Influence of topical anesthesia on tests diagnostic of blepharitis-associated dry eye syndrome.
OBJECTIVE
Despite the high frequency and clinical relevance of blepharitis-associated dry-eye syndrome, no agreement exists about whether diagnostic tests should be performed with or without topical anesthesia. The aim of this study was to compare the influence of topical anesthesia on the mean values of Schirmer's test, tear lysozyme, tear lactoferrin, and tear osmolarity in patients suffering from blepharitis-associated dry eye syndrome.


METHODS
The authors compared the mean values of Schirmer's test, tear osmolarity, tear lysozyme (turbidimetric assay), and tear lactoferrin (radial immunodiffusion) before and after topical anesthesia in the following groups: 56 normal subjects (group 1), 62 blepharitis patients (group 2), and 15 patients with blepharitis-associated dry eye syndrome (group 3). All clinical and laboratory tests were performed by masked observers.


RESULTS
In group I, mean values of Schirmer's test decreased 24.8% (p < 0.01) when performed after application of topical anesthesia. The other tests were not significantly modified. In groups 2 and 3, significant differences were seen in Schirmer's test (25.33% and 24.19% respectively, p < 0.001) and the lysozyme determination (14.00% and 13.22% respectively, p < 0.01). Differences between the normal subjects (group I) and the patient groups increased when the tests were performed after application of topical anesthesia reaching statistical significance in group 3 for all the tests.


CONCLUSIONS
Performing diagnostic tests after topical anesthesia instillation could be useful in detecting dry eye associated with blepharitis.
Herreras
J M
JM
Ocular Immunology, Uveitis and Cornea Unit, Instituto de Oftalmobiología Aplicada (IOBA), University of Valladolid, Spain.
Pérez
S
S
Pérez
H
H
Calonge
M
M
Pastor
J C
JC
D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage; D000328:Adult; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001762:Blepharitis / Q000175:diagnosis* / Q000378:metabolism; D004338:Drug Combinations; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D006801:Humans; D007781:Lactoferrin / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009113:Muramidase / Q000378:metabolism; D009278:Naphazoline / Q000008:administration & dosage; D009883:Ophthalmic Solutions; D009994:Osmolar Concentration; D013666:Tears / Q000187:drug effects / Q000378:metabolism; D013748:Tetracaine / Q000008:administration & dosage
D000316:Adrenergic alpha-Agonists; D000779:Anesthetics, Local; D004338:Drug Combinations; D009883:Ophthalmic Solutions; D013748:Tetracaine; D009113:Muramidase; D007781:Lactoferrin; D009278:Naphazoline