Abstract

Volume.116 Number.12

Original article : Clinical science

Clinical Characteristics of Short Tear Film Breakup Time (BUT)-type Dry Eye
Yuji Yamamoto1,2, Norihiko Yokoi2, Hisayo Higashihara2,3, Kayoko Inagaki2,4, Yukiko Sonomura2,5, Aoi Komuro2,6, Shigeru Kinoshita2
1 Department of Ophthalmology, Fukuchiyama City Hospital
2 Department of Ophthalmology, Kyoto Prefectural University of Medicine
3 Higashihara Internal and Eye Clinic
4 Department of Ophthalmology, Saiseikai Suita Hospital
5 Department of Ophthalmology, Yamashiro Public Hospital
6 Shijo Karasuma Komuro Eye Clinic

Purpose: To evaluate the clinical characteristics and management of short tear film breakup time (BUT)-type dry eye.
Methods: Clinical background and post-treatment changes of symptoms in 77 patients with short BUT-type dry eye were investigated. Treatment consisted of artificial-tear eye-drop instillation and, if necessary, the addition of a low-density-level steroid, hyaluronic acid, a low-density-level cyclopentolate prepared by ourselves and punctal plugs inserted into the upper and lower lacrimal puncta.
Results: There were three times more women than men among the patients, and the peak age of occurrence was in the twenties in the men and in the sixties in the women. Our findings show that visual display terminal (VDT) work, contact lens (CL) wear, and changes in the sex hormones may initiate subjective symptoms. Some patients had simultaneous conjunctivochalasis, allergic conjunctivitis, and meibomian gland dysfunction. Nineteen patients (24.7%) were effectively treated with eye-drop instillation alone. Thirty-seven patients (48.1%) required punctal-plug insertion, which was completely effective in only 8 of them (21.6%).
Conclusion: Mainly young men and menopausal women contract short BUT-type dry eye. Changes in sex hormones, VDT work and CL wear may be causal, and the disease cannot be controlled by eye-drop and punctal-plug treatment alone.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 116: 1137-1143, 2012.

Key words
Tear film breakup time (BUT), Short BUT-type dry eye, Eye drop treatment, Punctal plug, Ocular fatigue, A low-density-level cyclopentolate eye drop
Reprint requests to
Norihiko Yokoi, M.D., Ph.D. Department of Ophthalmology, Kyoto Prefectural University of Medicine. 465 Kajii-cho, Hirokouji-agaru, Kawaramachi-dori, Kamigyou-ku, Kyoto 602-0841, Japan