Pattern of vital staining and its correlation with aqueous tear deficiency and meibomian gland dropout.

PURPOSE

To assess the relationship between the degree and anatomic location of ocular surface vital staining and the degree of aqueous tear deficiency in patients with dry eye, as measured by the Schirmer test, and the presence of meibomian gland dropout.

METHODS

Twenty-two patients with dry eye (nine men and 13 women; mean age, 60 years) were prospectively enrolled in the study. Eleven subjects with no ocular disease were considered control subjects. Lissamine green vital staining, Schirmer test, and meibomian gland dropout were evaluated.

RESULTS

Patients were stratified based on their vital staining pattern (presence or absence of corneal staining). A progressive decrease in the Schirmer test result was found when the vital staining score increased (r = -0.655; P<0.0001). Patients with dry eye showed an increase in meibomian gland dropout when compared to control subjects (P<or=0.001).

CONCLUSIONS

The presence of corneal vital staining correlates with a more severe dry eye as shown by the Schirmer test. Patients with dry eye have an increased meibomian gland dropout. The degree and pattern of vital staining correlate with the severity of dry eye.