Abstract
One of the main reasons for abandonment of contact lenses (LC) corresponds to the symptoms of discomfort. The lid wiper epitheliopathy (LWE) is an epithelial alteration of a region of the palpebral margin called the lid wiper (LW). In recent years, such condition has been frequently evidenced in LC wearers, which has suggested that it could be a possible clinical indicator of interactions between the lens and the ocular surface; thus, they may lead to the development of different symptoms, and eventually to the drop out of the treatment. The objective of the current study is to develop a qualitative review of the literature, in order to present the different findings or concepts identified to date that support the association between LC wearer and LWE. Therefore, we pursue to identify the consensuses that have been reached, and the main recommendations for future research. As materials and methods, it was implemented a bibliographic search in PubMed, ScienceDirect, EBSCO, Springer, Cochrane, Scopus and Web of Science databases, having as inclusion criteria that they were original research articles that meet the “picor” criterion and the CASPe methodological quality criteria. 245 articles were reviewed, and 226 were excluded, as they did not meet the inclusion criteria, as well as 4 that did not meet the methodological quality. Also, in 19 articles it was evidenced that LWE is an epithelial alteration associated with symptoms of discomfort, and with the use of LC. However, LWE also occurs in non-LC users with symptoms, although less frequently, suggesting that the use of LC acts as a risk factor for epitheliopathy in LC wearers, and not as the only factor involved. While, tear instability is the main factor involved in the development of LWE in LC wearers and non-wearers. In addition, LWE and lid parallel conjunctival fold (LIPCOF) are associated with each other, and are in turn related to symptoms of discomfort in LC wears. In sum, the evidence supports mechanical trauma due to increased friction as the possible underlying mechanism.References
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Keywords
lid wiper epitheliopathy
discomfort