Friday, March 30, 2012

Dry Eye & Visual Acuity

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Dry Eye Symptoms & Visual Acuity

March 30, 2012


Symptomatic dry eye can result in a decreased ability to perform daily activities that have an impact on the quality of life.
The peer-reviewed journal, Eye, published The Singapore Malay Eye Study that assessed symptoms of dry eye on a population-based survey of 3280 adults aged 40-79. The assessment included questions of feeling of dryness, grittiness, burning sensation, redness, crusting of lashes, and tendency to shut the eyes.
The study participants were interviewed using a supplementary questionnaire consisting of 11 questions on vision-related daily living activities that are relevant to the local population of both genders and including near, intermediate and distance visual acuity, and contrast sensitivity. The assessment also included difficulties in activities such as navigating stairs, reading road signs, recognizing friends, watching television, reading newspapers, reading small print, driving at night, driving during daytime, cooking, playing chess/cards, and filling out forms.
Symptomatic dry eye was found to be significantly associated with difficulty in performing 7 out of 11 vision-related daily activities evaluated.
Study Summary.
What was known before this study

Dry eye is a common eye condition caused by diminished tear production or increased evaporation of tears.

It is known to affect the quality of vision because of the associated irregularity of the tear film and the optical refracting surfaces.

The effect of dry eye on daily activities has been a focus of research only recently.
What information the Singapore Malay Eye Study added

A reported impact of symptoms of dry eye or tear dysfunction on specific vision-related daily activities in a large population-based study.

Symptomatic dry eye significantly associated with difficulty in performing vision-related daily activities, independent of their visual acuity.

The specific activities that were significantly affected by symptomatic dry eye were navigating stairs, reading road signs, reading newspapers, cooking, recognizing friends, watching television, and driving at night.
It's interesting to note that the study found almost no gender difference among participants who experienced difficulty in reading road signs day or night (9% in men vs 13% in women). Overall more men drove at night than women; however, a greater proportion of females (31% of those who drove at night) experienced night driving difficulties compared with men.


Ellen Troyer, MT MA
Biosyntrx CEO / Chief Research Officer

PEARL

A study published in the March 16, 2012 IOVS looked at the prevalence of asymptomatic meibomian gland dysfunction (MGD) vs symptomatic MGD. The conclusion was that asymptomatic MGD is more common than symptomatic MGD, which suggests more careful attention should be paid to abnormal tear breakup time and fluorescein stainning since visual acuity and quality of life can be affected when any layer of the tear film is not biochemically intact.

Symptomatic dry eye seems to have a significant impact of quality of life even in people with good vision. Two obvious questions: 1) does visual acuity vary with dry eye symptomology due to inconsistant tear film stability? 2) is undertreatment of dry eye symptomology interferring with quality of life?









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References


Tong L, Waduthantri S, et al. Impact of symptomatic dry eye on vision-related daily activities: The Singapore Malay eye Study. Eye, May 21, 2010 [PubMed]

Prevalence of asymptomatic and symptomatic meibomian gland dysfunction in the general population of Spain. Eloy V, et al. IOVS, March 16, 2012. [abstract]

Lemp MA. The definition and classification of dry eye disease: report of the definition and classification subcommittee of the International dry eye workshop. Ocul Surf 2007; 5(2): 7592. | PubMed |
Behrens A, Doyle JJ, Stern L, Chuck RS, McDonnell PJ, Azar DT et al. Dysfunctional tear syndrome: a delphi approach to treatment recommendations. Cornea 2007; 26(7): 901. PubMed
Sullivan RM, Cermak JM, Papas AS, Dana MR, Sullivan DA. Economic and quality of life impact of dry eye symptoms in women with Sjogren's syndrome. Adv Exp Med Biol 2002; 506(Pt B): 11831188. | PubMed |
Begley CG, Caffery B, Chalmers RL, Mitchell GL. Dry Eye Investigation (DREI) Study Group. Use of the dry eye questionnaire to measure symptoms of ocular irritation in patients with aqueous tear deficient dry eye. Cornea 2002; 21: 664670. PubMed
Asbell PA, Lemp MA. Dry Eye Disease: The Clinician's Guide to Diagnosis and Treatment. Thieme Medical Publishers: New York, 2007.

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