Purpose:
Dry Eye Syndrome (DES) is a disease of the tears and ocular surface that is multi-factorial; resulting in a wide range of symptoms and signs with potentially damaging effects. A break-up in the tear film may induce an increase in higher order aberrations (HOA), thereby decreasing the quality of the retinal image. We hypothesize that treated patients with varying levels of DES will have an improvement in their HOA over time. For this study, patients with varying levels of DES had HOA measurements with wavefront analysis while instilling non-preserved artificial tears (OPTIVETM by Allergan) during sequential time frames.
Methods:
A complete dry eye work up and wavefront analysis using the iTrace (Tracey Technologies) were collected on 22 patients (19 with DES and 3 controls) who had no other eye related problems. Aberrometry (total and corneal topography) was measured prior to and at 1, 5, 10, 15, 30, and 60 mins after the tears were administered. The patients then used the drops 4x/day for 1 week, after which the above measurements were repeated. HOA at each time point was compared using an ANOVA for repeated measures (Systat, 2008) with comparisons between the two groups. Data are presented as HOA ± SEM.
Results:
The Optive drop significantly increased HOA across the time period studied (p<0.001). In post-hoc comparisons, the only significant time period was at 1 min after the drop. (p<0.001). There was no difference between the groups, but this was probably due to the small sample size.
Conclusions:
There are improvements in HOA over a period of time that demonstrate the importance of treating dry eye syndrome to maintain retinal image quality. Further investigation will help us better understand how higher order aberrations change in relation to tear film stability and the health of the cornea in dry eye patients. Further analysis by assessing the severity of the DES and the individual components of the HOA is needed to determine when this type of treatment will benefit the patient most.
Keywords: cornea: tears/tear film/dry eye • aberrations