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Eric T Brooker, Wanawalee Charoenchote; Effectiveness of the Double Pass Technique to Distinguish between Aqueous Deficient and Evaporative Dry Eye and to Measure the Ability of Punctal Occlusion to Improve Quality of Vision in Dry Eye Patients. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1994.
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© ARVO (1962-2015); The Authors (2016-present)
This objective of this study was to demonstrate the ability of the HD Analzyer to distinguish between aqueous deficient dry eye and evaporative dry eye and to quantify the quality of vision experienced by subject’s suffering from dry eye syndrome (DES) before and after treatment with Odyssey Parasol permanent punctal plugs. .
Eight subjects with concurrent diagnosed DES were measured on the Visiometrics High Definition Visual Quality Analyzer (HD Analyzer) to determine the impact of the DES on each subject’s visual quality. Patients also underwent standard dry eye diagnostic testing, which included: schirmer’s testing, TBUT and sodium fluorescein staining. After enrollment and initial assessment on the HD Analyzer subjects had permanent punctual plugs inserted into one tear duct on each eye. Subjects then returned in 4 weeks in order to repeat measurements and assess for improvement in their dry eye condition and quality of vision resultant to treatment of the optical surface with the use of Parasol Punctal Plugs.
Subjects were stratified into two groups: Lipid dysfunction group (LDG) n=6, which had obvious meibomitis and Aqueous Deficient Group (ADG) n=10, no signs of meibomian disease. The average TBUT for the LDG prior to punctal occlusion (p.o.): 5.95 seconds, for the ADG: 13.99 seconds; post p.o. 12.3 seconds and 16 seconds respectively. The average Schirmer’s score for the LDG prior to p.o. 9.81 millimeters(mm), for the ADG 4.45 mm; post p.o. 19.9 mm, for the ADG 5.88 mm. The average ocular scatter index (OSI) prior to p.o. in the LDG during 20 second tear film assessment (TFA) : 0.74, for the ADG: 0.23 (p=.04); post p.o. 0.44, and 0.18 respectively (p=0.03).
The HD-Analyzer has the ability to distinguish between two types of dry eye disease: aqueous deficient and lipid dysfunction. Punctal occlusion was effective in improving the tear film and visual quality in both study groups. This diagnostic instrument may be used to qualify and monitor a patient’s DES.
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