September 10, 2015
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Evaluate patients with contact lens-induced dry eye for binocular vision disorders

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Patients who are experiencing contact lens-induced dry eye symptoms may have a binocular vision disorder instead of or in addition to dryness, according to a study recently published in Optometry and Vision Science.

Rueff and colleagues conducted two studies to assess a relationship between dry eye symptoms and binocular vision (BV) disorders as well as the rate of occurrence of BV disorders in participants with contact lens-induced dry eye (CLIDE) symptoms.

In the first study, researchers evaluated 104 normal and dry eye participants who were enrolled in a larger dry eye study. Participants completed the Convergence Insufficiency Symptom Survey (CISS) and Ocular Surface Disease Index (OSDI).

In the second study, researchers evaluated 29 myopic participants who wore soft contact lenses. The participants had complaints of dry eye and best-corrected visual acuity of 20/25 or better. Participants also complete the OSDI and CISS as well as the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8). Researchers assessed heterophoria determination, binocular vergence measurement, near point of convergence and accommodative function while participants wore their contact lenses and tear break-up time assessment, ocular surface staining with fluorescein and lissamine green, Schirmer’s test and meibomian gland assessment without contact lenses.

Results showed that, in the first group of participants, CISS and OSDI symptom severity was significantly correlated. In the second group of participants, researchers found that 48.3% of the participants had a BV disorder.

"The results of this study can be used to guide clinicians to better address CLIDE-like symptoms," the authors concluded. "Basic BV testing may reveal a BV disorder that is causing or exacerbating symptoms of CLIDE. Accommodative testing, in particular, may provide a valuable tool for identifying the etiology of symptoms of discomfort while wearing contact lenses, especially in myopic contact lens wearers."

The researchers also said that their results indicated that dry eye researchers should add binocular vision testing to their exclusion criteria and subject evaluations in order to eliminate subjects who do not have dry eye or have both dry eye and a BV disorder. – by Chelsea Frajerman Pardes

Disclosure: The authors report no relevant financial disclosures.