Prabhasawat P, Tseng S C
Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL 33136, USA.
Br J Ophthalmol. 1998 Jun;82(6):666-75. doi: 10.1136/bjo.82.6.666.
To explore the pathogenic role of delayed tear clearance.
By comparing 10 patients with punctal obstruction and 20 asymptomatic normals, delayed tear clearance was diagnosed in 70 patients without apparent punctal obstruction using fluorescein clearance test.
The majority were older (71.4 (SD 1.2) years) and women (66%). Frequent complaints included redness, itching, mucus discharge, and crusting, which tended to be worse upon awakening. Common associated problems were medicamentosa (13%), drug induced pseudopemphigoid, ocular hypertension (27%), and glaucoma (7%). Topical non-preserved 1% methylprednisolone resulted in subjective (83%) and objective (80%) improvement and resolution of delayed tear clearance (87%).
These results indicate strong association of delayed tear clearance with intrinsically and extrinsically generated ocular surface inflammation. The presence of delayed tear clearance may set up a vicious cycle to aggravate the existing inflammation. Future prospective studies are needed to delineate the pathogenic role of delayed tear clearance in various ocular surface disorders.
探讨泪液清除延迟的致病作用。
通过比较10例泪点阻塞患者和20例无症状正常人，使用荧光素清除试验在70例无明显泪点阻塞的患者中诊断出泪液清除延迟。
大多数患者年龄较大（71.4（标准差1.2）岁），女性占66%。常见症状包括眼红、瘙痒、黏液分泌物和结痂，晨起时往往加重。常见的相关问题有药物性（13%）、药物性类天疱疮、高眼压（27%）和青光眼（7%）。局部使用非防腐剂1%甲基强的松龙可使主观症状（83%）和客观症状（80%）得到改善，泪液清除延迟得到缓解（87%）。
这些结果表明泪液清除延迟与内源性和外源性眼表炎症密切相关。泪液清除延迟的存在可能会形成恶性循环，加重现有的炎症。未来需要进行前瞻性研究，以阐明泪液清除延迟在各种眼表疾病中的致病作用。
