Relationship Between Ocular Surface Metrics and Corneal HOAs in Dry Eye Disease

Overview

This cross-sectional study analyzed 164 patients with varying dry eye disease (DED) severity to investigate correlations between ocular surface parameters and corneal higher-order aberrations (cHOAs). Findings indicate that increased severity of DED signs correlates with elevated cHOAs, particularly coma and trefoil aberrations, linked to tear film instability.

Background

Dry eye disease is a multifactorial condition characterized by tear film instability and ocular surface damage, leading to symptoms such as dryness, visual fluctuations, and discomfort. The tear film and corneal surface contribute significantly to the eye's refractive power, and instability can increase corneal higher-order aberrations, impairing vision. Despite known associations between tear break-up time and cHOAs, the relationship between specific aberration types and ocular surface metrics remains underexplored. This study aims to clarify these relationships across different severities of DED.

Data Highlights

Key Findings

• Corneal higher-order aberrations (cHOAs) increase with the severity of dry eye disease signs.
• Coma and trefoil aberrations show stronger correlations with ocular surface parameters than spherical aberrations.
• Reduced tear break-up time (TBUT) is associated with elevated cHOAs, indicating tear film instability impacts corneal optics.
• Ocular Surface Disease Index (OSDI) scores correlate with cHOAs, linking subjective symptoms to objective optical changes.
• Corneal fluorescein staining (CFS) severity parallels increases in cHOAs, reflecting ocular surface damage effects on vision quality.

Clinical Implications

Clinicians should consider evaluating corneal higher-order aberrations in patients with dry eye disease, especially those with moderate to severe signs, as these aberrations contribute to visual disturbances beyond refractive errors. Management strategies targeting tear film stability may help reduce cHOAs and improve visual quality. Incorporating ocular surface metrics alongside optical assessments can enhance diagnosis and treatment monitoring.

Conclusion

This study demonstrates a clear association between ocular surface disease severity and increased corneal higher-order aberrations in dry eye disease. These findings underscore the importance of comprehensive ocular surface evaluation to address visual quality impairments in DED patients.

References

1. TFOS DEWS II Report 2017 -- Definition and Classification of Dry Eye Disease
2. Zhang et al. 2021 -- Validation of the Chinese Version of the OSDI Questionnaire
3. Chinese Dry Eye Expert Consensus 2022 -- Diagnostic Criteria for Dry Eye Disease