Abstract
Purpose :
Lid wiper epitheliopathy is a clinical sign that has been associated with dry eye disease. This study used a semi-automated method to identify the effect of drop instillation and post-dye viewing time on the absorption of lissamine green and sodium fluorescein on the upper eyelid in order to ascertain the optimal methodology for LWE assessment.
Methods :
In 37 participants with LWE, 1-drop of 1% LG (10μL) was applied to the superior bulbar conjunctiva in the right eye, and photographs of the lid margin were taken 1, 3, and 5 minutes after instillation. Measurements were repeated in the same eye following instillations of 2-drops of 1% LG. The same procedures were followed for application of 2% NaFl (2μL) to the left eye. Staining area was determined using software to detect and measure dye-stained images. Analysis used a linear mixed model with fixed effects of time, number of drops and their interaction.
Results :
For LG, multivariate analysis showed that time of drop instillation was significant (p=0.0091) as was the area of staining in the 2-drop versus 1-drop condition (p<0.0001). For NaFl, there was a significant effect of time (p<0.0001), drops (p<0.0001), and a time/drops interaction (p<0.0134), suggesting that both time and number of drops are important.
Conclusions :
A single drop of dye is insufficient to reveal the full extent of LWE staining. A 2-drop instillation is recommended and observation is recommended between 1-5 minutes (LG) and between 3-5 minutes (NaFl).
This is a 2020 ARVO Annual Meeting abstract.