A Guide to Clinical Contact Lens Management

Signs, Symptoms, Diagnosis and Management

Academy for Eyecare Excellence™
IN COOPERATION WITH
Centre for Contact Lens Research
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LWE staining
LWE

Video: Lid Wiper Epitheliopathy - Fluorescein Stain (with Lid Eversion)

Lid Wiper Epitheliopathy - Fluorescein Stain (with Lid Eversion)

Video: Lid Wiper Epitheliopathy - Fluorescein Stain and Palpebral Staining

Lid Wiper Epitheliopathy - Fluorescein Stain and Palpebral Staining

Video: Lid Wiper Epitheliopathy - Lissamine Stain

Lid Wiper Epitheliopathy - Lissamine Stain

Lid Wiper Epitheliopathy (LWE)

Symptoms

  • Asymptomatic or may experience dryness and/or discomfort

Signs

  • Staining of the lid wiper (the portion of marginal conjunctiva that comes in contact with ocular surface during blinking)
  • The lid wiper region extends from Marx’s line (sharp green border staining superiorly) to the tarsal sulcus fold
  • Observed with sodium fluorescein and/or Lissamine green

Etiology

  • Aqueous deficiency may play a role since increased friction between the lid wiper region and ocular surface subject the lid wiper to trauma on blinking
  • Other possible causes include disorders of the adherent protective coatings of the epithelium of the lid wiper, disorders of blinking and ocular surface abnormalities

Prevalence

  • Common in dry eye patients

Differential Diagnosis

Management

  • Consider rewetting drops
  • If MGD co-exists, consider lid hygiene and hot compresses
  • Changing materials to lower friction surfaces
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