PURPOSE: To evaluate the diagnostic value of lacrimal punctal size in patients with dry eye. METHODS: We analyzed 55 patients (110 eyes) who underwent lacrimal punctal plug insertion in dry eye from June to November 2003. We performed BUT and Schirmer test, inquired about the symptoms of dry eye, and measured lower lacrimal punctal size by Punctal Gauging System(R). RESULTS: The mean number of symptoms of dry eye was 4.24 +/- 1.14, 4.57 +/- 1.22, 5.75 +/- 1.00, and 6.95 +/- 0.91 in lower lacrimal punctal size 0.5mm, 0.6mm, 0.7mm, and 0.8mm, and the mean BUT was 4.86 +/- 1.59 sec, 3.94 +/- 1.69 sec, 3.25 +/- 1.57 sec, and 3.53 +/- 0.96 sec, respectively. These differences were statistically significant (p<0.05). The mean result of Schirmer test was 5.76 +/- 3.37mm, 5.44 +/- 3.50mm, 3.50 +/- 2.22mm, and 3.79 +/- 2.99mm in lower lacrimal punctal size 0.5mm, 0.6mm, 0.7mm, and 0.8mm, respectively, but these differences were not statistically significant (p>0.05). CONCLUSIONS: These results suggest that an increase of lacrimal punctal size decreases the BUT results and causes discomfort for patients with dry eye symptoms. Thus, an increase of lacrimal punctal size is the causative factor of dry eye, and the measurement of lacrimal punctal size is thought to be helpful to diagnose dry eye and choose the size of lacrimal punctal plug.
Dry Eye Syndromes* ; Humans

Bacteriologic factors, such as enzymes and toxins produced by microbes, are one of diverse etiologic factors in dry eye syndrome. We investigated the conjunctival bacterial flora in dry eye patients and compared the results between dry eye patients and normal persons. There were no differences in bacterial flora between the two groups.
Dry Eye Syndromes ; Humans

Objective: The objectives of this study were to develop a cross-culturally adapted, Filipino version of the Ocular Surface Disease Index (OSDI) questionnaire and to assess its reliability. Methods: A Filipino-adapted version of the OSDI was developed following guidelines for language-specific questionnaires: forward translation into Filipino by 2 independent bilingual translators, back-translation into English by a language institution, and a final forward translation to Filipino resolved by a review committee. To check for equivalence, the English and Filipino versions of the OSDI were pretested on 16 patients in a dry eye clinic. The Filipino version was then administered to 36 participants, and a Cronbach alpha coefficient for reliability of the overall instrument and the alpha that would result if each item were removed were computed. Finally, the questionnaire was then retested on 11 dry eye patients to see if the coefficient would increase. Results: All reported no difficulty with the Filipino questionnaire, with 81.3% expressing preference in answering it. Most (81.3%) chose the same answer in at least half of the items in both languages, though the range of similar responses varied from 41.7% to 91.7%. Reliability testing of the Filipino questionnaire showed this to have fair internal consistency (α=0.5958). The value increased to moderate internal consistency (0.7576) when 3 items were removed. Conclusion A culturally-adapted OSDI in Filipino was successfully produced and was the preferred tool by most patient participants.
Dry Eye Syndromes

Objectives: To describe the population of dry eye disease (DED) patients seen at the Philippine General Hospital (PGH) Dry Eye Clinic, and to compare the diagnosis, type, and severity of DED using Oculus Keratograph® 5M (Oculus GmbH, Wetzlar, Germany) with clinical diagnosis. Methodology: This was a single-center comparative, cross-sectional study. Newly-diagnosed DED patients were recruited for the dry eye group. A subset of healthy volunteers without DED was also recruited for the control group. The clinical data for both groups were collected, and the Ocular Surface Disease Index (OSDI) questionnaire was administered. Standard clinical dry eye testing and Keratograph testing were subsequently done. The PGH Dry Eye Clinic definitions were used to classify the types of dry eye. Results: Eighty (80) eyes of 40 patients per group were examined. For the dry eye group, the mean age and OSDI scores were significantly higher, while the average tear break up time (TBUT) was significantly lower. There was no significant difference in average basal secretion test (BST) and Schirmer 1 measurements between the two groups. 73% had evaporative type dry eye, while 27% had mixed type. Majority of the DED patients were females of >50 years old with mild evaporative type. Foreign body sensation was the most common symptom. Overall, there was poor agreement between clinical and Keratograph assessments of diagnosis and severity among patients in the dry eye group, but there was acceptable agreement when assessment was done in the control group. Conclusions DED patients at the PGH have similar characteristics to reported DED of other Asian populations. Evaporative or short TBUT type dry eye is the most frequently seen. Further formal validity study is needed for Oculus Keratograph® 5M to increase the value of its data to be included in routine dry eye screening.
Dry Eye Syndromes ; Philippines

Objective: To determine the incidence of dry eye in patients undergoing clear cornea phacoemulsification and to investigate its effects on dry eye symptoms and tear function. Methods: This was a single-center, prospective, non-randomized study involving forty-nine (49) eyes from fortyfour (44) patients without preoperative dry eye, who underwent clear cornea phacoemulsification for age-related cataract. Main outcome measures were subjective grading of ocular discomfort, ocular surface disease index (OSDI), fluorescein tear break-up time (FTBUT), and Schirmer tests without anesthesia and with anesthesia. They were measured before surgery and 1 week, 1 month, and 3 months after surgery. Results: None of the patients qualified for the definition of dry eye disease before and after clear cornea phacoemulsification. Preoperative FTBUT (14.01 ± 0.56 seconds) decreased at 1 week (3.97 ± 0.21 seconds; p<0.001) and at 1 month (5.82 ± 0.32 seconds; p<0.001) after the surgery and gradually improved by 3 months (8.26 ± 0.54 seconds; p<0.001) after surgery. Preoperative Schirmer test without anesthesia (18.78 ± 1.17 mm) decreased at 1 week (14.02 ± 1.52 mm; p<0.001) and subsequently recovered by 3 months (16.31 ± 1.34 mm; p>0.05). Preoperative Schirmer test with anesthesia (14.24 ± 0.94 mm) decreased at 1 week (11.98 ± 1.00 mm; p=0.046) after surgery and went back to baseline levels by 3 months (13.80 ± 1.12 mm; p>0.05). Conclusion Patients without dry eye disease, who underwent clear cornea phacoemulsification, did not develop dry eye disease after the surgery. Temporary reduction in physiologic tear levels seen one week postsurgery gradually returned to near-normal baseline levels by the third postoperative month.
Dry Eye Syndromes ; Phacoemulsification

Dry eye disease (DED), currently and, perhaps, at long last a widely accepted prevalent ocular disorder, poses significant challenges, particularly in the developing world, including the Philippines. It disrupts the tear film, leading to discomfort and visual impairment, thereby affecting not only quality of life but economic productivity as well. The ubiquitousness of computer screen use and the evolution of cataract surgery into refractive surgery are only two causative factors of a complex, multivariate problem. Despite its global prevalence, a stark contrast exists in the awareness, diagnosis, and treatment of DED between developed and developing regions. This editorial aims to underscore these disparities, focusing on the crucial roles of healthcare awareness, diagnostic advancements, accessible treatment options, prioritization of governmental policies, and the ethical engagement of the pharmaceutical industry to enhance DED management in under-resourced settings.
Dry Eye Syndromes

The eye dry syndrome is increasingly and a difficult problem in the ophthalmology. There were about 15% of people over 60 years experienced the eye dry of which 10% must be treated. This disease usually considered because initial mild symptoms. However, these symptoms can lead eye burn that can not be treated. The superficial corneitis with severe pain and vision loss occurred subsequently. The corneal and conjunctival surface usually protected from chemical component, mechanical agent, microbial and virus and film of aqueous humor as a first barrier.
Dry Eye Syndromes ; Eye Burns

Objective: This study determined the prevalence of dry eye disease (DED) in a community located in a highaltitude tropical city in the Philippines. Methods: This was a cross-sectional study conducted in Barangay Lualhati in Baguio City from March 2019 to September 2022. Convenience sampling was done in recruiting adult permanent residents of the community. The participants underwent standardized DED evaluation consisting of symptom questionnaire, Ocular Surface Disease Index (OSDI) scoring, slit-lamp examination, fluorescein tear break-up time (TBUT) measurement, ocular surface fluorescein and lissamine green staining, and Schirmer test with and without topical anesthesia. DED was classified as aqueous tear deficiency type, evaporative type, or mixed type. Results: Data from 272 participants were analyzed which represented 23% of the adult population of the community. There were 111 participants who fulfilled the DED definition, and the prevalence rate of DED was 41%. The mean age of those with DED was 43.0 ± 17.6 years while the mean age of those without DED was 51.8 ± 16.6 years (p<0.001). More females (60%) had DED than males (40%). Majority (82%) reported use of digital devices as the main exacerbating factor. Mean OSDI score was significantly higher in those with DED than in those without DED (27.2 + 6.8 and 10.7 ± 6.4, respectively) (p<0.001). Corneal and conjunctival staining scores were also significantly higher in subjects with DED. Evaporative DED was the most common (88.3%). Mixed-type DED was seen in 11.7%. None had pure aqueous tear deficiency dry eye. Conclusion The prevalence rate of DED is greater in areas of higher altitude and DED can be exacerbated by prolonged screen time. This condition is no longer just a problem of the elderly and is now also seen in younger patients. All symptomatic patients should undergo tear break-up time evaluation since evaporative or short TBUT is the predominant type of DED.
Dry Eye Syndromes ; Eye ; Eye Disease

In order to diagnose dry eyes with the TMH, we studied the difference in the TMH between normal eyes and dry eyes. And we measured the time that the TMH after fluorescein instillation become the same with the TMH before fluorescein instillation. Measuring thar meniscus height(TMH) is easy after fluorescir instillation, but the TMH after fluorescein instillation is higher than the TMH before fluoresceirc instillation. Therefore, we measured the time that the TMH after fluorescein instillation became the same with the TMH before fluorescein instillation, and in order to diagnosis dry eyes with the TMH, we studied the difference in the TMH between normal eyes and dry eyes. The TMH was O.19 +/- O.05 mm in normal eyes and O.10 +/- O.04 mm in dry eyes, and there was a significant difference between the two groups. The time that the TMH after fluorescein instillation became the same with the TMH before fluorescein instillation was 2.19 +/- O.81 min. in the mormal eyes and 2.29 +/- O.73min. in the dry eyes. Within 4 min. after fluorescein instillation, the TMH became the same with the TMH before fluorescein instillation in all cases and the height persisted untill 7 min. after fluorescein instillation. Therefore, measuring the TMH will be easy if it is measured at 4-7 min. after fluorescein instillation.
Diagnosis ; Dry Eye Syndromes* ; Fluorescein

PURPOSE: The purpose of this study was to assess the relationship between the result of dacryoscintigraphy and the effect of punctal occlusion in dry eye syndrome. METHODS: Dacryoscintigraphy was performed in 86 eyes with dry eye syndrome and collagen plugs were inserted into low punctum. We evaluated the relationship between the results of dacryoscintigraphy and the effect of punctal occlusion with collagen plugs. RESULTS: In 36 eyes, tear transit time was normal in dacryoscintigraphy (Group I). In 28 eyes, tear transit time was more than 20 minutes (Group II). In 18 eyes, no tear transit was seen during 60 minutes and after dripping of normal saline, tear transit was seen (Group III). In 4 eyes, there was no tear transit after dripping of normal saline (Group IV). Symptom reduction after punctal occlusion with collagen plugs was observed in 34 eyes (94%) of Group I and 22 eyes (79%) of Group II . There was no significant differences between the two groups. In Group III, symptom reduction was observed in 4 eyes (22%) and it showed significant differences between the other groups. CONCLUSIONS: According to this results, punctal occlusion in dry eye syndrome was not effective in patients who showed tear transit after 60 minutes.
Collagen ; Dry Eye Syndromes* ; Humans