Dry Eye Syndrome in Patients with Conjunctival Concretions

Overview

Purpose:
To establish the possible correlation between the presence of conjunctival concretions and the instability of the tear film.

Methods:
The group consisted of 50 asymptomatic patients with accidentally detected conjunctival concretions, presented mostly for refractive errors at the outpatient department of the Department of Ophthalmology, School of Medicine Hospital, Prague, Czech Republic. The age of the patients ranged 24–69 years, mean 44.1 years. In 35 patients (group A) were present the conjunctival concretions only, in the remaining 15 patients (group B), together with the concretions, the Meibomian glands dysfunction was also discovered. The complete eye examination was performed, including detailed analysis of tarsal conjunctiva and fornices, Schirmer’s test I, the tear film break-up time (BUT) and rose bengal staining. In five patients, the mucin ferning test (MFT) was also performed.

Results:
Advanced to severe tear deficiency was detected in 42.8 % of patients of the group A, and in 46.6 % of patients in the group B respectively. BUT was shorter or extremely shorter (< 10 sec) in 51.4 % of patients in the group A and in 60 % of patients in the group B. The pathological staining with bengal rose was not detected even in a single patient. MFT was normal in all 5 examined patients (classification I and II).

Conclusion:
In patients with conjunctival concretions, the tear film deficiency may be present (decreased values of the Schirmer’s test and BUT). The tear film break-up time (BUT) is surprisingly shorter in younger patients (younger than 45 years of age), in patients with and also without Meibomian glands dysfunction as well. In older patients (over 45 years of age), the defect of the aqueous layer is more pronounced. Patients with conjunctival concretions are potentially affected with the dry eye syndrome.

Key words:
conjunctival concretions, dry eye, Schirmer’s test, the tear film break-up time (BUT), bengal rose staining, mucine fehrning test (MFT)