FREQUENT ASSOCIATION OF DELAYED TEAR CLEARANCE IN OCULAR IRRITATION

Aim-To explore the pathogenic role of delayed tear clearance. Methods- By comparing 10 patients with punctal obstruction and 20 asymptomatic normals, delayed tear clearance was diagnosed in 70 patients without a pparent punctal obstruction using fluorescein clearance test. Results- The majority were older (71.4 (SD 1.2) years) and women (66%). Frequen t complaints included redness, itching, mucus discharge, and crusting, which tended to be worse upon awakening. Common associated problems w ere medica-mentosa (13%), drug induced pseudo-pemphigoid, ocular hyper tension (27%), and glaucoma (7%). Topical non-preserved 1% methylpredn isolone resulted in subjective (83%) and objective (80%) improvement a nd resolution of delayed tear clearance (87%). Conclusion-These result s indicate strong association of delayed tear clearance with intrinsic ally and extrinsically generated ocular surface inflammation. The pres ence of delayed tear clearance may set up a vicious cycle to aggravate the existing inflammation. Future prospective studies are needed to d elineate the pathogenic role of delayed tear clearance in various ocul ar surface disorders.