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. 2019 Jun 28:13:1019-1026.
doi: 10.2147/OPTH.S210044. eCollection 2019.

An assessment of the ocular tear film in patients with thyroid disorders

Saud A Alanazi  1 , Abdullah A Alomran  1 , Ali Abusharha  1 , Raied Fagehi  1 , Naji J Al-Johani  2 , Gamal A El-Hiti  1 , Ali M Masmali  1
Affiliations

An assessment of the ocular tear film in patients with thyroid disorders

Saud A Alanazi et al. Clin Ophthalmol. .

Abstract

Objective: To investigate the ocular tear film in patients with thyroid disorders using various tests. Methods: The study involved the assessment of the ocular tear film in 20 patients with thyroid disorders (6 men and 14 women) aged 18-43 years (mean±standard deviation=34.3±3.2 years). An age-matched control group consisting of 20 subjects (8 males and 12 females) ranging in age from 18 to 43 years (31.3±2.9 years) was also examined under similar conditions. All patients completed the Ocular Surface Disease Index questionnaire, followed by the tear ferning test within the right eye. A phenol red thread test was carried out 10 mins later followed by the fluorescein tear break-up test with a 10-min gap between the tests being implemented. Results: The median score for the Ocular Surface Disease Index (P<0.05) showed the condition of mild dry eyes [median (IQR)=15.5 (21.9)] in patients with thyroid disorders compared to the control group [5.6 (3.6)]. The mean score for the phenol red thread test within both the right and left eyes showed acceptable tear volumes of 11.7±8.1 and 10.5±7.4 mm, respectively, but this was much lower (P<0.05) compared to those recorded within the control group (22.2±6.5 and 20.7±5.2 mm, respectively). In addition, the mean for the tear break-up time (P<0.05) scores in both eyes within the patients with thyroid disorders revealed a certain degree of eye dryness (4.9±1.6 and 4.2±1.9 s), while the control group showed normal eye scores (13.2±2.6 and 12.3±2.2 s). The median score for tear ferning grades showed eye dryness [2.0 (2.2)] within the study group and normal eyes [1.2 (0.9)] within the control group. Conclusions: Patients with thyroid disorders have a significant level of eye dryness compared to normal eye subjects.

Keywords: dry eye; ocular tear film; phenol red thread test; tear break-up time test; tear ferning patterns; thyroid gland disorders.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 2
Figure 2
The side-by-side boxplot for the TUBT (OD) within the study and control groups. Statistically significant at P<0.05. Abbreviation: TBUT, tear break-up time.
Figure 1
Figure 1
The side-by-side boxplot for the PRT (OD) within the study and control groups. Statistically significant at P<0.05. Abbreviation: PRT, phenol red thread.
Figure 3
Figure 3
The side-by-side boxplot for the TF test within the study and control groups. Statistically significant at P<0.05. Abbreviation: TF, tear ferning.
Figure 4
Figure 4
Examples of TF images obtained from the study group (showing dry eye conditions in most cases). Abbreviation: TF, tear ferning.
Figure 5
Figure 5
Examples of TF images obtained from the control group (showing normal eye conditions in all cases). Abbreviation: TF, tear ferning.
See this image and copyright information in PMC

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