[Effect of binocular accommodation and vergence function examinations and interventions on subjective discomfort of dry eye].

Abstract

Objective: To investigate the accommodation and vergence (AV) function of patients with mild to moderate refractory dry eye symptoms, and determine the impact of relevant interventions on subjective symptoms. Methods: A total of 103 patients with dry eye disease (DED) in Zhongshan Ophthalmic Center between December 2017 and June 2019 were included. After 3-month conventional treatment, the patients entered the treatment-responsive group if ocular surface disease index (OSDI) decreased ≥12.5, and others were recruited into the refractory symptoms group. Binocular AV function, OSDI, tear break-up time (TBUT), Schirmer s test (ST) and fluorescein staining (FL) were determined in all the patients. Corrective therapy on the AV dysfunction was added in the refractory symptoms group besides the conventional therapy. The above-mentioned indexes were reexamined 8 weeks later. The incidence of AV dysfunction was compared between the refractory symptoms group and the treatment-responsive group. Moreover, the differences of OSDI and tear film stability were compared before and after the corrective therapy in the refractory symptoms group. Results: Sixty of 103 DED patients were classified into the refractory symptoms group [mean age: (27±6) years; 18 males and 25 females] and 43 into the treatment-responsive group [mean age: (30±6) years; 32 males and 28 females]. The incidence of AV dysfunction in the refractory symptom group (100%) was higher than that of the treatment responsive group (72.1%) (P<0.001). Forty patients with refractory symptoms accomplished the 8-week corrective therapy, and the OSDI score was significant improved (23.4±16.0 vs 40.6±15.7, P<0.001). However, further changes in ST, TBUT and FL were not detected in these patients (all P>0.05). Conclusions: There is a high prevalence of AV dysfunction in patients with refractory symptomatic DED. The corrective therapy on AV may improve the subjective symptoms in these patients.