Staining patterns vital to early dry eye diagnosis

Dallas-A few properly placed drops of lissamine green can reveal staining patterns that are key to diagnosing dry-eye syndrome earlier than possible with other methods, according to new research from the University of Texas Southwestern Medical Center.

"What this research showed is that the degree and pattern of staining was a good, objective indicator of the severity of the tear deficiency," said James McCulley, MD, chairman of ophthalmology at the institution and senior author of the study.

In an article published in the July issue of Eye and Contact Lens (33[4]:177-179), he and colleagues identified three basic patterns indicating progressively dangerous conditions:

• The least severe condition is indicated by stains limited to the white of the eye between the lids toward the nose. This so-called nasal staining doesn't necessarily predict dry eye; it might be caused by environmental factors, such as pollution.

• The second level appears as stains in the white of the eye between the lids but toward the ear.

• The third and most severe level occurs when the stain also appears on the cornea, indicating a break in the surface cells where bacteria can penetrate.