Influence of Eyelid Pressure on Fluorescein Staining of Ocular Surface in Dry Eyes

PurposeTo determine the relationship between eyelid pressure during blinking and the fluorescein staining of the cornea and conjunctiva in dry eye patients.DesignCross-sectional prospective study.MethodsThe pressure of the upper and lower eyelids was measured with a specially designed blepahro-tensiometer in 130 eyes of 65 dry eye patients (D group) and in 58 eyes of 31 normal controls (N group). The correlations between the location and degree of ocular surface staining scores and the eyelid pressure were calculated for the D group.ResultsThe pressures of the upper and lower eyelids were significantly higher in the D group than in the N group (upper P < .0001, lower P = .0040). The lower eyelid pressure was significantly correlated with the ocular surface staining scores for the inferior cornea (r = 0.19, P = .0307) and conjunctiva (r = 0.19, P = .0252).ConclusionsThe significant correlation between the eyelid pressure and the ocular surface staining suggests that mechanical friction on the ocular surface by the eyelids may be one of the factors that affects the fluorescein staining of the inferior ocular surface.