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Bulgarian Review of Ophthalmology

Evaluation of subjective symptomatology in patients with limbal stem cell deficiency

Zarka Stoycheva, Yana Manolova, Yordan Yordanov, Binna Nencheva


Introduction: Patients suffering from limbal stem cell deficiency have a variety of symptoms ranging from hard-to-heal epithelial defects and recurrent corneal erosions to corneal vascularization and conjunctivalization, reduced visual acuity, photophobia, foreign body sensation, tearing, blepharospasm, and recurrent episodes of pain.

Aim: The aim of the present study is to evaluate subjective symptoms in patients with limbal stem cell deficiency.

Materials and Methods: The study included 64 patients with limbal stem cell deficiency, whose subjective signs of pain, photophobia, redness, tearing were evaluated using a questionnaire. The results were processed with SPSS v. 20 for Windows using variation, comparison and correlation analyses.

Results and Discussion: An important part of the discomfort of patients, regardless of the type of the illness, is the pain that affects their psycho-emotional state. The best pain response was found in eye diseases, wearing contact lenses, dry eye, iatrogenic factors and eye surgery. A significant part of the patients (61%) complained of photophobia in the absence of light or medium illumination. After being treated, the percentage dropped to 15.6%. In our sample, before treatment, 54.7% of the patients complained of moderate to severe redness. After the treatment, this number fell to 9.4%. In 59.4% of the individuals redness was missing or slightly present. Prior to treatment, the most severe redness was found in patients with chemical/thermal burns (44.4%) followed by those with injuries (34.5%). The appearance of secretion did not change significantly, which we think is due to the relocation of the patients from the group of those with a puruloid secretion to the previous group, that with the appearance of  clear secretion only.

Conclusion: The assessment of subjective symptomatology and visual function in patients with limbal stem cell deficiency showed that the greatest effect was observed in pain followed by photophobia, which was greatly reduced after treatment with amniotic membrane transplantation and the symptoms were minimized as well


subjective symptoms, pain, photophobia, redness, tearing

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About The Authors

Zarka Stoycheva
Specialized Eye Hospital, Varna

Yana Manolova
Medical University of Varna

Department of Ophthalmology and Visual Science, Faculty of Medicine

Yordan Yordanov
Burgas University „Prof. Dr. Asen Zlatarov”

Binna Nencheva
Medical University of Varna

Department of Physiotherapy, Rehabilitation, Thalassotherapy and Occupational Diseases, Faculty of Public Health;

Specialized Eye Hospital, Varna