Tear function and ocular surface findings in premature and term babies

Murat Dogru, Hatice Karakaya, Mehmet Baykara, Ahmet Özmen, Nilgun Koksal, Eiki Goto, Yukihiro Matsumoto, Takashi Kojima, Jun Shimazaki, Kazuo Tsubota

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective To describe the ocular surface and tear function findings in premature and term babies. Design Prospective, case-control study. Participants Forty-eight eyes of 24 premature babies seen at the Department of Ophthalmology of Uludag University School of Medicine, Bursa, Turkey, from March 2002 through September 2002 and 50 eyes of 25 healthy term babies were studied. Intervention The subjects underwent routine ophthalmic examinations; corneal sensitivity measurements; Schirmer test with anesthesia, with and without nasal stimulation; primary Jones test; fluorescein staining of the ocular surface; and conjunctival impression cytology. Main outcome measures Premature and term babies were compared for corneal sensitivity, lacrimal drainage system patency, tear function and ocular surface staining parameters, goblet cell density, and squamous metaplasia grade. The relation of these parameters to the status of the ocular surface was also investigated. Results Mean corneal sensitivity scores were 45±5.0 mm and 55±4.5 mm in the premature and term babies, respectively (P<0.001). Premature babies had a mean corneal fluorescein staining score of 1.5±0.25 points, compared with 0.22±0.28 points in the term babies (P<0.001). The mean Schirmer test scores without and with stimulation were 1.5±2.5 mm and 4.15±2.5 mm in the premature babies, respectively, compared with 15±3.5 mm and 18.75±4.5 mm in the term babies. The intragroup and intergroup Schirmer test scores were statistically significant (P<0.001). The primary Jones test was positive in 20.8% of the eyes in the premature babies, whereas it was positive in 84% of eyes in the term babies. The premature babies with positive primary Jones test results all had corneal epithelial defects or severe superficial punctuate keratopathy. Mean conjunctival impression cytology squamous metaplasia scores were 1.86±1.2 in the premature babies and 0.86±0.47 in the term babies (P<0.001). Mean goblet cell densities were 393±484 cells/mm2 and 739±503 cells/mm2 in the premature and term babies, respectively (P<0.001). Conclusion Decreased corneal sensitivity, reduced tearing, and lacrimal drainage patency are important determinants of ocular surface disease in premature infants. Premature newborns with low Schirmer test scores and a patent lacrimal system may experience corneal and conjunctival epithelial problems and should be carefully checked for the presence of dry eye complications.

Original languageEnglish
Pages (from-to)901-905
Number of pages5
JournalOphthalmology
Volume111
Issue number5
DOIs
Publication statusPublished - 2004 May
Externally publishedYes

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Tears
Goblet Cells
Metaplasia
Staining and Labeling
Fluorescein
Cell Biology
Drainage
Cell Count
Eye Diseases
Ophthalmology
Turkey
Nose
Premature Infants
Case-Control Studies
Anesthesia
Medicine
Outcome Assessment (Health Care)
Newborn Infant

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Dogru, M., Karakaya, H., Baykara, M., Özmen, A., Koksal, N., Goto, E., ... Tsubota, K. (2004). Tear function and ocular surface findings in premature and term babies. Ophthalmology, 111(5), 901-905. https://doi.org/10.1016/j.ophtha.2003.07.017

Tear function and ocular surface findings in premature and term babies. / Dogru, Murat; Karakaya, Hatice; Baykara, Mehmet; Özmen, Ahmet; Koksal, Nilgun; Goto, Eiki; Matsumoto, Yukihiro; Kojima, Takashi; Shimazaki, Jun; Tsubota, Kazuo.

In: Ophthalmology, Vol. 111, No. 5, 05.2004, p. 901-905.

Research output: Contribution to journalArticle

Dogru, M, Karakaya, H, Baykara, M, Özmen, A, Koksal, N, Goto, E, Matsumoto, Y, Kojima, T, Shimazaki, J & Tsubota, K 2004, 'Tear function and ocular surface findings in premature and term babies', Ophthalmology, vol. 111, no. 5, pp. 901-905. https://doi.org/10.1016/j.ophtha.2003.07.017
Dogru M, Karakaya H, Baykara M, Özmen A, Koksal N, Goto E et al. Tear function and ocular surface findings in premature and term babies. Ophthalmology. 2004 May;111(5):901-905. https://doi.org/10.1016/j.ophtha.2003.07.017
Dogru, Murat ; Karakaya, Hatice ; Baykara, Mehmet ; Özmen, Ahmet ; Koksal, Nilgun ; Goto, Eiki ; Matsumoto, Yukihiro ; Kojima, Takashi ; Shimazaki, Jun ; Tsubota, Kazuo. / Tear function and ocular surface findings in premature and term babies. In: Ophthalmology. 2004 ; Vol. 111, No. 5. pp. 901-905.
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abstract = "Objective To describe the ocular surface and tear function findings in premature and term babies. Design Prospective, case-control study. Participants Forty-eight eyes of 24 premature babies seen at the Department of Ophthalmology of Uludag University School of Medicine, Bursa, Turkey, from March 2002 through September 2002 and 50 eyes of 25 healthy term babies were studied. Intervention The subjects underwent routine ophthalmic examinations; corneal sensitivity measurements; Schirmer test with anesthesia, with and without nasal stimulation; primary Jones test; fluorescein staining of the ocular surface; and conjunctival impression cytology. Main outcome measures Premature and term babies were compared for corneal sensitivity, lacrimal drainage system patency, tear function and ocular surface staining parameters, goblet cell density, and squamous metaplasia grade. The relation of these parameters to the status of the ocular surface was also investigated. Results Mean corneal sensitivity scores were 45±5.0 mm and 55±4.5 mm in the premature and term babies, respectively (P<0.001). Premature babies had a mean corneal fluorescein staining score of 1.5±0.25 points, compared with 0.22±0.28 points in the term babies (P<0.001). The mean Schirmer test scores without and with stimulation were 1.5±2.5 mm and 4.15±2.5 mm in the premature babies, respectively, compared with 15±3.5 mm and 18.75±4.5 mm in the term babies. The intragroup and intergroup Schirmer test scores were statistically significant (P<0.001). The primary Jones test was positive in 20.8{\%} of the eyes in the premature babies, whereas it was positive in 84{\%} of eyes in the term babies. The premature babies with positive primary Jones test results all had corneal epithelial defects or severe superficial punctuate keratopathy. Mean conjunctival impression cytology squamous metaplasia scores were 1.86±1.2 in the premature babies and 0.86±0.47 in the term babies (P<0.001). Mean goblet cell densities were 393±484 cells/mm2 and 739±503 cells/mm2 in the premature and term babies, respectively (P<0.001). Conclusion Decreased corneal sensitivity, reduced tearing, and lacrimal drainage patency are important determinants of ocular surface disease in premature infants. Premature newborns with low Schirmer test scores and a patent lacrimal system may experience corneal and conjunctival epithelial problems and should be carefully checked for the presence of dry eye complications.",
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AU - Dogru, Murat

AU - Karakaya, Hatice

AU - Baykara, Mehmet

AU - Özmen, Ahmet

AU - Koksal, Nilgun

AU - Goto, Eiki

AU - Matsumoto, Yukihiro

AU - Kojima, Takashi

AU - Shimazaki, Jun

AU - Tsubota, Kazuo

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N2 - Objective To describe the ocular surface and tear function findings in premature and term babies. Design Prospective, case-control study. Participants Forty-eight eyes of 24 premature babies seen at the Department of Ophthalmology of Uludag University School of Medicine, Bursa, Turkey, from March 2002 through September 2002 and 50 eyes of 25 healthy term babies were studied. Intervention The subjects underwent routine ophthalmic examinations; corneal sensitivity measurements; Schirmer test with anesthesia, with and without nasal stimulation; primary Jones test; fluorescein staining of the ocular surface; and conjunctival impression cytology. Main outcome measures Premature and term babies were compared for corneal sensitivity, lacrimal drainage system patency, tear function and ocular surface staining parameters, goblet cell density, and squamous metaplasia grade. The relation of these parameters to the status of the ocular surface was also investigated. Results Mean corneal sensitivity scores were 45±5.0 mm and 55±4.5 mm in the premature and term babies, respectively (P<0.001). Premature babies had a mean corneal fluorescein staining score of 1.5±0.25 points, compared with 0.22±0.28 points in the term babies (P<0.001). The mean Schirmer test scores without and with stimulation were 1.5±2.5 mm and 4.15±2.5 mm in the premature babies, respectively, compared with 15±3.5 mm and 18.75±4.5 mm in the term babies. The intragroup and intergroup Schirmer test scores were statistically significant (P<0.001). The primary Jones test was positive in 20.8% of the eyes in the premature babies, whereas it was positive in 84% of eyes in the term babies. The premature babies with positive primary Jones test results all had corneal epithelial defects or severe superficial punctuate keratopathy. Mean conjunctival impression cytology squamous metaplasia scores were 1.86±1.2 in the premature babies and 0.86±0.47 in the term babies (P<0.001). Mean goblet cell densities were 393±484 cells/mm2 and 739±503 cells/mm2 in the premature and term babies, respectively (P<0.001). Conclusion Decreased corneal sensitivity, reduced tearing, and lacrimal drainage patency are important determinants of ocular surface disease in premature infants. Premature newborns with low Schirmer test scores and a patent lacrimal system may experience corneal and conjunctival epithelial problems and should be carefully checked for the presence of dry eye complications.

AB - Objective To describe the ocular surface and tear function findings in premature and term babies. Design Prospective, case-control study. Participants Forty-eight eyes of 24 premature babies seen at the Department of Ophthalmology of Uludag University School of Medicine, Bursa, Turkey, from March 2002 through September 2002 and 50 eyes of 25 healthy term babies were studied. Intervention The subjects underwent routine ophthalmic examinations; corneal sensitivity measurements; Schirmer test with anesthesia, with and without nasal stimulation; primary Jones test; fluorescein staining of the ocular surface; and conjunctival impression cytology. Main outcome measures Premature and term babies were compared for corneal sensitivity, lacrimal drainage system patency, tear function and ocular surface staining parameters, goblet cell density, and squamous metaplasia grade. The relation of these parameters to the status of the ocular surface was also investigated. Results Mean corneal sensitivity scores were 45±5.0 mm and 55±4.5 mm in the premature and term babies, respectively (P<0.001). Premature babies had a mean corneal fluorescein staining score of 1.5±0.25 points, compared with 0.22±0.28 points in the term babies (P<0.001). The mean Schirmer test scores without and with stimulation were 1.5±2.5 mm and 4.15±2.5 mm in the premature babies, respectively, compared with 15±3.5 mm and 18.75±4.5 mm in the term babies. The intragroup and intergroup Schirmer test scores were statistically significant (P<0.001). The primary Jones test was positive in 20.8% of the eyes in the premature babies, whereas it was positive in 84% of eyes in the term babies. The premature babies with positive primary Jones test results all had corneal epithelial defects or severe superficial punctuate keratopathy. Mean conjunctival impression cytology squamous metaplasia scores were 1.86±1.2 in the premature babies and 0.86±0.47 in the term babies (P<0.001). Mean goblet cell densities were 393±484 cells/mm2 and 739±503 cells/mm2 in the premature and term babies, respectively (P<0.001). Conclusion Decreased corneal sensitivity, reduced tearing, and lacrimal drainage patency are important determinants of ocular surface disease in premature infants. Premature newborns with low Schirmer test scores and a patent lacrimal system may experience corneal and conjunctival epithelial problems and should be carefully checked for the presence of dry eye complications.

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