Dry eye: An update on clinical diagnosis, management and promising new treatments

Clinical and Experimental Optometry

Volumn 84, Issue 1, 2001, Pages 4-18

  Albietz, Julie M ^a  

^a QUEENSLAND UNIVERSITY OF TECHNOLOGY   (Australia)

Author keywords

Artificial tear supplements; Dry eye; Dry eye treatments; Evaporative dry eye; Ocular surface disorders; Tear deficient dry eye; Tear film

Indexed keywords

EID: 1342329343     PISSN: 08164622     EISSN: 14440938     Source Type: Journal    
DOI: 10.1111/j.1444-0938.2001.tb04930.x     Document Type: Review

References (219)

1. Bron AJ. Non-Sjogren’s dry eye: pathogenesis, diagnosis and animal models. In: Sullivan DA ed. Lacrimal Gland, Tear Film and Dry Eye Syndromes. New York: Plenum Press, 1994: 471–488.
2. Holly FJ, Lemp MA. Tear physiology and dry eyes. Surv Ophthalmol 1977; 22: 69–87.
3. Lemp MA. Report of the National Eye Institute/Industry Workshop on Clinical Trials in Dry Eyes. CLAO J 1995; 21: 221–232.
4. Tseng SCG, Tsubota K. Important concepts for treating ocular surface and tear film disorders. Am J Ophthalmol 1997; 124:825–835.
5. Mathers WD. Why the eye becomes dry: a cornea and lacrimal gland feedback model functional unit concept. CLAOJ 2000; 26: 159–165.
6. Stern ME, Beurerman RW, Fox RI, Gao J, Mircheff AK, Plugfelder SC. The pathology of dry eye: the interaction between the ocular surface and lacrimal glands. Cornea 1998; 17:584–589.
7. Doughty MJ, Fonn D, Richter D, Simpson T, Caffery B, Gordon K. A patient questionnaire approach to estimating the prevalence of dry eye symptoms in patients presenting to optometric practices across Canada. Optom Vis Sci 1997; 74: 624–631.
8. Albietz JM. Prevalence of dry eye subtypes in clinical optometry practice. Optom Vis Sci 2000; 77: 357–363.
9. McCarty CA, Bansal AK, Livingston PM, Stanislavsky YL, Taylor HR. The epidemiology of dry eye in Melbourne, Australia. Ophthalmology 1998; 105: 1114–1119.
10. Schein OD, Muñoz B, Tielsch JM, Bandeen-Roche K, West SK. An epidemiological study of medication use and symptoms of dry eye. Invest Ophthalmol Vis Sci 1997; 38: S213.
11. Franck C. Fatty layer of the precorneal tear film in the ‘office dry eye syndrome. Acta Ophthalmon 1991; 69: 737–743.
12. Norn M. Pollution keratoconjunctivitis. Acta Ophthalmol 1992; 70: 269–273.
13. Kirchner R News Review. Rev Optom 1997; Oct: 7.
14. Bowman RW, Dougherty JM, McCulley JP. Chronic blepharitis and dry eyes. Int Ophthalmol Clin 1987; 27: 27–35.
15. Farris RL. Contact lenses and dry eye. Int Ophthalmol Clin 1991; 31: 83–90.
16. McMonnies C. Contact lens-related tear deficiency. Problems in Optometry 1990; 2: 584–598.
17. Wilson F. Adverse external ocular effects of topical ophthalmic therapy: an epidemiological, laboratory and clinical study. Trans Am Ophthalmol Sor 1983; 81: 854–965.
18. Baum J. Clinical manifestations of dry eye states. Trans Ophthalmol Soc UK 1985; 104: 415–423.
19. Tseng SCG, Hirst LW, Maumenee AE, Kenyon KR, Sun T, Green R. Possible mechanisms for the loss of goblet cells in mucin-deficient disorders. Ophthalmology 1984; 91: 545–552.
20. Whitcher JP. Clinical diagnosis of the dry eye. Int Ophthalmol Clin 1987; 27: 7–24.
21. Tiffany JM. The role of meibomian secretion in the tears. Trans Ophthalmol Soc UK 1985; 104: 396–401.
22. Smolin G. The role of tears in the prevention of infection. Int Ophthalmol Clin 1987; 27: 25–26.
23. Kessing SV. Mucous gland system of the conjunctiva. Acta Ophthalmol Suppl 1968; 46: 1–133.
24. Marquardt R. Histological studies of goblet cell counts in the human conjunctiva. In: Holly FJ ed. The Preocular Tear Film in Health, Disease and Contact Lens Wear. Lubbock, Texas: Dry Eye Institute INC, 1986: 312–318.
25. Watanabe H, Fabrincant M, Tisdale AS, Spurr-Michaud SJ, Linberg K, Gipson IK. Human corneal and conjunctival epithelia produce a mucin-like glycoprotein for the apical surface. Invest Ophthalmol Vis Sci 1995; 36: 337–344.
26. Dilly PN. Contribution of the epithelium to the stability of the tear film. Trans Ophthalmol Soc UK 1985; 104: 381–389.
27. Liotet S, van Bijsterveld OP, Kogbe O, Laroche L. A new hypothesis on tear film stability. Ophthalmologica 1987; 195: 119–124.
28. Prydal JI, Artal P, Woon H, Campbell FW. Study of human precorneal tear film thickness and structure using laser interferometry. Invest Ophthalmol Vis Sci 1992; 33: 2006–2011.
29. King-Smith PE, Fink BA, Fogt N, Nichols KK, Hill RM, Wilson GS. The thickness of the human precorneal tear film: evidence from reflection spectra. Invest Ophthalmol Vis Sci: 2000; 41: 3348–3359.
30. Kenyon KR. Anatomy and pathology of the ocular surface. Int Ophthalmol Clin 1979; 19: 169–195.
31. Bron AJ, Mengher LS, Davey CC. The normal conjunctiva and its response to inflammation. Trans Ophthalmol Soc UK 1985; 104: 424–435.
32. Sugrue SP, Ziesle JD. ZO1 in corneal epithelium: association to the zonula occludens and adherens junctions. Exp Eye Res 1997; 64: 11–20.
33. Wanko T, Lloyd B, Matthews J. The fine structure of the human conjunctiva in the perilimbal zone. Invest Ophthalmol Vis Sci 1994; 3: 285–301.
34. Kruse FE, Chen JJY, Tsai RFJ. Conjunctival transdifferentiations due to incomplete removal of limbal basal epithelium. Invest Ophthalmol Vis Sci 1990; 31: 1301–1314.
35. Huang AWJ, Tseng SCG. Corneal epithelial wound healing in the absence of limbal epithelium. Invest Ophthalmol Vis Sci 1991; 32: 96–105.
36. Lemp MA, Mathers WD. Corneal epithelial cell movement in humans. Eye 1989; 3: 438–445.
37. Puangsricharen V, Tseng SCG. Cytologic evidence of corneal diseases with limbal stem cell deficiency. Ophthalmolgy 1997; 102: 1476–1485.
38. Wilson SE, Li Q, Mohan RR, Tervo T, Vesaluoma M, Bennett GL, Schwall R, Tabor K, Kim J, Hargrave S, Cuevas KH. Lacrimal gland growth factors and receptors: lacrimal fibroblastic cells are a source of tear HGF. Adv Exp Med Biol. 1998; 438: 625–628.
39. Nakamura Y, Sotozono C, Kinoshita S. Inflammatory cytokines in normal human tears. Curr Eye Res 1998; 17: 673–676.
40. Baudouin C, Brignole F, Pisella PJ, Becquet F, Philip PJ. Immunophenotyping the human dendriform cells from the conjunctival epithelium. Curr Eye Res 1997; 16: 475–481.
41. Baudouin C, Brignole F, Becquet F, Pisella PJ, Goguel A. Flow cytometry in impression cytology specimens. A new method for evaluation of conjunctival inflammation. Invest Ophthamol Vis Sci 1997; 38: 1458–1464.
42. Rocha EM, Wickham LA, da Silveira LA et al. Identification of androgen receptor protein and 5alphareductase mRNA in human ocular tissues. Br J Ophthalmol 2000; 84: 6–84.
43. Sullivan DA, Krenzer KL, Sullivan BD, Tolls DB, Toda I, Dana MR. Does androgen insufficiency cause lacrimal gland inflammation and aqueous tear deficiency Invest Ophthalmol Vis Sci 1999; 40: 1261–1265.
44. Sullivan DA, Edwards JA. Androgen stimulation of lacrimal gland function in mouse models of Sjögren’s syndrome. J Steroid Biochem Mol Biol 1997; 60: 237–245.
45. Sullivan DA, Wickham LA, Ullman MD et al. Androgen control of the meibomian gland. Invest Ophthalmol Vis Sci (Suppl) 1997; 38: S444.
46. Elkon B. Apotosis and autoimmunity. J Rheum 1997; 24: 6–7.
47. de Roetth A. Hypofunction of the lacrimal gland and Sjögren syndrome. Lancet 1945; 65: 423–425.
48. Farris RL, Gilbard JP, Stuchell RN, Mandel ID. Diagnostic tests in keratoconjunctivitis sicca. CLAO J 1983; 9: 23–28.
49. Bjerrum KB. Keratoconjunctivitis sicca and primary Sjögren’s syndrome in a Danish population aged 30–60 years. Acta Ophthalmol 1997; 75: 281–286.
50. Nelson JD. Diagnosis of keratoconjunctivitis sicca. Int Ophthalmol Clin 1994; 34: 36–56.
51. Roetth E. Hypofunction of the lacrimal gland and Sjögren’s syndrome. Lancet 1945; 65: 423–425.
52. Lucca JL, Farris RL. Keratoconjunctivitis sicca in male patients with human immunodeficiency virus type 1. Ophthalmology 1990; 97: 1008–1010.
53. Calissendorff B, Azazi M, Lonnquist B. Dry eye syndrome in long-term follow-up of bone marrow transplanted patients. Bone Marrow Transplant 1989; 4: 675–678.
54. Gannot G, Lancaster HE, Fox PC. Clinical course of primary Sjögren’s syndrome: salivary, oral and serologic aspects. J Rheumatol 2000; 27: 1905–1909.
55. Daniels TE. Sjögren’s syndrome in a nutshell. Report. Port Wahington, NY: Sjögren’s Syndrome Foundation, 1990.
56. Pflugfelder SC, Huang AJW, Feuer W, Chuchovski PT, Pereira IC, Tseng SCG. Conjunctival cytologic features of primary Sjögren’s syndrome. Ophthalmology 1990; 97: 985–991.
57. Lemp MA, Keenan PC. Sjögren’s syndrome. In: Fraunfleder FT, Roy FN eds. Current Ocular Therapy. Philadelphia: WB Saunders, 1995: 238–239.
58. Patel S, Farrell JC, Grierson DJ. A possible reason for the lack of symptoms in aged eyes with low tear stability. Optom Vis Sci 1990; 67: 733–734.
59. Taneichi K, Nagashima M, Shibaki H. A patient with rheumatoid arthritis complicated by Sjogren’s syndrome that was possibly caused by Epstein-Barr virus. Intern Med 1993; 32: 77–79.
60. Raphael M, Bellefqih S, Piette J, Le Hoang P, Debre P, Chomette G. Conjunctival biopsy in Sj̈ogren’s syndrome: correlations between histological and immunochemical features. Histopathology 1988; 13: 191–202.
61. Pflugfelder SC, Tseng SCG, Pepose JS, Fletcher MA, Klimas N, Feuer W. Epstein-Barr virus infection and immunologic dysfunction in patients with aqueous tear deficiency. Ophthalmology 1990; 97: 313–323.
62. Bron AJ. Prospects for the dry eye. Trans Ophthalmol Soc UK 1985; 104: 802–826.
63. Kramer P, Lubin V, Potter W, Jacobs M, Labay G, Silverman P. Cyclic changes in conjunctival smears from menstruating females. Ophthalmology 1990; 97: 303–307.
64. Scharwtz CA. Take a deeper look at the ocular surface. Rev Optom 1990; 71–73.
65. Goebbels M. Tear secretion and tear film function in insulin dependent diabetics. Br J Ophthalmol 2000; 84: 19–21.
66. Linna TU, Perez-Santonja JJ, Tervo KM, Sakla HF, Sanz A, Tervo TM. Recovery of corneal nerve morphology following laser in situ keratomileusis. Exp Eye Res 1998; 66: 755–763.
67. Bergmanson JP. Histopathological analysis of the corneal epithelium after contact lens wear. J Am Optom Assoc 1987; 58: 812–818.
68. Lee JB, Ryu CH, Kim J, Kim EK, Kim HB. Comparison of tear secretion and tear film instability after photorefractive keratectomy and laser in situ keratomileusis. J Cat Refract Surg 2000; 26: 1326–1331.
69. Xu K, Yagi Y, Tsubota K. Decrease in corneal sensitivity and change in tear function in dry eye. Cornea 1996; 15: 235–239.
70. Horn MM, Martinson JR, Knapp LL, Paugh JR. Prevalence of meibomian gland dysfunction. Optom Vis Sci 1990; 67: 710–712.
71. McCulley JP, Sciallis GF. Meibomian keratoconjunctivitis. Am J Ophthalmol 1977; 84: 788–793.
72. Hykin PG, Bron AJ. Age related morphological changes in the lid margin and meibomian gland anatomy. Cornea 1992; 11: 334–342.
73. McCulley JP, Dougherty JM, Deneau DG. Classification of chronic blepharitis. Ophthalmology 1983; 89: 1173–1180.
74. Bron AJ, Benjamin L, Snibson GR. Meibomian gland disease. Classification and grading of lid changes. Eye 1991; 5: 395–411.
75. Gilbard JP, Rossi SR, Heyda KG. Tear film and ocular surface changes after closure of the meibomian gland orfices in the rabbit. Ophthalmology 1989; 6: 1180–1186.
76. Toda I, Shimazaki J, Tsubota K. Dry eye with only decreased tear break-up time is sometimes associated with allergic conjunctivitis. Ophthalmology 1995; 102: 302–309.
77. Greiner JV, Allansmith MR. Effect of contact lens wear on the conjunctival mucous system. Ophthalmology 1981; 88: 821–832.
78. Gupta A, Heigle TJ, Pflugfelder SC. Nasolacrimal stimulation of aqueous tear production. Invest Ophthalmol Vis Sci (Suppl) 1996; 37:851.
79. Tabbara KF. Ocular complications of vernal keratoconjunctivitis. Can J Ophthalmol 1999; 34: 88–92.
80. Rivas L, Oroza MA, Perez-Esteban A, Murube-del-Casttillo J. Morphological changes in the ocular surface in dry eyes 16 and other disorders by impression cytology. Graefe’s Arch Clin Exp Ophthalmol 1992; 230: 329–334.
81. Baudouin C, Haouat N, Brignole F, Bayle J, Gastraud P. Immunopathological findings in conjunctival cells using immunofluorescence staining of impression cytology specimens. Br J Ophthalmol 1992; 76: 545–549.
82. Gobbels M, Spitznas M. Effects of artificial tears on corneal epithelial permeability in dry eyes. Graefe’s Arch Clin Exp Ophthalmol 1991; 229: 345–349.
83. Tripathi BJ, Tripathi R, Kolli SP. Cytotoxicity of ophthalmic preservatives on human corneal epithelium. Lens Eye Tox Res 1992; 9: 361–375.
84. Diebold Y, Herreras JM, Callejo S, Argueso P, Calonge M. Carbomer versus cellulosebased artificial-tear formulations: morphologic and toxicologic effects on a corneal cell line. Cornea 1998; 17: 433–440.
85. Baudouin C, Pisella P-J, Fillacier K et al. Ocular surface inflammatory changes induced by topical anti-glaucoma medications. Ophthalmology 1999; 106: 556–563.
86. Nuzzi R, Finazzo C, Cerruti A. Adverse effects of topical antiglaucomatous medications on the conjunctiva and lacrimal response. Int Ophthalmol 1998; 22: 31–35.
87. Turacli E, Budak K, Kaur A, Mizrak B, Ekinci C. The effects of Song term topical glaucoma medication on conjunctival impression cytology. Int Ophthalmol 1997; 21: 27–33.
88. Caffery B, Richter D, Simpson T, Fonn D, Dougherty M, Gordon K. The prevalence of dry eye in contact lens wearers; part 2 of the Canadian dry eye epidemiology study (CANDEES). Invest Ophthalmol Vis Sci (Suppl) 1996; 3: S72.
89. Brennan NA, Efron N. Symptomatology of HEMA contact lens wear. Optom Vis Sci 1989; 66: 834–838.
90. Osborn G, Zantos S. Practitioner survey— management of dry eye symptoms in soft contact lens wearers. Contact Lens Spectrum 1989; Sept: 23–26.
91. Lemp MA. Surfacing abnormalies in the preocular tear film and dry eye syndromes. Int Ophthalmol Clin 1973; 13: 191–199.
92. Kline LN, DeLucca TJ. Effect of gel lens wear on the pre-corneal tear film. Int Contact Lens Clin 1975; 2: 56–62.
93. Cedarstaff TH, Tomlinson AA. Comparative study of tear evaporation rates and water content of soft contact lenses. Am J Optom Physiol Opt 1983; 60: 167–174.
94. Farris RL. Tear osmolarity and ocular surface disease in keratoconjunctvitis sicca. Trans Am Ophthalmol Soc 1985; 3: 501–545.
95. Hirst I.W, Tseng SG, Tsubota K. Current Concepts on Ocular Surface Disease. Allergan, 1993.
96. McMonnies CW. Key questions in a dry eye history. J Am Optom Assoc 1986; 57: 512–517.
97. Gilbard JP, Farris RL. Ocular surface drying and tear film osmolarity in thyroid eye disease. Acta Ophthalmol 1983; 61: 108–116.
98. Tsubota K, Fujihara T, Kaido M, Mori A, Mimiura M, Kato M. Dry eye and Meige’s syndrome. Br J Ophthalmonl 1997; 81: 439–442.
99. Void SD, Carroll RP, Nelson J.D. Dermatochalasis and dry eye. Am J Ophthalmol 1993; 115: 216–220.
100. Mellor D, Tseng SC. Conjunctivochalasis: literature review and possible pathophysiology. Surv Ophthalmol 1998; 43: 225–232.
101. Lui D, Stasior OG. Lower eyelid laxity and ocular symptoms. Am J Ophthalmol 1983; 95: 545–551.
102. Lemp MA. The precorneal fluid and blinking. Int Ophthalmol Clin 1981; 21: 55–64.
103. Hagan S, Lory B. Prevalence of dry eye among computer users. Optom Vis Sci 1998; 75: 712–713.
104. Tsubota K, Nakamori K. Dry eyes and video display terminals. N Eng J Med 1993; 328: 584.
105. Patel S, Farrell JC. Age-related changes in precorneal tear film stability. Optom Vis Sci 1989; 66: 175–178.
106. Backman H, Haghighat F. Indoor air quality and ocular discomfort. J Am Optom Assoc 1999; 70: 309–316.
107. Sommer HJ, Johnen J, Schongen P, Stolze HH. Adaptation of the tear film to work in air-conditioned rooms (office-eye syndrome). Ger J Ophthalmol 1994; 3: 406–408.
108. Albietz JM, Golding TR. Differential diagnosis and management of common dry eye subtypes. Clin Exp Optom 1994; 77: 244–260.
109. Schein OD, Munoz B, Tielsch JM, Bandeen-Roche K, West S. Prevalence of dry eye among the elderly. Am J Ophthamol 1997; 124: 723–728.
110. Schein OD, Hochberg MCMunoz B et al. Dry eye and dry mouth in the elderly: a population-based assessment. Arch Intern Med 1999; 159: 1359–1363.
111. Craig JP, Tomlinson A, Sturrock RD, Grierson DJ, Patel S. Tear physiology in rheumatoid arthritis. Invest Ophthalmol Vis Sci (Suppl) 1995; 36: S1043.
112. Shimazaki J, Goto E, Ono M, Shimmura S, Tsubota K. Meibomian gland dysfunction in patients with Sjogren’s syndrome. Ophthalmology 1998; 105: 1485–1489.
113. Seal DV, McGill JI, Mackie IA, Liakos GM, Jacobs P, Goulding NJ. Bacteriology and tear protein profiles of the dry eye. Br J Ophthalmol 1986; 70: 122–125.
114. Jannsen PT, van Bijsterveld OP. A simple test for lacrimal function: a tear lactoferrin assay by radial immunodiffusion. Graefe’s Arch Clin Exp Ophthalmol 1983; 220: 171–174.
115. Wilson SE, Schultz GS, Chegini N, Weng J, He Y. Epidermal growth factor, transforming growth factor, transforming growth factor beta, acidic fibroblast growth factor beta, basic growth factor and interleukin-1 proteins in the cornea. Exp Eye Res 1994; 59: 63–70.
116. Norn MS. External Eye Methods of Examination. Copenhagen: Scriptor, 1983: 153.
117. Nelson JD. Impression cytology. Cornea 1988; 7: 71–81.
118. Tseng SCG. Staging of conjunctival squamous metaplasia by impression cytology. Ophthalmology 1985; 92: 728–733.
119. Adams GWC, Dilly P.N, Kirkness CM. Monitoring ocular disease by impression cytology. Eye 1988; 2: 506–516.
120. Gilbard JP, Rossi SR, Gray KL, Hanninen LA. Natural history of disease in a rabbit model for keratoconjunctivitis sicca. Acta Ophthalmol 1989; 67 Suppl 192: 95–101.
121. Danjo Y, Watanbe H, Tisdale AS, George M, Tsumura T. Alteration of mucin in human epithelia in dry eye. Invest Ophthalmol Vis Sci 1998; 39: 2602–2609.
122. Lemp MA. New strategies in the treatment of dry eye states. Cornea 1999; 18: 625–632.
123. Tsubota K, Fujihara T, Saito K, Takeuchi T. Conjunctival epithelial expression of HLA-DR in dry eye patients. Ophthalmologica 1999; 213: 16–19.
124. Smith JA, Stern ME, Gao J, Schwalb TA, Rupp DC, Whitecup SM. Conjunctival inflammation in Sjogren’s syndrome and non-Sjögren’s syndrome keratoconjunctivitis sicca, Invest Ophthamol Vis Sci 2000; 41: S276.
125. Brignole F, Pisella PJ, Goldschild M, de Saint Jean M, Goguel A, Baudouin C. Flow cytometric analysis of inflammatory markers in conjunctival epithelial cells of patients with dry eye. Invest Ophthalmol Vis Sci 2000; 41: 1356–1363.
126. Metz DP, Bacon AS, Holgate S, Lightman SL. Phenotypic characterization of T cells infiltrating the conjunctiva in chronic allergic disease. J Allergy Clin Immunol 1996; 98: 686–696.
127. Bron AJ. Eyelid secretions and the prevention and production of disease. Eye 1988; 2: 164–171.
128. Rocha EM, Wickham LA, Huang Z, Toda I, Gao J, da Silveira IA, Sullivan DA. Presence and testosterone influence on the levels of anti- and pro-inflammatory cytokines in lacrimal tissue of a mouse model of Sjogren’s syndrome. Adv Exp Med Biol 1998; 438: 485–491.
129. Augustin AJ, Spitznas M, Kaviani N, Meller D, Koch FH, Grus F, Gobbels MJ. Oxidative reaction in the tear fluid in patients suffering from dry eyes. Graefe’s Arch Clin Exp Ophthalmol 1995; 233: 694–698.
130. Trocme SD, Hallberg CK, Gill KS, Gleich GJ, Tyring SK, Brysk MM. Effects of eosinophil granule proteins on human corneal epithelial cell viability and morphology. Invest Ophthalmol Vis Sci 1997; 38: 593–599.
131. Nelson JD. Diagnosis and treatment of dry eye: A clinical perspective. Cornea 2000; 19: S108.
132. Nichols KK, Begley CG, Caffery B, Jones LA. Symptoms of ocular irritation in patients diagnosed with dry eye. Optom Vis Sci 1999; 76: 838–844.
133. McMonnies CW, Ho A. Responses to a dry eye questionnaire from a normal population. J Am Optom Assoc 1987; 58: 588–591.
134. McMonnies CW, Ho A. Patient history in screening for dry eye conditions. J Am Optom Assoc 1987; 58:296–301.
135. Walt JG, Rowe MM, Stern KL. Evaluating the functional impact of dry eye: the Ocular Surface Disease Index. Drug Inf J 1997; 31: 1436.
136. Schiffman RM, Christianson MD, Jacobsen G, Hirsch JD, Reis B. Reliability and validity of the Ocular Surface Disease Index. Arch Ophthalmol 2000; 118: 615–621.
137. Cho P. Stability of the precorneal tear film: a review. Clin Exp Optom 1991; 74: 19–25.
138. Nally L, Ousler GW, Albelson MA. Ocular discomfort and tear film break-up time in dry eye patients: a correlation. Invest Ophthalmol Vis Sci 2000 Suppl; 41: S274.
139. Golding TR, Brennan NA. Diagnostic accuracy and intercorrelation of clinical tests for dry eye. Invest Ophthalmol Vis Sci 1993; 34: 823.
140. Greiner JV, Finnemore VM, Exford JM, Herman JP, Glonek T, Bueno EA, Korb D. Effects of fluorescein instillation methods on the stability of the tear film lipid layer. Cornea 2000; 19 Suppl: S90.
141. Feenestra PG, Tseng SCG. Comparison of fluorescein and rose Bengal staining. Ophthalmology 1992; 99: 605–617.
142. Tabery H. Dual appearance of fluorescein staining in vivo of diseased human corneal endothelium. A non-contact photomicrographic study. Br J Ophthalmol 1992; 76: 43–44.
143. Norn MS. Lisamin green. Vital staining of the cornea and conjunctiva. Acta Ophthalmol 1973; 51: 483–491.
144. Chodash J, Dix RD, Howell RC, Stroop WG, Tseng SC. Staining characteristics and antiviral activity of sulphorodamine B and lissamine green B. Invest Ophthalmol Vis Sci 1996; 35: 1046–1058.
145. van Bijsterveld OP. Diagnostic tests in the sicca syndrome. Arch Ophthalmol 1969; 82: 10–14.
146. Bron AJ. The Doyne Lecture: Reflections on the tears. Eye 1997; 11: 583–602.
147. Catania LJ. Primary Care of Anterior Segment. Norwalk, Connecticut: Appleton and Lange, 1995.
148. Lamberts DW. Keratoconjunctivtis sicca. In: Smolin G, Thoft RA eds. The Cornea. Scientific Foundations and Clinical Practice. Boston: Little, Brown & Company, 1983: 293–309.
149. Gilbard JP, Farris RL. Tear osmolarity and ocular surface disease in keratoconjunctivitis sicca. Arch Ophthalmol 1979; 97:1642–1648.
150. Little SA, Bruce AS. Repeatability of phenol-red and tear thinning time tests for tear Film function. Clin Exp Optom 1994; 77: 64–68.
151. Golding TR. Evaluation of tear film impairment in dry eye and hydrophilic contact lens wear. PhD Thesis: University of Melbourne, 1992.
152. Schirmer O. Studien zur physiologie der tranenabsonderung und tranenabfuhr. Graefe’s Arch Clin Exp Ophthalmol 1903; 56: 197–291.
153. Jones LT. The Iacrimal secretory system and its treatment. Am J Ophthalmol 1966; 62: 47–60.
154. Nelson JD. Electrolytes in ‘artificial tears’ mimic human tears, renew dry eyes. Ocular Surgery News 1994; 5: 39–41.
155. Hamano H, Hori M, Hamano T et al. A new method for measuring tears. CLAOJ 1983; 9: 281–289.
156. Goren MB, Goren SB. Diagnostic tests in patients with symptoms of keratoconjunctivitis sicca. Am J Ophthalmol 1988; 106: 570–574.
157. Sakamoto R, Bennett ES, Henry VA, Paragina S. The phenol red tear test: a crosscultural study. Invest Ophthalmol Vis Sci 1992; 34: 3510–3514.
158. Patel S, Farrell J, Blades KJ, Grierson DJ. The value of a phenol red impregnated thread for differentiating between the aqueous and non-aqueous tear deficient dry eye. Ophthal Physiol Opt 1998; 18: 471–476.
159. Khurana AK, Chaudhary R, Ahluwalia BK, Gupta S. Tear film profile in dry eye. Acta Ophthalmol (Copenh) 1991; 69: 79–86.
160. Jaanus S. Focus on pharmacology number 2: Managing the dry eye. Clin Eye Vision Care 1990; 2: 142–145.
161. Grene RB. Conjunctival pleating and keratoconjunctivitis sicca. Cornea 1991; 10: 367–368.
162. Höh H, Schirra F, Kienecker C, Ruprecht KW. Lid-parallel conjunctival fold (LIPCOF) and dry eye: a diagnostic tool for the contactologist. Contactologica 1995; 17E: 104–117.
163. Mackie IA, Seal DV. The questionably dry eye. Br J Ophthalmol 1981; 65: 2–9.
164. Wright P. Diagnosis and management of dry eyes. Trans Ophthal Soc UK 1971; 91: 119–128.
165. Gobbels M, Goebels G, Britbach R, Spitnas M. Tear secretion in dry eyes as assessed by objective fluorophotometry. Ger J Ophthalmol 1992; 1: 350–353.
166. Nelson JD. Simultaneous evaluation of tear turnover and corneal epithelial permeability by fluorophotometry in normal subjects and patients with keratoconjunctivitis sicca (KCS). Trans Am Ophthalmol Soc 1995; 93: 709–753.
167. Afonso AA, Monroy D, Stern ME, Feuer WJ, Tseng SC, Pflugfelder SC. Correlation of tear fluorescein clearance and Schirmer test scores with ocular irritation symptoms. Ophthalmology 1999; 106: 803–810.
168. Vitali C, Moutsopulos HM, Bombardiere S. The European Community Study Group on Diagnostic Criteria for Sjogren’s Syndrome. Ann Rheum Disease 1994; 53: 637–647.
169. Mathers WD, Sheilds WJ, Sachdev MS, Petroll WM, Jester JV. Meibomian gland dysfunction in chronic blepharitis. Cornea 1991; 10: 277–285.
170. Yokoi N, Takehisa Y, Kinoshita S. Correlation of tear lipid layer interference patterns with the diagnosis and severity of dry eye. Am J Ophthalmol 1996; 122: 818–824.
171. Josephson JE. Observations of the specular reflection from the anterior surface of the preocular tear film. In: Holly FJ ed. The Preocular Tear Film in Health, Disease, and Contact Lens Wear. Lubbock: Dry Eye Institute, Inc. 1986: 554–563.
172. Jackson WB. Differentiating conjunctivitis of diverse origins. Sunv Ophthalmol Suppl 1993; 38: 91–104.
173. Christiansen SC. Evaluation and treatment of the allergic patient. Int Ophthalmol Clin 1989; 29: 268–273.
174. Barsam PC, Sampson WG, Feldman GL. Treatment of the dry eye and related problems. Ann Ophthalmol 1972; 4: 122–129.
175. Friedlander MH. Conjunctivitis of allergic origin: Clinical presentation and differential diagnosis. Surv Ophlhalmol Suppl 1993; 38: 105–114.
176. Korb D. The role of blinking in successful contact lens wear. Int Contact Lens Clin 1974; 1:59–74.
177. Nelson JD, Drake MM, Brewer JT, Tuley M. Evaluation of a physiological tear substitute in patients with keratoconjunctivits sicca. In: Sullivan DA ed. Lacrimal Gland, Tear Film, and Dry Eye Syndrome. New York: Plenum Press, 1994: 453–457.
178. Farris RL. Staged therapy for the dry eye. CLAOJ 1991; 17: 207–215.
179. Gilbard JP. Dry eye: pharmacological approaches, effects, and progress. CLAOJ 1996; 22: 141–145.
180. Göbbels M, Spitznas M. Influence of artificial tears on the conjunctival epithelium in dry eye syndrome. Graefe’s Arch Clin Exp Ophthalmol 1989; 227: 139–141.
181. Lopez Bernal D, Ubels JL. Artificial tear composition and promotion of recovery of the damaged corneal epithelium. Cornea 1993; 12: 115–120.
182. Adams JL, Wilcox MJ, Trousdale MD, Chien D, Shimizu RW. Morphological and physiological effects of artificial tear formulations on corneal derived cells. Cornea 1992; 11:234–241.
183. Doughty MJ. Twice-daily use of a chlorbutanol preserved artificial tear on rabbit corneal epithelium assessed by scanning electron microscopy. Ophthal Physiol Opt 1992; 12: 457–466.
184. Doughty MJ. Acute effects of chlorobutanolor benzalkonium chloride-containing artificial tears on the surface features of rabbit corneal epithelial cells. Optom Vis Sci 1994; 71: 562–572.
185. Schaefer K, George MA, Abelson MB, Garfofalo C. A scanning electron micrographic comparison of the effects of two preservative-free artificial tear solutions on the corneal epithelium as compared to a phosphate buffered saline and a 0.02% benzalkonium chloride control. Adv Med Biol 1994; 350: 459–464.
186. Ubels J, McCartney M, Lantz W, Beaird J, Dayalan A. Effects of preservative free tear solution on corneal epithelial structure and function. Arch Ophthalmol 1995; 113: 371–378.
187. Gilbard JP, Rossi SR. An electrolyte-based solution that increases corneal glycogen and conjunctival goblet cell density in a rabbit model for keratoconjunctivitis sicca. Ophthalmology 1992; 99: 600–604.
188. Donshik PC, Nelson JD, Abelson M, McCully JP. Effectiveness of Bion Tears, Cellufresh, Aquasite, and Refresh Plus for moderate to severe dry eye. In: Sullivan D et al eds. Lacrimal Gland, Tear Film, and Dry Eye Syndrome 2. New York: Plenum Press, 1998: 753–760.
189. Shimmura S, Ono M, Shinozaki K et al. Sodium hyaluronate eyedrops in the treatment of dry eyes. Br J Ophthalmol 1995; 79: 1007–1011.
190. Mengher LS, Pandher KS, Bron AJ, Davey CC. Effect of sodium hyaluronate (0.1%) on break-up time (NIBUT) in patients with dry eyes. Br J Ophthalmol 1986; 70: 442–447.
191. Condon PI, McEwen CG, Wright M, Macintosh G, Prescott RJ, McDonald C. Double blind, randomised, placebo controlled, crossover, multicentre study to determine the efficacy of a 0.1% (w/v) sodium hyaluronate solution (Fermavisc) in the treatment of dry eye syndrome. Br J Ophthalmol 1999; 83: 1121–1124.
192. Yogi N, Komuro A, Nihida K, Kinoshita S. Effectiveness of hyaluronan on corneal epithelial barrier function in dry eye. Br J Ophthalmol; 1997; 81: 533–536.
193. Gurny R, Ryser IE, Tabataby C, Martenet M, Edman P, Camber O. Precorneal resistence times in humans of sodium hyaluronate as measured by gamma scintigraphy. Graefe’s Arch Clin Exp Ophthalmol 1990; 228:510–512.
194. Chibert H, Goldschimdt P, Pouliquen P et al. Preservatives on the ocular surface: new technology (ABAK) able to capture irreversibly benzalkonium chloride (BAK) for eye-drops. Invest Optalmol Vis Sci (Suppl) 1996; 37: S576.
195. Marsh P, Pflugfelder SC. Topical nonpreserved methylprednisolone therapy for keratoconjunctivitis sicca in Sjögren’s syndrome. Ophthalmology 1999; 106: 811–816.
196. Prabhasawat P, Tseng SCG. Frequent association of delayed tear clearance in ocular irritation. Br J Ophthalmol 1998; 82: 666–675.
197. Gilbard JP, Rossi SR, Heyda KG. Stimulation of tear secretion and treatment of dryeye disease with 3-isobutyl-methylxanthine. Arch Ophthalmol 1991; 109: 672–676.
198. Yerza BR, Mundasad M, Sylvester RN, Gordon JC, Cooper M, Kellerman DJ. A double-masked randomized, placebo controlled, rising-dose study of multiple ocular instillations of INS365 ophthalmic solution in patients with mild to moderate dry eye disease. Cornea 2000; 19: S138.
199. Mathers WD, Dolney AM. Objective demonstration of tear stimulation with oral pilocarpine in dry eye patients. Invest Ophthalmol Vis Sci (Suppl) 2000; 41: S60.
200. Sail K, Stevenson OD, Mundorf TK, Reis BL. Two multicenlre, randomised studies of the efficacy and safety of cyclosporine ophthalmic emulsion in moderate to severe dry eye disease. Ophthalmology 2000; 107: 631–639.
201. Stevenson D, Tauber J, Reis BL. Efficacy and safety of cyclosporin A ophthalmic emulsion in the treatment of moderate-to-severe dry eye disease: a dose-ranging, randomised trial. Ophthalmology 2000; 107: 967–974.
202. Tsubota K, Goto E, Shimmura S. Treatment of dry eye by autologous serum application in Sjögren’s syndrome. Br J Ophthalmol 1999; 83: 390–395.
203. Murube J, Murube E. Treatment of dry eye by blocking the lacrimal canaliculi. Surv Ophthalmol 1996; 40: 463–480.
204. Gilbard JP, Rossi SR, Azar DT, Heyda KG. Effect of punctal occlusion by Freeman silicone plug insertion on tear osmolarity in dry eye disorders. CLAOJ 1989; 15: 216–218.
205. Rumelt S, Remulla H, Rubin PA. Silicone punctal plug migration resulting in dacryocystitis and canaliculitis. Cornea 1997; 16: 377–379.
206. Driver PJ, Lemp MA. Meibomian gland dysfunction. Surv Ophthalmol 1996; 40: 343–347.
207. Quarterman MJ, Johnson DW, Abele DC et al. Ocular rosacea: Signs, symptoms and tear studies before and after treatment with doxycycline. Arch Dermatol 1997; 133: 49–54.
208. Sullivan DA, Wickham LA, Rocha EM et al. Androgens and dry eye in Sjögren’s syndrome. Ann NY Acad Sci 1999; 876: 312–324.
209. Gamache DA, Wei Z-U, Weimer L, Spellman JM, Yanni JM. Preservation of corneal integrity by the mucin secretagogue 15(s)-HETE in a rabbit model of desiccation induced dry eye. Cornea 2000; 19: S88.
210. Geerling G, Honnicke K, Schroder C et al. Quality of salivary tears following autologous submandibular gland transplantation for severe dry eye. Graefes Arch Clin Exp Ophthalmol 2000; 238: 45–52.
211. Wenkel H, Rummelt V, Naumann GO. Long term results after autologous nasal mucosal transplantation in severe mucous deficiency syndromes. Br J Ophthalmol 2000; 84: 279–284.
212. Chiou AG, Florakis GJ, Kazim M. Management of conjunctival cicatrizing diseases and severe ocular surface function. Surv Ophthalmol 1998; 43: 19–46.
213. Tseng SC, Prabhasawat P, Barton K, Gray T, Meller P. Amniotic membrane transplant with or without limbal allografts for corneal surface reconstruction in patients with limbal stem cell disease. Arch Ophthalmol 1998; 116:431–441.
214. Tsai RJF, Tseng SCG. Human allograft limbal transplantation for corneal surface reconstruction. Cornea 1994; 13: 389–400.
215. Farris RL, Kornfield S, Hart DE. The efficacy of moisture chamber eyeglasses are an efficacious treatment of severe dry eyes. Invest Ophthalmol Vis Sci (Suppl) 2000; 41: S273.
216. Tsubota K. Tear dynamics and dry eye. Prog Retin Eye Res 1998; 17: 565–596.
217. Kurihashi K. Moisture aid during sleep for treatment of treatment of dry eye: wet gauze eye mask. Ophthalmologica 1994; 208: 216–219.
218. Kuckelkorn R, Bertram B, Redbrake C, Remi M. Therapeutic hydrophilic bandage lenses after perforating keratoplasty in severe chemical burns. Klin Montasbl Augenheilkd 1995; 207: 95–101.
219. Lemp MA. Contact lenses and the dry-eye patient. Int Ophthamol Clin 1986; 26: 63–71.