PURPOSE: In severely tear-deficient dry eye patients whose puncta had been occluded, corneal and conjunctival rose bengal (RB) staining were graded and compared to before occlusion. SUBJECTS AND METHODS: Subjects were 17 eyes of 13 severely tear-deficient dry eye patients whose puncta had been successfully occluded (corneal fluorescein staining showed A 0 D 0 after occlusion). Corneal and conjunctival RB staining were graded 0, 1, 2 or 3, according to severity [B 1] at the cornea and at the temporal and nasal bulbar conjunctiva. The scores were then compared to those before punctal occlusion. To enable comparison of pre- and post-occlusion ocular surface concentrations of RB [B 2], post-occlusion concentration was adjusted by absorbing tears from the conjunctival sac with Schirmer's test paper until the lower meniscus height was equal to that before occlusion, as monitored by video-meniscometer. RB dye was then instilled into the patients conjunctival sac. RESULTS: RB staining score at the cornea decreased significantly; in contrast, no significant improvement was found at the nasal and temporal conjunctiva (p = 0.0025, p = 0.05, p = 0.7, respectively, Wilcoxon test). CONCLUSION: In accordance with the basic interpretation of RB staining, these results imply that RB positive staining [B 3] on the conjunctival surface is caused by a factor other than aqueous deficiency.
PURPOSE: In severely tear-deficient dry eyepatients whose puncta had been occluded, corneal and conjunctival rose bengal (RB) staining were graded and compared to before occlusion. SUBJECTS AND METHODS: Subjects were 17 eyes of 13 severely tear-deficient dry eyepatients whose puncta had been successfully occluded (cornealfluorescein staining showed A 0 D 0 after occlusion). Corneal and conjunctival RB staining were graded 0, 1, 2 or 3, according to severity [B 1] at the cornea and at the temporal and nasal bulbar conjunctiva. The scores were then compared to those before punctal occlusion. To enable comparison of pre- and post-occlusion ocular surface concentrations of RB [B 2], post-occlusion concentration was adjusted by absorbing tears from the conjunctival sac with Schirmer's test paper until the lower meniscus height was equal to that before occlusion, as monitored by video-meniscometer. RB dye was then instilled into the patients conjunctival sac. RESULTS:RB staining score at the cornea decreased significantly; in contrast, no significant improvement was found at the nasal and temporal conjunctiva (p = 0.0025, p = 0.05, p = 0.7, respectively, Wilcoxon test). CONCLUSION: In accordance with the basic interpretation of RB staining, these results imply that RB positive staining [B 3] on the conjunctival surface is caused by a factor other than aqueous deficiency.