title: Clinical characterization of asymptomatic or minimally symptomatic young patients showing signs compatible with dry eye: a pilot study.
abstract: OBJECTIVE
  To evaluate and characterize the clinical profile of young asymptomatic or minimally symptomatic patients without diagnosis of dry eye but showing signs compatible with dry eye syndrome (DES).
  
  
  METHODS
  Prospective study including a total of 50 consecutive subjects with ages ranging from 18 to 40 years that were identified as asymptomatic or minimally symptomatic by means of the Ocular Surface Disease Index (OSDI) (score of <22). In all patients, a complete battery of tests for the diagnosis of DES was performed including the evaluation of the tear film break-up time (TFBUT), the level of corneal and conjunctival staining, and the eyelid and Meibomian morphology.
  
  
  RESULTS
  The OSDI score was significantly higher in women than in men (median: 12.5 vs. 5.3, P=0.01). Low grades of ocular surface staining, dysfunction of Meibomian gland expression, and alteration of quality of Meibomian secretions were observed in 56%, 58%, and 84% of eyes, respectively. More eyes with some dysfunction of Meibomian gland expressibility had a TFBUT less than 5 sec (P=0.033). A statistically significant difference in the OSDI score was found between patients with and without systemic allergies (P=0.036) and between male and female (P=0.01). Likewise, the OSDI score was significantly higher in those women wearing contact lenses compared with those not wearing them (P=0.012).
  
  
  CONCLUSIONS
  Asymptomatic or minimally symptomatic young subjects may present low grades of clinical signs compatible with DES, with a trend to more symptomatology in women and allergic patients. These outcomes should be confirmed in future studies with larger samples.
authors.affiliation: Clínica Cirugía Ocular de Madrid S.L. (J.G.-C.), Madrid, Spain; Departamento de Física Teórica, Atómica y Óptica (R.M.), Universidad de Valladolid, Valladolid, Spain; Instituto de Oftalmobiología Aplicada (IOBA Eye Institute) (R.M.), Universidad de Valladolid, Valladolid, Spain; Departamento de Óptica (D.P.P.), Farmacología y Anatomía, Universidad de Alicante, Alicante, Spain; and Investigación Personalizada al Servicio de la Salud (IPASS) S.L. (D.P.P.), Alicante, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: González-Cavada
authors.forename: Raul
authors.initials: R
authors.lastname: Martin
authors.forename: David P
authors.initials: DP
authors.lastname: Piñero
mesh_terms: D000293:Adolescent; D000328:Adult; D003228:Conjunctiva / Q000378:metabolism; D003315:Cornea / Q000378:metabolism; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D005143:Eyelids / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008537:Meibomian Glands / Q000378:metabolism / Q000473:pathology; D010865:Pilot Projects; D011446:Prospective Studies; D013666:Tears / Q000378:metabolism; D055815:Young Adult