J Korean Ophthalmol Soc > Volume 57(10); 2016 > Article
Journal of the Korean Ophthalmological Society 2016;57(10):1507-1513.
DOI: https://doi.org/10.3341/jkos.2016.57.10.1507    Published online October 15, 2016.
The Relationship between Subjective Ocular Discomfort and Blepharitis Severity in Dry Eye Patients.
In Hee Moon, Tae Im Kim, Kyoung Yul Seo, Eung Kweon Kim, Hyung Keun Lee
1The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. shadik@yuhs.ac
2Institute of Corneal Dystrophy Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
건성안 환자들의 주관적인 안구 불편감과 안검염 중증도의 관계
연세대학교 의과대학 안과학교실 시기능개발연구소1, 연세대학교 의과대학 안과학교실 각막이상증연구소2
Although a number of clinical parameters are well known to affect dry eye (DE) disease, it is unknown which factor mostly affects the discomfort of DE. Blepharitis is recognized as one of the leading causes of evaporative-type DE disease, but there have been no large-scale study to investigate the effect of blepharitis on DE symptoms. The purpose of this study was to evaluate the factors influencing subjective ocular discomfort in DE patients with blepharitis and to determine which parameter is most highly related to severity of blepharitis. METHODS: This investigation was a cross-sectional, clinical study. The test population consisted of DE patients suffering from moderate blepharitis. Seventy-three subjects aged 22 to 81 years (mean age 56.36) were enrolled, 49 of whom completed the investigation on a total of 49 eyes. A detailed assessment was conducted, including history taking, visual analog scale (VAS) pain scoring, ocular surface disease index (OSDI) questionnaire, blepharitis severity grading (score 0-4), conjunctival, corneal fluorescein staining (score 0-4), and tear break up time (TBUT) assessment. RESULTS: The results revealed significant correlations between subjective symptoms and blepharitis severity. Significant increases in overall VAS score, OSDI score (p = 0.031, p = 0.006) were recorded in DE patients with severe blepharitis. Conjunctival erosion was significantly related to VAS score (p = 0.016). Other parameters were not significantly related with VAS and OSDI scores. Additionally, conjunctival erosion was related with blepharitis severity (p < 0.0001), and corneal erosion was not correlated with blepharitis severity. TBUT also did not show any statistical correlation with blepharitis. CONCLUSIONS: Our results showed that blepharitis severity is the main factor influencing subjective pain and discomfort in DE patients, although blepharitis severity was not related with the known clinical parameters of DE such as corneal erosion and TBUT. This study indicates that targeting treatment for blepharitis can significantly improve quality of life for patients suffering from DE disease.
Key Words: Blepharitis;Dry eye disease;Meibomian gland dysfunction;Subjective symptoms;Visual analog scale (VAS) score

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