Purchase this article with an account.
C. Valente, S. Barabino, E. Corsi, M. Iester, M. Rolando; Symptoms and Signs of Lacrimal Dysfunction in Glaucomatous Patients. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2601.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
to evaluate in glaucomatous patients the presence of symptoms of lacrimal dysfunction using the Ocular Surface Disease Index (OSDI) questionnaire. To examine if glaucomatous patients with positive OSDI have ocular surface epithelial staining.
thirty patients,18 years of age or older, with ocular hypertension or open-angle glaucoma were sequentially examinated. None of them had a history of use of cyclosporine, steroids, NSAIDs, ocular surgery in the last six months. All the patients used antiglaucomatous drops q.d. or b.i.d. or t.i.d or q.i.d. Each of them filled out an OSDI questionnaire. Fluorescein corneal staining (NEI grading system), lissamine green conjunctival staining (NEI grading system), Schirmer I test were performed in all patients with positive OSDI (Score >12). For the statistical analysis we considered data of right eye.
using the OSDI questionnaire 14 of 30 patients (47%) showed at least mild symptoms of lacrimal dysfunction (Score>12) and 11 (37%) had severe OSDI (Score>32). Decrease in tear production (Schirmer I test<10mm/5min) was seen in only 4 glaucomatous patients. Lissamine green conjunctival staining resulted positive in at least one eye of all the 14 patients while fluorescein corneal staining was positive in at least one eye of 12 patients. The mean and SD of lissamine green conjunctival and fluorescein corneal staining were respectively of 7.4±6.6 and 3.2±2.8 . Five patients had severe lissamine green staining, two patients had severe corneal staining. We found a statistically significant difference in lissamine green staining (p<0.05 Student’s t-test) between 8 patients using drops of antiglaucomatous drugs q.d. or b.i.d. and 6 patients using drops t.i.d or q.i.d. The mean and SD of OSDI values were worse in patients using drops t.i.d or q.i.d (50.8±25.5) than in patients using drops q.d. or b.i.d. (37.5±8.9), although a statistically significant result was not found. There was no correlation between the results of all clinical tests and the symptoms of lacrimal dysfunction researched with OSDI. Half of the patients believed that the cause of symptoms of lacrimal dysfunction may be the use of antiglaucomatous drops, but only one used sometime tear substitutes.
almost 50% of patients in therapy with topical antiglaucomatous drops showed symptoms of lacrimal dysfunction. Symptoms of ocular surface diseases seem to be greater in patients using daily a larger number of drops.
This PDF is available to Subscribers Only