A precise method of using rose bengal in the evaluation of dry eye and the detection of changes in its severity

Randomized controlled trial of trehalose: An efficient autophagic bioprotectant in the management of dry eye disease

PURPOSE:

To compare the therapeutic effect of sodium hyaluronate (SH)–trehalose (Trehalube, Microlabs, Bangalore, India, SH 0.1% and trehalose 3%) or SH (0.1% Hylotears, Raymed, Chandigarh, India) alone in patients with dry eye disease (DED).

MATERIALS AND METHODS:

Patients were randomized into two groups: SH-trehalose (SH 0.1% and trehalose 3%) or SH (0.1% Hylotears) alone. The Ocular Surface Disease Index (OSDI) questionnaire was used to assess patient's symptoms. Patients were followed up at 4 and 8 weeks, and OSDI score, tear film break-up time (TBUT), tear film height (TFH), Schirmer's test, and conjunctival staining were evaluated at each visit.

RESULTS:

A total of 384 patients were included in the study, 192 patients in each arm. The mean age of participants was 37.62 + 14.4 years and 225 were women (56%). The improvement in Schirmer's test was significantly better in the SH-trehalose group at 8 weeks (5.26 + 4.3 mm, 95% confidence interval = 4.6–5.9 mm) compared to the SH group (3.71 + 3.9, 95% confidence interval = 3.15–4.28 mm). The TBUT and TFH showed slight improvement at 4 weeks in both groups, but not at 8 weeks. There were no group differences at all-time points in terms of conjunctival staining and OSDI-based grades of DED.

CONCLUSION:

It was found that treating dry eye with SH-trehalose leads to greater improvement in the Schirmer's values and TBUT after 8 weeks of sustained use in patients with DED, and this was more pronounced in those with severe DED.

Topical cyclosporine A 0.5% as a possible new treatment for superior limbic keratoconjunctivitis

PURPOSE

To report the early success of the use of topical cyclosporine A 0.5% drops to treat Theodore's superior limbic keratoconjunctivitis (SLK).

DESIGN

A retrospective noncomparative case series.

PARTICIPANTS

Five patients diagnosed with SLK.

INTERVENTION

All five patients were treated with topical cyclosporine A 0.5% drops as primary or adjunctive therapy after treatment failure in some of prednisolone acetate 1% drops and topical silver nitrate 0.5% application. Topical cyclosporine A 0.5% drops were used four times a day in both eyes.

MAIN OUTCOME MEASURES

Resolution of symptoms (foreign body sensation and irritation) and signs (rose bengal staining, tarsal papillary reaction, and injection).

RESULTS

All five patients had long-term (6 months to 3 years) improvement of irritation and foreign body sensation, as well as improvement of injection and filamentary keratitis. Aside from burning on instillation, there were no complications related to this therapy.

CONCLUSIONS

Topical cyclosporine A 0.5% is helpful as primary or adjunctive therapy for SLK. It may also be used as a maintenance drug to prevent recurrence. Further study may delineate the specific role and treatment parameters for the use of topical cyclosporine A 0.5% in the treatment of SLK.

Closed chamber thermometry and humidity measurements in normal and dry eye patients: a pilot study

PURPOSE

To verify the diagnostic value of closed chamber thermometry and humidity measurement in normal and dry eye patients.

METHODS

In 20 patients (40 eyes) with dry eye and 20 normal sex- and age-matched controls (40 eyes), aged from 11 to 61 years (mean 37.52 yrs, standard deviation, (SD) 14.81) temperature was measured by infrared thermometry and humidity measured in a closed chamber 15 mm from the cornea. The temperature reading in degrees C and humidity in % (RH) were noted on closing and then opening the eye for five seconds.

RESULTS

The temperature rose significantly, by 0.11 degrees C +/- 0.02, between the closed and open eye positions (p < 0.000) in normal eyes, but there was no change in dry eyes. The humidity in normal eyes in the closed position was 49.50 +/- 4.67% and 50.03 +/- 4.65% in the open position (p < 0.00001). Humidity in the closed and open positions in dry eyes was 52.77 +/- 7.13% and 53.59 +/- 6.75% (p < 0.00000). The difference between closed and open dry eyes was 1.25 +/- 0.40%, compared to 0.54 +/- 0.20% in normal controls (p < 0.005). No relationship was found with age or sex.

CONCLUSIONS

Thermometry and humidity measurements in a dry eye patient had a 100% diagnostic value. The reading of no change in thermometry and more than 1% change in humidity were highly diagnostic of dry eyes.