Br J Ophthalmol 1998;82:666-675 ( June )
Frequent association of delayed tear clearance in ocular
irritation
Pinnita Prabhasawat,
Scheffer C G Tseng
Ocular Surface and Tear Center, Department of
Ophthalmology, Bascom Palmer Eye Institute, and Department of Cell
Biology and Anatomy, University of Miami School of Medicine, Miami,
Florida, USA
Correspondence to: Scheffer C G Tseng, MD,
PhD, Bascom Palmer Eye Institute, William L McKnight Vision Research
Center, 1638 NW 10th Avenue, Miami, FL33136, USA.
Accepted for publication 21 January 1998
AIM To explore the pathogenic role of delayed tear clearance.
METHODSBy comparing 10 patients with punctal
obstruction and 20 asymptomatic normals, delayed tear clearance was
diagnosed in 70 patients without apparent punctal obstruction using
fluorescein clearance test.
RESULTSThe majority were older (71.4 (SD 1.2)
years) and women (66%). Frequent complaints included redness, itching,
mucus discharge, and crusting, which tended to be worse upon awakening.
Common associated problems were medicamentosa (13%), drug induced
pseudo pemphigoid, ocular hypertension (27%), and glaucoma
(7%). Topical non-preserved 1% methylprednisolone resulted
in subjective (83%) and objective (80%) improvement and resolution
of delayed tear clearance (87%).
CONCLUSIONThese results indicate strong
association of delayed tear clearance with intrinsically and
extrinsically generated ocular surface inflammation. The presence of
delayed tear clearance may set up a vicious cycle to aggravate the
existing inflammation. Future prospective studies are needed to
delineate the pathogenic role of delayed tear clearance in various
ocular surface disorders.
Keywords:
medicamentosa;
ocular irritation;
tear clearance;
tear turnover
© 1998 by British Journal of Ophthalmology
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