Eye Patch Research Articles

Types of Fibers used in Non Implantable Medical textile and their Applications

Medical textiles have become an emerging sector in the technical textile market. The medical industry is persistently achieving novel production practices to develop high quality products in a biodegradable and eco-friendly way. The key factors of medical textiles are non-toxic, biologically compatible, high strength, resistant to allergens and cancer, comfort, antifungal and antimicrobial performance. The recent development in medical textile had made the hardest and painful days of the sufferers to snug days. Non-implantable materials are used on external applications of the body. It may or may not be in contact with the skin .These materials are used in diverse field such as products for wound ease, adhesive bandages ,protective eye pads ,plasters, surgical gowns, padding material, orthopaedic support belts, bandages etc. This article discusses the significance of Fibers used in implantable medical textiles products and their applications.

8640 Thyroid Orbitopathy in Pregnancy

Abstract Disclosure: Z. Maisonet -Feliciano: None. M. Alvarado: None. L.A. Gonzalez-Rodriguez: None. M. Ramirez: None. L. El Musa Penna: None. J. Segarra-Villafane: None. I.C. Arroyo: None. W. Medina-Torres: None. L.R. Sepulveda-Garcia: None. Thyroid orbitopathy, often associated with Graves' disease, is characterized by the inflammation and swelling of ocular tissues. Its occurrence or exacerbation during pregnancy is infrequent, primarily due to the immunosuppressive state inherent in pregnancy. In most instances, the immunosuppression associated with pregnancy leads to a reduction in TRAb levels, although they continue to be present in women who have an active form of the disease. The course and severity of ocular manifestation do not always correlate with thyroid hormone levels. Strict control of thyroid function is crucial in patients with thyroid eye disease. This report sheds light on the rare occurrence of thyroid orbitopathy during pregnancy, a condition that complicates treatment due to potential risks to both the mother and the child. In this case, a 35-year-old pregnant woman with no prior history of thyroid issues exhibited symptoms of hyperthyroidism in her first trimester, including unintended weight loss, anxiety, and tremors in the upper limbs. She also presented with ocular discomfort, diplopia, and eyelid lag. Thyroid tests confirmed Graves Disease, with a significant elevation in Thyroid Stimulating Immunoglobulin (TSI): 243 %, Free thyroxine (T4): 1.08 ng/dl and Triiodothyronine (T3): >1.89 units and decreased Thyroid Stimulation Hormone (TSH): 0.001 uIU/ml. Ophthalmic examination revealed mild Graves orbitopathy due to bilateral exophthalmos (measured by Hertel’s exophthalmometer) 21mm on both sides, Marginal reflex distance (MDR) 1: right eye 9 mm and left 7mm. MDR 2: right eye 6mm and left eye 7mm. Right upper eyelid retraction, lagophthalmos of the right eye, limitation in the upward movement of the left eye, and vertical diplopia on extreme gazes without signs of orbital compression. Considering her normal FT4 levels and the mild nature of her hyperthyroidism, the decision was made to prioritize the mother's treatment while minimizing fetal risk, thus opting not to initiate antithyroid medication but to closely monitor her thyroid function. Symptomatic management of her orbitopathy was provided including lubricating eye drops and an eye patch. Throughout the progression of her pregnancy, her TSI levels exhibited a decreasing trend while FT4 remained within normal limits. Following delivery, there was a notable improvement in her ocular symptoms, and her TSH started increasing up to normal values of 1.29 uIU/ml and FT4 remained in range. This report underscores the importance of recognizing uncommon presentations of autoimmune thyroid conditions, such as thyroid orbitopathy, during pregnancy. It emphasizes the complexities and necessary considerations in treating these cases. A collaborative approach involving endocrinology, ophthalmology, and obstetrics is essential to safeguard the health of both the mother and the fetus. Presentation: 6/1/2024

Evidence-Based Strategies for Warm Compress Therapy in Meibomian Gland Dysfunction.

Despite promising results from technological therapies like intense pulsed light application, warm compress therapy is a mainstay in meibomian gland dysfunction (MGD). However, applying warm compresses (WC) to the eyelids is palliative rather than curative and not always dispensed with specific instructions. The range of eyelid warming treatments available and lack of clear directives for use creates uncertainty for patients accustomed to explicit dosage information. This report examines data from clinical studies across the past 20years to identify effective protocols for three types of WC-hot towel, microwavable eye mask, and self-heating eye mask (EM). Literature search for studies on WC and MGD published between 2004 and 2023 in English was conducted. Studies wherein hot towel, microwavable EM, and self-heating EM were used in a treatment arm were included and those wherein they served only as control or were used in conjunction with another intervention were excluded. 20 resulting studies were separated into 3 groups: 5 on temperature profiles of WC, 6 with single application of WC, and 9 with repeated applications. Study methods and outcomes were tabulated, and a qualitative review was performed, attending to WC protocol and efficacy, as indicated by measures of tear film, meibomian gland health, and dry eye questionnaires. Data from the aforementioned studies revealed that each method can achieve target eyelid temperature of 40°C. A single application of WC-ranging from 5 to 20min-can significantly improve tear quality, while repeated applications significantly relieve symptoms associated with dry eyes from MGD and, in most studies, significantly improve meibomian gland health. Hot towels, however, require frequent reheating to maintain eyelid temperatures above 40°C, rendering them relatively ineffective in longitudinal studies. Microwavable EM retain heat well across 10min and were found to improve tear break-up time and/or meibomian gland score. Self-heating EM have variable activation times and were typically applied for longer periods, showing benefits akin to microwavable EM in short-term studies. Studies monitoring compliance indicate greater deviation from protocol with higher application frequencies or longer-term use. Evidence suggests superior heat retention and therapeutic effects on specific contributing factors in MGD (such as Demodex) with moist-heat compress. Considering decreased patience adherence to therapy with increased usage frequencies, and balancing needs to provide succinct instructions for various compress types, an advisable strategy is for patients to apply a moist-heat generating EM (microwavable or self-heating) to each eye for at least 10min, prepared according to manufacturer's instructions.

AYURVEDIC MANAGEMENT OF PRE-MACULAR HAEMORRHAGE: A CASE STUDY

Pre-macular haemorrhage (PMH) is a condition characterized by bleeding between hyaloid and retina leading to visual impairment. Ayurveda offers extensive treatment protocols for managing such posterior segmental disorders. This case study presents the successful Ayurvedic management of PMH in a 54-year-old female patient who is a known hypertensive. The patient presented with a sudden onset of blurred vision in the right eye and black patches in the vision. After a thorough Ayurvedic assessment, a treatment plan including Netra kriyakalpas and panchakarma procedures was adopted along with oral medications. For one month, the patient experienced significant improvement in visual acuity, and the resolution of the haemorrhage was confirmed by ophthalmological examination and imaging studies. This case highlights the potential of Ayurveda as an effective approach to managing pre-macular haemorrhage.

Microcephaly with or without chorioretinopathy, lymphedema, or mental retardation (MCLMR)- the new lacunae: a case report

BackgroundMicrocephaly with or without chorioretinopathy, lymphedema, or mental retardation is a rare autosomal dominant disease caused by mutations in KIF11 which disrupt EG5 protein function, impacting the development and maintenance of retinal and lymphatic structures due to its expression in the retinal photoreceptor cilia. The primary ocular finding in MCLMR is chorioretinopathy. Additional features can include microphthalmia, angle-closure glaucoma, persistent hyperplastic primary vitreous, cataract, pseudo-coloboma, persistent hyaloid artery, and myopic or hypermetropic astigmatism. The appearance of the chorioretinal lesions as white to pinkish, round, non-elevated atrophic areas devoid of blood vessels resembles the lacunae in Aicardy syndrome. Due to the lack of systematic description of the lesions and significant phenotypical variability, there is an impending need for a detailed report of each case.Case presentationA child with microcephaly detected in the third trimester of gestation began her following in the ophthalmology department due to a non-visually significant cataract. Shortly after, she developed nystagmus and large-angle alternating esotropia with cross-fixation. Her fundus initially showed a pallid optic disc and pigmentary changes, developing thereafter retinal lacunae and a retinal fold. Her differential diagnosis accompanied the dynamic changes in her fundus, which included congenital infections, Leber´s Congenital Amaurosis and Aicardy syndrome. At 19 months old, genetic testing identified a heterozygous mutation (c.1159 C > T, p.Arg387*) in the KIF11 gene. The patient underwent bilateral medial rectus muscle recession surgery at 2 years old for persistent esotropia, with significant improvement. Refraction revealed a hyperopic astigmatism in both eyes (+ 0.25 -2.50 × 180 OD and + 0.75 -2.00 × 170 OS). She continues to require right eye patching for 2 hours daily.ConclusionsThis case report expands the phenotypic spectrum of MCLMR by demonstrating a unique combination of retinal features which sheds new light on differential diagnosis from Aicardy syndrome. Our findings emphasize the significant phenotypic variability associated with MCLMR, particularly regarding ocular involvement. This underscores the importance of detailed clinical evaluation and comprehensive reporting of cases to improve our understanding of the disease spectrum and genotype-phenotype correlations.

Effectiveness of an Acupuncture Steam-Warming Eye Mask on Dry Eye Disease in Visual Display Terminal Users: A Prospective Randomized Controlled Trial.

We aim to evaluate the effectiveness of an acupuncture steam-warming eye mask (ASEM) on dry eye disease (DED) in visual display terminal (VDT) users. This prospective randomized clinical trial included VDT users with DED-related features who were randomly assigned to the ASEM group (ASEM for 2 weeks, 20 participants) or the steam-warming eye mask (SEM) group (SEM for 2 weeks, 20 participants). The tear film break-up time (TBUT), Schirmer test, tear meniscus height, ocular surface staining scores, eyelid and meibomian gland exam, subjective symptoms, and quality of life (QoL) scores before and after treatment were collected. A generalized linear mixed model was applied to compare the improvement of symptoms and signs between the two groups. After the 2-week treatment, all the subjective symptoms and questionnaire scores in the ASEM group improved significantly (all p < 0.05), whereas the feelings of relaxation, comfortable, and refreshment did not change in the SEM group (both p > 0.05). The TBUT, tear meniscus height, and meibum quality in the lower eyelid were significantly better in the ASEM group than the SEM group (all p < 0.05), whereas no significant changes were observed in the Schirmer test and ocular surface staining scores. Compared with the SEM group, the ASEM group experienced a stronger feeling of refreshment (p = 0.013), lower sensation of ocular discharge (p = 0.031), higher TBUT (p = 0.045), better meibomian gland expressibility of both eyelids (both p < 0.05), and better meibum quality of both eyelids (both p < 0.05), even after adjustments for age and sex. In conclusion, comparing with SEM, ASEM can improve some subjective DED symptoms, tear film stability, and meibum status in VDT users.

Strength and targeted-sustained release properties of sodium alginate-polyacrylamide hydrogel for anti-wrinkle eye-patch

The creation of a reliable eye wrinkle solution is essential to meet consumer needs and enhance their quality of life. Researchers devised hydrogels using sodium alginate (SA) and polyacrylamide (PAM), known for their high stretchability and compressive abilities. Acetyl hexapeptide-8 (AH8) is a safe anti-wrinkle ingredient, was incorporated via β-cyclodextrin microencapsulation to ensure minimal side effects. The study conducted transdermal absorption as well with FT-IR experiments and revealed that covalent bonds conferred toughness and ductility, while hydrogen bonds facilitated slow and sustained release. The porous structure of the hybrid gel observed by SEM (average pore size of 430.7 ± 52.2 μm), porosity(60.33 ± 19.95) and swelling rate(525.82 ± 134.29 %) all indicated excellent water retention and drug delivery capabilities. Remarkably, acetyl hexapeptide-8 was first encapsulated in β-cyclodextrin microcapsules as the active anti-wrinkle substance in the study, exhibited pH sensitivity. This research aims to develop a novel anti-wrinkle eye patch using SA-PAM double-network hydrogel and expect to present promising avenues for enhancing mechanical properties and developing medical beauty products suitable for consumers with sensitive skin.

The central and peripheral corneal response to short-term hypoxia.

To quantify the magnitude and recovery of central and limbal corneal oedema induced by short-term unilateral eyelid closure without contact lens wear. The left eye of 10 adults with healthy corneas was patched using a folded eye pad for 30 min. High-resolution optical coherence tomography images (which captured the limbal and central corneal regions simultaneously) were obtained before patching, immediately after eye opening and again at 1, 2, 5, 6, 9, 10, 14 and 15 mins after eyelid opening. Oedema was measured from the limbus (scleral spur) to the central cornea (thinnest corneal location) along the horizontal meridian. A greater amount of limbal oedema was noted (mean [SD] 3.84 [1.79] %) compared to the central cornea (2.48 [0.61] %; p = 0.04) after 30 mins of unilateral eyelid closure. Both central and limbal corneal oedema recovered rapidly following eyelid opening, with no significant differences in the rate of corneal recovery between corneal locations (p = 0.90). Short-term unilateral eyelid closure resulted in ~55% more relative oedema in the limbal region compared to the central cornea. Rapid recovery of oedema and corneal overshoot (thinning beyond the baseline corneal thickness) was observed within 1-2 min of eyelid opening for both central and peripheral regions.

Acute abducens nerve palsy following coronavirus disease 2019 vaccination: a case report

BackgroundAbducens nerve palsy is the most common isolated ocular cranial nerve palsy. In adults, nontraumatic etiologies of isolated sixth cranial nerve palsy can include vascular disease, inflammation, tumors, and a prior history of infection.Case presentationWe present a case of a 52-year-old Asian male who developed acute abducens nerve palsy after vaccination with the AstraZeneca coronavirus disease 2019 vaccine. A complete workup including magnetic resonance imaging of the brain and orbits revealed no abnormalities. The patient experienced a gradual recovery over 10 weeks through alternative eye patching. The abducens nerve palsy is postulated to be correlated with the coronavirus disease 2019 vaccine.ConclusionDespite the recognized efficacy and cost benefits of coronavirus disease 2019 vaccines, clinicians should be aware of the possible association between cranial nerve palsies and coronavirus disease 2019 vaccines.

Wearable, Biocompatible, and Dual-Emission Ocular Multisensor Patch for Continuous Profiling of Fluoroquinolone Antibiotics in Tears.

The abuse or misuse of antibiotics in clinical and agricultural settings severely endangers human health and ecosystems, which has raised profound concerns for public health worldwide. Trace detection and reliable discrimination of commonly used fluoroquinolone (FQ) antibiotics and their analogues have consequently become urgent to guide the rational use of antibiotic medicines and deliver efficient treatments for associated diseases. Herein, we report a wearable eye patch integrated with a quadruplex nanosensor chip for noninvasive detection and discrimination of primary FQ antibiotics in tears during routine eyedrop treatment. A set of dual-mode fluorescent nanoprobes of red- or green-emitting CdTe quantum dots integrated with lanthanide ions and a sensitizer, adenosine monophosphate, were constructed to provide an enhanced fluorescence up to 45-fold and nanomolar sensitivity toward major FQs owing to the aggregation-regulated antenna effect. The aggregation-driven, CdTe-Ln(III)-based microfluidic sensor chip is highly specific to FQ antibiotics against other non-FQ counterparts or biomolecular interfering species and is able to accurately discriminate nine types of FQ or non-FQ eyedrop suspensions using linear discriminant analysis. The prototyped wearable sensing detector has proven to be biocompatible and nontoxic to human tissues, which integrates the entire optical imaging modules into a miniaturized, smartphone-based platform for field use and reduces the overall assay time to ∼5 min. The practicability of the wearable eye patch was demonstrated through accurate quantification of antibiotics in a bactericidal event and the continuous profiling of FQ residues in tears after using a typical prescription antibiotic eyedrop. This technology provides a useful supplement to the toolbox for on-site and real-time examination and regulation of inappropriate daily drug use that might potentially lead to long-term antibiotic abuse and has great implications in advancing personal healthcare techniques for the regulation of daily medication therapy.

Effectiveness of Earplugs and Eye Masks on Sleep Quality and Fatigue Among Nonventilated Patients in an Intensive Care Unit.

Sleep is a basic physiological need and is imperative for healing and rejuvenation. However, the environment of the intensive care unit (ICU), including loud sounds and bright lights, can undermine patients' sleep quality. This study was designed to determine the effectiveness of overnight use of earplugs and eye masks to improve sleep quality and potentially influence hemodynamic parameters and mitigate fatigue among nonventilated patients in an ICU. This experimental study was conducted among 84 nonventilated patients in an ICU. The patients were evenly divided between an intervention group (n=42) and a control group (n=42). The intervention group patients received earplugs and eye masks for three consecutive nights from 10:30 pm to 6:30 am, while the control group patients received routine care. Clinical data, responses to the Richards-Campbell sleep questionnaire, and rankings on a numerical fatigue scale were collected before (pretest) and after the intervention each night and the next morning (posttests 1, 2, and 3). The results revealed a significant reduction in fatigue. At pretest, fatigue scores in the study group were 4.19±1.64. The score was significantly reduced to 3.40±1.39 at posttest 1 and then to 2.21±1.00 at posttest 3 (p<0.0001). The sleep quality for the study group showed a significant improvement from the pretest score of 43.73±8.27 to 60.35±6.85 at posttest 3 (p<0.001), whereas the control group had slightly worse sleep quality, with 40.64±8.67 at pretest and 45.63±6.95 at posttest 3. Continuous patient monitoring is an essential nursing care activity in ICUs while ensuring good-quality sleep promotes healing and reduces fatigue. Sleep quality can be supported by devices such as earplugs and eye masks to limit undue disturbances in the ICU settings.

Nurse-led counselling programme on the adherence to eye patch application among children with amblyopia: a randomised control trial

ObjectiveTo assess the impact of the nurse-led counselling programme on eye patch application for improvement of adherence to eye patch application and vision among children with amblyopia.Material and methodsA randomised...

Impact of patching treatment on quality of life among children with amblyopia in Gaza Strip, Palestine

Background: Eye patching treatment affects the health-related quality of life of children with amblyopia. However, the extent of this effect in Gazan children with amblyopia remains unknown. This study evaluated the effect of patching on the health-related quality of life in Gazan children with unilateral or bilateral refractive amblyopia. Methods: This cross-sectional study was conducted at Gaza Ophthalmic Hospital, Gaza Strip, Palestine, from September 2019 to October 2020 with adherence to the standard operating procedures of the coronavirus pandemic. Children with refractive amblyopia who completed patching therapy with a successful outcome were recruited. After patching therapy was completed, the parents completed an 18-item parental Amblyopia Treatment Index (ATI) questionnaire via telephone. Results: Twenty-four children having 36 eyes with refractive amblyopia and a mean (standard deviation) age of 7.6 (1.8) years were included. Children underwent 2 h or 2–6 h of daily patching for 12 or 17 weeks. The mean values for total ATI score, adverse effects subscale, difficulty with compliance subscale, and social stigma subscale were 2.6, 2.6, 2.7, and 2.9, respectively, indicating that part-time patching was mostly accepted and had less impact on health-related quality of life. Treatment compliance was high; children complained at the time of patch application but did not pay attention to the patch once it was in place. In most children, the patch caused no adverse effects related to physical activities such as fun activities, learning, writing or drawing, visualizing, or playing with toys. Social stigma due to patch complications or different perceptions was not a concern. However, the perceptions of others were a major concern (n = 19, 79.2%). No significant association was found between the overall ATI score or the score of any of the subscales (adverse effects, difficulty with compliance subscale, or social stigma) and the child’s age, sex, number of lines improved in visual acuity of the amblyopic eye, severity of amblyopia, laterality, or treatment period (all P &gt; 0.05). Conclusions: The ATI questionnaire score and its three subscales revealed that the quality of life among Gazan children with refractive amblyopia was less affected by the part-time patching treatment. In the future, the ATI questionnaire could be used with various treatment modalities and types of amblyopia in the same setting to provide more practical guidelines on the management of amblyopia.

Presumed macular toxicity of high-dose intravitreal ganciclovir

Abstract: A 56-year-old male with bilateral cytomegalovirus retinitis was initiated on oral valganciclovir and intravitreal ganciclovir injection twice a week in first 2 weeks and once a week in subsequent weeks. An intravitreal dose of 2 mg/0.08 mL was administered in the 1st week. Considering the suboptimal response, the dose of intravitreal ganciclovir was increased to 4 mg/0.08 mL. After 4 weeks of therapy (four doses of 4-mg ganciclovir), the patient complained of worsening of vision. Fundus examination showed resolving retinitis, but the optical coherence tomography (OCT) showed neurosensory detachment (NSD) at the fovea in both eyes with inner retinal hyperreflectivity in the right eye. Considering the possibility of retinitis involving fovea, a higher dose of intravitreal ganciclovir (6 mg/0.08 mL) was administered. The patient reported further worsening of vision immediately after removing the eye patch 2 hr following the injection. OCT showed a full-thickness hyperreflective vertical band with ellipsoid zone disruption at the fovea and inner retinal hyperreflectivity in the right eye. Hyperreflective vertical band with NSD was seen in the left eye. A possibility of macular toxicity due to intravitreal ganciclovir was considered. Intravitreal therapy was stopped and oral valganciclovir was continued. At 1-month follow-up, the patient reported improvement in vision. The hyperreflectivity and NSD were resolved at month follow-up. Although higher doses of ganciclovir up to 6 mg have been used in the past, it would be better to avoid higher doses considering the development of presumed drug toxicity in our case following the use of 4 mg and 6 mg.

Effectiveness of the smartphone application in increasing compliance with occlusion therapy in children with amblyopia: a randomized controlled trial

ABSTRACT Aim: To determine the effectiveness of the Amblyopia Treatment Chulalongkorn University (ATCU) application in improving compliance to occlusion therapy in amblyopic children. Methods: We developed a smartphone application called Amblyopia Treatment Chulalongkorn University (ATCU), which includes education, patching calendar, mini-games, and notifications, offering caregivers a comprehensive tool to enhance amblyopia treatment adherence through informative content, interactive features, and personalized reminders. Children aged 4–12 years with strabismic, anisometropic, deprivation, or mixed-type amblyopia were recruited and randomly assigned to either use ATCU application to facilitate eye patching (group A) or receive standard care (group B). Compliance with eye patching (primary outcome) was measured as a percentage of actual patching hours which were subjectively reported by caregivers, compared to prescribed patching hours, assessed at 1 and 3-month follow-up. Secondary outcomes include best corrected visual acuity (BCVA). Results: Between October 2018 and December 2019, 45 children were enrolled in our study, with all meeting eligibility criteria. One participant was lost to follow-up, and only one child was newly diagnosed with amblyopia, while the others had undergone patching as a prior treatment. At 1-month, compliance was significantly higher in group A (85%) than in group B (64%) [median difference 22% (95% CI, 3 to 48; p = .037)]. At 3-months, the compliance was also higher in group A (80%) than group B (55%), but not significantly [median difference 13% (95% CI, −6 to 30; p = .096)]. BCVA improvement in group A was higher than group B at both follow-up periods [mean difference 0.04 logMAR (95% CI, 0.01 to 0.07; p = .025) at 1-month and 0.04 logMAR (95% CI, 0.01 to 0.08; p = .022) at 3-month follow-up]. Conclusion: The ATCU application significantly improved compliance with occlusion therapy at 1-month. This application may be helpful as an adjunctive tool in the treatment of amblyopia.

A Smart Flexible Sleep-Aid Eye Mask Based on Acupoint Electric Pulse Stimulation Combined Bioelectrical Signal Feedback

A Smart Flexible Sleep-Aid Eye Mask Based on Acupoint Electric Pulse Stimulation Combined Bioelectrical Signal Feedback

QUALITY OF LIFE PERSPECTIVE CORRELATION IN CHILDREN UNDERGOING AMBLYOPIA OCCLUSION THERAPY AND THEIR PARENTS AS PROXY

Abstract&#x0D; Introduction &amp; Objectives : One of the main therapies used to treat amblyopia in the dominant eye is occlusion therapy. When used on the dominant eye during activities, eye patches can lead to quality of life issues include visual, cosmetic, and psychosocial disorders. To improve visual acuity in the suppressed eye and stop a progressive loss of visual acuity, therapy must be followed. An important factor affecting a child's compliance with occlusion therapy is parental support. Parental negativity affects children's level of support, and as a result, a decreased compliance. This research aimed to determine the relationship between quality of life and the perspectives of parents and children receiving occlusion therapy.&#x0D; Methods : This is a correlation study with a cross-sectional design. Fifty-one subjects were addressed in the amblyopia children's group and fifty-one subjects in the parents’ group. Every participant was directly interviewed. Correlation analysis was used to assess the relationship between the results of interviews with children and their parents.&#x0D; Results : There is a decrease in the quality of life in children undergoing therapy, both from the perspective of the child and their parents. The decline in the quality of life that occurs in children is not as low as parents think. The results of the questionnaires for the children and their parents in total demonstrated a significant correlation (p = 0.0001) and a moderately positive correlation (R = 0.598).&#x0D; Conclusion : There is a positive correlation between children and parents in assessing the quality of life due to occlusion therapy.

Efficacy of 2% Hydroxypropyl Methylcellulose and Bandage Contact Lens for the Management of Dry Eye Disease after Cataract Surgery

Objectives. To investigate the effect of 2% hydroxypropyl methylcellulose (HPMC) and bandage contact lens (BCL) on dry eye disease after cataract surgery. Methods. This prospective randomized controlled trial included 63 eyes which were divided into the balanced salt solution (BSS), HPMC, BCL, and combined HPMC and BCL (H&amp;B) groups. The Ocular Surface Disease Index (OSDI), tear meniscus height (TMH), and average tear break-up time were measured before cataract surgery and 30 days postoperatively. Differences in corneal nerve fiber (CNF) and dendritic cell (DC) density in various directions were evaluated and compared. The CNFs and DCs in central and infratemporal directions were observed using in vivo confocal microscopy. Data were evaluated using the Kruskal–Wallis rank-sum test and analysis of variance. Results. The differences in variations in OSDI and TMH after cataract surgery between the four groups were statistically significant (P&lt;0.05). The postoperative OSDI of the HPMC group decreased compared with their preoperative OSDI. A statistically significant difference in the variations of OSDI score was observed between the HPMC and other groups (P&lt;0.05). The postoperative variations in TMH in the HPMC group were significantly higher than those observed preoperatively and significantly differed between HPMC and BCL groups and between BCL and H&amp;B groups (P&lt;0.05). Postoperatively, the density of corneal DCs decreased in BSS and HPMC groups and increased in BCL and H&amp;B groups (P&lt;0.001). Conclusions. The application of 2% HPMC in cataract surgery has a certain effect on managing dry eye after cataract surgery. Although the use of BCLs after cataract surgery has some benefits, it may cause mild ocular surface inflammation. Nevertheless, using 2% HPMC with BCLs in the perioperative phase of cataract surgery can alleviate the subjective discomfort of patients and can safely and effectively replace eye patch after cataract surgery.

Efficiency of Combining Heated Eye Mask with Intense Pulsed Light Therapy as a Treatment Option for Evaporative Dry Eye Disease.

Background and objectives: The study aimed to establish the efficiency of combining the Posiforlid heated eye mask with intense pulsed light therapy (IPL), as a treatment strategy for evaporative dry eye disease. Materials and methods: This study included 110 patients, respectively 220 eyes, diagnosed with evaporative dry eye disease, patients between 18 and 86 years old, divided into two study groups. The first one, the control group, consisted of 73 patients treated with IPL therapy, and the second of 37 patients, who underwent IPL therapy associated with Posiforlid heated eye mask. Subjective evolution was assessed using an eye fitness test (EFT) regarding symptomatology. Objective assessment of the ocular surface was performed by tear film stability evaluation (TFSE), non-invasive first break-up time (NIFBUT), non-invasive average breakup time (NIABUT), ocular surface inflammatory evaluation (OSIE), measuring of the central tear meniscus height (CTMH) and thinnest tear meniscus height (TTMH). The assessment was performed at the beginning of the IPL treatment, during the IPL sessions, at the end of the IPL treatment, and afterward, at 3, 6, and 12 months. Results: Tear film stability has increased in both study cases, but no statistically significant difference was observed between the two groups studied. For the control group, tear film stability evaluation (TFSE) started from 310.56 ± 389.54 at baseline (time 1 presentation) to 114.40 ± 122.90 after 12 months, and for the heated mask group, from 391.11 ± 456.45 (time 1 presentation) to 97.38 ± 105.98 after 12 months. NIABUT increased from 10.72 ± 4.90 seconds to 14.79 ± 3.72 seconds in the control group, and from 11.11 ± 5.08 seconds to 15.84 ± 2.26 seconds in the second group. OSIE decreased, as expected, from 7.18 ± 7.93 percent in the control group to 2.24 ± 2.38 percent after 12 months and from 7.42 ± 7.77 percent to 2.47 ± 2.50 percent in the Posiforlid group. Although significantly lower, there was no significant difference between the two studied groups. No statistically significant changes were registered in the studied quantitative parameters. Using the EFT test, great improvements were registered regarding symptomatology, with a score increasing from 29.99 ± 8.60 to 39.10 ± 5.08 in the control group and from 27.35 ± 9.24 to 38.35 ± 4.62 in the other group. Again, the same statistical result was registered on this variable. Conclusions: The improvement of tear film stability, ocular surface inflammatory condition, and subjective symptoms during IPL therapy sessions and the first year of observation after the completion of the treatment was not necessarily increased by the additional use of a heated eye mask. Abbreviations: IPL = intense pulsed light therapy, EFT = eye fitness test, NIFBUT = non-invasive first break-up time, NIABUT = non-invasive average break-up time, OSIE = ocular surface inflammatory evaluation, TFSE = tear film stability evaluation, CTMH = central tear meniscus height, TTMH = thinnest tear meniscus height, DED = dry eye disease, MGD = meibomian gland dysfunction, SD = standard deviation.

Effect of Eye Masks and Ear Plugs on Quality of Sleep of Patients in Intensive Care Unit

Sleep has physiologic importance and adequate sleep is necessary for the maintenance of good health and well-being of all patients especially the critically ill. The study aimed to test the effect of eye masks and ear plugs on the quality of sleep among patients admitted to Intensive Care Units (ICU) and to identify the factors affecting the quality of sleep in ICU. An experimental cross-over design was adopted. Fourty subjects were selected using consecutive sampling from the Cardiac ICU, Neuro ICU, and Surgical ICU of the hospital. The tools used were the Richard Campbell Sleep Questionnaire (RCSQ) to assess the quality of sleep and the Visual Analogue Scale to measure factors causing sleep disturbance in the ICU. Results showed that eye mask and ear plug were effective in improving sleep among patients in ICU. While sleeping without interventions all of the subjects in ICU reported poor sleep. After using the eye mask and ear plugs 27.5 percent of subjects reported very good sleep 65 percent of subjects reported good sleep and only 7.5 percent had poor sleep. The mean score and standard deviation of quality of sleep of patients in ICU increased from 17.90 ±3.90 to 36.87±4.09 while sleeping with eye mask and ear plugs. This increase was significant at a 0.05 level of significance with a p value of 0.000. Eye masks and ear plugs were effective in improving sleep among patients in ICU. The most important factor affecting the quality of sleep of patients in ICU was light followed by anxiety, pain and alarms. The study concluded that Intensive care nurses have to use eye mask and ear plug for ICU patients to promote sleep which will help in reducing the use of sedatives. Nurses should take measures to reduce light and sound in ICU during night time and take measures to reduce anxiety and pain effectively for promoting sleep.