TFOS lifestyle report: Effects of environmental conditions on the ocular surface

Abstract

This presentation summarizes the findings of the Environmental Conditions Subcommittee of the recent Workshop of the Tear Film & Ocular Surface Society, entitled “A Lifestyle Epidemic: Ocular Surface Disease” (www.tearfilm.org). The tear film and the ocular surface morphofunctional unit are directly exposed to the surrounding environment. Environmental factors with potential, probable or well‐established impact on the ocular surface health include: climate factors (temperature, humidity, windspeed, altitude, dew point, ultraviolet light), outdoor and indoor pollutants (gases, particulate matter, and airborne pollutants) and allergens. These factors interact each other in complex and concurrent ways, contributing to different specific ocular surface diseases, including dry eye, ocular allergies, conjunctival and corneal degenerative conditions, injuries, and neoplastic diseases. Age and sex, race/ethnicity, geographical area, and seasonality are some of the key elements playing a relevant role in environmental factors‐related ocular surface diseases.Throughout an extensive narrative review process, this report evaluated in detail the evidence about each of those environmental conditions and the associated ocular surface diseases. Distinct environmental conditions may increase risk and/or aggravate certain conditions and may contribute to specific diseases. Indeed, a systematic review, conducted to investigate the association between outdoor pollution and dry eye signs and symptoms, found evidence supporting the risk factor role of air pollution (from NO2 and CO, but not from PM10) and soil pollution (from chromium).