Involvement of Eyelid Pressure in Lid-Wiper Epitheliopathy

Objectives: To determine whether eyelid pressure is involved in the development of lid-wiper epitheliopathy (LWE). Methods: Study 1: The eyelid pressure was measured with a blepharo-tensiometer, and the degree of LWE was assessed in 79 eyes of 43 non-contact lens (CL) wearers. Study 2: The movements of the eyelids and displacement of the eyes during spontaneous blinking were photographed with a high-speed camera. The eyelid pressure was also measured in 34 normal eyes of 19 non-CL wearers who were not part of Study 1. Results: Study 1: Upper-LWE was detected in 24 of 79 eyes (30.4%), and no significant difference was detected in the eyelid pressure between any grade of upper-LWE. Lower-LWE was detected in 41 of 79 eyes (51.9%), and the eyelid pressure (27.9 +/- 2.8 mmHg) in eyes with grade 3 LWE was significantly higher than that with grade 0 LWE (19.7 +/- 1.3 mmHg; p < 0.05). Study 2: The lower eyelid pressure was significantly correlated with the length of the horizontal movement of the lower eyelids (p < 0.05) and also with the degree of posterior movement of the eye globe (p < 0.05). Conclusions: The higher pressure from the eyelid may be one of the causes for the development of lower-LWE.