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Lid laxity may help diagnose dry eye
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Clinicians should consider evaluating patients with lid laxity for ocular surface disease, according to results of a study presented at the Association for Research in Vision and Ophthalmology meeting that evaluated symptoms and other signs of dry eye in subjects with lax lids.
Researchers performed the lid snap test (LST) for lower eyelid/orbicularis oculi laxity and the medial canthal laxity test (MCT) on 66 subjects and the InflammaDry Test for MMP-9 on the right eye in all subjects, with 33 eyes in the same cohort.
Each subject underwent infrared meibography imaging on all eyelids, and all were examined for the presence of cylindrical dandruff.
Subjects also responded to three dry eye symptoms questionnaires: Ocular Surface Index, Dry Eye Questionnaire-5 and the Total Ocular Symptom Score (TOSS).
Researchers found a mild positive relationship between cylindrical dandruff and positive InflammaDry MMP-9, lid snap and the severity of cylindrical dandruff, lid snap and DEQ-5, and lid snap and TOSS.
Cylindrical dandruff is indicative of Demodex blepharitis, researcher Tracy Doll, OD, told Primary Care Optometry News, and “Patients with cylindrical dandruff should examined for ocular inflammation.”
Using the Pearson coefficient, researchers found a moderate positive relationship in lid snap and MCT, lid snap and SPEED, lid snap and OSDI, lid snap and meibomian gland dropout of upper and lower lids, and lid snap and age.
“The correlation between lid laxity, symptoms and other signs of dry eye helps to emphasize the importance of investigating these patients for ocular surface disease,” the researchers concluded in the abstract. “Lid laxity may become a helpful tool in the diagnosis of dry eye and is an important test for patients with dry eye symptoms.”
“We should be checking all patients with lax/loose lower eyelids for dry eye conditions, including Demodex blepharitis,” Doll added. – by Abigail Sutton
Reference:
Doll T, et al. Lid laxity and concurrent signs of ocular surface disease. Presented at: Association for Research in Vision and Ophthalmology; Honolulu; April 29-May 3, 2018.
Disclosures: Doll reported no relevant financial disclosures. Please see the full study for all remaining authors’ financial disclosures.