The Influence of Work Environment Factors on the OcularSurface in a One-Year Follow-Up Prospective Clinical Study.

Edyta Chlasta-Twardzik,Aleksandra Górecka-Nitoń,Edward Wylęgała,Anna Nowińska

doi:10.3390/diagnostics11030392

Edyta Chlasta-Twardzik, Aleksandra Górecka-Nitoń + Show 2 more

Open Access

https://doi.org/10.3390/diagnostics11030392

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Abstract

The purpose of this study was to assess the effect of environmental working conditions on the symptoms and signs of dry eye disease and to examine whether and how those conditions impact the ocular surface. Methods: This single-center, prospective clinical study with a 1-year follow-up included 150 patients. The following parameters were evaluated: non-invasive keratograph break-up time (NIKBUT), tear meniscus height (TMH), and conjunctival and limbal hyperemia. We also performed staining of the surface of the eye for simulated fluorescein images, Schirmer’s test I, assessment of Meibomian gland dysfunction (MGD), and an Ocular Surface Disease Index (OSDI) questionnaire. Results: In the OW (office workers) group, in people working >4 h at the computer, the NIKBUT before work and the Schirmer test results were statistically significantly lower than in people working <4 h. The conjunctival hyperemia result before work was statistically significantly higher for people working >4 h at a computer in both groups and after work in the MW (medical workers) group. Low relative air humidity in the building and air-conditioned rooms negatively affects the tear film, causing the symptoms of dry eye disease. At the 1-year follow-up, there was a statistically significant reduction in conjunctival and limbal hyperemia in the OW group as well as a statistically significant reduction in TMH at the first examination before and after work, and in the second examination after 1 year in both groups. Conclusions: Environmental factors such as reduced relative air humidity, increased air temperature, and decreased illumination have a negative impact on the ocular surface.

Highlights

Dry eye disease (DED) is a common ocular surface disorder
Some participants were excluded from the study after 1 year for the following reasons
The groups differed statistically significantly (p < 0.05) in terms of the severity of DED and the sum of the points obtained on the basis of the Ocular Surface Disease Index (OSDI) questionnaire

Summary

Introduction

Dry eye disease (DED) is a common ocular surface disorder. Its complexity was highlighted by the updated definition in the recent official report of the International Dry EyeWorkshop (DEWS 2017): “Dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles” [1]. In a recent clinical trial, Laihia et al demonstrated that disruption of hyperosmolar stress is indispensable for rescue processes on the ocular epithelia to begin. This can be achieved by supporting the stability of the tear film layers, normalizing its osmolarity and establishing continuous biophysical protection for the ocular surface [2]. Established risk factors that may influence the occurrence or intensification of DED have been reported in the literature. Those include environmental factors such as extreme temperature or reduced relative humidity [7,9]. Contact lens wear, use of video display terminals (VDT)

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