Got dry eyes? Measuring eyelid sensitivity may reflect the causes

October 3, 2012

A simple test of eyelid sensitivity may help vision professionals in evaluating one of the most common eye-related symptoms: dry eyes. A new study linking increased eyelid sensitivity to decreased function of the eyelid margins is presented in the article – "Lid Margins: Sensitivity, Staining, Meibomian Gland Dysfunction, and Symptoms", appearing in the October issue of Optometry and Vision Science, official journal of the American Academy of Optometry.

Isabelle Jabert, OD, MPH, PhD, FAAO, and colleagues of The University of New South Wales, Sydney, used a test called esthesiometry to measure the sensitivity of the eyelid margins—the very edge of the upper and lower eyelids. The test, easily performed in the optometrist's office, provides an accurate measure of the lid margin's sensitivity to touch. The included 27 healthy adults, average age 31 years.

The researchers then looked at how eyelid sensitivity was related to the function of some specialized structures of the eyelid margin. A special dye was also used to stain the innermost layer of the eyelid margin to assess the function of the meibomian glands, which secrete a specialized oil-like substance into the tear fluid.

The results showed some surprising differences between the upper and lower eyelids—including greater sensitivity of the lower-lid margin, compared to the upper lids.

And it was this increased lower lid sensitivity that was found to be related to hyperosmolarity of the tear film—that is, more concentrated tears. The finding suggests the potential for a new approach to clinically assessing tear osmolarity via lower lid sensitivity measures. Whereas past studies have shown a relationship between corneal sensitivity and osmolarity, none have addressed the possible lid sensitivity relationship. The ease with which the non-transparent lids can be accessed to measure sensitivity provides a potential clinical advantage over measuring sensitivity to touch on the cornea.

By comparison, the relationship between tear osmolarity and staining appears much more ambiguous.

The authors' results emphasize clear differences in staining and sensitivity between the upper and lower lids; for example the upper lids appear to be less sensitive and they stain less. Such findings may turn out to be important for interpretation of future studies of the dry eye condition.

Increased osmolarity and decreased meibomian gland function have both been linked to symptoms related to dry eye: one of the most common ocular complaints, especially in older people.

Recent research has led to increased understanding of the delicate structure and function of the lid margin, and their contribution to common eye-related symptoms. "There is renewed interest in the role of the eyelids in dry eye and meibomian gland dysfunction," comments Anthony Adams, OD, PhD, Editor-in-Chief of Optometry and .

The new results suggest that esthesiometry could provide optometrists with a simple test of lid margin , providing evidence of tear osmolarity. "This suggests a promising new tool for evaluating ocular health and effectiveness of treatment in dry eye disease and meibomian gland dysfunction," Dr Adams adds. The findings may provide "an expanded set of tools" for identifying problems leading to , and possibly for evaluating the effectiveness of new treatments.

Explore further: Common acne medication doubles risk of eye infection

More information: To read the article Lid Margins: Sensitivity, Staining, Meibomian Gland Dysfunction, and Symptoms", please visit journals.lww.com/optvissci/Ful … ng,_Meibomian.5.aspx

Related Stories

Common acne medication doubles risk of eye infection

May 23, 2012
Millions of teenagers suffer from acne, and they deal with the embarrassing skin blemishes by taking popular prescription medications such as Accutane or Roaccutane. Now, however, research from Tel Aviv University shows that ...

Caffeine use may offer relief for millions of dry eye sufferers

April 17, 2012
Researchers at the University of Tokyo's School of Medicine have shown for the first time that caffeine intake can significantly increase the eye's ability to produce tears, a finding that could improve treatment of dry eye ...

Recommended for you

Research reveals biological mechanism of a leading cause of childhood blindness

November 16, 2017
Scientists at the Virginia Tech Carilion Research Institute (VTCRI) have revealed the pathology of cells and structures stricken by optic nerve hypoplasia, a leading cause of childhood blindness in developed nations.

Genetic treatment for blindness may soon be reality

November 11, 2017
Patients who had lost their sight to an inherited retinal disease could see well enough to navigate a maze after being treated with a new gene therapy, according to research presented today at AAO 2017, the 121st Annual Meeting ...

Study finds donor corneas can be safely preserved for longer period

November 10, 2017
Results from a large, national clinical trial show that corneal donor tissue can be safely stored for 11 days without negatively impacting the success of transplantation surgery to restore vision in people with diseases of ...

Exploring the genetics of glaucoma and retinal development

November 10, 2017
Guillermo Oliver, PhD, the Thomas D. Spies Professor of Lymphatic Metabolism, recently published two studies related to the eye, one on retinal formation and the other on the genetics behind glaucoma.

Scientists discover potential treatment to stop glaucoma in its tracks

November 6, 2017
Vision scientists at the University of California, Berkeley, and the University of Toronto have discovered that naturally occurring molecules known as lipid mediators have the potential to halt the progression of glaucoma, ...

New focus on correcting refractive vision

October 25, 2017
While doctors take delight in solving the common issue of refractive vision error by prescribing eye glasses, Flinders University researchers have found that many patients are upset with this solution and claim it affects ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.