Abnormalities of tear function in patients with pseudoexfoliation

Subashini Kaliaperumal; Indu Govindaraj; Vasudev Anand Rao

Subashini Kaliaperumal Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
Indu Govindaraj Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
Vasudev Anand Rao Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

Keywords: Dry eye, Pseudoexfoliation, Schirmer’s test, Tear function

Abstract

Background and Aim: Pseudoexfoliation (PEX) seems to affect the tear secretion and tear film stability by altering cell morphology in conjunctiva. We aimed to study the abnormalities of tear secretion and tear film that can occur in patients with PEX material on lens. Methods: In this prospective non‑randomized study, Group 1 consisted of 30 eyes of 15 normal subjects without PEX material on lens serving as controls and Group 2 consisted of 43 eyes of 30 patients with PEX at least in one eye. Patients with ocular surface disorder, PEX glaucoma, previous ocular surgeries and adnexal abnormalities were excluded. To study the tear function, Schirmer’s two and tear film break‑up time (TBUT) were performed in all eyes. Results: Average Schirmer’s and TBUT in Group 1 were 22.05 ± 4.4 mm and 14.75 ± 2.5 s respectively, whereas in Group 2 they were 10.6 ± 7 mm and 5.6 ± 2.8 s and the differences were clinically significant (P < 0.001). Within Group 2, among the 17 unilateral PEX syndrome the average Schirmer’s and TBUT in eyes with PEX material was 11.7 ± 6.4 mm and 6.4 ± 1.8 s respectively whereas in fellow uninvolved eye they were 12.9 ± 5.9 mm and 6.6 ± 2.1 s. This difference was not statistically significant (P = 0.065). Conclusion: PEX syndrome causes unstable tear film and reduced tear secretion.