Lid-wiper epitheliopathy and dry-eye symptoms in contact lens wearers.
OBJECTIVE
To evaluate whether dry-eye symptoms are associated with epitheliopathy of that portion of the upper eyelid marginal conjunctiva-the lid wiper-that wipes the ocular, or contact lens surface, during blinking.


METHODS
Subjects were divided into two groups based on the presence or absence of dry-eye symptoms. The lid wiper of asymptomatic (n=75) and symptomatic (n=30) soft contact lens wearers was examined, following the instillation of fluorescein and rose bengal dyes. Lid-wiper staining was graded zero to 3.


RESULTS
Eighty percent of the symptomatic subjects displayed lid-wiper staining compared to 13% of the asymptomatic subjects. The difference in staining between the two groups was significant (P<0.0001). Of the symptomatic subjects, 20% showed no staining; 26.6%, grade 1 staining; 36.6%, grade 2; and 16.6% showed grade 3 staining. Of the asymptomatic subjects, 87% exhibited no staining; 9%, grade 1 staining; 3%, grade 2; and 1% showed grade 3 staining.


CONCLUSIONS
This study describes a new clinical condition, lid-wiper epitheliopathy, an alteration of the epithelium of that portion of the marginal conjunctiva of the upper eyelid that wipes the ocular surface, diagnosed by staining with fluorescein and rose bengal dyes.
Korb
Donald R
DR
Korb Associates, Boston, MA 02116, USA. drkorb@aol.com
Greiner
Jack V
JV
Herman
John P
JP
Hebert
Eric
E
Finnemore
Victor M
VM
Exford
Joan M
JM
Glonek
Thomas
T
Olson
Mary Catherine
MC
D000328:Adult; D003229:Conjunctival Diseases / Q000209:etiology* / Q000473:pathology; D003263:Contact Lenses, Hydrophilic / Q000009:adverse effects*; D003287:Contrast Media; D015352:Dry Eye Syndromes / Q000209:etiology*; D004848:Epithelium / Q000473:pathology; D005141:Eyelid Diseases / Q000209:etiology* / Q000473:pathology; D005260:Female; D019793:Fluorescein; D005456:Fluorescent Dyes; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012395:Rose Bengal
D003287:Contrast Media; D005456:Fluorescent Dyes; D012395:Rose Bengal; D019793:Fluorescein