Abstract
Purpose
Lid wiper epitheliopathy (LWE) is a clinical sign that has been associated with dry
eye disease. This study used a semi-automated method to identify the effect of drop
instillation and post-dye viewing time on the absorption of lissamine green (LG) and
sodium fluorescein (NaFl) on the upper eyelid in order to ascertain the optimal identification
for LWE assessment.
Methods
In 37 participants with LWE, 1-drop of 1% LG (10 μL) was applied to the superior bulbar
conjunctiva in the right eye, and photographs of the lid margin were taken 1, 3, and
5 min after instillation. Measurements were repeated in the same eye following instillations
of 2-drops of 1% LG. The same procedures were followed for application of 2% NaFl
(2 μL) to the left eye. Staining area was determined using software to detect and
measure dye-stained images. Analysis used a linear mixed model with fixed effects
of time, number of drops and their interaction.
Results
For LG, multivariate analysis showed that time of drop instillation was significant
(p = 0.0091) as was the area of staining in the 2-drop versus 1-drop condition (p < 0.0001). For NaFl, there was a significant effect of time (p < 0.0001), drops (p < 0.0001), and a time/drops interaction (p < 0.0134), suggesting that both time and number of drops are important.
Conclusion
A single drop of dye is insufficient to reveal the full extent of LWE staining. A
2-drop instillation is recommended and observation is recommended between 1 and 5
min (LG) and between 3 and 5 min (NaFl).
Keywords
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Article info
Publication history
Published online: May 14, 2020
Accepted:
April 24,
2020
Received in revised form:
April 22,
2020
Received:
January 10,
2020
Identification
Copyright
© 2020 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
