Tear Film Instability and Ocular Surface Changes in Pseudoexfoliation Syndrome: A Case-Control Study
Antony A. P. Elias, Bhagwati WadwekarAbstract
Background:
Pseudoexfoliation (PXF) syndrome is an age-related systemic disorder characterised by the deposition of abnormal fibrillar extracellular material in ocular tissues. In addition to its association with glaucoma and cataract, PXF may adversely affect tear film stability, resulting in tear-film instability and ocular-surface abnormalities. This study evaluated objective tear-film stability and ocular-surface changes in patients with PXF syndrome.
Methods:
A hospital-based case–control study was conducted over 18 months at a tertiary care centre. We enrolled 48 patients with clinically diagnosed PXF syndrome and 48 controls, frequency-matched for age and gender. Tear film evaluation included Tear Meniscus Height (TMH), Schirmer’s test, Tear Film Break-Up Time (TBUT), and Lissamine Green staining. Continuous variables were compared using the unpaired
Results:
PXF participants demonstrated significantly impaired tear film parameters compared with controls. Mean TMH, Schirmer’s test values and TBUT were significantly lower in the PXF group. Abnormal TMH, Schirmer’s test, and TBUT were observed in 77%, 90%, and 93.7% of PXF patients, respectively, whereas all controls had normal values. Lissamine Green staining revealed significantly greater ocular surface damage in the PXF group (
Conclusions:
Pseudoexfoliation syndrome was associated with significant tear-film instability and objective ocular-surface abnormalities. Routine assessment of tear-film function and ocular-surface status may be considered in patients with PXF to facilitate early recognition of these abnormalities.