Contribution of break up time in the diagnosis and the treatment of dry eye syndrome in tropic area: about 234 patients in Abidjan

Dry eye disease (DED) can be evaluated clinically by the tear film break up time (BUT). There is a discrepancy between symptoms in relationship with dry eye disease and objectives measures of BUT. So we tried to evaluate the reliability of BUT in the diagnosis and treatment of this disease in black African people. We carried out a prospective study of 6 months where melanoderms adults presenting subjective symptoms of dry eye disease according a questionnaire of 7 items were included. Then the measure of BUT is performed after ocular instillation of fluorescein eyedrop. This measured is done by recording the time elapsed from the last complete palpebral blink to the appearance of the first dry spot. Patients with subjective symptoms and time of BUT lower than 10seconds were called concordants (suffering really of DED). The discrepant group was represented by a BUT upper than 10seconds despite the fact that these patients answered positively to the questionnaire. This survey included 234 patients and the average age was 49.1 years. Sex-ratio was 0.68 and we noticed predominance of BUT between 5 and 10seconds in 42.3% of cases. Subjective symptoms were strengthened clinically by a BUT lower to 10seconds in 149 patients. Therefore, the reliability of BUT as clinic tool for the diagnosis after symptoms in relationship with DED was 63.7%. In the group of concordants, women were more likely than men to experience symptoms of DED (P=0.0005). Age upper than 50 years and computer usage were risk factors of DED (P