Abstract
Purpose :
Dry eye disease (DED) can present with symptoms of photophobia, burning, and grittiness, which can increase the blink rate (BR). Benign Essential Blepharospasm (BEB) is characterized by increased blinking and eyelid spasms, and is often associated with DED. The Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) treatment can help minimize the signs/symptoms of DED using PROSE devices (PD). The purpose of this pilot study is to determine if PDs can be used to reduce the BR in DED/BEB patients.
Methods :
Patients had a primary diagnosis of DED or BEB, and had appropriately fitting PDs. An infrared blink detector was used to measure the BR with no PD on and with a PD filled with clear preservative-free saline (refer as “clear PD”). BR data was also collected on a PD filled with saline and sodium fluorescein (NaFl) mixed (refer as “NaFl PD”). This was because NaFl is commonly used in PD assessment and some patients reported further relief of symptoms with it present. All BR measurements were taken over 3 mins while watching 3 similar, but different film trailers on a computer.
Results :
BR was measured on 8 patients; 6 DED and 2 BEB as primary diagnoses. Ages were 39-70 yo; all were female. 3 patients were established PD wearers; 5 were new to PROSE, with 1 new PD wearer having worn scleral lenses before.
The BR with no PD, clear PD, and NaFl PD averaged 31 blinks/min, 15 blinks/min, and 12 blinks/min, respectively.
7/8 patients showed a reduction in BR from no PD to clear PD, and another 7/8 showed a further reduction from clear PD to NaFl PD. All patients showed a reduction in BR from no PD to NaFl PD.
The average percent BR reduction was 51% from no PD to clear PD, 32% from clear PD to NaFl PD, and 69% from no PD to NaFl PD.
Both the clear PD and NaFl PD showed a statistically significant reduction in BR when compared to no PD (P<0.03), but there was no significant difference between the PD groups.
Conclusions :
Our patients had an average BR of 31 blinks/min when on the computer, which is significantly higher than the average population computer BR of 3-8 blinks/min. With either the clear PD and/or NaFl PD, all patients had a reduction in BR. The NaFl PD had a greater BR reduction than the clear PD but not significantly, perhaps due to the small sample size. These findings suggest that either the clear PD and/or the NaFl PD may be a new novel approach to treat excessive BR in DED/BEB. Further research is still ongoing.
This is a 2020 ARVO Annual Meeting abstract.