Ocular Surface Disorders May Follow Blistering Skin Diseases, Lower Quality of Life

Autoimmune blistering skin disease (AIBD) patients experience reduced quality of life (QOL) and more severe ocular surface disorders, including dry eye, symblepharon and corneal opacity, according to findings published in BMC Ophthalmology.

Researchers conducted a cross-sectional study to investigate the relationship between ocular surface disorders and QOL among patients with AIBD. The study included 24 AIBD patients (18 with pemphigus and 7 with pemphigoid) and 25 nonAIBD patients placed into a control group. The researchers assessed ocular surface disease index (OSDI), ocular surface evaluation, including slit-lamp examination, Schirmer I test, tear break-up time, corneal fluorescein staining, lid-parallel conjunctival folds, meibomian gland evaluation, presence of symblepharon, and corneal opacity. 

Clinicians issued multiple questionnaires about QOL to patients, and QOL and ocular surface tests were compared between AIBD patients and patients in the control group. The researchers evaluated the associations between ocular surface parameters and QOL in the AIBD patients. 

During the study, 92% of AIBD patients and 87.5% of age- and sex-matched non-AIBD control patients were diagnosed with dry eye. AIBD patients reported lower short form questionnaire (SF-36) scores (P <.05) and more severe OSDI. They also had worse Schirmer I test scores, tear break-up times, corneal fluorescein staining, presence of symblepharon, and corneal opacity measures (P <.05), compared with those in the control group. SF-36 composite scores or scores on the SF-36 subscales were correlated with OSDI and Schirmer I test.

Due to the correlation confirmed by this study between AIBD, ocular surface disorders, and low QOL, the researchers emphasize the importance of heightened awareness among clinicians regarding the overlap of morbidities in the AIBD population.

“This study may show that a multidisciplinary collaboration between specialists in ophthalmology, dermatology, internal medicine and psychology is conducive to improve the management of AIBD and enhance quality of life among these patients,” the researchers explain.

Study limitations include small sample size, single-center design, and a lack of comprehensive assessment of the impact of AIBD severity on dry eye.