title: Lid-wiper epitheliopathy and dry-eye symptoms in contact lens wearers.
abstract: 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.
authors.affiliation: Korb Associates, Boston, MA 02116, USA. drkorb@aol.com
authors.forename: Donald R
authors.initials: DR
authors.lastname: Korb
authors.forename: Jack V
authors.initials: JV
authors.lastname: Greiner
authors.forename: John P
authors.initials: JP
authors.lastname: Herman
authors.forename: Eric
authors.initials: E
authors.lastname: Hebert
authors.forename: Victor M
authors.initials: VM
authors.lastname: Finnemore
authors.forename: Joan M
authors.initials: JM
authors.lastname: Exford
authors.forename: Thomas
authors.initials: T
authors.lastname: Glonek
authors.forename: Mary Catherine
authors.initials: MC
authors.lastname: Olson
mesh_terms: 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
chemical_list: D003287:Contrast Media; D005456:Fluorescent Dyes; D012395:Rose Bengal; D019793:Fluorescein