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Compliance with hygiene improved symptoms of lid disease
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Researchers reinforced the role of lid hygiene as first-line therapy in patients with lid margin disease, according to cross-sectional study data in Eye & Contact Lens.
Patients were assessed for dry eye symptoms by completing the dry eye questionnaire 5 (DEQ-5). They were also evaluated for the features of lid disease. The presence of anterior blepharitis, eyelid vascularity and inspissation were graded on a scale from 0 to 3, with 3 being severe. Meibum quality was graded on a scale of 0 to 4, with 0 being clear, 1 being cloudy, 2 being granular, 3 being like toothpaste and 4 being no meibum extracted. Corneal staining was graded from 0 to 5 based on the Bron scale.
A total of 207 patients participated, with a mean age of 69 years.
After instruction, patients were given standardized instructions for lid hygiene: to apply warm compresses to the eyelids for 5 minutes twice daily followed by an eyelid scrub with warm water. Baby shampoo was recommended but not required. A follow-up phone call was conducted 6 weeks after the clinical visit to assess patient compliance and satisfaction with the therapy regime.
Most patients, 61%, reported having dry eye symptoms, and, of those patients, symptoms were present for 4.5 years, on average.
The mean DEQ5 score for all patients was 5.5. As researchers expected, those who self-reported dry eye symptoms had higher DEQ5 scores.
Of the 188 patients who were followed up with, 104 (55%) reported compliance with the therapy, 56 patients with water alone and 48 with water and baby shampoo.
The reasons for noncompliance included inconvenience (nine patients), forgetfulness (28 patients) and feeling that they did not need therapy (47 patients), according to researchers.
Eight patients reported that lid hygiene did not help with symptoms, and the remaining 96 reported improvement in symptoms.
The only factor found to be significantly associated with a poorer response to lid hygiene was a longer time of reported dry eye symptoms.
Researchers found that compliance with therapy was only moderate in patients with self-reported dry eye symptoms and expectedly poor in those without symptoms.
“The known discordance between clinical signs and symptoms of dry eye may underlie a similar lack of association between initial ocular surface signs and satisfaction with lid hygiene therapy,” researchers wrote.
Additionally, researchers found that no specific sign or symptoms of lid hygiene disease was associated with a better or poorer response to therapy. – by Abigail Sutton
Disclosure: The researchers reported no relevant financial disclosures.
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