and overall dry eye symptoms
Author Affiliations & Notes
  • Donald R Korb
    Korb Associates, Boston, Massachusetts, United States
    Research, TearScience, Inc., Morrisville, North Carolina, United States
  • Caroline A Blackie
    Korb Associates, Boston, Massachusetts, United States
    Research, TearScience, Inc., Morrisville, North Carolina, United States
  • Footnotes
    Commercial Relationships   Donald Korb, Korb Associates (F), TearScience, Inc. (F); Caroline Blackie, Korb Associates (F), TearScience, Inc. (F)
  • Footnotes
    Support  Korb Associates, Boston, MA, Tearscience Inc, Morrisville, NC
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 6189. doi:
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      Donald R Korb, Caroline A Blackie; Treating inadequate lid seal in patients with dry eye using an overnight ointment reduces discomfort upon awakening and overall dry eye symptoms. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6189.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To retrospectively evaluate whether treating inadequate lid seal in patients with dry eye with an overnight ointment would improve overall symptoms and the specific symptoms of discomfort upon awakening.

Methods : The de-identified data of consecutive patients (n=21, 9 males, 12 females), from a single clinic in Boston, MA, who met the inclusion criteria for the study and were fully consented, were included. Inclusion criteria: over the age of 18, no history of lid surgery, no lagophthalmos, no current infective ocular disease, and no ocular surgery within the last 6 months. The patients also all had: 1. A prior diagnosis of dry eye and a history of treatment; 2. A dry eye symptom score of 7 or higher (max score = 28) using the SPEED questionnaire; 3. An ‘eye discomfort upon awakening’ score of 1 or higher (0=no discomfort, 1=mild, 2 = moderate, and 3 =significant discomfort) despite current comprehensive dry eye therapy; 4. A lid seal compromise score, using the Korb-Blackie Lid Light test, of 1 or higher (0=no compromise, 1=mild, 2-=moderate, 3=severe). All patients were treated for the inadequate lid seal using a petrolatum ointment applied to the inner eyelids, immediately prior to bedtime, every night for 2 months. All patients returned for the designated follow-up approximately 2 months later.

Results : The mean (± standard deviation) age and symptom scores of the patients were as follows. Mean age: 57.5 ±12.8 years. The SPEED score decreased from 12.2±2.3 pre-treatment to 7.0±3.0 post-treatment (p<0.0001). The discomfort upon awakening score decreased from 1.8±0.6 pre-treatment to 0.6±0.7 post-treatment (p<0.0001).

Conclusions : Treatment of compromised lid seal with ointment during sleeping hours minimizes symptoms of discomfort upon awakening and overall ocular surface symptoms as measured by the SPEED questionnaire. This therapy should be considered as adjunctive therapy for those patients with dry eye and inadequate lid seal whenever discomfort upon awakening is present, including those managed with other therapies.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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