Artificial Tears Research Articles

Short-term changes in tear osmolarity after instillation of different osmolarity eye drops in patients with dry eye

This study investigated short-term changes in tear osmolarity of dry eye patients after using artificial tears containing sodium hyaluronate (SH) at different osmolarities. It comprised 80 patients with dry eye whose tear osmolarity measurement using the TearLab osmolarity system was 300 mOsm/L or greater. Patients who had external ocular disease, glaucoma, or other concomitant ocular pathology were excluded. After being randomly divided into four groups, the participants received different kinds of SH eye drops as follows: Groups 1–3 were given one of three concentrations (0.1%, 0.15%, and 0.3%) of isotonic drops, while Group 4 received 0.18% hypotonic SH eye drops. The tear osmolarity concentrations were evaluated at baseline and again at 1-, 5-, and 10-min after instillation of each eye drop. Tear osmolarity showed a significant decrease after instillation of four types of SH eye drops after up to 10 min compared to baseline. Patients who received hypotonic SH eye drops showed an enhanced decrease in tear osmolarity compared with the isotonic SH eye drops after 1 min (p < 0.001) and 5 min (p = 0.006), but the difference was not significant at 10 min (p = 0.836). The enhanced immediate effect of hypotonic SH eye drops at lowering tear osmolarity in patients with dry eye seems to be limited unless these drops were used frequently.

Shedding light on the viscoelastic behavior of artificial and human tears: A microrheological approach

This study conducts research on the viscoelastic properties of biological fluids, including both hyaluronic acid-containing lubricating eye drops and human tears, by means of passive microrheology. By tracking the Brownian motion of tracer particles of various sizes in the fluids, we were able to probe their viscoelastic properties. The results showed that the viscoelastic properties of artificial tears, such as Newtonian viscosity and relaxation time, scale to the concentration and macromolecular size of hyaluronic acid, resembling unentangled semidiluted solutions. Moreover, human tears were found to have a viscosity that is 50% greater than that of pure water, comparable to artificial tears containing 0.1% hyaluronic acid, but with a relaxation time one order of magnitude longer than ophthalmic solutions. This behavior was attributed to their intricate composition. The distinctive aspect of this study lies in demonstrating the feasibility of measuring the rheological properties of human tears, a biofluid of great interest, using extremely small sample volumes and microrheology, providing comprehensive information across a wide range of frequencies approaching those corresponding to blinking upon the application of the Cox–Merz rule. These findings are of significant value as they pave the way for future research on small volumes of tears from ophthalmic patients.

Optimal acupuncture protocol improving symptoms of typical dry eye syndrome: meta-analysis and systematic review

Previous meta-analyses have shown a superiority of acupuncture over artificial tear for treating typical dry eye syndrome (DES). However, given that the acupuncture protocols were quite diverse in the randomized controlled trials (RCTs) included in the meta-analyses, it is necessary to establish the acupuncture guidelines. Thus, the optimal acupuncture protocol involved in improvements of tear-film breakup time (BUT) or Schirmer tear test (STT) was examined by meta-analyses for RCTs in patients with typical DES. Eight databases until Jun 2018 were searched for 21 RCTs (n = 1542 eyes) comparing effectiveness of acupuncture versus artificial tear control. Indirect comparison of Bucher analysis was used to find specific acupoints (SAPs) improving BUT or STT by comparing the outcomes between subgroups of the RCTs including and excluding certain SAPs. Meta-analysis was examined for the outcomes in subgroups of the RCTs based on the number of SAPs, and network meta-analysis was for multiple pairwise comparisons across the protocols using the SAPs to yield relative effects. The Bucher analyses identified nine SAPs with positive effects on BUT or STT, and the positive relations of two SAPs involved in improvements of both BUT and STT suggested potential combinations of three (‘KI3–LI4–SP6’ or ‘KI3–GB14–ST2’) or four SAPs (‘KI3–BL1–EX-HN7–SP6’). Subgroup meta-analyses showed the SAP-depending improvements of BUT or STT in the subgroups including more than three SAPs, compared with the artificial tear control. Meta-regression and network meta-analyses revealed significant correlations between the number of SAPs and the improvements of BUT and STT, and demonstrated that acupuncture using four SAPs for 21–30 days, particularly at two–three times per week, can be optimal for improving the symptoms of typical DES. These results provide useful information for guiding acupuncture in clinical trials for DES.

Osteopathic manipulative treatment in improving symptoms and quality of life in patients with Graves’ ophthalmopathy: A case report

BackgroundGraves' Disease (GD) is an autoimmune disorder, with ∼50% of GD patients developing Graves’ Ophthalmopathy (GO). Common presentations include lid retraction, exophthalmos, disfigurement, ocular pain, and pressure. Treatment of GD depends on disease severity, ranging from artificial tears to ocular surgeries. Patients with GO symptoms experience a decreased quality of life (QoL) and could benefit from additional treatment options. ObjectiveThis case report describes the use of osteopathic manipulative treatment (OMT) as an adjunct to standard care for a patient with symptomatic GO, and measurement of treatment response with a standardized QoL assessment tool. Clinical featuresClinical evaluation of a patient with GO showed clinical activity score to be 4 with oppressive feeling behind globes, hyperemia, and eyelid edema. Corneal displacement measured by Hertel exophthalmometer indicated increased proptosis. CT scan showed enlarged extraocular muscles bilaterally, with signs of edema in retrobulbar fat. Visual acuity and optic nerves were within normal limits. Intervention and outcomesThis case report demonstrates the use of OMT in long-term reduction of ocular pain and pressure by relieving orbital myofascial tension along with improving ocular circulation, in a patient with GO. Using the European Group On Graves’ Orbitopathy QoL questionnaire, the patient noted better quality of life (93, 81.3 for pretreatment visual and appearance scores, respectively, and 100, 87.5 for post-treatment visual and appearance scores, respectively) and perceived reduced exophthalmos. ConclusionsProviding OMT as a cost effective, non-invasive treatment option for GO symptoms could meet a significant need for GO patients and warrants further study.

CASE REPORT DIAGNOSIS AND TREATMENT OF VERNAL KERATOCONJUNCTIVITIS

Background: Vernal keratoconjunctivitis (VKC) is a bilateral ocular allergic disease mediated by hypersensitivity reactions. VKC events occur in boys in the first decade of life and continue until puberty. Early identification and effective treatment are essential because the condition is recurrent and potentially burdensome to the patient's quality of life. This case report examines the diagnosis, management, and therapy options for patients with VKC and highlights the significance of the clinician's involvement in cases with VKC.Case Presentation: We report a case, a boy, 8 years old, came to the eye clinic at Cut Meutia Hospital with pain in both eyes, red eyes, decreased vision, and increased eye discharge. This complaint has been experienced for the past few years, and most appeared when the patient played under the sun or when the patient's allergy came. Examination showed mild conjunctival inflammation, pseudoptosis, and papillae on the limbus.Conclusion: The patient was diagnosed with VKC and received several treatments, including artificial tear and dexamethasone.

The Multifold Etiologies of Limbal Stem Cell Deficiency: A Comprehensive Review on the Etiologies and Additional Treatment Options for Limbal Stem Cell Deficiency.

Given the various ocular manifestations of limbal stem cell insufficiency, an awareness of the genetic, acquired, and immunological causes and associated additional treatments of limbal stem cell deficiency (LSCD) is essential for providers. We performed a comprehensive review of the literature on the various etiologies and specific therapies for LSCD. The resources utilized in this review included Medline (PubMed), Embase, and Google Scholar. All English-language articles and case reports published from November 1986 through to October 2022 were reviewed in this study. There were collectively 99 articles on these topics. No other exclusion criteria were applied. Depending on the etiology, ocular manifestations of limbal stem cell deficiency range from dry eye syndrome and redness to more severe outcomes, including corneal ulceration, ocular surface failure, and vision loss. Identifying the source of damage for LSCD is critical in the treatment process, given that therapy may extend beyond the scope of the standard protocol, including artificial tears, refractive surgery, and allogeneic stem cell transplants. This comprehensive review of the literature demonstrates the various genetic, acquired, and immunological causes of LSCD and the spectrum of supplemental therapies available.

Comparison of matrix metallopeptidase-9 expression following cyclosporine and diquafosol treatment in dry eye

Purpose We sought to evaluate the expression of matrix metalloproteinase-9 (MMP-9) in dry eyes treated with 0.05% cyclosporin A and 3.0% diquafosol tetrasodium. Methods One-hundred ninety-five eyes of 195 patients with dry eye were divided into three groups as follows: group 1, cyclosporin group (n = 69); group 2, diquafosol group (n = 59); and group 3, artificial tears eyes (n = 67). All eyes were treated and followed up for three months. Schirmer I Test, corneal staining, tear-film break-up time (TBUT), and tear-film MMP-9 content were measured at three months and compared between groups. The expression of MMP-9 was confirmed using a point-of-care test device (InflammaDry®; RPS Diagnostics, Sarasota, FL, USA) and graded as zero to four points. Results At the third month, MMP-9 expression was lower in group 1 as compared with in groups 2 and 3 (p = 0.020 and 0.006, respectively). The mean MMP-9 grade according to point-of-care testing was also lower in group 1 than in groups 2 or 3 (p = 0.002 and 0.038, respectively). MMP-9 showed a correlation with corneal staining in both groups 1 and 2 (all p < 0.001) and with Schirmer I Test and TBUT in group 1 (p = 0.018 and 0.015, respectively). Conclusions MMP-9 expression and grade were lower after treatment with cyclosporin than after treatment with diquafosol in the dry eye disease. Anti-inflammatory treatment can decrease ocular MMP-9 levels in dry eye disease.

Effects of artificial tears on keratocyte cell density after femtosecond laser in situ keratomileusis: a prospective, comparative, interventional, contralateral eye study

Background: Flap creation during laser refractive surgery restructures the anterior cornea, particularly the stroma, reducing the keratocyte cell density (KCD). This reduced density makes it challenging to completely regenerate to the presurgical phase. The aim of the present study was to investigate the effects of two types of artificial tear (AT) interventions on KCD up to 3 months after femtosecond laser-assisted in situ keratomileusis (FS-LASIK) surgery. Methods: This prospective, double-blind, comparative, interventional, contralateral eye study recruited patients with myopia scheduled for FS-LASIK. Inclusion criteria were healthy individuals aged 19 – 25 years with moderate or high myopia, a maximum cylindrical error of - 1.25 diopters, and a maximum pupil size of 6.5 mm who had undergone FS-LASIK and completed 3 months of follow-up. Complete optometric and ophthalmologic examinations were performed. Bilateral simultaneous FS-LASIK surgery was performed using the same femtosecond laser platform as in the standard procedure. The Research Randomizer was used to determine the eye to be treated with Systane® Hydration (Alcon Laboratories, Inc., Fort Worth, TX, USA) or Systane® ULTRA (Alcon Laboratories, Inc., Fort Worth, TX, USA) AT. KCD was examined using real-time images obtained from in vivo confocal microscopy (Heidelberg Retina Tomograph 3 with the Rostock Cornea Module, HRT III RCM); Heidelberg Engineering GmbH, Heidelberg, Germany) at baseline and 1- and 3-month postoperative visits. Results: We included 60 eyes of 30 participants with a mean (standard deviation) age of 21.34 (1.85) years and a male-to-female ratio of 1:1 who completed 3-month post-FS-LASIK surgery follow-up. KCD did not differ significantly between the two groups at any visit (all P &gt; 0.05); nevertheless, mean KCD was initially reduced up to 1 month postoperatively and then revealed a slight increase up to 3 months postoperatively in Systane® Hydration-treated eyes and continued to reduce in Systane® ULTRA-treated eyes. Intragroup comparisons revealed that the eyes treated with ATs experienced a significant reduction in KCD between the preoperative and 1-month postoperative visits and between the preoperative and 3-month postoperative visits (all P &lt; 0.05). Treatment-related complications were not observed. Conclusions: Overall, KCD reduced up to 3 months post-FS-LASIK surgery. Both AT types exerted a comparable effect on postoperative KCD up to 3 months. Future studies with a more frequent administration of ATs, longer follow-up periods, and a control group are required before preliminary outcomes of the present study can be generalized.

Mini-Review: Clinical Features and Management of Granular Corneal Dystrophy Type 2.

Granular corneal dystrophy type 2 (GCD2) is an autosomal dominant corneal stromal dystrophy that is caused by p.Arg124His mutation of transforming growth factor β induced (TGFBI) gene. It is characterized by well demarcated granular shaped opacities in central anterior stroma and as the disease progresses, extrusion of the deposits results in ocular pain due to corneal epithelial erosion. Also, diffuse corneal haze which appears late, causes decrease in visual acuity. The prevalence of GCD2 is high in East Asia including Korea. Homozygous patients show a severe phenotype from an early age, and the heterozygote phenotype varies among patients, depending on several types of compound heterozygous TGFBI mutations. In the initial stage, conservative treatments such as artificial tears, antibiotic eye drops, and bandage contact lenses are used to treat corneal erosion. Different surgical methods are used depending on the depth and extent of the stromal deposits. Phototherapeutic keratectomy removes anterior opacities and is advantageous in terms of its applicability and repeatability. For deeper lesions, deep anterior lamellar keratoplasty can be used as the endothelial layer is not always affected. Recurrence following these treatments are reported within a wide range of rates in different studies due to varying definition of recurrence and follow-up period. In patients who have undergone corneal laser vision-correction surgeries such as photorefractive keratectomy, LASEK, or LASIK including SMILE surgery, corneal opacity exacerbates rapidly with severe deterioration of visual acuity. Further investigations on new treatments of GCD2 are necessary.

Long-Term Activity and Safety of a Low-Dose Hydrocortisone Tear Substitute in Patients with Dry Eye Disease

Purpose A clinical trial was conducted to evaluate the activity of a new artificial tear containing hyaluronic acid (HA) and low-dose hydrocortisone to control dry-eye disease (DED) symptoms. Methods a randomized, controlled, double-masked study was carried out at the Ocular Surface and Dry Eye Center, “Luigi Sacco” University Hospital (Milan, Italy), between June 2020 and June 2021. The study involved patients with DED for at least 6 months. After an initial 7-day treatment with corticosteroid, the treatment with the new artificial tear (four-times a day for 6 months) was compared with a control HA solution. Results A total of 40 patients were considered. We observed a significant improvement in the frequency and intensity of DED symptoms in both groups. After corticosteroid discontinuation, the maintenance of the therapeutic advantage was observed only in the treatment group, which also showed a significant improvement of the tear film break-up time (p ≤ 0.05) and infiltrated macrophages (p < 0.05). A significant reduction in fluorescein and Lissamine staining (p < 0.05) was observed in the treatment group, suggesting damage reduction at both corneal and conjunctival levels. Intraocular pressure did not change at the end of the treatment period and was maintained within the normal range, sustaining the product’s safety. Conclusions Our findings support the prolonged use of the new eye drop with low-dose hydrocortisone, also in the DED initial stages, to prevent the degenerating towards a chronic condition (http://www.isrctn.com/ISRCTN16288419).

Artificial tears source of outbreak of extensively drug-resistant P. aeruginosa in the US

Artificial tears source of outbreak of extensively drug-resistant P. aeruginosa in the US

Development of occupational ophthalmology: from dry eye syndrome to artificial tears

Development of occupational ophthalmology: from dry eye syndrome to artificial tears

Phase 1/2 study of tusamitamab ravtansine in patients with advanced solid tumors: Pooled safety analysis of corneal adverse events.

e15003 Background: Tusamitamab ravtansine (tusa rav) is a novel antibody-drug conjugate (ADC) targeted to carcinoembryonic antigen-related cell adhesion molecule 5 (CEACAM5) and delivering DM4, a cytotoxic maytansinoid. CEACAM5 is highly expressed in several tumor types, including nonsquamous non-small cell lung cancer (NSQ NSCLC). An open-label, Phase 1/2, dose-escalation/expansion study (NCT02187848) in patients with advanced solid tumors found the maximum tolerated dose of tusa rav to be 100 mg/m2 every 2 weeks (Q2W) with a dose-limiting toxicity of microcystic keratopathy. Tusa rav had a favorable safety profile and, in patients with NSQ NSCLC with high CEACAM5 expression, promising antitumor activity. Methods: Here we evaluate pooled corneal safety results in patients (n = 186) who received tusa rav 100 mg/m2 Q2W, including cohorts of patients with NSQ NSCLC, colorectal, gastric, or small cell lung cancers. Patients who had history of corneal disorders, contraindications to ocular prophylactic drops, or were unable to stop contact lens use for the study were ineligible. Artificial tear use was encouraged during the study. Results: In patients treated with tusa rav 100 mg/m² (median treatment duration 8.7 weeks [range 2–154]), corneal treatment-emergent adverse events (TEAEs) were reported in 56/186 (30.1%), with the worst grade being Grade 1 as asymptomatic (n = 7), Grade 2 (n = 33), and Grade 3 (n = 16). No patients had Grade 4 (perforation or blindness) or serious corneal adverse events. The most frequent corneal TEAEs were keratitis and keratopathy in 22% and 11.8% (Grade 3 in 6.5% and 2.7%) of 186 patients, respectively. Occurrence of Grade ≥2 corneal events was significantly associated with tusa rav exposure in Q2W dosing (including dose-escalation ≤150 mg/m2). Most patients with corneal TEAEs had first occurrence within the first 4 cycles (45/56), including 16 in Cycle 2 and none in Cycle 1. At analysis cut-off, corneal TEAEs had resolved in 40/56 (71.4%) patients. The median recovery time was 20.5 days (range, 8–264). Of the 186 patients, corneal TEAEs led to cycle delay in 15.6%, cycle delay with dose reduction in 7.0%, and no treatment discontinuations. Corneal TEAEs recurred in 19/56 (33.9%) patients with a median time to recurrence of 16 days. Primary prophylaxis (ophthalmic vasoconstrictor, corticosteroid gel, and/or cold masks at infusion) in only the right eye in 107 patients did not show benefit (98% of the 55 events were bilateral), supporting use of secondary prophylaxis only as needed in subsequent patients. Conclusions: Corneal TEAEs observed in the study were nonserious and typically reversible; management with dose modification allowed continuation of treatment. These results support the ongoing clinical development of tusa rav. Further investigation of the mechanisms of corneal TEAEs with ADCs and their management is necessary. Clinical trial information: NCT02187848 .

Prevalence of Digital Eye Strain Among University Students and Its Association with Virtual Learning During the COVID-19 Pandemic.

The prolonged use of digital devices is a major risk factor for digital eye strain (DES) syndrome. To estimate the prevalence of DES symptoms among students at Imam Abdulrahman University who use digital devices for virtual learning and leisure activities. This was a retrospective cross-sectional study conducted by asking medical students of Imam Abdulrahman bin Faisal University to complete a self-administered online questionnaire. The questionnaire was used to determine the effect of the hours spent on digital devices and other factors, such as screen distance and not using artificial tears, on the development of DES. The severity (moderate or severe) and frequency (occasionally, always, or never) of 16 eye strain-related symptoms, including eye pain, headache, and itching, were evaluated by using the Computer Vision Syndrome Questionnaire. The overall prevalence of DES in the sample was found to be 68.53%. The largest proportion of students were found to have mild DES (43.20%), and only 11% had severe DES. The most common symptoms reported in our sample were headache, dryness, and burning. Female gender, using smartphones for online classes, and not using eye lubricants were significantly associated with increased severity of DES. In the wake of the COVID-19 pandemic, virtual learning has become an integral part of education, leading to increased use of digital technology. The aim of this study was to investigate the impact of virtual learning on eye strain and to determine the prevalence and effects of DES. A questionnaire was administered to participants, and the findings revealed a DES prevalence of 68.53%. The use of eye drops for lubrication and smartphones for classes was significantly associated with DES. Furthermore, females were found to be more susceptible to severe DES symptoms than males. The development of a tool such as the Computer Vision Syndrome Questionnaire to predict DES prevalence could reduce clinic time and resources by minimizing unnecessary follow-up and ophthalmology referrals.

Inhibitor Effects of Some Artificial Tears Drops on Human Carbonic Anhydrase Enzyme-II (hCA-II)

Carbonic anhydrases (CAs) are a metalloenzyme that contains zinc ions in their active sites, and they reversibly catalyze the reactions of hydration of CO2 and dehydration of HCO3-in the living. In this study, human carbonic anhydrase II (hCAII) isoenzyme was purified from human erythrocytes by affinity column (Sepharose 4B-L-tyrosine-sulfanilamide). The inhibitory effect of artificial tear drops on hCAII isoenzyme was investigated. IC50 values were calculated as 1.01 µL for sodium hyaluronate, 140.06 µL for polyvinyl alcohol+povidone, and 49.51 for polyethylene glycol+propylene glycol. The Ki value for sodium hyaluronate was found as 0.339±0.121 mM. According to these results, sodium hyaluronate was the most effective inhibitor in terms of application volume (microliter) among the three drugs examined.

Role of α-Crystallin protein-protein interactions in disorders of the system and its therapeutic approaches: a new study

α- Crystallin, a major eye lens protein with chaperone activity is vital in cataract development. As a member of the small heat shock protein superfamily, α-Crystallin is able to recognise and bind denatured or unfolded proteins, thereby preventing their aggregation. An important constituent of eye drops and artificial tears is polyethylene glycol-400(PEG-400) which can interact with α- Crystallin and lead to alterations in its tertiary structure, namely the global transition to a non-native form. Another protein, which is characterised by its presence in the insoluble fraction of vertebrate nuclear fiber cells, is Galectin-Related Interfiber Protein (GRIFIN) in the Ocular lens which is a novel binding partner of α-Crystallin. Formation of complexes involving such proteins may influence cell elongation and suture formation during lens development. The binding of PEG-400 or GRIFIN with α-Crystallin may serve as a rationale for the discovery of various therapeutic molecules used for the treatment of eye-related diseases involving crystallin proteins.

Topical nonsteroidal anti-inflammatory drugs in the prevention of pseudophakic cystoid macular edema following phacoemulsification: A systematic review

Introduction: The goal of surgeons to avoid Pseudophakic Cystoid Macular Edema (PCMO) has led to the widespread use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) after cataract surgery, although current research into the best anti-inflammatory drugs to avoid PCMO is still underway. This review aimed to determine the efficacy of topical NSAIDs in preventing PCMO following phacoemulsification. Methods: This systematic review was built on the recommended reporting items for systematic reviews and meta-analyses (PRISMA) and PICO criteria for papers during the previous 10 years. The keywords was searched by Boolean operator: “NSAIDs” AND “Prevention” AND “Cystoid Macular Edema” AND “Optical Coherence Tomography” AND “Phacoemulsification”. According to STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist, the quality of each chosen article was evaluated. Results: We have selected five articles of prospective cohort studies, which involved 756 patients whom received topical NSAIDs (Nepafenac 0.3%, Ketorolac Tromethamine 0.4%Nepafenac 0.1%, , and Diclofenac 0.1%) in treatment group and 700 patients received Placebo (Artificial tears) in control group. There was significant difference of central macular thickness based on OCT results between NSAIDs and control (placebo) group after uneventful phacoemulsification. Additionally, NSAIDs used as a preventative before phacoemulsification procedure exhibited a significantly reduced rise in central foveal thickness compared to placebo. There were changes of central macular thicknes postoperatively, and were significantly different from preoperative. Conclusion: It has been demonstrated that topical NSAIDs successfully lower the incidence of Pseudophakic Cystoid Macular Edema following phacoemulsification.

KIE how to use Corticosteroid and Vitamins to Patients after Cataract Surgery at KMU Madura

The main cause (50%) of blindness in Indonesia is cataracts, cataracts are one of the main health problems in the elderly, the only way to overcome blindness due to cataracts is to perform cataract surgery. Cataracts are a common disease that is often suffered by the elderly, cataracts themselves are characterized by cloudiness in the lens of the eye so that it blocks clear vision, based on national data from the 2014-2016 Ministry of Health's rapis assessment of avoidable blindness needs survey, with the target population being the age group Over 50 years it is known that the blindness rate reaches 3% and cataracts is the highest cause of blindness (81%), representatives and association of Indonesian ophthalmologists dr. Aldiana Halim said that in 2017 there were 8 million people with visual impairments. As many as 1.6 million blind people, plus 6.4 million people with moderate to severe visual impairment, of these, 81.2% of visual impairment is caused by cataracts, other causes are reflex and glaucoma or eye disorders related to diabetes. Corticosteroids are natural steroid hormones in humans which are produced by the adrenal cortex gland and function to treat inflammation or autoimmune disorders in the body. the function of this corticosteroid class of drugs is the same as the corticosteroid hormone produced by the body. After cataract surgery, the doctor gives several drugs to the patient to prevent post-surgical complications including infection (given antibiotics for prophylaxis), dry eye syndrome (given artificial tear drops) and to reduce pain (given anti-inflammatories). This community service aims to increase the knowledge of post-cataract surgery patients about how to use corticosteroid eye drops and how long to use corticosteroid eye drops.

Neurosensory abnormalities and stability of a mouse model of dry eye disease

This study aimed to use a mouse model of dry eye disease (DED) induced by topical administration of benzalkonium chloride (BAK) and assess its stability and the presence of neurosensory abnormalities, including ocular pain. Eight-week-old C57BL6/6 N male mice were used in this study. Mice were treated with 10 μL of 0.2% BAK dissolved in artificial tears (AT), administered twice daily for 7 days. After one week, animals were randomized into two groups: one was administered with 0.2% BAK in AT once per day for 7 days, while the other was not further treated. Corneal epitheliopathy was quantified at days 0, 3, 7, 12, and 14. Moreover, tear secretions, corneal nociception, and corneal nerve integrity were measured after BAK treatment. After sacrifice, corneas were dissected to assess nerve density and leukocyte infiltration by immunofluorescence. Topical BAK instillation for 14 days significantly increased corneal fluorescein staining (p < 0.0001) compared to day 0. On the other hand, interruption of BAK instillation was associated with improvement of corneal epitheliopathy (day 12, p < 0.0001; day 14, p < 0.001). BAK treatment increased ocular pain (p < 0.0001) and resulted in a significant increase in leukocyte infiltration in the cornea (p < 0.01). Moreover, corneal sensitivity was reduced (p < 0.0001), together with corneal nerve density (p < 0.0001) and tear secretion (p < 0.0001). One week twice a day, followed by one additional week once a day, of 0.2% BAK topical administration induces stable clinical and histological signs of DED, which is associated with neurosensory abnormalities, including pain.

Randomized Controlled Study of Cooled vs Room-Temperature Artificial Tears for Reducing Ocular Surface Irritation After Intravitreal Injection.

Purpose: To evaluate the efficacy of cooled vs room-temperature artificial tears in reducing ocular discomfort after intravitreal injections (IVIs). Methods: Patients receiving a standard intravitreal injection in the retina clinic who met the eligibility criteria and provided informed consented were enrolled in the study. Patients were randomized to the cooled tears or room-temperature tears intervention group. Both groups rated their ocular discomfort following IVI after cooled or room-temperature tears were administered. Results: The cooled group comprised 48 patients and the room-temperature group, 61 patients. There was no significant difference in the reduction of ocular discomfort between the cooled vs room-temperature artificial tears groups (P = .387). In addition, there was a similar level of reduction in ocular discomfort after either intervention (P = .681) regardless of whether or not the patients routinely used artificial tears after previous IVIs. Conclusions: Cooled tears provided no additional benefit in reducing ocular discomfort post-IVI compared with room-temperature tears. Baseline tear use after an IVI may have no true benefit other than a potential placebo effect, recall bias, or both.