Abstract

Purpose: We investigated the association between ocular surface disease index (OSDI) score and conjunctival ultraviolet autofluorescence (CUVAF) in normals and dry eye patients. Methods: Subjects aged 18 to 65 years were enrolled after obtaining a written informed consent and a comprehensive ocular evaluation. Dry eye diagnosis was made objectively using Tear film break-up time and Schirmer’s 1 test. OSDI questionnaire were used to assess the symptoms of dry eye. Sun exposure was assessed using Melbourne visual impairment questionnaire. UV induced conjunctival damage was measured using CUVAF photography which consist of custom developed smartphone-based camera system. Setup includes a portable eye cup placed on smart phone camera fitted with UV emitting LED. Autofluorescence photographs of the nasal and temporal conjunctiva were captured. The conjunctival area of damage identified using CUVAF photography was outlined traced using polygon selection tool in ImageJ software and area was calculated. Result: Mean age of subjects in normal group (N-30) was 23.4 ± 6.37 and dry eye group (N-30) was 30.83 ± 13.75. Mean OSDI score in dry eye group was of 27.37 ± 10.42 which was significantly higher (p < 0.05) compared to normal group 9.59 ± 9.19. The average TBUT score in normal group was 11.56 ± 1. 99, and in dry eye group was 4.83 ± 2.789 with significant difference (p < 0.05). Mean conjunctival area of damages in right and left eye of normal group was 2234.1 ± 4891.4 and 1498.8 ± 4130.5 with no significant difference (p > 0.05). Similarly, in dry eye group was 4828.43 ± 5805.5 and 4755.88 ± 5514.8 with no statistically different (p > 0.05). Average CUVAF area showed a weak negative correlation with OSDI score (r - -0.48) (p > 0.05). Conclusion: CUVAF is a valuable tool to assess UV induced conjunctival damage. CUVAF area was significantly higher in dry eye group than normals. Average CUVAF area was negatively correlated with subjective symptoms of dry.