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Presumed hyposecretory/hyperevaporative KCS: tear characteristics
James P McCulley1, Ward E Shine, Joel Aronowicz
1Department of Ophthalmology, University of Texas, Southwestern Medical Center at Dallas, USA.
Transactions of the American Ophthalmological Society
|February 20, 2004
Summary
Patients with dry eye (keratoconjunctivitis sicca) show reduced tear production and increased meibomian gland dropout. Tear evaporation was not elevated, and its correlation with gland dropout was not found.
Area of Science:
- Ophthalmology
- Ocular Surface Disease
Background:
- Keratoconjunctivitis sicca (KCS) is a common condition causing ocular surface dryness.
- Understanding the specific physiological characteristics of KCS patients is crucial for effective management.
Purpose of the Study:
- To characterize patients diagnosed with ocular surface drying and KCS.
- To differentiate between classic KCS and KCS with Meibomian Gland Dysfunction (MGD).
Main Methods:
- Patients with KCS and controls were assessed.
- Evaluations included vital staining, tear volume, flow, turnover (fluorophotometry), meibomian gland dropout (meibography), evaporation (evaporometry), and tear production (Schirmer 1 test).
- Patients were categorized into classic KCS or KCS with MGD based on meibomian gland secretions.
Main Results:
- All KCS patients exhibited decreased tear volume, flow, and Schirmer 1 values, alongside increased meibomian gland dropout.
- No significant increase in tear evaporation was observed in KCS groups compared to controls.
- A correlation between meibomian gland dropout and tear evaporation was not identified.
Conclusions:
- Ocular surface drying in KCS, without inflammation, is linked to reduced tear volume, flow, and increased meibomian gland dropout.
- The specific contribution of meibomian gland dropout or MGD to KCS requires further investigation, as it did not correlate with increased tear evaporation in this study.