Dry Eye Disease In Healed Keratitis: A Paired Eye Comparative Study

Purpose: To evaluate long-term ocular surface and NEI staining changes in eyes with healed keratitis compared to their contralateral fellow eyes.

Institutional study conducted at a tertiary care centre in india. (Dr. R.P. Centre for Ophthalmic Sciences, AIIMS, New Delhi, India)

This prospective, observational paired-eye study included 50 patients with unilateral healed keratitis. Both affected and fellow eyes were assessed using Ocular Surface Disease Index (OSDI), Schirmer test, tear film breakup time (TBUT), meibography, ocular surface analyzer (OSA), LipiView interferometry, and NEI staining scores. Paired statistical analyses were performed. Subgroup analyses were also conducted based on gender, systemic disease, type of infection, scar characteristics, and treatment.

Mean age was 39.67 years. Abnormal OSDI scores were observed in 30 patients (61.2%). Healed eyes had significantly worse visual acuity (logMAR 1.84 vs 0.14; p<0.001), lower Schirmer values (14.1 vs 16.8 mm; p=0.028), reduced TBUT (8.17 vs 9.91 s; p=0.030), increased meibomian gland dropout (p<0.001), and higher NEI corneal (10.96 vs 5.67), conjunctival (7.02 vs 4.89), and total scores (17.94 vs 10.73; all p<0.001). Comparison of LLT measured by OSA and LipiView showed significant differences (p=0.057).

Patients with healed keratitis demonstrate persistent ocular surface abnormalities, including tear film instability, gland dropouts, and epithelial staining. Thus, patients of healed keratitis require continued ocular surface monitoring, and dry eye management during follow up even after clinical resolution of healed keratitis.