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E. Noda, M. Yamaguchi, A. Shiraishi, M. Matsumoto, T. Kohno, K. Ohta, Y. Ohashi; The Relationship Between Eyelid Tension and Localization of Keratoconjunctival Epitheliopathy in Dry Eye. Invest. Ophthalmol. Vis. Sci. 2009;50(13):520.
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© ARVO (1962-2015); The Authors (2016-present)
We hypothesized that the eyelid tension (LT) caused during blinking may influence ocular surface disorder. In this study, the relationship between LT and the localization of keratoconjunctival epitheliopathy (KCE) in dry eye was investigated.
LT was measured in 130 eyes of 65 dry eye patients (D group) and 58 eyes of 31 normal controls (N group) using an LT measuring device specially designed for this study. The maximum and average eyelid tension (MLT and ALT) of the superior and inferior eyelids were used as parameters of LT. KCE was evaluated using corneal and conjunctival fluorescein staining scores (0-3) for the superior, middle and inferior regions of the cornea, and the superior, nasal/temporal interpalpebral, and inferior regions of the conjunctiva. Values for Schirmer’s test, BUT (tear breakup time), TMH (tear meniscus height: low, middle, high), conjunctivochalasis (0-3), upper eyelid shape (single, double), eyelid ptosis (+/-), lid wiper epitheliopathy (0-3) and meibomian gland dysfunction (0-2) were examined.
The LT results were as follows (mmHg: D/N group). Superior: MLT 26.1±5.9/21.5±6.8, ALT 20.2±5.7/16.2±6.2 and inferior: MLT 25.2±7.1/21.0±7.8, ALT 19.6±6.6/16.4±6.8. In all locations, the LT values of the D Group were higher than those of the N Group (p<0.005). KCE scores for the inferior cornea and inferior conjunctiva were correlated with the inferior MLT and ALT, respectively (p<0.005), and those for the superior conjunctiva (SLK) were correlated with the superior MLT and ALT (p<0.05). There was no correlation between any of the LT values and KCE scores for the superior and middle cornea or the interpalpebral conjunctiva.
The LT in dry eyes was higher than that in normal eyes. In dry eyes, the localization of KCE and elevated LT were correlated. Elevated LT may be a risk factor for KCE in dry eye.
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