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Prevalence of lower lid wiper epitheliopathy greater than upper, study finds
Clinical studies should focus on the lower eyelid margin, according to a study recently published in Eye & Contact Lens.
Shiraishi and colleagues reported that lid wiper epitheliopathy (LWE) was seen more often in lower lids than the upper lids in their study.
Researchers evaluated 508 patients of the outpatient clinic of the Department of Ophthalmology, Ehime University Hospital, which included 229 who did not wear contact lenses, 137 who wore soft contacts and 71 who wore gas-permeable contacts.
They determined the degree of LWE as well as tear break-up time and cornea-conjunctival staining with fluorescein and lissamine green staining.
Results showed that in patients who did not wear contact lenses, the prevalence of lower LWE was significantly higher than upper LWE, at 39.5% and 12.5%, respectively. Additionally, the prevalence of both types of LWE was higher in younger patients than older patients and higher in contact lens wearers than patients who did not wear contact lenses.
Researchers found that, in patients who were contact lenses, the differences between upper LWE and lower LWE were not significant. In patients who wore soft contact lenses, upper LWE was identified in 58.1% of eyes and lower LWE in 68.1% of eyes. In patients who wore GP lenses, upper LWE was identified in 84.4% of eyes and lower LWE in 71.9% of eyes.
"We found that the prevalence of LWE in randomly selected patients who visited the ophthalmological outpatient clinic was higher for lower LWE than upper LWE," the authors concluded. "The higher prevalence of lower LWE may be caused by the continuous friction of the lower eyelid on the same region of the cornea during blinking. More attention should be paid to the lower eyelid margins and movements during blinking."
Disclosure: The authors have no funding or conflicts of interest to disclose.