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Frequent association of delayed tear clearance in ocular irritation
1Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL 33136, USA.
Aim:
To explore the pathogenic role of delayed tear clearance.
Methods:
By comparing 10 patients with punctal obstruction and 20 asymptomatic normals, delayed tear clearance was diagnosed in 70 patients without apparent punctal obstruction using fluorescein clearance test.
Results:
The majority were older (71.4 (SD 1.2) years) and women (66%). Frequent complaints included redness, itching, mucus discharge, and crusting, which tended to be worse upon awakening. Common associated problems were medicamentosa (13%), drug induced pseudopemphigoid, ocular hypertension (27%), and glaucoma (7%). Topical non-preserved 1% methylprednisolone resulted in subjective (83%) and objective (80%) improvement and resolution of delayed tear clearance (87%).
Conclusion:
These results indicate strong association of delayed tear clearance with intrinsically and extrinsically generated ocular surface inflammation. The presence of delayed tear clearance may set up a vicious cycle to aggravate the existing inflammation. Future prospective studies are needed to delineate the pathogenic role of delayed tear clearance in various ocular surface disorders.