Evaluation of the Clinical Course of Dry Eye Syndrome

TLDR: Within the observation period of up to 8 years, the dry eye syndrome improved or stabilized under appropriate treatment, and subjective reports as well as frequency of artificial tear application were reduced.

Abstract: Objective: To assess subjective symptoms, tear func- tion factors, and ocular surface morphology in the clinical course of patients with dry eye syndrome under treatment within an observation period of up to 8 years. Methods: In 97 patients (78 women and 19 men) with ocular discomfort, a clinical diagnosis of dry eye syn- drome was made based on typical symptoms and a re- ducedtearfilmbreakuptimeoflessthan10seconds.Sub- sequent evaluations revealed a diagnosis of aqueous tear deficiency in 9 patients, meibomian gland dysfunction in32patients,andaqueousteardeficiencycombinedwith meibomianglanddysfunctionin30patients,aqueoustear deficiency associated with Sjogren syndrome in 12 pa- tients,andaqueousteardeficiencyandmeibomiangland dysfunction associated with Sjogren syndrome in 14 pa- tients. Follow-up assessments were performed 12 to 94 months (mean follow-up, 40 months) after the initial di- agnosis. Main Outcome Measures: In different subgroups of dry eye tear film breakup time, Schirmer test with- out local anesthesia (Schirmer I), fluorescein and rose bengal staining, impression cytology, as well as subjec- tive dry eye symptoms and frequency of tear substitute application were compared at baseline and after a fol- low-up of 1 to 8 years (mean, 3.3 years). Results: At baseline, tear film function and ocular sur- facetestresultsfoundmorepathologicabnormalitiesand more severe subjective symptoms in patients with aque- ousteardeficiencyassociatedwithSjogrensyndromeand aqueous tear deficiency and meibomian gland dysfunc- tion associated with Sjogren syndrome compared with the other groups who had dry eye syndrome. No differ- encesinfrequencyoftearsubstituteapplicationwereob- served. At follow-up, tear breakup time, Schirmer I test results, and corneal fluorescein staining improved com- pared with baseline values, whereas rose bengal stain- ing and impression cytology of the conjunctival surface remained almost unchanged. Subjective symptoms and frequency of artificial tear application were reduced.