Dry Eye Problems Research Articles

Navigating Dry Eye Research: A Comprehensive Review of Etiology, Clinical Trials, Patents, and Recent Advancements.

Millions of people worldwide suffer from dry eye disease. Dry eye, a multifunctional condition of the ocular surface, typically occurs in conjunction with an unbalanced tear film. With increasing age, the dry eye problem becomes worse. Aqueous-deficit dry eye and evaporative dry eye are the two traditional classifications for dry eye. Various examination tools are used to diagnose dry eye. Clinical trials are conducted in four phases to check the safety and efficacy of drugs. The quick clearance from the precorneal space is ensured by the eye's advanced defense mechanism. It restricts the integrated medicine's entry into the eyes, resulting in a usually low bioavailability for topical eyedrops. In this study, we focus on recently developed formulations for curing dry eye. This review's goal was to outline the etiology, clinical discovery and development, patents, and recent advancements for dry eye disease. The current study has described the widespread incidence of dry eye, which was found to be more common as people aged and recently developed formulations are treating dry eyes. According to research, novel formulations are enhancing ocular drug delivery. In this review, etiology, clinical data, dry eye formulation patents, and recent advancements are all included.

Dissociation Kinetics and Antimicrobial Activity of Ofloxacin Antibiotic in Artificial Tears Via 1H-NMR, Raman, and UV-Vis Spectroscopic Analysis.

Introduction: The hydrogen-bonded networks play a significant role in influencing several physicochemical properties of ofloxacin in artificial tears (ATs), including density, pH, viscosity, and self-diffusion coefficients. The activities of the ofloxacin antibiotic with Ats mixtures are not solely determined by their concentration but are also influenced by the strength of the hydrogen bonding network which highlight the importance of considering factors such as excessive tear production and dry eye conditions when formulating appropriate dosages of ofloxacin antibiotics for eye drops. Objectives: Investigating the physicochemical properties of ofloxacin-ATs mixtures, which serve as a model for understanding the impact of hydrogen bonding on the antimicrobial activity of ofloxacin antibiotic eye drops. Determine the antimicrobial activities of the ofloxacin-Ats mixture with different concentration of ofloxacin. Methods: The ofloxacin-ATs mixtures were analyzed using 1H-NMR, Raman, and UV-Vis spectroscopies, with variation of ofloxacin concentration to study its dissociation kinetics in ATs, mimicking its behavior in human eye tears. The investigation includes comprehensive analysis of 1H-NMR spectral data, self-diffusion coefficients, Raman spectroscopy, UV-Vis spectroscopy, liquid viscosity, and acidity, providing a comprehensive assessment of the physicochemical properties. Results: Analysis of NMR chemical shifts, linewidths, and self-diffusion coefficient curves reveals distinct patterns, with peaks or minima observed around 0.6 ofloxacin mole fraction dissociated in ATs, indicating a strong correlation with the hydrogen bonding network. Additionally, the pH data exhibits a similar trend to viscosity, suggesting an influence of the hydrogen bonding network on protonic ion concentrations. Antibacterial activity of the ofloxacin-ATs mixtures is evaluated through growth rate analysis against Salmonella typhimurium, considering varying concentrations with mole fractions of 0.1, 0.4, 0.6, 0.8, and 0.9. Conclusions: The antibiotic-ATs mixture with a mole fraction of 0.6 ofloxacin exhibited lower activity compared to mixtures with mole fractions of 0.1 and 0.4, despite its lower concentration. The activities of the mixtures are not solely dependent on concentration but are also influenced by the strength of the hydrogen bonding network. These findings emphasize the importance of considering tear over-secretion and dry eye problems when designing appropriate doses of ofloxacin antibiotics for eye drop formulations.

Prevalence of dry eye in postmenopausal women at a tertiary level hospital

BACKGROUND: Dry eye disease is a multifactorial ocular surface disease that causes symptoms of vague ocular pain, discomfort, grittiness, burning sensation, itching, and redness in the eyes. It is one of the most common disorders of the eye which is often underrecognized and can significantly affect the quality of life of patients. OBJECTIVES: The objective of this study is to assess how often postmenopausal women have dry eyes and to evaluate the relationship between dry eye disease and age in postmenopausal women. MATERIALS AND METHODS: During 3 months, postmenopausal women who attended the ophthalmology outpatient department at a tertiary level hospital participated in a hospital-based cross-sectional study. Four hundred postmenopausal women were conveniently selected as the sample. To identify the existence of dry eyes, Schirmer's test was performed. RESULTS: The study population's average age was 59.09 ± 8.46 years. In the research, the average age of menopause onset was 47.68 ± 2.67 years. Dry eye condition was found to be 39.75% prevalent. The vast majority of individuals with dry eye illness had moderate dry eyes (18.25%). Dry eyes became more common with age, which was statistically significant. CONCLUSION: The findings of the current study have shown that many postmenopausal women experience dry eye disease. The study emphasizes the value of routine eye examination for postmenopausal women to identify dry eye problems early, receive the proper treatment, and help these women improve their quality of life.

Face Mask in COVID-19 and Its Association With Dry Eye Disease: A Cross-Sectional Study.

To determine whether wearing a face mask for more than three to six hours/day leads to the new onset of symptoms or worsening of pre-existing dry eye disease (DED) in healthcare workers (HCWs) of our institute. An observational cross-sectional study, where 114 HCWs using face masks regularly participated voluntarily in the study. A survey with a modified Ocular Surface Disease Index (OSDI) questionnaire was completed by participants. They were divided into groups based on their sex, age, how long they had been wearing face masks, and whether they had a history of DED. We found that for HCWs who had previously experienced DED and who were under the age of 40, wearing a face mask for more than three to six hours/day could contribute to or worsen symptoms of DED. Also, we observed that the N-95mask has a higher chanceof causing DED than surgical masks. Medical professionals need to be aware of any potential dry eye symptoms related to the prolonged use of a face mask. Additional consideration should be given to patients who already have DED. The possible concerns that incorrectly fitted facemasks may cause to the health of their ocular surface should be discussed with patients by ophthalmologists. Future research involving larger populations will shed light on the prevalence and scope of the mask-associated dry eye problem.

Sodium Hyaluronate Eye Drops for College Students with Computer Vision Syndrome in Indonesia

Highlight: Computer vision syndrome (CVS) that causes dry eyes becomes a health problem for college students. Sodium hyaluronate eyedrops can be used as one of the CVS therapy strategies for students suffering from CVS. Abstract: The use of computers and mobile devices is increasing. Computers and mobile devices help our daily work or study. However, prolonged use of them may cause computer vision syndrome (CVS). Nowadays, CVS becomes a health problem for everyone working with computers or mobile devices including college students because it causes dry eyes. It may disrupt reading, doing professional work, or using a computer which is important for college students to complete academic tasks. Sodium hyaluronate can be used to overcome the dry eye problem due to CVS. To assess the effectiveness of sodium hyaluronate eyedrops on students suffering from CVS, pre- and post-administration of sodium hyaluronate was measured for two weeks. Inclusion criteria for this study were college students aged 20-35 years, using a computer for >2 hours a day, not using nonsteroidal anti-inflammatory drugs (NSAIDs), not consuming drugs, or having a disease that affects tear production and bearing no pregnancy. Parameters assessed include tear break-up time using the Tear Break-Up Time (TBUT) test, tear production using the Schirmer I test, the number of clinically subjective symptoms, and Ocular Surface Disease Index (OSDI) scores. Data were analyzed using student paired t-tests or Wilcoxon Rank Test. There were statistically significant differences before and after the TBUT (4.4 vs 6.7 seconds; p<0.0001); the Schirmer I Test (4 vs 6 mm; p<0.05), and the number of clinically subjective symptoms (3 vs 0 clinically subjective symptoms; p<0.0001). The OSDI scores did not show statistical differences before and after administration of sodium hyaluronate (27 vs 21; p>0.05), but there was a positive impact from moderate to mild dry eye. Sodium hyaluronate eyedrops can be used as one of the CVS therapy strategies for students suffering from CVS.

Self-moisturizing contact lens employing capillary flow

In spite of the great promise that contact lenses offer from vision correction to wearable sensing technologies, wearing contact lens often reported to result in dry eye problems and associated inflammation or corneal wound. To mitigate these health concerns, strategies to keep the lens moisturized by maintaining a tear film have currently been explored. Herein, we demonstrate the utility of the well-known capillary rise in microchannels embedded in the contact lens via soft-lithographic replication of a master structure manufactured by the 3D-additive manufacturing technique. The inherently considered drawback of the 3D printing technique, the staircase effect occurs during the layer-wise building of the master structure and produces microcapillaries in a replicated polydimethylsiloxane contact lens. These microcapillaries facilitate the capillary rise through the channels to maintain a moisturized contact lens. The capability of fabricating curved microchannels and polishing the optical zone results in a self-moisturized contact lens with high optical transmittance for the pupil region. The technique adopted here is free from the usage of any external driving sources and complicated nanostructure fabrication onto the biocompatible contact lens and thus offers the possibility of easy adoption with the existing fabrication techniques. • Self-Moisturizing contact lens employing capillary flow. • Self-moisturizing contact lens without involving hazardous materials or electronic components. • 3D printed mold for fabrication of microchannel embedded contact lens. • Exploiting staircase effect for creating the capillary array.

Prevalence and Risk Factors of Dry Eye Symptoms after Successful Dacryocystorhinostomy for Patients with Lacrimal Passage Obstruction

To investigate the prevalence of dry eye symptoms after successful dacryocystorhinostomy and explore the potential risk factors. This cross-sectional study included 565 patients with lacrimal passage obstruction (LPO) who underwent external dacryocystorhinostomy. Ocular Surface Disease Index (OSDI) total score of 13 or more was regarded as presence of dry eye symptoms. OSDI total score greater than 22 combined with self-reported dry eye was defined as symptomatic dry eye. Logistic regression and linear regression were used to examine the associations between OSDI scores and its potentially predictive factors. Of the 565 patients, 344 completed the questionnaire, among which 101(29.4%) patients presented with dry eye symptoms, including 53(15.4%) mild, 14(4.1%) moderate and 34(9.9%) severe, and 48(14.0%) patients can be defined as symptomatic dry eye. Univariate logistic regression revealed that age, educational levels, income levels, and hypertension were significantly correlated with the presence of dry eye symptoms (P < 0.05). After multivariate adjustment, lower income levels were found significantly associated with dry eye symptoms (P < 0.05). Univariate linear regression demonstrated that age, lower educational levels, surgery history, and hypertension were significantly associated with OSDI total score (P = 0.037, 0.012, 0.022, 0.029 respectively). Multivariate stepwise linear regression manifested that educational levels and the surgery history influenced the OSDI total score mostly (P = 0.021, 0.036 respectively). Dry eye problem of LPO patients after successful dacryocystorhinostomy cannot be ignored. In the preoperative evaluation, we should pay special attention to the elderly patients with lower educational levels, lower income levels or systemic diseases.

Prevalence of dry eye symptoms and risk factors in Saudi Arabia

Background: Dry eye is a multifactorial condition of the tears and ocular surface that causes discomfort, visual disruption, and tear film instability, as well as the risk for ocular surface injury. It is accompanied by an increase in the osmolality of the tear film as well as ocular surface inflammation. Dry eye is a prevalent ocular disease that leads to ophthalmologist appointments. The prevalence of the disease varies greatly between epidemiological studies, depending on how the sickness is characterised and diagnosed, as well as depending on the sector of the population surveyed. It is expected to be between 7.4% and 33.7 percent Methods: A descriptive cross-sectional survey was used targeting all groups of population in Aseer region. The study was conducted during 2021. Data was collected using structured questionnaire which included person’s socio-demographic data, and the OSDI (ocular surface disease index) combined with questions relevant to the target of our research ((the repetitive habitual/behavioral factors leading to Dry eye disease (DED)), and also using SAS-SV (smartphone addiction scale) in the context of users of smart phones. Results: Out of 2,527 total respondents, 694 (27.5%) have no issues related to eyes, while 1,833 (62.5%) have eye related issues. The mean (SD) of age was 29.4 (8.9) years. 67.0% were females while 33.0% were males. 22.9 % were exposed to air conditioners, 22.9% used contact lenses, 7.36 % used lubricant drops, while 6.3% live in a dry weather area. Conclusion: Dry eye illness is a prevalent ophthalmological condition with a number of clinical predictors, including the use of electronic devices and other risk factors. Teachers and health professionals should teach the students and nation about the awareness of dry eye problems. Key words: Dry eye, electronic devices, risk factors, diseases

Managing Chronic Health Needs in Child Care and Schools—Prader-Willi Syndrome (PWS)

Patient Education| 2021 Managing Chronic Health Needs in Child Care and Schools—Prader-Willi Syndrome (PWS) Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Managing Chronic Health Needs in Child Care and Schools—Prader-Willi Syndrome (PWS). Pediatric Patient Education 2021; 10.1542/ppe_document129 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All AAP SitesAll PublicationsPediatric Patient Education Search Advanced Search Subjects: Managing Chronic Health Needs in Child Care Prader-Willi syndrome (PWS) is a genetic condition that affects the brain and causes newborns and young infants to be weak and slow to gain weight but shifts to causing excessive hunger and weight gain in toddlers. It affects boys and girls equally. Prader-Willi syndrome occurs at 1 in 15,000 to 30,000 births. Children with PWS tend to be short and to have obesity, with characteristic facial features. Findings include short stature, incomplete sexual development, intellectual deficits, and behavioral issues. They have obsessive behavior toward foods, which can cause problems, including aggressive behavior and eating inappropriate foods. They can have sleep problems with and without having obesity. Developmental delays are common, including gross-motor and speech delays. Autism spectrum disorder is diagnosed in about 25% of the children. Dry mouth and eye problems can also be seen, as well as hip and spine... © 2019 American Academy of Pediatrics. All rights reserved. You do not currently have access to this content.

Face masks can lead to dry eye problems

Yiannis Kotoulas investigates advice for practitioners on the new phenomenon of mask-associated dry eye

Corneal degenerations in central India: Clinical profile and visual impact

Corneal degenerations in central India: Clinical profile and visual impact - IJCEO- Print ISSN No: - 2395-1443 Online ISSN No:- 2395-1451 Article DOI No:- 10.18231/j.ijceo.2019.115, Indian Journal of Clinical and Experimental Ophthalmology-Indian J Clin Exp Ophthalmol

Dry eye syndrome and cataract surgery

Introduction. Dry eye syndrome has become a common problem after ocular surgeries with a significant impact on the quality of life. Many patients, who have undergone cataract surgery, postop?eratively developed dry eye symptoms. Dry eye syndrome is one of the risk factors associated with cataract surgery. Material and Methods. The prospective study included 80 patients. We recorded the self-reported dry eye symptoms, the values of Schirmer test, tear breakup time, and best corrected visual acuity preoperatively, as well as 7 days and 1 month after the surgery. Results. A total of 80 patients were included in the study, 45 (56.2%) females and 35 (43.8%) males. The mean age of patients was 61.5 years (SD ? 6.2, range 57 - 70 years). The best corrected visual acuity at the time of surgery was 0.4 or less in 70 patients (87.5%). Most patients reported a significant improvement in visual acuity after surgery; 68 (85%) eyes achieved a best corrected visual acuity of 0.5 or higher (median 0.7; range 0.5 - 1.0). The mean tear breaking time in cata?ract patients before surgery was 12.4 sec, 7 days after the surgery it was 8.2 sec (p &lt; 0.05) and 1 moth after the surgery 11.1 sec. The majority of patients had mild (47.5%) and moderate (33.75%) Schirmer test values. Dry eye with wetting &lt; 5 mm after 5 minutes was found in 16.2% of patients before cataract surgery; 7 days after the surgery (p &lt; 0.05) it was found in 23.75% of patients and one month after surgery 11.1 sec. A foreign body sensation and watery eye were the most reported symptoms before cataract surgery. Seven days after the surgery foreign body sensation was present in 48.75% and watery eyes in 40% of patients. Conclusion. Significant increase in dry eye symptoms after cataract surgery was found with increasing age. Self reported dry eye problems are more common in patients with lower Schirmer test and best corrected visual acu?ity values before cataract surgery. Patients with concomitant dry eye disease require preoperative and postoperative treatment of dry eye to prevent aggravation of the existing symptoms that may affect the visual outcome after cataract surgery.

Prevalence and Risk Factors of Dry Eye Disease in Kuantan, Malaysia

Background: To determine the prevalence of dry eye disease (DED) at Jalan Hospital Eye Care, International Islamic University Malaysia (IIUM), Kuantan, Malaysia. Methods: The dry eye symptoms and tear breakup time test (TBUT) values retrieved from the medical records of 643 patients were retrospectively analysed. Dry eye cases with one or more symptom were included. ‘Yes’ or ‘no’ responses were used in discriminant analysis of tear abnormality (TBUT < 5 seconds). Results: The crude prevalence of DED was 48.5%, the age-adjusted prevalence was 43% in women <50 years of age, and 68.4% in those ≥50 years of age. Contact lens wear and low TBUT values were associated with DED risk in men. Age of ≥50 years and a low tear meniscus height (TMH) score were associated with risk of DED symptoms in women. Conclusions: The prevalence of DED in optometric outpatients at IIUM was relatively high, especially in the elderly population. Symptoms and signs were poorly associated with DED. TBUT performed well in diagnosing dry eye and may be useful to improve the assessment of patients with dry eye problems in this region.

Tear film secretion and stability in welders.

Welders are prone to ocular injuries and ocular surface problems due to exposure to ultraviolet light. The aim of this study was to evaluate the tear film comprehensively and assess objective and subjective indices of dry eye in welders. In this historical cohort, welders with at least 5 years of experience were compared with controls. A complete evaluation of ocular health was done for all participants. The Schirmer test (invasive and non-invasive) and Invasive Tear Break-Up Time (ITBUT) were applied for objective evaluation and the Ocular Surface Disease Index (OSDI) was used for subjective assessment of the tear film status. The results were compared between the two groups using the SPSS software. The results of 140 welders (mean age: 46.66 ± 13.01 years) and 172 controls (mean age: 45.05 ± 12.61) were analyzed. The values of the Schirmer test and ITBUT were significantly lower in welders than controls; the difference was more prominent for the Schirmer test as compared to TBUT (Schirmer difference = 4.98 mm, ITBUT difference = 2.23 s). OSDI values were also significantly lower in welders than controls (P < 0.001). Considering a cut-off point of 12, 81.2% of welders had degrees of dry eye which was severe in 46.2% while 35.5% of controls had dry eye. The results indicate that the percentage of dry eye and tear problems is far higher in welders than non-welders. Most of the affected welders have severe dry eye. It seems that the main reason for dry eye in these people is aqueous deficiency.

An experimental study on frosting and defrosting performances of a novel air source heat pump unit with a radiant-convective heating terminal

Abstract When the outdoor air temperature is low and relative humidity is high, frost will occur and accumulate on the outdoor coil of an ASHP unit, which may decrease the heating performances of the ASHP unit to a large degree. In addition, the defrosting performances of the commonly used defrosting method (reverse cycle defrosting) are poor due to the closed indoor air fan and insufficient energy stored in a conventional indoor coil. On the other hand, the conventional indoor coil based on forced convective heat transfer may cause strong draught sensation and dry eye problem and make users feel less comfortable than radiant heating terminals. Therefore, to improve the system defrosting performances and combine the merits of the conventional indoor coil and those of radiant heating terminals, a novel radiant-convective heating terminal was developed and integrated with an ASHP unit. The frosting and defrosting performances of the novel system were experimentally investigated, and the results showed that the average values of radiant panel surface temperature, outlet air temperature for the novel heating terminal, and system COP were 36.6 °C, 29.4 °C, and 2.78, respectively, during a 66-min frosting period (air temperature is 2.0 °C and relative humidity 84.0%). In addition, the ratio of the radiant heating capacity to natural convective heating capacity to forced convective heating capacity remained at around 1.5:1.0:7.4 during the whole frosting period. Furthermore, the experimental results demonstrated that the novel heating terminal could provide sufficient energy for the defrosting, and some energy could be provided for space heating through radiant and natural convective heat transfer during defrosting. The defrosting and resuming heating periods were 105 and 65 s, respectively.

An experimental study on a novel radiant-convective heating system based on air source heat pump

Air source heat pump (ASHP) has been widely applied to many parts of the world due to its simple structure and low initial cost. To save energy consumed for spacing heating and enhance the indoor t ...

Cambios en la película lagrimal con el uso simultáneo de lentes de contacto y tratamientos anticonceptivos hormonales

En la actualidad, cada vez más hombres y mujeres han empezado a utilizar métodos anticonceptivos con el fin de limitar el número de hijos que desean tener. Los anticonceptivos están compuestos por hormonas como la progestina y los estrógenos. El uso de estos produce cambios hormonales que repercuten sistémicamente en el cuerpo, lo que puede generar alteraciones oculares, específicamente en la película lagrimal (PL). Así mismo, la PL puede sufrir transformaciones en su estructura con el uso de lentes de contacto (LC). El objetivo de este artículo es dar a conocer a los profesionales de la salud visual los cambios en la PL con el uso simultáneo de LC y tratamientos anticonceptivos hormonales, con el fin de mejorar la práctica clínica, especialmente en la adaptación de LC. La investigación se desarrolló por medio de una revisión bibliográfica en la que se recopilaron y correlacionaron estudios, artículos y literatura en los que se analiza el tema. Como conclusión, se puede afirmar que las hormonas sexuales como los estrógenos, la progesterona, la prolactina y los andrógenos disminuyen la calidad de la PL. La alteración de las concentraciones hormonales y los LC producen cambios en los lípidos y las proteínas de las glándulas de Meibomio (GM), lo que hace que se generen problemas de ojo seco.

Comparison Between Botulinum Toxin A Injection and Lacrimal Punctal Plugs for the Control of Post-LASIK Dry Eye Manifestations: A Prospective Study.

IntroductionLaser in situ keratomelieusis (LASIK) is one of the commonest refractive procedures performed nowadays. The dry eye problem is nearly universal in all patients after LASIK and it can be so annoying that the post-operative patient satisfaction is sometimes precluded. Conventional treatment includes the use of artificial tears. Alternative methods such as punctal plugs and botulinum toxin injection can be used for the management of post-LASIK dry eye. The aim of this study is to compare botulinum toxin injection in the orbicularis muscle to lacrimal punctal plugs for the control of post-LASIK dry eye manifestations.MethodsThis is a prospective study that included 60 patients who had LASIK eye surgery for correction of refractive errors. Patients were randomly assigned to one of three methods of dry eye management; the first method was conventional medical treatment with preservative-free tear substitutes only (group A: 20 patients = 40 eyes); the second method was intraoperative injection of botulinum toxin A (BTA) in the orbicularis muscle below the lower punctum of both eyes (group B: 20 patients = 40 eyes) and the third method was intraoperative insertion of temporary extended duration silicone punctal plugs in the lower punctum of both eyes (group C: 20 patients = 40 eyes).ResultsIn the first follow-up visit after 2 weeks, the two test groups (B, C) showed a statistically significant increase in both tear film break up time (TBUT) and Schirmer test score with a decrease in the OSDI score and daily frequency of lubricants used in comparison to the control group A. These differences were maintained in the next follow-up visit but they became statistically insignificant at the 3rd and 6th post-operative months. Complications were encountered more in the punctal plug patients (60%) than in BTA patients (25%) and this difference was statistically significant.ConclusionThe use of BTA injection to control dry eye symptoms by inducing temporary punctal ectropion is an effective method to improve patient satisfaction after LASIK eye surgery. It has higher level of patient satisfaction and fewer complications in comparison to punctal plugs or topical standard dry eye treatment.

New Grading System and Treatment Guidelines for the Acute Ocular Manifestations of Stevens-Johnson Syndrome

To describe a new grading system and associated treatment guidelines for the acute ocular manifestations of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Prospective case series. Seventy-nine consecutive patients (158 eyes) evaluated and treated for acute ocular involvement in SJS or TEN during hospitalization. Photographic and chart review of acute ocular findings, interventions received, and outcomes with regard to visual acuity, dry eye symptoms, and scarring sequelae at least 3 months after the acute illness. Visual acuity, dry eye severity, and scarring of the ocular surface and eyelids were assessed after follow-up of at least 3 months. Cases graded as mild or moderate were managed medically. All had best-corrected visual acuity (BCVA) of 20/20, no dry eye symptoms, and no scarring sequelae. Cases graded as severe or extremely severe were treated with urgent amniotic membrane transplantation (AMT) in addition to medical management. Severe cases all had BCVA of 20/20 and mild or no dry eye problems. Five of 28 patients had mild tarsal conjunctival scarring. No other scarring sequelae occurred. Nine of the 10 extremely severe cases had BCVA of 20/20 (1 was 20/30). Three of 10 had moderate scarring of the tarsal conjunctiva and lid margins and also moderate dry eyes with severe photophobia. Seven of 10 had only mild or no dry eye symptoms and scarring sequelae. This grading system facilitates decision making in the evaluation and management of the acute ocular manifestations of SJS and TEN. Mild and moderate cases have a low risk of significant scarring or visual sequelae and may be monitored and treated medically if not worsening. Severe and extremely severe cases should receive urgent AMT to decrease the risk of scarring and visual sequelae.

Three-Year Longitudinal Survey Comparing Visual Satisfaction with LASIK and Contact Lenses

To assess patient satisfaction and perceived outcomes with different methods of refractive error correction through annual surveys administered over a 3-year period. Prospective, longitudinal, parallel-group, multicenter survey. A total of 1800 subjects, aged 18 to 60 years, who had LASIK or continued using contact lenses. Twenty sites across the United States enrolled subjects who completed a study-specific baseline survey during a contact lens examination or while being evaluated as a candidate for LASIK. Links to follow-up surveys were emailed annually for 3 years. Between-group differences were assessed by analysis of variance, and associations were assessed by logistic multivariate regression. Visual satisfaction. Of 1800 subjects, 694 (39%) comprised the control group who continued contact lens wear, 819 (45%) wore contacts at baseline and had LASIK, and 287 (16%) wore glasses at baseline and had LASIK. Most contact lens users had worn them successfully ≥5 years. The proportion expressing strong satisfaction with their current vision correction method decreased from 63% at baseline to 54% at year 3 in the contact lens control group, whereas 88% of former contact lens wearers and 77% of former glasses wearers were strongly satisfied with LASIK at year 3. Patients 40 years of age or younger when they had LASIK were somewhat more likely to be strongly satisfied than older patients. LASIK significantly reduced difficulties with night driving and nighttime visual disturbances among former contact lens users and former glasses users. The proportion with dry eye symptoms at 1, 2, or 3 years after LASIK was not significantly increased relative to baseline contact lens wear but was significantly increased relative to baseline glasses use, consistent with many glasses users having tried and abandoned contact lenses because of latent dry eye problems. Compared with continued contact lens wear, LASIK significantly reduced the self-reported rates of eye infections, ulcers, and abrasions each year. Compared with contact lens wear, current LASIK technology improved ease of night driving, did not significantly increase dry eye symptoms, and resulted in higher levels of satisfaction at 1, 2, and 3 years follow-up.