title: Evaluation of the clinical course of dry eye syndrome.
abstract: OBJECTIVE
  To assess subjective symptoms, tear function factors, and ocular surface morphology in the clinical course of patients with dry eye syndrome under treatment within an observation period of up to 8 years.
  
  
  METHODS
  In 97 patients (78 women and 19 men) with ocular discomfort, a clinical diagnosis of dry eye syndrome was made based on typical symptoms and a reduced tear film breakup time of less than 10 seconds. Subsequent evaluations revealed a diagnosis of aqueous tear deficiency in 9 patients, meibomian gland dysfunction in 32 patients, and aqueous tear deficiency combined with meibomian gland dysfunction in 30 patients, aqueous tear deficiency associated with Sjögren syndrome in 12 patients, and aqueous tear deficiency and meibomian gland dysfunction associated with Sjögren syndrome in 14 patients. Follow-up assessments were performed 12 to 94 months (mean follow-up, 40 months) after the initial diagnosis.
  
  
  METHODS
  In different subgroups of dry eye tear film breakup time, Schirmer test without local anesthesia (Schirmer I), fluorescein and rose bengal staining, impression cytology, as well as subjective dry eye symptoms and frequency of tear substitute application were compared at baseline and after a follow-up of 1 to 8 years (mean, 3.3 years).
  
  
  RESULTS
  At baseline, tear film function and ocular surface test results found more pathologic abnormalities and more severe subjective symptoms in patients with aqueous tear deficiency associated with Sjögren syndrome and aqueous tear deficiency and meibomian gland dysfunction associated with Sjögren syndrome compared with the other groups who had dry eye syndrome. No differences in frequency of tear substitute application were observed. At follow-up, tear breakup time, Schirmer I test results, and corneal fluorescein staining improved compared with baseline values, whereas rose bengal staining and impression cytology of the conjunctival surface remained almost unchanged. Subjective symptoms and frequency of artificial tear application were reduced.
  
  
  CONCLUSIONS
  Within the observation period of up to 8 years, the dry eye syndrome improved or stabilized under appropriate treatment. Although no patient was completely cured, subjective reports as well as frequency of artificial tear application were reduced.
authors.affiliation: Department of Ophthalmology, University Hospital, Graz, Austria. jutta.hortwath@uni-graz.at
authors.forename: Jutta
authors.initials: J
authors.lastname: Horwath-Winter
authors.forename: Andrea
authors.initials: A
authors.lastname: Berghold
authors.forename: Otto
authors.initials: O
authors.lastname: Schmut
authors.forename: Ingrid
authors.initials: I
authors.lastname: Floegel
authors.forename: Verena
authors.initials: V
authors.lastname: Solhdju
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bodner
authors.forename: Gerold
authors.initials: G
authors.lastname: Schwantzer
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Haller-Schober
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015352:Dry Eye Syndromes / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy; D005141:Eyelid Diseases / Q000175:diagnosis; D005260:Female; D019793:Fluorescein; D005456:Fluorescent Dyes; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008537:Meibomian Glands / Q000473:pathology; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D012189:Retrospective Studies; D012395:Rose Bengal; D013666:Tears / Q000378:metabolism
chemical_list: D005456:Fluorescent Dyes; D009883:Ophthalmic Solutions; D012395:Rose Bengal; D019793:Fluorescein