Mild Dry Eye Research Articles

A study to correlate over the counter drugs and ophthalmologists prescribed osmoprotective drugs among prolonged visual display terminal users

To find out the drug instillation behaviour, the relationship between drug instillation behaviour and subjective symptoms & compliance rate of OTC purchased Osmoprotective drugs and to find the correlation between OTC drugs and Ophthalmologist prescribed drugs among VDT users. A prospective, cross-sectional study included 100 subjects who use OTC-purchased Osmoprotective drugs and have not visited Ophthalmologist recently. The study data were collected by asking one sutured questionnaire to find out the complete scenario of OTC drug usage patterns. Subjects were tested for Schirmer’s II test and according to the diagnosis, Osmoprotective drugs were prescribed. In our study, out of 100 subjects a significant majority (86%) did not visit ophthalmologists in the recent past, therefore the prevalence of OTC drugs has increased. Schirmer’s-II test indicated that most participants experienced mild dry eye symptoms in both eyes (14.26 + 4.21 & 14.37 +4.20). CarboxymethylCellulose emerged as the most commonly used OTC drug (64%). A significant association was observed between the dry eye severity levels before and after treatment (p < 0.000). Only 2 drugs CarboxymethylCellulose (p < 0.003) and Polyethylene glycol and polypropylene glycol (p < 0.000) are commonly given in both OTC and ophthalmologist prescriptions. This work gives a detailed insight into drug usage patterns purchased from OTC and also found the correlation between OTC drugs and Ophthalmologist prescribed drugs.

Comparison of therapeutic effects of 0.05% Cyclosporine A versus 0.1% Fluorometholone in Chinese patients with mild dry eye unresponsive to artificial tears: a randomized control study

BackgroundTo assess and compare the therapeutic outcomes of 0.05% Cyclosporine A (CsA) ophthalmic solution versus 0.1% Fluorometholone (FML) eyedrops in Chinese patients with mild dry eye disease (DED) unresponsive to conventional artificial tears (AT).MethodsA total of 43 patients with mild DED, who have failed to respond to conventional AT therapy for over 3 months, were randomly assigned to receive either 0.05% CsA or 0.1% FML twice daily for 6-months. In addition, all the patients were instructed to use 0.1% SH 4 times a day as supplementary therapy. Dry eye examination, including Ocular Surface Disease Index (OSDI) questionnaire, non-invasive tear break-up time (NIBUT), Schirmer scores, corneal fluorescein staining (CFS) scores, and conjunctival goblet cell (CGC) density, intraocular pressure (IOP), Best corrected visual acuity (BCVA) was conducted at baseline and then evaluated at 1, 3, and 6 months after treatment. Corneal endothelial cell density, corneal dendritic cells (DCs) and nerves were assessed by in vivo confocal microscopy at baseline and 6 months after treatment.ResultsAt 3 and 6 months after treatment, OSDI scores in the 0.05% CsA group showed more improvement than those in the 0.1% FML group. CFS was significantly lower and Schirmer scores were significantly higher in 0.05% CsA group compared with 0.1% FML group. NIBUT improved significantly in both groups, with greater improvement in the 0.05% CsA group at the 1-, 3-, and 6-month visits. Throughout the duration of the study, the 0.1% FML group exhibited no notable enhancement in CGC density. Conversely, a substantial elevation in CGC density was observed in the 0.05% CsA group. After 6 months of treatment, significantly reduced corneal DC density and area were obtained in 0.05% CsA group as compared to 0.1% FML group, while there were no significant changes in cornea nerve fiber density, cornea nerve fiber length and cornea nerve fiber width in both groups. Additionally, after 6 months of treatment, neither group showed any statistically significant changes in IOP, BCVA or in corneal endothelial cell density.ConclusionThe administration of 0.05% CsA proved effective in managing mild DED, offering a supplementary advantage in improving Schirmer scores, restoring CGC density and reducing corneal DC density compared to 0.1% FML eyedrops. Consequently, 0.05% CsA eyedrops are recommended as a safe and efficacious therapeutic alternative for patients with mild DED who fail to respond to conventional tear substitutes therapy.Clinical trial registration numberChinese Clinical Trial Registry, ChiCTR2200066441, Registered 06 December 2022-Retrospectively registered.

A Study on the Prevalence of Dry Eye Disease in Newly Diagnosed Autoimmune Disorders in a Tertiary Eye Care Hospital

INTRODUCTION: The aims of the study were to assess the prevalence and severity of dry eye in autoimmune disorders. The objectives included studying the prevalence of dry eye in patients with autoimmune disorders and assessing the severity of dry eye in each individual with an autoimmune disorder.AIM: To assess the prevalence and severity of dry eye in patients newly diagnosed with Autoimmune disorders.OBJECTIVES: • To study the prevalence of dry eye in patients newly diagnosed with Autoimmune disorders.• To assess the severity of dry eye in each patient with an Autoimmune disorder.MATERIAL AND METHODS: The study design is a cross-sectional study. The study population included hospital-based population newly diagnosed with autoimmune disorders. The study was conducted in the state of Tamil Nadu, with the study setting being the Ophthalmology Outpatient Department at SBMCH. The study period was 11/2 years from Jan 2023 to June 2024. Ethical considerations include obtaining approval from the Medical Ethical Committee of Sree Balaji Medical College and Hospital before commencing the study. The resources and funding for the study was self-funded.RESULTS: The mean age of the study participants were 32.34±9.05 years. Gender-wise, 43.8% were males, and 56.2% were females, indicating a female preponderance. Among the autoimmune disorders studied, Rheumatoid arthritis (32.9%), Psoriasis (27.4%),and Sjogren’s syndrome (12.3%) were the most prevalent. Tear film meniscus height results revealed that 80.8% had TFMH <0.25% and 19.17% had TFMH 0.25-0.50mm.Tear film breakup time (TBUT) results revealed that 64.4% had TBUT more than 10 seconds, and 35.6% had 5 to 10 seconds. The Rose Bengal test showed positive results in 43.8% and was negative in 56.1% of patients. Schirmer’s test 1 showed 35.6% had moderate dry eye followed by 32.8% had mild dry eye and 17.8% had severe dry eye. Schirmer’s test 2 also showed 36.9% of patients had moderate dry eye,31.5% had mild dry eye and 20.5% had severe dry eye. Ocular surface disease index questionnaire (OSDI) indicated 38.4% had mild dry eye,30.1% had moderate dry eye,15.1% had severe dry eye and 16.4% had normal tear function.CONCLUSION: The study provides a valuable understanding of the prevalence and characteristics of dry eye syndrome in a diverse population with various autoimmune conditions. The findings highlight important demographic patterns, ocular manifestations, and tear function parameters among individuals with autoimmune diseases.

Repeatability of Scheimpflug-Placido camera in mild dry eye versus normal eyes according to the topographical position of the cornea.

We aimed to investigate the repeatability of various corneal measurements according to topographical location in the entire cornea measured by dual rotating Scheimpflug-Placido camera and to explore the differences in repeatability between patients with mild dry eye and those with normal eyes. In both the normal and dry eye groups, divided based on BUT or the height of the tear film, there were no statistically significant differences in the ratio of unacceptable variation (RUV) and ICC. The consistency of the examination of the anterior and posterior refractive values and corneal thickness according to the corneal location, measured three times repeatedly using the Galilei anterior segment camera, was high. There was no difference based on the height of the tear film or the tear film break-up time. However, caution is needed when interpreting the values of the anterior corneal refractive values, as there can be changes of more than 0.5D within 3mm of the central area.

Two-year Outcomes of Ultra-low-dose Radiotherapy in the Treatment of Ocular Adnexal B-cell Lymphomas.

This study focuses on the efficacy and 2-year outcomes of ultra-low-dose radiotherapy (RT) in treating primary and secondary ocular adnexal lymphoma (OAL). A retrospective analysis was conducted on patients with OAL between 2017 and 2022, treated with 4 Gy of RT. The primary and secondary outcomes assessed were response rate, progression-free survival, and lymphoma-related death. Twenty-one patients with primary and secondary OAL of diverse, presentations, subtypes, and stages were included. The orbital tumors had an average size of 17 × 16 × 16 mm. Of the 14 primary OAL cases, 3 (14%) had T1N0M0 disease, 8 (38%) T2N0M0, and 3 (14%) T3N0M0 (AJCC 8th edition staging); of the 7 secondary OALs, 4 (19%) were stage IE, 2 (10%) stage IIE, and 1 (5%) stage IIIE (Ann Arbor staging). Ultra-low-dose RT yielded a 95% complete response rate and 100% progression-free survival rates, both locally and systemically at 2 years. Mild dry eyes were reported in 14% of patients as a late treatment toxicity. Ultra-low-dose RT emerges as an effective and well-tolerated treatment approach for OAL. Our findings support the use of 4 Gy, showcasing high complete response rates (95%) and durable disease control without significant local relapses over an average follow up of 27 months. Our results align with earlier investigations, validating the curative potential of ultra-low-dose RT and reinforcing the concept of achieving favorable outcomes with minimal intervention. This approach may potentially alleviate the burden of long-term ocular side effects associated with higher radiation doses, enhancing the overall quality of life for OAL patients.

Effect of Electromagnetic Radiation Induced DRY EYE Conditions in Human Eye

Purpose-The aim of this study is to determine the impact of dry eye induced due to electromagnetic radiation produced during use of digital screen. Methodology- The project was held through camping and OPD work during the clinical posting in Haryana and New Delhi. The invitation to participate in the camping was done through social media, hoarding and pamphlet. Data collection was done in Microsoft excel sheet basis on age group. To detect dry eye in patents eye few test was done such as shimmer test, TBUT test, by slit lamp examination few things were observed which was essential to detect dry eye such as Conjunctival Congestion, Meibomitis Dots, and Corneal shine. After all this the statistical analysis was done. Result- The EMR affected individuals were excessively used mobile phones, laptops, tablets, and PCs. According to this data, 60% of child experiences mild dry eye, 66.6% of young experiences moderate dry eye, 74 % of adult experiences serve dry eye. The test results of the present investigative study suggest that all the test results were significant at p < 0.05. Conclusion- The result of the study suggests that excess use of mobile phones, tablets, laptop, and computer leads to dry eye among the patients specially having working hours more than or at least 8-10 hours.

Body mass index, diet, and outdoor activity linked with meibomian gland abnormalities in children.

Dry eye disease is frequently underdiagnosed in pediatric patients. Meibomian gland morphology abnormalities (atrophy and tortuosity) may be associated with dry eye. This study examined risk factors for gland morphology abnormalities in children. This study aimed to characterize meibomian gland morphological abnormalities (atrophy and tortuosity) and identify risk factors for the same in children. A total of 160 children, primarily African American and Hispanic, aged 5 to <18 years underwent a comprehensive eye exam including slit-lamp examination to evaluate the meibomian glands, conjunctival papillae, and tear film. Infrared photography was performed including assessment of noninvasive tear film breakup time and tear meniscus height. Meibomian gland atrophy and tortuosity were assessed. A modified Ocular Surface Disease Index survey was administered along with surveys on screen time, diet, and outdoor activity. Linear multiple regression was performed to determine risk factors for meibomian gland abnormalities. The average age of participants (76 male, 84 female) was 10.9 ± 3.0 years. Severe meibomian gland atrophy (score ≥2) was found in 31.0% of participants in at least one eyelid. Severe meibomian gland tortuosity (score ≥2) was found in 84.0% of participants in at least one eyelid. The median symptom score was 9.8 (range, 0 to 71), with 16.9, 8.8, and 12.5% of the children having mild, moderate, and severe dry eye symptoms, respectively. Elevated body mass index (p<0.001), reduced outdoor activity (p=0.02), and unhealthy diet (p=0.01) were found to be risk factors for meibomian gland abnormalities. Screen time, symptom score, age, gender, and race/ethnicity were not associated with gland abnormalities (all p values >0.05). This study determined that meibomian gland morphological abnormalities were commonly found in children aged 5 to <18 years. Risk factors for these abnormalities include elevated body mass index, an unhealthy diet, and reduced outdoor activity.

Inflammation due to ocular surface homeostasis imbalance caused by pterygia: tear lymphotoxin-alpha study and a literature review

ObjectiveTo estimate the pterygium ocular surface state, and compare with healthy eyes and dry eyes. To investigate the inflammation due to pterygia growth by tear Lymphotoxin-alpha (LT α) test.DesignProspective, single-center study.Participants400 patients, divided into 100 pterygium group, 100 mild dry eye group, 100 moderate dry eye group, and 100 age-and sex-matched normal controls.MethodsThe non-invasive break-up time (NIBUT), tear meniscus height (TMH) test, corneal fluorescein staining (CFS), meibomian gland loss score (MGs), and lipid layer thickness (LLT) were evaluated in all patients. Pterygium status and ocular status in the pterygium group were collected. The tear LT α test was conducted in the pterygium patients group.ResultPterygium can affect the ocular surface, leading to decreased tear film stability. The TMH, NIBUT, CFS, MGs, and lipid layer thickness can provide insights into this phenomenon. The presence of pterygium can change the structure and condition of the ocular surface. Tear LT α testing shows an abnormal decrease in LT α levels in pterygium patients. This indicates an immune-inflammation microenvironment that causes tissue repair deficiency.ConclusionThe dry eye triggered by the growth of pterygium may originate from the tear film instability due to pterygia. As an inflammatory index, LT α in the development of pterygium and the aggravation of dry eye patients can indicate that the ocular surface is in different inflammatory states. Future tear testing in LT α may be a potential indicator to assess the inflammatory status of the dry eye.

Ocular Surface Changes in Glaucomatous Patients Undergoing Cataract Surgery Combined with Micro Invasive Glaucoma Surgery (2nd Generation Trabecular Stents Istent Inject ®): A Study about 69 Eyes

Introduction: The purpose of this study was to evaluate ocular surface changes and dry eyes symptoms in patients undergoing cataract surgery by phacoemulsification combined with implantation of two trabecular stents (Istent Inject®). Methods: This single-arm prospective interventional clinical trial enrolled 69 patients with mild-to-moderate open-angle glaucoma taking 1 to 4 glaucoma medications that underwent phacoemulsification combined with implantation of two trabecular stents (Istent). We explored several key data about ocular surface and glaucoma evolution throughout the follow-up, including the Ocular Surface Disease Index score, the Oxford score, the Efron conjunctival score, and the Fluorescein Tear Break-up Time (FTBUT). Results: Mean OSDI scores improved from 40.1 ± 21.6 (severe dry eye) preoperatively to 17.5 ± 15.3 (mild dry eye) at 3 months. While 73% of eyes had moderate or severe OSDI scores preoperatively, only 29% had such scores at 3 months. The mean FTBUT increased from 4.3 ±2.4 seconds preoperatively to 6.4 ±2.5 seconds at 3 months; the average Oxford staining score decreased from 1.4 ± 1.0 preoperatively to 0.4 ± 0.6 at 3 months. There was a reduction in the number of glaucoma medications from 1.5 to 0.6 medications. Mean IOP decreased from 17.4 ± 4.2mmHg to 14.5 ± 3.2mmHg at the 3 months follow-up. The safety profile of the surgery was excellent. Conclusion: The implantation of two trabecular stents (Istent inject®) combined with cataract surgery resulted in clinical and functional improvements in ocular surface health, as well as significant reductions in IOP and medications in patients with open-angle glaucoma.

Immunopathological mechanisms and clinical manifestations of ocular graft-versus-host disease following hematopoietic stem cell transplantation.

Graft-versus-host disease is among themost common clinical complications following allogeneic hematopoietic stem cell transplantation. It causes inflammation-mediated destruction and dysfunction of various organ systems including ocular tissues in 60-90% of the patients and is termed ocular GVHD (oGVHD). In oGVHD, donor-derived T-cells recognize host antigens as foreign, resulting in immune dysregulation, inflammation and fibrosis of lacrimal glands, meibomian glands, cornea, and conjunctiva. The clinical presentation in oGVHD patients range from mild dry eye symptoms to catastrophic inflammation mediated pathological changes which can cause corneal perforation and blindness. In this review article, we provide detailed insights into the impact of mucosal barrier disruption, the afferent and efferent phases of immunological response involving activation of antigen presenting cells and T cells, respectively. We evaluate the evidence outlining the effector phase of the disease leading to cellular destruction and eventually fibrosis in patients with oGVHD. Finally, we discuss the well-established criteria for the diagnosis of oGVHD.

Clinical correlation of CD4 count and dry eye disease (DED) severity among Human Immunodeficiency Virus (HIV) patients: A case study in Voluntary Counseling and Testing Clinic RSUP Prof Ngoerah, Bali

Introduction: Dry eye disease (DED) is a condition affecting the surface of the eye and the stability of tears, influenced by various factors. It has been documented as one of the most common ocular issues in the front segment among individuals with HIV, typically appearing in the later stages of the disease. The study sought to examine the clinical relationship between CD4 count and the severity of the condition. Method: This study was conducted as a cross-sectional analysis within a hospital setting, involving 75 HIV-positive patients (140 eyes) aged between 18 and 50 years. These patients were referred to the ophthalmology clinic in the Voluntary Counseling and Testing (VCT) center due to complaints related to ocular surface issues, and they were enrolled in the study. All patients underwent a thorough ophthalmological assessment, including the completion of a dry eye questionnaire, specifically the Ocular Surface Disease Index (OSDI), and measurement of tear film break-up time (TBUT). Results: The research revealed a notable moderate positive correlation between CD4 count and TBUT (r=0.509; p=0.005), and a negative correlation with OSDI score (r=-0.252, p=0.035). Significant differences were observed in CD4 count between mild and moderate dry eyes (p=0.005) as well as between mild and severe dry eyes (p=0.005). No significant difference was found between moderate and severe dry eyes (p=0.435). The severity of dry eye in HIV patients appears to vary across different clinical stages of the disease, coinfection statuses, and treatment histories, although these differences did not reach statistical significance in the results. Conclusion: A correlation exists between CD4 count and the severity of dry eye disease among HIV patients. HIV patients with lower CD4 counts are at a higher risk of developing severe dry eye disease.

Overview and Correlation Between Work Stress and Dry Eyes Syndrome among Nurses in Indonesia

Exhausted nurses in providing nursing care can impact work stress. Many factors cause work stress. Work stress is the type of psychological stress that reduces the lacrimal gland's activity, affecting dry eye syndrome. The study aims to analyze the correlation between work stress and nurses' dry eye syndrome in Nganjuk General Hospital. The study was a descriptive correlative observational with a cross-sectional design. The sample was 84 nurses, taken by simple random sampling. Data were collected using Health and Safety Executive (HSE) and Ocular Surface Disease (OSDI) questionnaires. The study showed nurses experienced mild stress (96.43%) and moderate dry eye syndrome (36.90%). There was a positive correlation between work stress and dry eye syndrome in nurses in the weak category (r=0.356; p= 0.001&lt; 0.05). There were no significant differences in work stress by age, gender, working period, and marital status (p=0.388; p=0.687 p=0.730; p = 0.839 &gt; α 0.05). There was a significant difference in work stress based on education (p=0.033 &lt; α 0,05). There were no significant differences in dry eye syndrome with age, gender, working period, and marital status (p=0.644; p=0.436; p= 0.865; p=0.072; p=0.719 &gt; α 0,05). The study conclusion is that work stress is related to dry eyes syndrome. Apart from that, work stress is also influenced by the level of education. Therefore, interventions to reduce work stress in nurses should pay attention to education level to reduce the risk of dry eyes syndrome.

Clinical Correlation of CD4 Count and Dry Eye Disease (DED) Severity Among HIV Patients: A Case Study in Voluntary Counseling and Testing Clinic Prof Ngoerah General Hospital, Bali

Abstract&#x0D; Introduction &amp; Objectives : Dry Eye Disease is a multi-factorial ocular surface and tear film instability disease. It has been reported as one of the most frequent anterior segment ocular manifestations in HIV patients, occurring late in the disease. The study aimed to investigate clinical correlation of CD4 count and severity of the disease.&#x0D; Methods : This study was a hospital based cross-sectional study where 75 HIV patients (150 eyes) aged 18-50 years old were referred to ophthalmology clinic in VCT for ocular surface related complaints and were included in the study.&#x0D; Results : The study showed significant moderate positive correlation between CD4 count with Tear Break Up Time (TBUT) (r-value=0.509;p-value=0.05) and negatively correlated with Ocular Surface Disease Index (OSDI) score (r-value=-0.252, p-value=0.035). There were a significant difference in CD4 count between mild and moderate dry eyes (p-value=0.005) and between mild and severe dry eyes (p-value=0.005), however no significant difference was observed between moderate and severe dry eyes (p value=0.435). The severity of dry eye in HIV patients also tends to differ in-between clinical stage of the disease (p value=0.513) and with the presence of co-infection (p value=0.228), although the result was not statistically significant.&#x0D; Conclusion : There is a correlation between CD4 Count and Dry Eye Disease severity among HIV patients. The lower the CD4, the higher the risk for HIV patients to get severe dry eye disease. This shows the importance of CD4 control and monitoring to prevent various ocular disease and manifestations related to HIV.

THE RELATIONSHIP BETWEEN DURATION OF GAS EMISSION EXPOSURE AND DRY EYE SYNDROME (DES) ON TAXIBIKE DRIVERS IN CENTRAL JAKARTA

Abstract&#x0D; Introduction &amp; Objectives : Dry eye syndrome (DES) is a breakdown in the natural layer of tears that coats the front of the eye. Air quality in Jakarta indicated to be harmful to human health. The average annual PM 2.5 figure in Central Jakarta recorded 27.6 μg/m3. This figure is far beyond WHO standard that is 10 μg/m3. According to AAO one of the risk factors for dry eyes is exposure/injury to chemicals and the environment (dusty, windy, hot/dry). Therefore duration of traffic related air pollutions exposure may have an effect with the severity of dry eye syndrome on taxibike drivers in Central Jakarta.&#x0D; Methods : Analytic observation with cross sectional approach. Population was 196 taxibike drivers of Central Jakarta from April-May 2023. Data collection was by means of a questionnaire containing identity,informed consent,duration of exposure,and DES questions accordance with OSDI provisions. The results obtained are then recorded, aggregated, and entered into charts and tables. Hypothesis test used is chi-square.&#x0D; Results : There were 196 participated in this study. A total of 8 participants(4,1%) with &gt;12hours duration of exposure experienced severe dry eyes, 18 participants(9.2%) experienced moderate, 102 participants(52%) experienced mild dry eyes and the rest was normal(34.6%). According to this, prevalence of DES was more frequent in taxibike drivers who worked 6-12hours more than in &lt;6hours of worked (OR: 1.764) and the severity increased with duration of exposure(p&lt;0.05).&#x0D; Conclusion : The duration of gas emission exposure has significant correlation with the frequency and severity of DES on taxibike drivers in Central Jakarta.

Unveiling Ocular Manifestations in Systemic Lupus Erythematosus.

Systemic Lupus Erythematosus (SLE) is a complex autoimmune disorder characterized by immune dysregulation and multi-organ involvement. In this concise brief review, we highlight key insights into Ocular Systemic Lupus Erythematosus (SLE), an intricate autoimmune disorder with diverse organ involvement. Emphasizing the formation of autoantibodies and immune complex deposition, we delve into the inflammation and damage affecting ocular structures. Clinical presentations, ranging from mild dry eye syndrome to severe conditions like retinal vasculitis, necessitate a comprehensive diagnostic approach, including clinical exams, serological testing, and imaging studies. Differential diagnosis involves distinguishing SLE-related ocular manifestations from other autoimmune and non-inflammatory ocular conditions. The multidisciplinary management approach, involving rheumatologists, ophthalmologists, and immunologists, tailors treatment based on ocular involvement severity, encompassing corticosteroids, immunosuppressive agents, and biologics. Follow-up is crucial for monitoring disease progression and treatment response. Future perspectives revolve around advancing molecular understanding, refining diagnostic tools, and exploring targeted therapies. Novel research areas include genetic factors, microbiome composition, and biotechnology for tailored and effective SLE ocular treatments.

Ocular toxicity of psychotropic medications in a tertiary hospital in Lagos, Nigeria.

Objective: This study aimed to determine the ocular toxicity of the psychotropic drugs used by patients and to proffer suggestions on how to prevent visual impairment or blindness in patients on antipsychotics. Methodology: This was a prospective, hospital-based cross-sectional study. Participants were adult patients between 18 and 70 years, diagnosed with psychosis, and who had been on antipsychotic medications for at least one year. All the recruited participants had an examination of the anterior and posterior segments of the eyes done. Schirmer's test, Tear film Break-up time (TBUT), Central Corneal thickness (CCT), Colour vision test, and Contrast sensitivity test were done. The collected data was analyzed using IBM SPSS 28.0. Results: The study enrolled patients who were mainly females (55.1%). The highest age group of the cases was 29-38 years (29.7%). The examination of the eyes and investigations revealed that 10.2% of the respondents on antipsychotics had color vision deficiency and 25.4% - loss of contrast sensitivity. Lid pigmentation was observed in 20.3% and cataract in 32.2%. Degeneration of the peripheral retina was observed in 4.2% of patients on antipsychotic medication. Schirmer's test showed mild, moderate, and severe dry eyes in 11%,17.8%, and 20.3% of the participants respectively. The test for Central Corneal Thickness (CCT) showed 50.0% of the respondents had a thin cornea and 24.6% had a thick cornea. 17.8% of the surveyed respondents manifested high eye pressure. Discussion: Psychotropics are the gold standard for the treatment of psychotic episodes and disorders. The choice of drug, dosing, and mode of administration depends on the severity of the psychotic disorder. Higher doses of psychotropics were reported to cause toxicity in different organs in the body including the eyes, especially on long-term use and high dosage and this can affect the quality of life of the individual negatively. Conclusion: The earliest and most prominent side effect seen in patients on psychotic medication was dry eyes. There were a few cases of blinding eye diseases like glaucoma, and cataract. For these reasons, ophthalmic assessments should be included as part of the management of psychiatric patients early at the start of antipsychotic treatment. Abbreviations: FGA = First Generation Antipsychotics, SGA = Second Generation Antipsychotics, TCAs = Tricyclic Antidepressants, CCT = Central Corneal Thickness, IOP = Intraocular Pressure, TBUT =Tear film Break-up Time, BIO = Binocular Indirect Ophthalmoscope.

Dry Eyes Illness in Psychiatric Patients Placed on Antipsychotic Medications

Introduction: Psychosis is used to describe conditions that affect the mind where there has been loss of contact with reality. Most psychotic disorders are treated with a combination of medications and psychotherapy. A significant ocular side effect of anti-psychotic drugs is dry eyes which often do not get adequate attention thus leading to great discomfort to the patient. Methodology: The study was a hospital-based, case-control prospective study where patients diagnosed with a psychotic disorders within the age groups of 18 to 70 years and who have been on anti-psychotic treatment for at least one year were examined by a consultant ophthalmologist. Healthy adults were enrolled from the Ophthalmology outpatient clinic as the control for the study. Result: The case group comprised 53(44.9%) males and 65(55.1%) females. The age group with the highest representation amongst the cases- 29.7% was the 29-38-year-olds. On the medication history, 65(55.1%) started taking antipsychotic drugs within 1-5 years. 65.3% of the respondents were on antipsychotic monotherapy-commonly Olanzapine tablets. Schirmer’s test was normal in most of the participants in both cases 50.8% and control 53.4% but those that have been on medication for 5 years or less demonstrated the highest occurrence of severe dry eyes with a prevalence rate of 23.1% while those on medication for over 10 years showed a higher prevalence of mild dry eyes accounting for 20.8% of the cases. Tear film Break-up Time (TBUT) showed Dry eyes in 50.8% of cases. A significant proportion (56.9%) of those who had been on medication for 1-5 years were found to be exhibiting dry eyes. Conclusion: An association was observed between Dry eye disease and antipsychotic medication as early as within 1-5 years of using the medication. Ophthalmic assessment should be incorporated early in the course of treatment.

The effect of a preservative-free prostaglandin analogue on the condition of the ocular surface in patients with glaucoma

PURPOSE. The study aimed to evaluate the antihypertensive effectiveness and the condition of the ocular surface in patients with glaucoma during monotherapy with the drug Traviolan® (travaprost 0.05%).METHODS. This longitudinal, randomized, prospective study included 27 patients (59.6% women, 40.4% men; mean age 64.1±6.4) with uncompensated primary open-angle glaucoma in early and moderate stages receiving mono-therapy with β-blockers or carbonic anhydrase inhibitors. This was a longitudinal, randomized, prospective, observational study. All patients underwent a complete ophthalmological examination and assessment of dry eye symptoms using a questionnaire (Ocular Surface Disease Index, OSDI). An objective assessment of the condition of the ocular surface was carried out using the Sirius corneal topography device, which is used for assessment of tear film breakup time (TBUT). All patients were re-examined after 12 weeks.RESULTS. Intraocular pressure was significantly reduced at all study visits and amounted to 5.9±2.8 mm Hg at week12 (25.9%). There was a significant reduction in symptoms of dry eye, irritation, itching, and foreign body sensation (p&lt;0.05 for each parameter). A significant improvement was also noted in terms of the condition of the ocular surface, and in most patients the symptom complex was classified as mild dry eye syndrome (p&lt;0.05). Additionally, there was also a significant improvement in the OSDI score (p&lt;0.05) with a mean of 17.95±5.35 points. The tear film breakup time by the end of observation increased by 4.1±2.3 sec and amounted to 7.4±3.1 sec.CONCLUSION. The drug Traviolan® has high antihypertensive effectiveness and good tolerability, and improves the condition of the ocular surface.

Study of Face Mask-associated Dry Eye among Medical Students.

The purpose of this study was to evaluate face mask-associated factors causing dry eye among medical students. This was a cross-sectional study conducted on undergraduate medical and dental students, of all phases, while they were attending offline classes and were required to wear face masks in accordance with the government regulations. Sociodemographic data, ocular and medical history, face mask-wearing practices, screen usage, and quantification of symptoms using the modified Ocular Surface Disease Index (OSDI) questionnaire were collected. Objective tests were conducted in students having dry eye. The association of quantitative variables was done using ANOVA, Mann-Whitney, and Kruskal-Wallis test, whereas the Chi-square test was done for qualitative variables. Multivariate logistic regression was used to identify the risk factors for varying severity of dry eye. The mean age of the 410 students was 21 ± 1.6 years. According to the OSDI, 39.51% (162/410) of students had dry eyes, 23.41% (96/410) had mild dry eye, 8.78% (36/410) had moderate dry eye, and 7.32% (30/410) had severe dry eye. Face mask-associated factors which were significantly linked to dry eye were N95 masks, loose-fit masks, and 6-8 h of continuous mask use. The Schirmer's test and tear film break-up time were performed on 29 and 20 students, respectively, mean values being 19.25 ± 5.29 mm and 10.15 ± 1.41 s for nonsevere and 6.53 ± 1.55 mm and 5.3 ± 0.98 s for severe dry eye, respectively. It is important to educate medical students and create awareness regarding "face mask-appropriate behavior" to reduce the chances of dry eye secondary to face masks use.

Clinical evaluation of dry eye in type 2 diabetes mellitus: A hospital-based study from Eastern India

Abstract Background: The burden of dry eye in Indian patients with type 2 diabetes mellitus is not well documented. Methods: A hospital-based cross-sectional clinical study was conducted in a tertiary healthcare centre in Eastern Odisha on 100 T2DM patients from January 2017 to January 2019 to study the burden of dry eye. A detailed history of presenting symptoms, duration, progression and any associated condition, if present, were recorded. A detailed history regarding diabetes mellitus and treatment was recorded. The assessment of dry eye symptoms of patients was made using a questionnaire. The comprehensive ocular surface evaluation examination included visual acuity, and anterior segment examination included corneal surface, height of tear meniscus, pre-corneal tear film, tear film break-up time (TBUT) and Schirmer’s test. Results: Their mean age was 53.7 ± 9.8 years; there were 54 were males. Sixty-two patients had complaints of dry eye. Mild, moderate and severe dry eye were noted in 31, 22 and 9 patients, respectively. Twenty-six patients with mild dry eye disease were noted with glycosylated haemoglobin HbA1c (%) levels between 6.1 and 7, and eight patients with severe dry eye disease had HbA1c 8%. TBUT was found to decrease as the severity of dry eye increased. Conclusions: In the present study, a strong association was found between T2DM and dry eye. It is necessary to examine the ocular surface routinely in DM patients for early detection of dry eye and prevention of structural damage to the ocular surface.