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Donald Korb, Caroline Blackie; The Korb-Blackie Lid Light Test. Invest. Ophthalmol. Vis. Sci. 2013;54(15):942.
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The Korb-Blackie (KB) lid light test was developed to investigate the possibility that apparently normal, closed, lids fail to create the necessary protective seal to prevent ocular surface dessication during sleeping. The test results are correlated with symptoms of eye discomfort upon awakening.
Patients (n=148) reporting for routine eye examinations that met the inclusion criteria for the study were enrolled. Inclusion criteria: willingness to participate in the study, over the age of 18, no lid or closure (e.g. lagophthalmos) abnormalities, no current ocular inflammation/disease, no ocular surgery within the last 6 months, no history of lid surgery. After answering a simple questionnaire regarding their eye comfort upon awakening, patients were asked to rest their heads back against the head rest of a semi-reclined exam chair and to close their eyes as if they were falling sleep. A transilluminator was lightly placed against the closed outer upper eyelid of each eye. The apparently closed lids were examined for the presence of any light emanating from the lid area between the lashes. The examiner positioned their eye level inferiorly such that they were looking up, to optimize viewing of the designated region. The lids were divided into three sections: temporal, central and nasal. The amount of visible light in each section was quantified on a scale of 0 - 3 where 0 = no light, 1 = minimal, 2 = moderate and 3 = severe. Eye discomfort upon awakening was quantified on a scale of 0 - 2 where as 0 = no discomfort, 1 = mild and 2 = significant discomfort.
The mean age of the patients = 53.9±16.2 years (50 males; 98 females). Data for right eyes only are presented. The mean light score for each lid region was: temporal = 0.3±0.5; central = 1.0±1.0; nasal = 0.5±0.7, indicating the central region is the least likely to close completely. The level of eye discomfort upon awakening was significantly correlated with the number of lid sections (0-3) emanating light during the KB lid-light test (p<0.0001).
The KB lid light test reveals that light emanating from between closed lids, which is correlated to symptoms of ocular discomfort upon awakening, may be linked to the ability of the lids to prevent ocular surface desiccation during sleeping.
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