Abstract
PurposeTo evaluate ocular surface alterations in two populations at different exposure levels to particulate matter (PM) in their living and work environments.MethodsA cross-sectional study was conducted, including 78 volunteers from Argentina who lived and worked under different pollution levels in an urban (U; n = 44) or industrial zone (I; n = 34). Mean exposure level to PM was evaluated. Responses to the Ocular Symptom Disease Index and McMonnies questionnaire were obtained from all subjects. Subsequently, an assessment through the Schirmer I test (ST), slit lamp microscopy, vital staining, and tear breakup time was conducted. Statistical analyses with Chi-square and Bartlett's tests, as well as Student's t-tests and principal component analysis (PCA), were performed.ResultsParticles of size 2.5 μm (PM) level was significantly higher in the I group than the U group (P = 0.04). Ocular surface parameters including bulbar redness, eyelid redness, and the degree of vital staining with fluorescein (SF) and lissamine green (SLG) exhibited difference between the groups. With regards to the tear film, statistically significant differences in the ST value and meibomian gland dysfunction between the groups were detected (P = 0.003 and P = 0.02, respectively). Conjunctival SF and SLG, and ST values were identified as factors which could distinguish groups exposed to different PM levels.ConclusionSubjects exposed to higher levels of PM in the outdoor air presented greater ocular surface alterations. Thus, ST, SF, and SLG values could be used as convenient indicators of adverse health effects due to exposure to air pollution.
Highlights
Existing reports in the literature on the effects of air pollution on ocular health are limited to physiological symptoms or signs and/or alterations at a morphological level.[4]
In order to characterize ocular health in individuals exposed to different levels of air pollutants, as well as to identify the associations between effectors and symptoms, reports have indicated the use of various tests and/or questionnaires.[8, 9, 11, 12]
The ocular surface disease index (OSDI) evaluates ocular alterations based on the symptomatology declared by patients independent of their environmental conditions
Summary
The ocular surface comprises various structures in contact with the environment, namely the palpebral and bulbar conjunctival epithelium, corneoscleral limbus, corneal epithelium, and tear film, which provide anatomical, physiological, and immunological The ocular surface functions in generating good visual quality, nourishing and lubricating tissues, and protecting the eye against cellular debris and foreign particles.[2]. It can be affected by trauma, infections, or environmental factors, which may compromise the structural integrity of its components. This can lead to various forms of corneal and conjunctival dysfunction such as increasing order of severity, pain and itching,[3] mild corneal abrasion to severe loss of stem cells, decreased vision,[4] and blindness.[5]
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