PURPOSE Effectiveness of the Double Pass Technique to Distinguish between Aqueous Deficient and Evaporative Dry Eye while Measuring the Effects of Punctal Occlusion on Quality of Vision in Dry Eye Patients Eric T. Brooker O.D., Wanawalee Charoenchote O.D. Advanced Vision Institute, Las Vegas, NV • By evaluating the change in ocular scatter over time, the device can help us to distinguish between types of dry eye (Fig. 2 &3) • The HD Analyzer can be used to monitor a patients DES and record and quantify the effectiveness of implemented therapeutics. (Fig. 4) • The outputs from the HD Analyzer provide physicians with an objective record to share with patients and explain their DES condition • The AcuTarget HD (AcuFocus, Inc) is the next generation of this technology and has additional functionality to support cataract and refractive surgery treatment centration. The HD Analyzer has the ability to distinguish between two types of dry eye disease: aqueous deficient and lipid dysfunction. Punctal occlusion was effective in improving the tear film and visual quality in both groups. METHODS 1994-B0293 COMMERCIAL RELATIONSHIPS Eric T. Brooker O.D. is a clinical consultant for Visiometrics and AcuFocus. To evaluate the ability of the HD Analyzer to distinguish between aqueous deficient dry eye and evaporative dry eye and to quantify the quality of vision experienced by subject’s suffering from dry eye syndrome before and after insertion of Parasol silicone punctal plugs. RESULTS Sixteen eyes with concurrent diagnosed DES were measured on the HD Analyzer (Fig. 1) to determine the impact of the DES on each subject’s visual quality. Patients also underwent standard dry eye diagnostic testing: schirmer’s, TBUT, and sodium fluorescein staining. After enrollment and baseline testing all subjects had permanent punctal plugs inserted into one tear duct in each eye. Subjects then returned in 4 weeks in order to repeat measurements and to assess for any improvements in their DES and quality of vision resulting from instillation of punctal plugs. Subjects were stratified into two groups for analysis : Lipid dysfunction (LDG) n = 6 (obvious signs of meibomitis) and the Aqueous deficient (ADG) n=10 (no signs of meibomian disease). The average TBUT for the LDG prior to punctal occlusion (p.o.): 5.95 secs. for the ADG: 13.99 secs. Post p.o. the LDG: 12.3 secs and the ADG : 16 secs. Average Schirmer’s score for the LDG prior to p.o.: 9.81 mm, for the ADG: 4.45 mm; post p.o. the LDG: 19.9 mm, and ADG 5.88mm. Finally the ocular scatter index scores improved in both groups during the 20 sec tear film assessment conducted on the HD Analyzer: pre p.o. LDG: 0.74, ADG: 0.23(p=0.04); post p.o. LDG: 0.44 , ADG: 0.18 (p=0.03). Figure 4. Aqueous deficient patient pre/post punctal occlusion Figure 1. HD Analyzer and Sample Optical Quality Output Figure 3. Patient with lipid dysfunctional dry eye Aqueous-Deficient Dry Eye (n=10) Meibomian Gland Dysfunction (n=6) Baseline Post- Occlusion Baseline Post-Occlusion Increase in Objective Scatter Index (OSI) during 20-second Tear Film Analysis 0.23 0.18 0.74 0.44 TBUT, seconds 13.99 16.00 5.95 12.30 Schirmer’s, mm 4.45 5.88 9.10 19.90 Figure 2. Patient with Aqueous deficient dry eye syndrome DISCUSSION SUMMARY
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PURPOSE
Effectiveness of the Double Pass Technique to Distinguish between Aqueous Deficient and Evaporative Dry Eye while Measuring the Effects of Punctal Occlusion on Quality of Vision in Dry Eye Patients
Eric T. Brooker O.D., Wanawalee Charoenchote O.D. Advanced Vision Institute, Las Vegas, NV
• By evaluating the change in ocular scatter over time, the device can help us to distinguish between types of dry eye (Fig. 2 &3)
• The HD Analyzer can be used to monitor a patients DES and record and quantify the effectiveness of implemented therapeutics. (Fig. 4)
• The outputs from the HD Analyzer provide physicians with an objective record to share with patients and explain their DES condition
• The AcuTarget HD (AcuFocus, Inc) is the next generation of this technology and has additional functionality to support cataract and refractive surgery treatment centration.
The HD Analyzer has the ability to distinguish between two types of dry eye disease: aqueous deficient and lipid dysfunction. Punctal occlusion was effective in improving the tear film and visual quality in both groups.
METHODS
1994-B0293
COMMERCIAL RELATIONSHIPS Eric T. Brooker O.D. is a clinical consultant for Visiometrics and AcuFocus.
To evaluate the ability of the HD Analyzer to distinguish between aqueous deficient dry eye and evaporative dry eye and to quantify the quality of vision experienced by subject’s suffering from dry eye syndrome before and after insertion of Parasol silicone punctal plugs.
RESULTS
Sixteen eyes with concurrent diagnosed DES were
measured on the HD Analyzer (Fig. 1) to determine the impact of the DES on each subject’s visual quality. Patients also underwent standard dry eye diagnostic testing: schirmer’s, TBUT, and sodium fluorescein staining. After enrollment and baseline testing all subjects had permanent punctal plugs inserted into one tear duct in each eye. Subjects then returned in 4 weeks in order to repeat measurements and to assess for any improvements in their DES and quality of vision resulting from instillation of punctal plugs.
Subjects were stratified into two groups for analysis : Lipid dysfunction (LDG) n = 6 (obvious signs of meibomitis) and the Aqueous deficient (ADG) n=10 (no signs of meibomian disease). The average TBUT for the LDG prior to punctal occlusion (p.o.): 5.95 secs. for the ADG: 13.99 secs. Post p.o. the LDG: 12.3 secs and the ADG : 16 secs. Average Schirmer’s score for the LDG prior to p.o.: 9.81 mm, for the ADG: 4.45 mm; post p.o. the LDG: 19.9 mm, and ADG 5.88mm. Finally the ocular scatter index scores improved in both groups during the 20 sec tear film assessment conducted on the HD Analyzer: pre p.o. LDG: 0.74, ADG: 0.23(p=0.04); post p.o. LDG: 0.44 , ADG: 0.18 (p=0.03).
Figure 4. Aqueous deficient patient pre/post punctal occlusion
Figure 3. Patient with Aqueous deficient dry eye syndrome
Figure 1. HD Analyzer and Sample Optical Quality Output Figure 3. Patient with lipid
dysfunctional dry eye
Aqueous-Deficient Dry Eye (n=10)
Meibomian Gland Dysfunction (n=6)
Baseline Post-Occlusion
Baseline Post-Occlusion
Increase in Objective Scatter Index (OSI) during 20-second Tear Film Analysis
0.23 0.18 0.74 0.44
TBUT, seconds 13.99 16.00 5.95 12.30
Schirmer’s, mm 4.45 5.88 9.10 19.90
Figure 2. Patient with Aqueous deficient dry eye syndrome
DISCUSSION
SUMMARY
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