Abstract
Purpose :
The use of hypotensive eye drops for glaucoma produces an alteration of the ocular surface, which over time can lead to a reduction in corneal sensitivity. The purpose of this cross-sectional study is to analyze corneal sensitivity with a new noncontact and hand-held air jet esthesiometer (Brill Engines, Spain) in a group of patients with glaucoma, and to compare it with the corneal sensitivity of healthy subjects.
Methods :
23 patients (46 eyes) who use or used at any time in the past topical hypotensive medications were recruited as glaucoma group. 21 healthy patients (33 eyes) were enrolled as a control group. In all patients, corneal sensitivity was measured with the non-contact esthesiometer placed in the slit lamp. Three measurements at each device level were taken in the lower quadrant of the cornea. In patients who did not perceive any stimulus, a level of 11 mbar (one point above the maximum detection level) was assigned. A keratography test (Keratograph 5M, Oculus) was carried out to measure the tear meniscus height (TMH), noninvasive tear breakup time (NIBUT), bulbar redness (Jenvis scale) and corneal staining (CS) (Oxford scale). Both corneal sensitivity and the other ocular surface measurements were compared between glaucoma patients and healthy controls. A 95% confidence level was considered statistically significant.
Results :
The mean age of the glaucoma patients was 69.5 ± 11.7 years and 56.5% were female. They used a mean of 2 ± 1.2 hypotensive drops daily. The mean age of the healthy patients was 36.3 ± 10.5 years and 60.6% were female. The mean value of corneal sensitivity was 6.6 ± 2.8 mbar in the glaucoma group and 3.2 ± 1.4 mbar in control group. Adjusting for age and sex, esthesiometry and CS values were significantly higher in glaucoma patients than in the control group (p=0.02 and p=0.04 respectively). NIBUT scores and TMH values were lower in the glaucoma group versus the control patients (p=0.005 and p=0.01 respectively).
Conclusions :
Corneal sensitivity measured with a novel noncontact esthesiometer was reduced in patients who use or used hypotensive medications compared to controls. Statistically significant differences were also found in other dry eye parameters, except for ocular redness. In clinical practice, this esthesiometer might be a portable and easy to use device to test for corneal sensitivity in patients with glaucoma.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.