How blink anomalies can contribute to post-lasik neurotrophic epitheliopathy
5) If the tear film is insufficient to separate the ocular or lens surface from the lid wiper then frictional trauma occurs causing lid wiper epitheliopathy
(LWE) (see Figure 1).
Efficacy of cyclosporine A in the treatment of acute posterior multifocal placoid pigment epitheliopathy
Ophthalmologic consultation showed bilateral multiple diffuse corneal epithelial microcysts and mild superficial punctate epitheliopathy
Clinical reference cases are then presented, on vitreous and pathologies of the vitreoretinal interface, macular degeneration, diabetic retinopathy, vascular occlusion of the retina, retinal epitheliopathy
, cysticercosis, Vogt-Koyangi-Harada syndrome, and complex cases.
Only rarely are the corneas exposed to the infiltrate, but in rare cases where lacrimal gland involvement causes punctate corneal epitheliopathy
, the patient may suffer from a dry eye condition.
16) There is also evidence of links between discomfort and lid signs, namely lid wiper epitheliopathy
and meibomian gland dysfunction.
VGX-100 significantly reduced inflammation and corneal epitheliopathy
in a mouse model of Dry Eye Disease.
Inflammatory etiologies include uveitis-glaucoma-hyphema syndrome, sympathetic ophthalmia, sarcoidosis, pars planitis, multiple sclerosis, rheumatoid arthritis, birdshot chorioretinopathy, Behcet disease, Vogt-Koyanagi-Harada disease, sterile endophthalmitis, multifocal choroiditis, and acute posterior multifocal placoid pigment epitheliopathy
33) Clinically, this may result in lid wiper epitheliopathy
(LWE) (see Figure 2).
The problem of dry eye after LASIK is most likely the result of the severing of corneal nerves (LASIK-induced neurotrophic epitheliopathy
, or LNE) when the flap is made, rather than diminished tear production as previously thought.
Staining of the line of Marx is a normal finding, (18) whereas staining of the lid wiper, termed lid-wiper epitheliopathy
(LWE) seems to occur when the tear film is too thin to prevent damage caused by the friction of repeated blinking, and has been shown to be related to decreased mucin production.