Purpose: During blinking the marginal conjunctiva of the upper eyelid is in close apposition to the ocular surface, resulting in upper lid margin staining (ULMS). ULMS may be a useful diagnostic sign in subjects who exhibit symptoms but no obvious clinical manifestations of dry eye disease. The purpose of this study was to show the different clinical presentations of ULMS in adapted silicone hydrogel (SH) contact lens wearers.
Methods: 38 adapted SH lens wearers wearing a variety of SH materials were evaluated for ULMS using fluorescein (Fl) and lissamine green (LG) stains. Digital images were obtained with both stains and ULMS patterns were evaluated using digital image analysis.
Results: ULMS was sorted into 6 different categories, including, no ULMS, ULMS with vertical streaks, short horizontal band ULMS, speckled ULMS, comb-shaped ULMS and thick horizontal band ULMS. The percentages of subjects with ULMS were; 45 with Fl, 74 with LG and 42 with Fl+LG stains. In eyes with ULMS the distribution patterns were: vertical streak patterns in 3% with Fl and 13% with LG; short horizontal band in 16% with Fl and 26% with LG; speckled appearance in 21% with Fl and 27% with LG; comb-shaped appearance in 8% with Fl and 27% with LG; thick horizontal band in 18% with Fl and 29% with LG. The data report the prevalence of subjects with different ULMS patterns, and as some subjects had different types in each eye the percentages add up to more than 100.
Conclusions: Using Fl and LG stains, we were able to identify 5 different clinical patterns of ULMS. This is the first report of the range of clinical manifestations of ULMS with Fl and LG stains, in subjects wearing SH materials. Evaluation of these patterns would aid in the management of ULMS. Further studies are needed to understand the relationship between these clinical signs and reported symptoms.
Sponsor: Johnson & Johnson Vision Care |
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