Optimal methodology for lid wiper epitheliopathy identification

Area of Science:

• Ophthalmology
• Dry Eye Disease Research
• Ocular Surface Diagnostics

Background:

• Lid wiper epitheliopathy (LWE) is a clinical sign linked to dry eye disease.
• Accurate assessment of LWE is crucial for diagnosing and managing dry eye.
• Current methods may not fully capture the extent of LWE staining.

Purpose of the Study:

• To evaluate the impact of dye drop number and post-instillation time on lissamine green (LG) and sodium fluorescein (NaFl) absorption.
• To determine optimal conditions for assessing LWE using a semi-automated method.
• To enhance the diagnostic accuracy of LWE identification.

Main Methods:

• A semi-automated software method was used to measure dye staining area on the upper eyelid.
• 37 participants with LWE received 1 or 2 drops of LG (right eye) or NaFl (left eye).
• Photographs were taken at 1, 3, and 5 minutes post-instillation; data analyzed using a linear mixed model.

Main Results:

• For both LG and NaFl, the number of dye drops significantly affected staining area (p < 0.0001).
• Time post-instillation also significantly impacted staining for both dyes (p < 0.0091 for LG, p < 0.0001 for NaFl).
• A significant interaction between time and number of drops was observed for NaFl (p < 0.0134).

Conclusions:

• A single drop of dye is inadequate for fully revealing LWE staining.
• Two drops of dye are recommended for improved LWE assessment.
• Optimal observation times are 1-5 minutes for LG and 3-5 minutes for NaFl.