TY - JOUR
T1 - A Protective Eye Shield Reduces Limbal Strain and Its Variability during Simulated Sleep in Adults with Glaucoma
AU - Flatau, Alison
AU - Solano, Francisco
AU - Jefferys, Joan L.
AU - Damion, Christopher
AU - Quigley, Harry A.
N1 - Funding Information:
Contributions by A.F. and C.D. are based upon work supported in part by the National Science Foundation under grant no. #13377502 and undergraduate supplements to this grant (program manager Dr T.A. Conway). Any opinions, findings, and conclusions or recom-mendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foun-dation. H.A.Q., J.L.J., and F.S. were supported in part by EY01765 (Core Facility Grant to Wilmer Institute) and by unrestricted sup-port from William T. Forrester and from Livingston and Saranne Kosberg. C.D. was supported by an undergraduate supplement to this grant. This support allowed the coauthors to make the indicated contributions to design and conduct of the study; supported collec-tion, management, analysis, and interpretation of the data; and preparation and review of this manuscript for publication.
Publisher Copyright:
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2018
Y1 - 2018
N2 - Purpose:To determine the effect of wearing a protective eye shield (mask) on limbal strain magnitude and variability in glaucoma eyes when sleeping with 1 side of the face down (FD) against a pillow.Methods:A prospective, randomized, interventional trial was conducted at the Wilmer Eye Institute with 36 glaucoma patients. A contact lens sensor measured limbal strain (output in equivalent millivolts) during intervals of up to 60 minutes in lateral decubitus, FD, and supine positions. Eighteen subjects wore a mask during 1 of 2 FD intervals, with randomized assignment of the interval. Data from additional trials with no mask were included in some analyses. In addition, some facial-feature dimensions from 3D scanned images of 23 subjects were compared with limbal strain data.Results:Wearing a mask trends toward a reduced mean change in contact lens sensor output (limbal strain) on moving to a FD positions [+34.1 mVeq, P=0.01 reduced by -22.3 mVeq, P=0.09 (n=36)]. Mask wearing reduced variability in strain while FD [-22.8 mVeq, P=0.04 (n=18)]. In eyes with past progressive visual field loss, the effect of the mask reduced mean strain change when moving to FD [-44.8 mVeq, P=0.02 (n=31)]. Longer corneal apex to nose-tip and to temple lengths were associated with reduced variability while FD [P=0.02 and 0.04, respectively (n=23)]. Treating both lengths as confounding factors increased statistical significance, particularly for analysis of the no-mask change in strain data moving to and from the FD position [P=0.004 to 0.002 and P=0.03 to 0.01 (n=23)].Conclusion and Relevance:Wearing a mask reduced limbal strain and variation in limbal strain during simulated FD sleep, particularly in eyes with past field worsening, as did some facial features.
AB - Purpose:To determine the effect of wearing a protective eye shield (mask) on limbal strain magnitude and variability in glaucoma eyes when sleeping with 1 side of the face down (FD) against a pillow.Methods:A prospective, randomized, interventional trial was conducted at the Wilmer Eye Institute with 36 glaucoma patients. A contact lens sensor measured limbal strain (output in equivalent millivolts) during intervals of up to 60 minutes in lateral decubitus, FD, and supine positions. Eighteen subjects wore a mask during 1 of 2 FD intervals, with randomized assignment of the interval. Data from additional trials with no mask were included in some analyses. In addition, some facial-feature dimensions from 3D scanned images of 23 subjects were compared with limbal strain data.Results:Wearing a mask trends toward a reduced mean change in contact lens sensor output (limbal strain) on moving to a FD positions [+34.1 mVeq, P=0.01 reduced by -22.3 mVeq, P=0.09 (n=36)]. Mask wearing reduced variability in strain while FD [-22.8 mVeq, P=0.04 (n=18)]. In eyes with past progressive visual field loss, the effect of the mask reduced mean strain change when moving to FD [-44.8 mVeq, P=0.02 (n=31)]. Longer corneal apex to nose-tip and to temple lengths were associated with reduced variability while FD [P=0.02 and 0.04, respectively (n=23)]. Treating both lengths as confounding factors increased statistical significance, particularly for analysis of the no-mask change in strain data moving to and from the FD position [P=0.004 to 0.002 and P=0.03 to 0.01 (n=23)].Conclusion and Relevance:Wearing a mask reduced limbal strain and variation in limbal strain during simulated FD sleep, particularly in eyes with past field worsening, as did some facial features.
KW - glaucoma
KW - intraocular pressure
KW - limbal strain
KW - protective eye shield
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U2 - 10.1097/IJG.0000000000000826
DO - 10.1097/IJG.0000000000000826
M3 - Article
C2 - 29194205
AN - SCOPUS:85044160504
SN - 1057-0829
VL - 27
SP - 77
EP - 86
JO - Journal of glaucoma
JF - Journal of glaucoma
IS - 1
ER -