The Dry Eye Zone

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Abstract: What makes a Sjogrens dry eye different?

Rose bengal staining, according to this study!

Rose Bengal Staining of the Temporal Conjunctiva Differentiates Sjogren's Syndrome from Keratoconjunctivitis Sicca.
Invest Ophthalmol Vis Sci. 2010 Jan 27. [Epub ahead of print]
Caffery B, Simpson TL, Wang S, Bailey D, McComb J, Rutka J, Slomovic A, Bookman A.
School of Optometry, University of Waterloo, Waterloo, Canada.

Purpose: To compare the clinical presentation of 231 patients with primary Sjogren's syndrome (pSS) with 89 aqueous deficient dry eye patients (KCS), to determine those procedures that best differentiate these groups in the eye care clinic.

Methods: The records of all patients seen at the University Health Network Sjogren's Syndrome Clinic from October 1992 to July 2006 were reviewed and documented. Patients were diagnosed with pSS by the AECC criteria of 2002. KCS controls were non-SS patients with symptoms of dry eye and Schirmer scores of <= 10 mm in 5 minutes in at least one eye. There were 90 variables used in the analysis of the total database. Recursive partitioning was used to generate tree diagrams that demonstrate which characteristics best distinguished pSS from KCS.

Results: Recursive partitioning of the full database demonstrated that the serum immunoglobin Ro and the status of the salivary gland biopsy are most important in distinguishing pSS and KCS. The presence of rose bengal staining of the temporal conjunctiva was the most important noninvasive ocular variable to separate the groups. Total rose bengal staining also improved the sensitivity. Using non-invasive techniques only, staining of the temporal conjunctiva and severity of dry mouth symptoms proved to be the major factors in distinguishing pSS from KCS.

Conclusions: Rose bengal staining of the ocular surface is an important observation in the detection of SS and the differentiation of pSS and KCS.