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Ophthalmic drug delivery faces major limitations due to poor absorption across the corneal membrane. This process is primarily driven by diffusion and is influenced by two main factors: the physicochemical properties of the drug and tear drainage. Most ophthalmic drugs, such as pilocarpine, epinephrine, atropine, and local anesthetics, are weak bases. They are typically formulated at an acidic pH to enhance chemical stability. However, this leads to high ionization, reducing their ability to...
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Intense Pulsed Light for the Treatment of Dry Eye Owing to Meibomian Gland Dysfunction
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Short break-up time type dry eye has potential ocular surface abnormalities.

Yoshiyuki Ichihashi1,2, Takeshi Ide1,2, Minako Kaido1

  • 1Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.

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Corneal fluorescein staining (CFS) can appear after a single eye opening in individuals with short tear break-up time (s-BUT) dry eye. This finding suggests CFS is a dynamic indicator of ocular surface changes in s-BUT dry eye.

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dry eyefluoresceinshort break up timesuperficial punctate keratitis

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Area of Science:

  • Ophthalmology
  • Ocular Surface Disease
  • Dry Eye Disease

Background:

  • Short tear break-up time (s-BUT) dry eye is characterized by rapid tear film evaporation.
  • Corneal fluorescein staining (CFS) is often used to assess ocular surface damage.

Purpose of the Study:

  • To investigate the development of CFS in patients with s-BUT dry eye.
  • To determine if CFS can occur following brief periods of eye opening.

Main Methods:

  • A clinical case series design was employed.
  • Ocular surface evaluations were conducted on 13 individuals diagnosed with s-BUT dry eye.
  • Tear function was assessed using Schirmer's test and tear break-up time (BUT) evaluation.

Main Results:

  • All participants exhibited a short BUT, with adequate tear quantity.
  • CFS developed in all cases after a single eye opening, appearing as dark spots on the cornea.
  • In some instances, the observed CFS resolved over time.

Conclusions:

  • CFS can manifest dynamically following a single eye opening in individuals with s-BUT dry eye.
  • CFS should be considered a dynamic phenomenon, not solely a static marker of ocular surface abnormalities.
  • s-BUT dry eye presents a potential for developing observable ocular surface abnormalities.