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July 28, 2021
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Low vision patients not routinely tested for dry eye disease despite high risk

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Results from a retrospective chart review on dry eye disease and low vision showed low vision patients are at risk for dry eye disease, but low numbers of dry eye disease tests are performed in low vision eye exams.

Researchers published the findings in Optometry and Vision Science.

“With the use of visual aids in low vision patients more likely to be increasingly digital in the future, coupled with the need for sustained gaze and the current age demographics, low vision patients may be more at risk for an altered tear film leading to dry eye disease,” Etty Bitton, OD, MSc, FAAO, of the University of Montreal, and colleagues wrote. “It may also be clinically relevant to determine if low vision patients have risk factors for dry eye disease, other than disease.”

Researchers conducted a retrospective chart review of randomly selected patients (aged 26 to 97 years) qualifying under the Quebec health insurance system as low vision, with a BCVA of 20/60 or less in at least one eye, visual field diameter of 60 degrees or those with hemianopsia.

The final analysis included 201 adult patients, (mean age, 71.2 years; 60.2% women) whose charts were reviewed for patient demographics and dry eye risk factors, with relevant tests being analyzed.

Bitton and colleagues reported that 25% of the reviewed charts included at least one dry eye symptom, 30.3% indicated use of medications known to exacerbate dry eye disease, 49.2% showed at least one disease associated with dry eye disease, and 72.1% mentioned at least one ocular surgery. Investigators also wrote that artificial tears were documented in 26.8% of charts, and few (8.95%) charts included specific dry eye exams.

“Eye care practitioners working in low vision should consider assessing dry eye symptoms and associated ocular signs in this vulnerable patient base during an initial examination or during a follow-up visit, as this may enhance the stability of vision, the adoption and sustained use of recommended low vision devices and, by consequence, the vision-related quality of life for patients,” Bitton and colleagues wrote.