The Influence Of Palpebral Fissure Height On The Tear Film Dysfunction

To determine the influence of palpebral fissure height measured with plastic ruler in a primary gaze position on the tear film dysfunction in healthy individuals, according to age and gender. 

This cross-sectional study was performed in the Outpatient Department of Ophthalmology, University Hospital Center in Zagreb, Croatia.

A total of 120 adult subjects consecutively attending the Outpatient Ophthalmology Department for the standard eye examination during the two months were enrolled in the study, and divided according to age into two groups with an equal distribution of men and women. Subjects with ophthalmic pathology or other conditions and disorders that could influence the tear film stability were excluded from the study. Age of 50 was determined as an age limit. Both of the groups included 30 subjects with and without tear film dysfunction symptoms. Schein questionnaire was used in order to determine the presence of the tear film dysfunction symptoms. Ocular signs were assessed by TBUT.

Symptoms of the tear film dysfunction were significantly more pronounced and more frequent in younger women with higher mean values of the palpebral fissure height (p=0,029). In older women, a significantly negative correlation was found between the palpebral fissure height and the frequency of symptoms (p=0,003). Palpebral fissure height was significantly negatively correlated with TBUT values in both groups, younger (p<0.001) and older subjects (p=0.009). 

This study showed that an enlarged exposed ocular surface due to higher palpebral fissure height in healthy individuals' primary gaze position negatively affects the tear film stability and alters the eye desiccation in both age groups. Measuring of palpebral fissure height in combination with the assessment of symptoms and clinical signs, can be an useful tool in diagnostic algorithm of tear film dysfunction in everyday clinical practice. FINANCIAL DISCLOSURE: None.