Measurement of clinical, bio- and neuro- markers of ocular surface and tear film in subjects with itchy eyes

Download files
Access & Terms of Use
open access
Copyright: Kolanu, Sailesh
Altmetric
Abstract
Purpose: Ocular itchiness is the commonest symptom of ocular allergy. This thesis aimed to characterize itchy eyes by examining its seasonal variation, association with pollen counts and climatic variables and changes to the clinical, bio- and neuro- markers of ocular surface and tear film and allergy markers associated with this symptom. Methods: An online survey was repeated 4 times during various seasons. Pollen counts and climatic variables were collected simultaneously. Changes in ocular surface, tear film and neuro-markers were measured, following conjunctival provocation in subjects susceptible to allergy. A cross sectional 3-group study was conducted to measure differences in ocular surface, tear film, neuro-markers and allergy markers in subjects with itchy eyes. Results: 50-62% subjects reported itchy eyes. Ocular severity score (graded 0-21) was higher in spring than autumn (2 grades; p<0.0001) and winter (2 grades; p=0.009). Higher maximum wind gusts (p=0.005), lower evaporation with higher pollen counts (p=0.03) increased the severity of itchy eyes. Acute changes during an allergic reaction were characterized by itchy eyes and increases in conjunctival hyperaemia (graded 0-4; 1.1 grades increase; p=0.005), chemosis (graded 0-3; 2 grades increase; p=0.002) and lid roughness (graded 0-4; 1 grades increase; p=0.005). Subjects with itchy eyes (both with and without allergy) not only had increases in conjunctival signs (hyperaemia (0.7 grade increase; p<0.0001), chemosis (1 grade increase; p<0.0001)); lid roughness (0.9 grade increase; p<0.0001) and lid margin staining (graded 0-4; 1 grade increase; p=0.01) but also in neuro-markers such as corneal sensation threshold (0.12 grams/mm2 increase; p<0.006) and sub-basal corneal nerve density (4mm/mm2 decrease; p<0.0001). Changes in allergy markers (skin prick (p=0.004) and Allerwatch (p=0.01)) were limited to subjects with allergy. Discriminant analysis showed that itchy eyes could be distinguished from normal eyes using a combination of conjunctival and neuro-markers. Subjects with itchy eyes and allergy could be distinguished using a combination of allergy and neuro-markers. Conclusion: Seasonal variations, association with pollen counts and changes to the ocular surface, tear film and neuro-markers indicated itchy eyes to be allergic in nature. Changes to the allergy markers being limited to subjects with allergies indicated itchy eyes might be a sub clinical form of allergy.
Persistent link to this record
Link to Publisher Version
Link to Open Access Version
Additional Link
Author(s)
Kolanu, Sailesh
Supervisor(s)
Jalbert, Isabelle
Golebiowski, Blanka
Willcox, Mark
Creator(s)
Editor(s)
Translator(s)
Curator(s)
Designer(s)
Arranger(s)
Composer(s)
Recordist(s)
Conference Proceedings Editor(s)
Other Contributor(s)
Corporate/Industry Contributor(s)
Publication Year
2016
Resource Type
Thesis
Degree Type
PhD Doctorate
UNSW Faculty
Files
download public version.pdf 7.59 MB Adobe Portable Document Format
Related dataset(s)