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M.J. Collins, R. Iskander, R. Gillon, A. Saunders, E. Anthony, S. Hook; Blinking Patterns and Corneal Staining . Invest. Ophthalmol. Vis. Sci. 2006;47(13):93.
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Our aim was to investigate the blinking patterns of normal subjects and soft contact lens wearers and determine if these blinking characteristics were associated with corneal fluorescein staining.
Fifteen young soft contact lens wearers and eleven young normal subjects participated in the study. The subjects were selected to have no significant eyelid pathology. High–speed filming (100 frames/sec) was used to capture the natural blinking patterns of the subjects for approximately three minutes. Custom written software was used to measure the vertical palpebral aperture at the start and end of the downward motion of the upper eyelid. The vertical gap between the lids at the lowest point of the upper lid movement during each blink was measured (closed palpebral aperture). Corneal fluorescein staining was quantified on a 0 to 4 scale for each subject.
Closed palpebral apertures in both the normal and soft contact lens wearing subjects showed a wide distribution, with 22% of blinks being incomplete (<2/3 open aperture) in both groups of subjects. In soft contact lens wearers, there was a significant correlation (r2=0.40, p<0.05) between the mean closed palpebral aperture and the grade of corneal staining (primarily located inferiorly). The normal subjects did not show the same degree of correlation (r2=0.16, p>0.1). However the distribution of closed palpebral apertures was significantly different between those subjects with corneal staining compared to those without corneal staining (Kolmogorov–Smirnov test, normals with p=0.002 and soft lens wearers with p<0.001).
The distribution of closed palpebral apertures of both normal and soft contact lens wearing subjects showed no clear distinction between complete and incomplete blinks. Both groups of subjects show evidence of an association between the mean closed palpebral aperture size (degree of incomplete blinking) and the grade of corneal fluorescein staining, but the association is stronger in soft contact lens wearers.
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