Dry Eye Signs and Symptoms in Women With Premature Ovarian Failure | External Eye Disease | JAMA Ophthalmology | JAMA Network
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Clinical Sciences
February 2004

Dry Eye Signs and Symptoms in Women With Premature Ovarian Failure

Author Affiliations

From the Division of Epidemiology and Clinical Research, National EyeInstitute (Drs Smith, Vitale, and Reed), Clinical Center (Mss Grieshaber andGoodman), Developmental Endocrinology Branch, National Institute of ChildHealth and Human Development, National Institutes of Health (Ms Vanderhoofand Drs Calis and Nelson), Bethesda, Md. The authors have no relevant financialinterest in this article.

Arch Ophthalmol. 2004;122(2):151-156. doi:10.1001/archopht.122.2.151
Abstract

Objective  To examine whether women with premature ovarian failure (POF) have abnormalfindings in ocular surface or tear parameters and whether they report symptomsof ocular discomfort compared with age-matched controls.

Methods  Sixty-five patients with POF and 36 age-matched healthy controls wereexamined for signs and symptoms of dry eye. The Ocular Surface Disease Indexquestionnaire and the 25-item National Eye Institute Visual Function Questionnaire(NEI-VFQ 25) were administered to the participants. Assessments of ocularsurface damage (Oxford and van Bijsterveld scores of vital dye staining) andtear status (Schirmer tests 1 [without anesthesia] and 2 [with anesthesia]and tear breakup time) were performed.

Results  Women with POF scored significantly worse than controls on all ocularsurface damage parameters: Oxford score (3.2 vs 1.7; P =.001), conjunctival lissamine green (2.1 vs 1.3; P =.02), corneal fluorescein staining (1.2 vs 0.4; P =.005), and van Bijsterveld score (2.1 vs 1.3; P =.02). Further, the proportion of patients with POF meeting the dry eye diagnosticcriterion of a van Bijsterveld score greater than or equal to 4 was significantlygreater among women with POF than among controls (20% vs 3%; P = .02). The POF group also tended to have worse scores than controlson self-reported symptoms, as measured by the overall Ocular Surface DiseaseIndex (12.5 vs 2.1; P<.001) and the overall NEI-VFQ(94 vs 98; P = .001) afteradjustment for age and race. Schirmer test scores and tear breakup time didnot differ.

Conclusions  Women with POF were more likely to exhibit ocular surface damage andsymptoms of dry eye than age-matched controls. They were not, however, morelikely to have reduced tear production. To our knowledge, this associationbetween ocular surface disease and POF has not been previously reported. Thesedata provide further evidence of the multifaceted role of sex hormones inthe health and disease of the ocular surface.

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