Optimal methodology for lid wiper epitheliopathy identification

Lievens, Chris and Norgett, Yvonne and Briggs, Nancy and Allen, Peter M. and Vianya-Estopa, Marta (2021) Optimal methodology for lid wiper epitheliopathy identification. Contact Lens and Anterior Eye, 44 (3). p. 101332. ISSN 1476-5411

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Official URL: https://doi.org/10.1016/j.clae.2020.04.016

Abstract

Purpose: Lid wiper epitheliopathy (LWE) is a clinical sign that has been associated with dry eye disease. This study used a semi-automated method to identify the effect of drop instillation and post-dye viewing time on the absorption of lissamine green (LG) and sodium fluorescein (NaFl) on the upper eyelid in order to ascertain the optimal identification for LWE assessment. Methods: In 37 participants with LWE, 1-drop of 1% LG (10 μL) was applied to the superior bulbar conjunctiva in the right eye, and photographs of the lid margin were taken 1, 3, and 5 min after instillation. Measurements were repeated in the same eye following instillations of 2-drops of 1% LG. The same procedures were followed for application of 2% NaFl (2 μL) to the left eye. Staining area was determined using software to detect and measure dye-stained images. Analysis used a linear mixed model with fixed effects of time, number of drops and their interaction. Results: For LG, multivariate analysis showed that time of drop instillation was significant (p = 0.0091) as was the area of staining in the 2-drop versus 1-drop condition (p < 0.0001). For NaFl, there was a significant effect of time (p < 0.0001), drops (p < 0.0001), and a time/drops interaction (p < 0.0134), suggesting that both time and number of drops are important. Conclusion: A single drop of dye is insufficient to reveal the full extent of LWE staining. A 2-drop instillation is recommended and observation is recommended between 1 and 5 min (LG) and between 3 and 5 min (NaFl).

Item Type: Journal Article
Keywords: lid wiper, epitheliopathy, dry eye, lissamine green, sodium fluorescein
Faculty: Faculty of Science & Engineering
Depositing User: Ian Walker
Date Deposited: 11 May 2020 10:10
Last Modified: 25 Nov 2021 15:30
URI: https://arro.anglia.ac.uk/id/eprint/705501

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