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In Vivo Confocal Microscopy in the Diagnosis and Management of Dry Eye: A Focus on Imaging Protocols and Interpretation
Published on: November 11, 2025
Corneal fluorescein staining correlates with visual function in dry eye patients
Minako Kaido1, Yukihiro Matsumoto, Yuta Shigeno
1Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. fwiw1193@mb.infoweb.ne.jp
Investigative Ophthalmology & Visual Science
|November 24, 2011
Summary
Dry eye disease with superficial punctate keratopathy significantly impairs visual function and optical quality. Functional visual acuity (VA) measurement is an effective tool for assessing visual performance in dry eye patients.
Area of Science:
- Ophthalmology
- Corneal Diseases
- Visual Optics
Background:
- Dry eye disease (DED) is a prevalent condition affecting ocular surface health and visual quality.
- Superficial punctate keratopathy (SPK) is a common sign of ocular surface damage in DED.
- Understanding the impact of SPK on visual function is crucial for patient management.
Purpose of the Study:
- To evaluate changes in functional visual acuity (VA) and higher-order aberrations (HOAs) in patients with DED.
- To compare visual function and optical quality between DED patients with and without SPK and healthy controls.
Main Methods:
- A prospective comparative case series included 22 DED patients (classified by SPK presence) and 10 healthy controls.
- Functional VA and HOAs were measured using specialized systems under blink-free conditions.
- Parameters were compared across groups (SPK-positive, SPK-negative, control), and correlations were analyzed.
Main Results:
- DED with SPK showed significantly worse visual function (visual maintenance ratio, VA variation) and optical quality (coma-like, total HOAs) compared to DED without SPK and controls.
- Epithelial damage severity correlated with visual function and HOA measures.
- DED without SPK exhibited minor visual deterioration, primarily detected by visual maintenance ratio.
Conclusions:
- Corneal optical disturbances in DED, particularly with SPK, negatively impact visual performance.
- Functional VA measurement offers an efficient and applicable method for evaluating visual performance in dry eye patients, comparable to wavefront aberration measurements.
