Evaluation of Tear Film Osmolarity in Cases with Chronic Blepharitis

Abstract

Objectives: To investigate the tear film osmolarity in eyes with chronic blepharitis. Materials and Methods: Patients with symptomatic chronic blepharitis were included in the study. After ophthalmologic examination, tear osmolarity was measured. Tear film breakup time (TBUT), Schirmer II test with anesthesia, and slit-lamp corneal fluorescein staining were also performed. The tear film osmolarity results were compared with those of healthy subjects. Results: Ten eyes of 10 patients (6 women, 2 men) with a mean age of 47.4±14.4 years (31 to 62 years) and 12 eyes of 12 healthy individuals (10 women, 2 men) were examined. Patients’ symptoms included foreign body sensation, photophobia, redness, burning, itching, scaling, eyelash loss, and recurrent hordeolum. There was no any other systemic or ocular pathology that could result in dry eye. Mean osmolarity was 323.8±19.91 mOsm/L (298-365 mOsm/L), mean TBUT was 4.22±2.17 seconds (1-8 secs,), and mean Schirmer measurement was 7.2±3.26 mm (4-15 mm). Corneal staining was observed in 65% of the eyes. The mean osmolarity of normal group was 302.17±8.54 mOsm/L (288-316 mOsm/L), mean TBUT was 12.5±4.52 seconds (8-23 secs), and mean Schirmer measurement was 13.17±7.83 mm (5-30 mm). There was a statistically significant difference between the mean osmolarity, TBUT, and Schirmer measurements of the two groups (t-test; p=0.003, p<0.001, and p=0.04, respectively). Conclusion: The dry eye symptoms in chronic blepharitis result from imbalance between the aqueous and lipid components of the tear film allowing increased evaporation. This condition does not only change TBUT and Schirmer results but also increases the osmolarity of the tear film significantly indicating serious dry eye disease in chronic blepharitis. (Turk J Ophthalmol 2015; 45: 5-8)

Keywords

• Blepharitis
• tear film osmolarity
• dry eye