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Category: Volume 11 Issue 09 September 2023
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Title: A Study of Correlation between Tear Film Break - Up Time (TBUT), Pterygium and Pinguicula on Patents Attending a Tertiary Centre, North Bengal Medical College & Hospital, Darjeeling, Sub Himalayan Region, India

Authors: Dr Malabika Debbarma, Dr Pekila Lama Bhutia, Dr Saptarshi Mondal

 DOI: https://dx.doi.org/10.18535/jmscr/v11i9.08

Abstract

Introduction: Degenerative changes in conjunctive are quite common in India, especially after 40 years of age. Degenerative changes like Pterygium and Pinguicula occurs especially due to prolonged exposure to ultra violet rays who lives in dry windy area and having pre-existing dry eye syndrome.

Pterygium is a elastotic degeneration of the subconjunctival tissue approaches towards the cornea in a triangular fashion. Pterygium is mostly prevalent on the palpebral aperture mostly in the nasal side. It is thought that the predominantly nasal location is related to reflection of light from the nasal bridge on to the nasal conjunctiva. The ultraviolet light may be mediated by mutation in the P53 gene.

Pinguicula is also associated with prolong exposure to ultraviolet light, occur mostly to outdoor workers and those who live in tropical area near the equator.

Materials & Methods:  A written consent of patients willing to be included in the study. The material needed are Whatman paper, Slit Lamp Bio microscope, Torch Lights, Snellen’s chart, Near vision chart, etc.

The present institution based descriptive observational study conducted at the Department of Ophthalmology of North Bengal Medical College and Hospital, Darjeeling as OPD procedure. A total of 84 patients with unilateral Pterygium and Pinguicula devoid of any systemic diseases. A correlation with TBUT and prevalence of Pterygium and Pinguiculae were observed and documented.

Results: The study includes 84 patients with an mean age of 57 years. The mean TBUT was less in eyes of with Pterygium (8-9 Seconds) than in control eyes (14-16 Seconds). TBUT,  less than 10 Seconds, considered as abnormal TBUT, was found in 36 eyes out of 84 eyes with Pterygium (42.86%), compared with 16 eyes out of 84 eyes with Pinguicula (19.05%) and 15 of 84 control eyes. A TBUT of less than 10 seconds (abnormal TBUT) was more significantly associated with eyes wise Pterygium compared to control eyes.

Conclusion: In this study we found that Pterygium is significantly associated with abnormalities of tear film, but not such with Pinguicula. TBUT may very person to person according to prolong exposure to UV rays, occupations, geographic, and environmental factors.

Keywords: Tear film Break-Up Time (TBUT), Pterygium, Pinguicula.

References

  1. Rieger G. The importance of the precorneal tear film for the quality of optical imaging. Br J Ophthalmol. 1992;76:157–8. 10.1136/bjo.76.3.157 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
  2. International Dry Eye Workshop. The definition and classification of dry eye disease: report of Definition and Classification Subcommittee of International Dry Eye Workshop. Ocul Surf. 2007;5:75–92. 10.1016/S1542-0124(12)70081-2 [PubMed] [CrossRef] [Google Scholar]
  3. Craig JP, Nichols KK, Akpek EK, Caffery B, Dua HS, Joo CK, et al. TFOS DEWS II Definition and Classification Report. Ocul Surf. 2017;15(3):276–83. 10.1016/j.jtos.2017.05.008 [PubMed] [CrossRef] [Google Scholar]
  4. Lemp MA. Report of the National Eye Institute/Industry Workshop on Clinical Trials in Dry Eye. CLAO J. 1995;21:221–32. [PubMed] [Google Scholar]
  5. Lee JH, Kee CW. The significance of tear film break-up time in the diagnosis of dry eye syndrome. Korean J Ophthalmol. 1988;2:69–71. 10.3341/kjo.1988.2.2.69 [PubMed] [CrossRef] [Google Scholar]
  6. Trees GR, Tomlinson A. Effect of artificial tear solutions and saline on tear film evaporation. Optom Vis Sci. 1990;67:886–90. 10.1097/00006324-199012000-00002 [PubMed] [CrossRef] [Google Scholar]
  7. Korb DR, Greiner JV, Herman J. Comparison of fluorescein break-up time measurement reproducibility using standard fluorescein strips versus the Dry Eye Test (DET) method. Cornea. 2001;20:811–5. 10.1097/00003226-200111000-00007 [PubMed] [CrossRef] [Google Scholar]
  8. Norn MS. Dead, degenerate and living cells in conjunctival fluid and mucous thread. Acta Ophthalmol (Copenh). 1969;47:1102–15. 10.1111/j.1755-3768.1969.tb02509.x [PubMed] [CrossRef] [Google Scholar]
  9. Pflugfelder SC, Tseng SC, Sanabria O, Kell H, Garcia CG, Felix C, et al. Evaluation of subjective assessments and objective diagnostic tests for diagnosing tear-film disorders known to cause ocular irritation. Cornea. 1998;17:38–56. 10.1097/00003226-199801000-00007 [PubMed] [CrossRef] [Google Scholar]
  10. Goto T, Zheng X, Okamoto S, Ohashi Y. Tear film stability analysis system. Introducing a new application for video keratoscopy. Cornea. 2004;23:65–70. 10.1097/01.ico.0000136685.88489.70 [PubMed] [CrossRef] [Google Scholar]
  11. Szczesna DH, Iskander DR. Lateral shearing interferometry for analysis of tear film surface kinetics. Optom Vis Sci. 2010;87:513–7. 10.1097/OPX.0b013e3181e17279 [PubMed] [CrossRef] [Google Scholar]
  12. Nichols JJ, Nichols KK, Puent B, Saracino M, Mitchell GL. Evaluation of tear film interference patterns and measures of tear break-up time. Optom Vis Sci. 2002;79:363–9. 10.1097/00006324-200206000-00009 [PubMed] [CrossRef] [Google Scholar]
  13. Tonge SR, Hunsaker J, Holly FJ. Non-invasive assessment of tear film break-up time in a group of normal subjects – implications for contact lens wear. J Br Cont Lens Assoc. 1991;14:201–5. 10.1016/0141-7037(91)80022-E [CrossRef] [Google Scholar]
  14. Madden RK, Paugh JR, Wang C. Comparative study of two non-invasive tear film stability techniques. Curr Eye Res. 1994;13:263–9. 10.3109/02713689408995787 [PubMed] [CrossRef] [Google Scholar]
  15. Lan W1 Lin L, Yang X, Yu M. Automatic noninvasive Tear Breakup Time (TBUT) and conventional fluorescent TBUT. Optom Vis Sci. 2014;9:1412–8. 10.1097/OPX.0000000000000418 [PubMed] [CrossRef] [Google Scholar]
  16. Hong J, Sun X, Wei A, Cui X, Li Y, Qian T, et al. Assessment of tear film stability in dry eye with a newly developed keratograph. Cornea. 2013;32:716–21. 10.1097/ICO.0b013e3182714425 [PubMed] [CrossRef] [Google Scholar]
  17. Mengher LS, Bron AJ, Tonge SR, Gilbert DJ. A non-invasive instrument for clinical assessment of the pre-corneal tear film stability. Curr Eye Res. 1985;4:1–7. 10.3109/02713688508999960 [PubMed] [CrossRef] [Google Scholar]

Corresponding Author

Dr Malabika Debbarma

Associate Professor, Ophthalmology Department, North Bengal Medical College, West Bengal, INDIA