Wydanie 2/2006

Przydatność testu klinicznego – wskaźnika przepływu łez – w szybkim rozpoznawaniu i różnicowaniu zespołu suchego oka

Usefulness of the Clinical Test – Tear Function Index – in Quick Dry Eye Syndrome Diagnosis and Differentiation

Agnieszka Kujawa, Radosław Różycki

IKlinika Okulistyczna Wojskowego Instytutu Medycznego w Warszawie
Kierownik: prof. dr hab. n. med. Andrzej Stankiewicz

Summary: The traditional diagnostic method for detecting and distinguishing between the dry eye syndrome and Sjögren’s syndrome requires a number of tests. Most of them can be carried out in ophthalmologic outpatient clinics but some of the more specific ones require the resources of larger facilities. Because of this situation, new testing methods are sought, which would allow a reliable and rapid way to identify the disorder. It is our belief that one of such methods is provided by the evaluation of the tear function index (TFI) which dynamically evaluates both the emission and the flux of tears. The method’s advantage is great sensitivity and specificity as well as the ability to carry out the tests in outpatient clinics.
Aim: The aim of this study is to evaluate the usefulness of a new testing method in quick dry eye syndrome diagnosis and identification.
Materials and Methods: Patients who have been diagnosed with dry eye syndrome (qualified on the basis of a modified Bausch &Lomb protocol) were divided into 5 age groups. Each age group was matched with an appropriate control group. In all, 100 people (200 eyes) were tested. Into the conjunctival sacks of both eyes 0.5% fluorescein solution and 0.4% hydrochloric oxybuprocain solution was administered using micropipette. After five minutes the Schirmer II test was performed. The result obtained was compared to a standardized color scale by which fluorescein clearance in tears was read. The tear function index was calculated as the result of multiplying the Schirmer II test results by the fluorescein clearance in tears.
Results: The results obtained were interpreted as follows: a tear function index of over 96 was correct with a lower result indicating the dry eye syndrome and index of less than 34 suggesting the presence of the Sjögren’s syndrome. In situations where the low tear function index suggested Sjögren’s syndrome the final diagnosis was made on the basis of European criteria.
Conclusions: 1. Determining the tear function index simplifies detection and distinguishing process between disorders of the surface of the eyeball. 2. It is a quick, simple test which complements the existing diagnostic methods used to identify the dry eye syndrome.

Keywords: Drye eye syndrome, clinical test, diagnosis, differentiation.