Relationship Between Eyelid Pressure and Ocular Surface Disorders in Patients With Healthy and Dry Eyes

PURPOSE. To determine whether an eyelid pressure measurement device, called a blepharotensiometer, can detect changes in the eyelid pressure in different types of ocular surface disorders. METHODS. First, the repeatability of the blepharo-tensiometer was determined by measuring the eyelid pressures on 3 separate days from healthy volunteers and calculating the intraclass correlation coefficients (ICCs). Second, to determine the ability of the blepharo-tensiometer to detect changes in the eyelid pressures in different types of ocular surface disorders, we compared the eyelid pressure of healthy eyes with dry eyes. Third, the correlations between the eyelid pressure and the location and magnitude of fluorescein staining of the ocular surface were analyzed. Fourth, the eyelid pressure in eyes with lid-wiper epitheliopathy (LWE) was measured. RESULTS. The ICCs ranged from 0.675 to 0.911 for the upper eyelid and 0.663 to 0.925 for the lower eyelid. The pressures of the upper and lower eyelids were significantly higher in dry eyes than in healthy eyes. The inferior ocular surface staining scores were strongly correlated with the lower eyelid pressure by multivariate analysis. The lower eyelid pressure was significantly correlated with the grade of the lower LWE. CONCLUSIONS. The blepahro-tensiometer can obtain repeatable measurements of the eyelid pressure and can be used to evaluate the pressure of the eyelids on the ocular surface in healthy and diseased eyes. The significant correlations between the eyelid pressure and the ocular surface staining suggests that the pressure on the ocular surface probably contributes to ocular surface disorders.