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Pathologic myopia associated with higher OSDI scores, lower TBUT
Patients with pathologic myopia experienced more severe Ocular Surface Disease Index symptoms and faster tear film breakup times than controls, according to a study.
The study compared 45 patients with pathologic myopia with 44 healthy individuals. Researchers defined pathologic myopia as spherical equivalent (SE) refractive errors greater than 6 D and axial globe length (AL) of more than 26.5 mm.
No statistically significant difference between groups was seen in corneal staining or in Schirmer's 1 test scores, both with and without anesthesia, but SE, keratometry, AL, tear breakup time (TBUT) and OSDI scores were each statistically significantly different between groups (P < .001).
Mean TBUT was 7.2 seconds in the myopic group and 13.6 seconds in the control group. Sixty percent of patients in the pathologic myopia group had severe OSDI symptoms, whereas 75% of patients in the control group had no ocular symptoms.
"This supports the relationship between pathological myopia with tantalic [dry eye syndrome],” a condition that occurs in some abnormalities that lead to increased eyelid space, according to the authors.
Disclosure: The study authors report no relevant financial disclosures.
Perspective
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In this study, patients with high myopia (greater than 6 D) were found to have higher OSDI scores, which relate to the symptoms of dry eye as well as lower tear film breakup times than emmetropic patients. There were also differences in Schirmer's scores, but they were not statistically significant. There are many possible explanations for these findings, but it would be expected that patients with long eyes have greater corneal exposure due to an increased interpalpebral fissure, which would explain the reduced tear film stability in high myopes found in this study. Further work is required to determine whether lacrimal gland function is also impacted.
The important clinical implication of this study is that the patients who are most interested in visual rehabilitation with contact lenses and laser vision correction may be at greater risk for dry eye symptoms, which make visual rehabilitation more difficult in these patients.