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A novel method to predict the dry eye symptoms in new contact lens wearers

Pult, Heiko, Murphy, Paul James and Purslow, Christine 2009. A novel method to predict the dry eye symptoms in new contact lens wearers. Optometry and Vision Science 86 (9) , E1042-E1050. 10.1097/OPX.0b013e3181b598cd

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Purpose. Lid wiper epitheliopathy (LWE) and lid parallel conjunctival folds (LIPCOF) give moderate prediction levels for dryness symptoms in experienced contact lens (CL) wearers. This study investigated whether a combination of LWE and LIPCOF plus other tear film tests and subjective evaluation before contact lens fitting was better able to predict CL-induced dry eye (CLIDE) symptoms. Methods. Tear meniscus height, non-invasive break-up time (NIBUT), ocular hyperaemia, LIPCOF, phenol red thread test, corneal and conjunctival staining, and LWE of the right eye of 33 new soft CL wearers (12 males, 21 females, median age = 30.5 years; range = 19 to 44) were assessed in a prospective 2-mo longitudinal study. Symptoms were evaluated by the Ocular Surface Disease Index (OSDI) and subjects were grouped according to their response in the Contact Lens Dry Eye Questionnaire (CLDEQ) during the study (20 symptomatic and 13 asymptomatic). The subjects were fitted with vifilcon A and senofilcon A lenses for a 2-week period, consecutively. Results. Limbal hyperaemia (repeated measures analysis of variance; p < 0.05) and LWE (Friedman; p < 0.004) increased significantly during the study but not LIPCOF (p >= 0.318; temporal, nasal, and Sum), bulbar hyperaemia (p = 0.432), staining (p >= 0.060), OSDI (p = 0.126), or CLDEQ (p = 0.317, [kappa] = 0.279). Limbal hyperaemia significantly decreased in senofilcon A lenses. Wearing comfort among symptomatics was significantly better with senofilcon A (p = 0.005). At the enrolment visit, the subjects who became symptomatic exhibited significantly decreased NIBUT and increased LIPCOF and OSDI (range, p < 0.027). The best test combination to predict CLIDE (logistic regression analyses) was LIPCOF Sum plus NIBUT and OSDI, (positive predictive value = 87% and accuracy = 91%). Conclusions. LIPCOF, NIBUT, and OSDI are significant discriminators for CLIDE in new CL wearers compared with hyperaemia, tear meniscus height, phenol red thread test, staining, and LWE. The best test combination is NIBUT plus LIPCOF Sum and OSDI (named the Contact-Lens-Predicting-Test).

Item Type: Article
Date Type: Publication
Status: Published
Schools: Optometry and Vision Sciences
Subjects: R Medicine > RE Ophthalmology
Uncontrolled Keywords: contact lens, dry eye, symptoms, lid parallel conjunctival folds, lid wiper epitheliopathy, tear film, questionnaire
Additional Information: Accession: 00006324-200909000-00004
Publisher: American Academy of Optometry
ISSN: 1040-5488
Last Modified: 04 Jun 2017 03:29

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