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Corneal epithelial breakdown linked to senile sunken upper eyelids
Ophthalmology. 2011;118(12):2487-2492.
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Senile sunken upper eyelids were associated with ocular surface morbidity related to exposure and desiccation, a study found.
"Such new understanding will help us to formulate appropriate therapies to manage corneal surface breakdown in elderly patients with complex and confusing ocular surface diseases," the study authors said.
The retrospective study included 38 eyes with sunken eyelids and 26 age-matched controls with dry eye syndrome. Mean patient age was 72.2 years in the study group and 69.2 years in the comparator group.
Sunken upper eyelids were classified as mild in eight cases, moderate in 10 cases and severe in 20 cases.
Symptoms, eyelid blinking and closure, Bell's phenomenon, apposition of lids and puncta to the globe, conjunctival inflammation and conjunctival chalasis were used to measure ocular surface deficits.
Fluorescein staining, rose bengal staining and fluorescein clearance testing were used to gauge corneal epithelial breakdown.
Study results showed that ocular irritation and pain were significantly more common in controls than in the study group (P = .002). Tearing and mucous accumulation were more common in the study group (P = .04).
Corneal epithelial breakdown was identified more frequently in the study group than controls (P = .0002) and was significantly more common in severely afflicted eyes (P = .02).
A significant majority of study eyes with corneal epithelial breakdown had at least one exposure-related deficit such as infrequent or incomplete blinking, incomplete closure or abnormal Bell's phenomenon, the authors said.