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Y. Yamamoto, A. Mitani, M. Yamaguchi, A. Shiraishi, Y. Hara, T. Uno, Y. Ohashi; Displacement of the Bulbar Conjunctiva During Blinking in Dry Eye Patients. Invest. Ophthalmol. Vis. Sci. 2009;50(13):516.
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© ARVO (1962-2015); The Authors (2016-present)
We recorded blinking dynamics with a high speed camera and analyzed the change in conjunctival blood vessel position (BVP) as an index of bulbar conjunctival displacement in patients with dry eye.
The dry eye group was comprised of 10 eyes diagnosed by the 2006 Japanese dry eye diagnostic criteria (D group, 39.4 ± 10.0, mean age ± SD, yrs), and the normal group consisted of 19 eyes (N group, 32.7 ± 8.2 yrs). Using a high speed camera (KEYENCE VW-6000TM), a tracking point was established on a conjunctival blood vessel, and the change in position of the point was measured from the beginning of eyelid closure until it was no longer possible to track movement. In addition, change in BVP was measured by an identical method 30 seconds after administration of 0.1% sodium hyaluronate eye drops.
The average change in BVP in the D group (0.56±0.19 mm) was significantly larger compared with the N group (0.41±0.13 mm). (p=0.026). A positive correlation was found between corneal and conjunctival fluorescein staining scores and the change in BVP (r = 0.462, p<0.01), while a negative correlation existed between Schirmer values and the change in BVP (r = -0.514, p<0.01). There was no correlation between BUT values and change in BVP. After administration of sodium hyaluronate eye drops, the average change in BVP was 0.43±0.19 mm in the D group and 0.33±0.12 mm in the N group. In both groups, the values significantly decreased after administration of the eye drops (p<0.01).
The amount of bulbar conjunctival displacement during blinking was correlated with the severity of dry eye, and was reduced after administration of the sodium hyaluronate eye drops in both dry eyes and normal eyes. These results suggest that the displacement of the bulbar conjunctiva may reflect stress caused by friction between the eyelid and the conjunctiva during blinking.
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