Moderate Dry Eye Disease Research Articles

Study on association of dry eye disease (DED) with visual display terminal (VDT) use among medical college students

To study the prevalence of Dry Eye Disease (DED) among undergraduate medical students using Visual Display Terminal (VDT). : Cross-sectional study was conducted on 444 students at Medical college Hospital in the department of Ophthalmology. All the consented study participants, after ruling out the exclusion criterion, underwent dry eye workup which included routine slit lamp examination and Tear film break up time (TBUT). In this study, TBUT ≤ 10 seconds was considered abnormal. They were asked to fill out an OSDI (Ocular Surface Disease Index) questionnaire (Allergen Inc, Irvine, Calif, USA). The participants were asked to answer questions related to VDT use. Statistical analysis was done using the SPSS software (IBM). Based on the OSDI questionnaire, clinically significant DED was found in 28.8%. DED was classified as mild DED in 17.1%, moderate DED in 6.3% and severe DED in 5.4% of the participants. Among those with DED, VDT use was 2 to 4 hours in 29% of the participants, VDT > 4 hours was seen in 32.7% of participants. Thereby, indicating that increase in VDT use had an association with increase in prevalence of DED. DED based on signs (TBUT< or = 5 sec) was observed in 86.3% of participants.: There is a statistically significant association between VDT use and DED among young students.

Expert opinion on the prescription practice of artificial tear formulations for the management of dry eye disease in Indian settings: A questionnaire-based survey

Clinical studies suggested that Carboxymethyl cellulose (CMC) and Hyaluronic acid (HA) were equally effective in treating DED, other studies have shown that one treatment option outperforms the other.So, this study aimed to explore expert opinions on the use of artificial tear formulations for the effective treatment of dry eye disease (DED) in Indian settings, specifically focusing on prescribing practices for different severity levels of DED. The cross-sectional, questionnaire-based study in which data was collected through a multiple-response questionnaire. The questionnaire comprised 22 questions, covering various aspects such as the clinical characteristics of DED patients and the utilization of artificial tear formulations at different stages of the disease. Among the 54 respondents, 63% of them observed a higher prevalence of DED in individuals aged 25 to 40 years. Furthermore, 77.77% of respondents identified burning or stinging in the eyes as a significant symptom of aqueous deficiency in DED patients. As a first-line treatment for mild DED, 51.85% of participants recommended 0.5% Carboxymethyl cellulose (CMC) eye drops, while 44.44% suggested using combination eye drops containing polyethylene glycol and Propylene glycol (PEG-PG) for moderate DED cases. In the case of severe DED, the majority (68.52%) of respondents preferred prescribing sodium Hyaluronate (SH) eye drops.Experts have recommended the use of CMC eye drops to provide temporary relief from itchiness and pain caused by eye dryness, wind exposure or sun exposure. They have recommended the prescription of 0.5% CMC eye drops three times daily for mild DED patients.

Efficient capture of dry eye data from the real world: The Save Sight Dry Eye Registry

PurposeTo describe a web-based, high-quality data collection tool able to track the clinical data of patients with dry eye disease (DED) in routine clinical practice. DesignRetrospective analysis of core system web data from a prospectively designed, observational, routine clinical practice registry, the Save Sight Dry Eye Registry (SSDER). MethodsPatients with DED, from 11-Nov-2020 to 04-Mar-2024 were analysed. Ocular Surface Disease Index (OSDI) and Ocular Comfort Index (OCI) questionnaires collected patient-reported DED symptoms, and the Patient Health Questionnaire-4 (PHQ-4) screened for anxiety and depression. Outcome data include index visit demography, DED symptoms and signs. ResultsFifteen clinicians (ophthalmologists and optometrists) from nine practices across Australia, France, Germany, Nepal, Spain and the United Kingdom contributed data, comprising index visits of 958 eyes from 479 patients (mean±SD age 56±17 years; 78.7% female). Up to 89.9% of the patients had either evaporative or mixed DED based on clinician's judgement. Mean OSDI symptom score at index visit was 35.7 ± 19.4 (n = 366), and the mean sores for frequency and intensity of discomfort with the OCI was 31.9 ± 6.1 and 31.4 ± 6.8 (n = 202) respectively. Forty-one percent of patients had mild to severe symptoms of anxiety and depression. Median tear breakup time and tear meniscus height were 5 (IQR 2–8) seconds and 0.3 (IQR 0.2–0.4) mm, respectively. Ocular surface staining was graded as none (37.6%), minimal (31.7%), mild (19.8%), moderate (8.8%) and severe (2.1%). ConclusionThe SSDER facilitated the collection of data from patients with DED from real-world clinical practice. Presenting patients had moderate DED, which was mostly evaporative in nature. Symptoms of anxiety and depression were reported by more than one-third of the cohort.

Silk-Derived Protein-4 Versus Vehicle Control in Treating Patients With Moderate to Severe Dry Eye Disease: A Randomized Clinical Trial

In this study the safety and efficacy of silk-derived protein 4 (SDP-4), also known as amlisimod, eye drops against a vehicle control formulation in patients with moderate to severe dry eye disease (DED) was assessed. SDP-4 is a novel, naturally derived, anti-inflammatory wetting agent that enhances coating on the ocular surface. Exploratory Phase 2, 12- and 8-week, serial cohort, multicenter, double-masked, randomized, vehicle-controlled study. In the first cohort (N = 305), patients were randomized 1:1:1:1 to SDP-4 (0.1%, 1%, 3% wt./wt.) or vehicle control and dosed 2 times per day (BID), while in the second cohort patients were randomized 1:1 with 1% wt./wt. SDP-4, the best performing formulation from the first cohort, or vehicle control BID (N = 151). Diagnosed DED patients were treated in the United States between April 2019 and May 2021. The first cohort of subjects had moderate to severe baseline symptoms, while the second cohort had moderate baseline symptoms to study the impact of baseline symptoms on SDP-4 performance. Key sign and symptom end points were mean change from baseline in TBUT and total SANDE score (0-100 visual analog scale) throughout the study. SDP-4 (1%) significantly increased TBUT vs the vehicle control (P < .05) at days 28 and 56 in the first cohort, and patient symptomatology from baseline was reduced by 46% based on subject reported SANDE VAS scores at day 84. Patients with more severe baseline DED symptoms experienced a significantly greater amount of relief than when compared to patients with moderate DED (P < .05). All treatment groups were well tolerated with a 2.6% total discontinuation rate. To the best of our knowledge, this was the first-in-human use of SDP-4 in a clinical trial. SDP-4 is a first-in-class protein ingredient that offers a safe and multi-modal treatment approach for alleviating severe DED symptoms within a novel formulation.

Observational Clinical Investigation Evaluating an Ophthalmic Solution Containing Xanthan Gum and Low Concentration Desonide Phosphate in Dry Eye Disease Treatment.

Patients with dry eye disease (DED) complain of a multitude of symptoms that affect their visual function and quality of life (QoL). This clinical investigation assessed the performance, tolerance, and safety of a novel preservative-free ophthalmic solution containing xanthan gum 0.2% and desonide sodium phosphate 0.025%. This was an observational, prospective, multicentric, and post-market clinical investigation to assess the effect of three times a day instillation of the study formulation in patients suffering from DED. The primary objective was to achieve a 50% reduction in conjunctival hyperemia index as assessed with the OCULUS Keratograph after 1 month of treatment compared to baseline values. The secondary objectives included patient-reported outcomes, clinical performance, and safety. Thirty patients were enrolled (21 women, 9 men) with a mean age of 61.10 ± 14.53years. The instillation of the study formulation was associated with a significant reduction in redness scores after 1 month of treatment compared to baseline (mean - 0.51 ± 0.51; p ≤ 0.0001). Although the primary endpoint was not completely met, a 50% reduction in the conjunctival hyperemia index was achieved in 23% of the participants, and 77% showed a reduction of 26% of the same index. In addition, the ophthalmic solution significantly increased tear film break-up time, and a significant reduction of corneal and conjunctival staining with fluorescein was achieved. It also reduced DED symptoms and had a very good safety profile. the study formulation produced a significant improvement in the signs, symptoms, and QoL of patients with mild to moderate DED with a good safety profile after 1 month of treatment.

A cross-sectional study of optometrists' attitudes towards dry eye disease management in Hong Kong: A web-based survey in Hong Kong

PurposeThis study aimed to explore the practices of optometrists in Hong Kong towards diagnosing and managing dry eye disease (DED). MethodsFrom September 2021 to March 2022, an online questionnaire was distributed to optometrists in Hong Kong through several professional associations. The questionnaire included questions about the importance and usefulness of various diagnostic tests, as well as inquiries about management strategies and recommended follow-up schedules for DED. Responses were compared between optometrists who were more or less proactive in continuing education to identify potential differences. ResultsThe analysis included 68 valid responses. Sixty-one of them were Part 1 optometrists that represents 5.5 % of registered Part 1 optometrists back in 2022. Assessment of clinical symptoms was the most commonly performed investigation (93 %) and considered the most important (75 %) procedure in DED assessments, followed by corneal staining and fluorescein tear break-up time. Traditional diagnostic tests were preferred over newer methods, such as osmolarity, which were not yet commonly used. Unpreserved lubricants (90 %) and lid hygiene (63 %) were the primary treatments recommended for mild DED. Optometrists who had more experience and frequent participation in continuing education were more confident in diagnosing and managing DED, and more likely to recommend omega-3 supplements for moderate DED. ConclusionThe diagnostic and management strategies of optometrists in Hong Kong were generally consistent with the recommendations of the Dry Eye Workshop II report. However, standardized DED questionnaires and newer diagnostic tools were not commonly used. Evidence-based optometric care for dry eye management should be encouraged in Hong Kong optometric practice.

Tear film stability in patients with symptoms of dry eye after instillation of dual polymer hydroxypropyl guar/sodium hyaluronate vs single polymer sodium hyaluronate.

This study evaluated the tear film stability in patients with symptoms of dry eye after installation of dual polymer hydroxypropyl guar/sodium hyaluronate (DPHG/SH) vs single polymer SH. Patients with recently diagnosed mild to moderate dry eye disease (OSDI score 23-32 points) were included. For each patient, the right eye was randomized to receive DPHG/SH or 0.15% SH. Just after the administration of the drop to the right eye, the fellow eye received the other eye drop. The first non-invasive Keratograph first break-up time (NIKBUT), average NIKBUT and tear meniscus height (TMH) were measured before administration of the eye drops, at 1-min, 15min, 30min, 60min, 90min, and 120min after instillation. A total of 29 patients aged 22.8 ± 2.2years participated in the study (21 women). No differences between the eye receiving DPHG/SH and single polymer SH were observed for the first NIKBUT (p = 0.45) and average NIKBUT (p = 0.24) variables at any time point. Both DPHG/SH and single polymer SH increased the TMH (p of time effect < 0.001), but with no difference between groups (p = 0.95). Both DPHG/SH and single polymer SH solutions provide lubrication of the eye surface, however, with no difference in NIKBUT and TMH evaluations for up to two hours following administration.

Evaluation of Meibomian Glands and Tear Film in Pterygium Patients

BACKGROUND&#x0D; In this study we wanted to estimate the tear film and meibomian gland abnormalities in pterygium patients, and compare the tear film in pterygium eye with non pterygium eye.&#x0D; METHODS&#x0D; This was a prospective study conducted in the outpatient department of ophthalmology of Adichunchanagiri institute of Medical sciences, Bellur, Mandya. A TBUT of &lt;10 secs, Schirmer &lt;10 secs and Meibomian glands &lt;1/3 of lid area considered to be abnormal.&#x0D; RESULTS&#x0D; The Schirmer’s test showed 41.1% of dry eye out of which 28.8% was mild, 12.3% was moderate dry eye disease. And TBUT test showed 51.1% dry eye out of which 31.2% was mild, 8.8% was moderate and 11.1% was severe dry eye disease. 27(30%) patients had grade 1, 26(28.9) patients with grade 2 and 24(26.7) patients with grade 3 meibomian gland disorder. In eyes with pterygium, results were significantly different.&#x0D; CONCLUSIONS&#x0D; Meibomian gland and tear film may be altered in patients having pterygium, which may lead to ocular discomfort and dry eye.

Incidence of Dry Eye Syndrome After Cataract Surgery with Phacoemulsification Technique in Padang Eye Center Hospital

Introduction &amp; Objectives : Dry eyes is one of the most common ophthalmological problems. The etiology of dry eyes is usually multifactorial, such as medication, aging, systemic disease, allergy, computer usage, environmental factors, meibomian gland dysfunction and ophthalmic surgery. Cataract is still one of the leading causes of vision impairment globally. No medical treatment is effective to remove cataract. Thus, the only option is cataract removal surgery. The most common technique of cataract surgery in Padang Eye Center Hospital is phacoemulsification. This study aims to assess the incidence of dry eye syndrome after phacoemulsification surgery without complication in patients with no previous history of dry eye syndrome.&#x0D; Methods : This study was conducted using a prospective study. The evaluation uses Ocular Surface Disease Index ( OSDI ) questionnaire and tear break-up time ( TBUT ) test performed preoperatively and three times postoperatively at one week, one month and three months follow-up after surgery.&#x0D; Results : 110 eyes of 96 patients diagnosed with cataracts who had undergone phacoemulsification surgery were enrolled in this study. The mean age of patients is 62.46 ± 6.14 years, and 59,09% were men. After one week of surgery, only 9,09% had results 0-12 on the OSDI scale, and 43,63% represented moderate dry eye disease ( OSDI score 23-32 ) and TBUT test results from 61,82% of patients had dry eyes, which improved gradually after time.&#x0D; Conclusion : The incidence of dry eye syndrome significantly increased after one-week post-surgery. But after one month postoperative, the patients’ condition gradually improved and returned to normal after three months postoperatively.

Clinical Impact of Ambient Particulate Matters on Dry Eye Disease

Purpose: Dry eye disease (DED) has become a common ocular surface disorder in the recent decades, which can be influenced by environmental factors. This study aimed to examine the clinical association between DED and ambient air pollutants.Methods: A total of 216 patients (18 patients per each month) diagnosed with DED were enrolled in this retrospective study. Ocular surface disease index (OSDI), tear film breakup time (TFBUT), fluorescein corneal staining (FCS), and Schirmer’s test 1 (ST1) were examined. The monthly concentrations of air pollutants in 2018 were obtained from the data released by the Korean Ministry of Environment. Based on the mean of PM&lt;sub&gt;10&lt;/sub&gt; and PM&lt;sub&gt;2.5&lt;/sub&gt;, subgroup with exposure to low (L–PM) or high concentration of PM (H–PM) was analyzed.Results: Patients had moderate DED as high OSDI, low TFBUT, increased FSC, and decreased ST1. During the year 2018, monthly variation of PM showed that May to October was the period of L-PM and January to April and November to December was the period of H-PM. In subgroup analysis, patients in H-PM showed significantly higher OSDI, FCS, and lower ST1 compared to in L-PM. However, there was no significant difference in TFBUT between subgroups.Conclusions: DED was more severe in the period of H-PM than L-PM even though there was no difference in tear film instability between both periods. Ambient inflammatory factors including PM might deteriorate ocular surface as well as tear secretion, resulting in aggravating DED.

Dry Eye Para-Inflammation Treatment: Evaluation of a Novel Tear Substitute Containing Hyaluronic Acid and Low-Dose Hydrocortisone.

Purpose: The purpose of this study was to check the efficacy and safety of a novel tear substitute containing hyaluronic acid and low-dose hydrocortisone in the treatment of moderate dry eye disease. Methods: In this prospective randomized study, 38 patients with moderate dry eye disease were divided into two treatment groups: Group 1 received one drop of 0.2% sodium hyaluronate and 0.001% hydrocortisone four times daily for 3 months, while Group 2 received 0.15% sodium hyaluronate and 3% trehalose at the same dosage. OSDI and SANDE questionnaires, Non-Invasive Break-Up time (NIBUT), Tear Meniscus Height (TMH), meibography, Lipid Layer Thickness (LLT), Tear Break-Up Time (TBUT), Corneal Staining Score (CFS), and Intraocular Pressure (IOP) were evaluated at baseline and after 1, 2, and 3 months of treatment. Results: During the treatment period, Group 1 showed statistically significant improvement in OSDI score (p = 0.002), SANDE score (p = 0.01), NIBUT (p < 0.0001), LLT (p < 0.0001), TBUT (p = 0.01), and CFS (p = 0.02). In Group 2, significant improvement was observed only in the TBUT score (p < 0.05). Comparison of the two groups showed that NIBUT and LLT were significantly different at the end of treatment (p = 0.001 for both comparisons), with more favorable results for sodium hyaluronate and hydrocortisone than for sodium hyaluronate and trehalose. No significant variations in intraocular pressure were observed in either group during the treatment period (p > 0.05). Conclusions: The study confirms that a 3-months treatment with hyaluronic acid 0.2% in combination with low-dose hydrocortisone 0.001% improves the signs and symptoms of moderate DED and that a low-dosage 0.001% hydrocortisone can be helpful in preventing the progression to chronic stages of DED.

Hypochlorous acid hygiene solution in patients affected by blepharitis: a prospective randomised study

Background/aimsTo investigate the clinical outcomes and antimicrobial activity of an hypochlorous acid hygiene solution compared with hyaluronic acid wipes for blepharitis treatment in patients with dry eye disease (DED).MethodsThis study...

Dry Eye Symptoms in Jazan University Lecturers During the COVID-19 Pandemic Using Ocular Surface Disease Index (OSDI).

Background Dry eye disease (DED) is a disease of the ocular surface charac-terized by instability of the tear film, which causes ocular surface inflamma-tion and damage that leads to ocular symptoms, discomfort, and visual disturbance. Dry eye is a common ocular condition and a major reason for ophthalmologist visits. Compulsory e-learning has arisen in colleges and schools with the coronavirus disease 19 (COVID-19) pandemic as a tool for new teaching and learning. DED is an emerging threat to public health and is directly proportional to digital screen viewing length. DED diagnosis flowchart begins with history-taking of associated risk factors and a screening test by Ocular Surface Disease Index (OSDI). Therefore, we aim to assess the prevalence and the severity of DED among Jazan University lecturers and to identify the associated risk factors. Methods A total of 150 participants were recruited for this descriptive, observational study. Participants completed an online questionnaire that contained questions about sociodemographics, electronic devices they used, the average number of hours of use in a day as well as the distance and posture while reading, and factors that may influence visual symptomssuch as the use of glasses, frequent changes in glasses prescription and DED symptoms. Results The results showed that the prevalence of DED was high, with 23% of participants having mild DED, 12% having moderate DED, and 29% having severe DED. DED was associated with a number of sociodemographic and clinical factors, including younger age, female gender, occupation as a lecturer, and use of digital devices. Conclusion This study highlights the need to develop strategies to prevent and control DED among high-risk groups, such as university lecturers. Future research should focus on identifying more effective ways to prevent DED and to improve the management of DED symptoms.

Quantum molecular resonance electrotherapy (Rexon-Eye) for recalcitrant dry eye in an Asian population.

To assess the safety, efficacy, patients' satisfaction and acceptability of Rexon-Eye electrotherapy in treating Asian severe dry eye disease (DED) patients. Prospective parallel-arm pilot study recruiting 40 DED Chinese patients with >moderate recalcitrant DED (Contact Lens Research Unit [CCLRU] > grade 2). Subjects were randomized into 2 groups, undergoing four weekly treatment sessions each: group 1 received full treatment power; group 2 received control treatment (power 1 treatment). Non-invasive tear break-up time (NIBUT), cornea fluorescein staining graded via CCLRU and Schirmer's I test were compared pre- and 2 months post-treatment. The SPEED and QUEST questionnaires that evaluated subjective symptoms and treatment satisfaction, respectively, at baseline and 2 weeks post-treatment were carried out. Tear cytokine levels in both groups were examined at 2 weeks post-treatment. The amount of improvement in post-treatment corneal staining in the inferior corneal zone was significant in Group 1 (p = 0.038) but not in Group 2 (p = 0.832). Group 1 eyes with worse baseline staining (total score >9.8) had a significantly greater reduction of corneal staining than those with better baseline staining (-11.7 ± 1.98 vs. -4.6 ± 2.89, p < 0.001). There were no other significant differences in NIBUT, Schirmer's 1 and cornea fluorescein staining grading within or between the groups.: Group 1 (n = 24) had improved subjective dryness scores compared to Group 2 (n = 16) (SPEED score: 6.38 + 4.16 vs. 10.0 + 6.36, p = 0.04). No significant differences were seen in 11 tear cytokine levels at 2 weeks post-treatment between the 2 groups. In Asian DED patients treated with Rexon-Eye, inferior cornea staining showed significant improvement compared to placebo, and eyes with greater cornea staining at baseline achieved a greater improvement in staining. There were no other significant improvements in NIBUT and Schirmer's 1. Rexon-Eye also improved subjective DED scores in 41.7% of eyes without any adverse effects.

Efficacy and Safety of the Melanocortin Pan-Agonist PL9643 in a Phase 2 Study of Patients with Dry Eye Disease.

Purpose: The melanocortin receptor pan-agonist PL9643, a potential therapy for ocular diseases, was investigated in a phase 2, 12-week study in patients with dry eye disease (DED). Methods: This was a placebo-controlled study evaluating efficacy and safety of thrice-daily PL9643. Placebo (vehicle) was similar to tears. Primary endpoints were intra-patient changes in inferior corneal fluorescein staining and ocular discomfort after 12 weeks. Secondary endpoints were changes in additional DED signs or symptoms. Multiple secondary endpoints were not adjusted for multiplicity. Patients with moderate or severe DED were analyzed in addition to the overall intent-to-treat (ITT) population. Results: In the ITT population (n = 160) the PL9643 group did not demonstrate significant treatment difference versus placebo at week 12/day 85 for the primary endpoints (P > 0.05). In patients with moderate or severe DED (n = 53), PL9643 treatment demonstrated either nominally significant (P < 0.05) or trending (P < 0.1) improvement over placebo in mean change from baseline at week 12/day 85 in several sign endpoints, including fluorescein staining in inferior, superior, corneal sum, and total sum regions; Lissamine Green staining in temporal, nasal, conjunctival sum, and total sum regions; and tear film breakup time. Conjunctival redness also showed (nonsignificant) improvement at week 12/day 85. There were no drug-related adverse events (AEs) and no drug-related discontinuations. Conclusions: PL9643 showed no significant efficacy for the ITT population; however, efficacy results across several signs and symptoms in the subpopulation of moderate to severe DED patients, the low number of ocular AEs, and no tolerability issues suggest that PL9643 shows promise as a therapeutic for DED. Clinical Trial Registration number: NCT04268069.

Prevalence and Determinants of Symptomatic Dry Eye Disease Among Adult Urban Residents of High-Altitude Areas of Southwest Saudi Arabia - A Survey.

To estimate the prevalence and determinants of Ocular Surface Disease Index (OSDI) score based dry eye disease (DED) among the adult urban population of four cities located at high altitudes in Southwest Saudi Arabia. This cross-sectional survey was held in 2023. OSDI questionnaire was used to collect the responses of the adult participants. The score was further graded into none, mild, moderate, and severe DED to estimate age-sex-adjusted DED prevalence. The OSDI score was correlated to demographic (age group, gender, education, occupation, city) and risk factors like smoking and co-morbidities. Of the 401 adults, 388 (response rate of 97.8%) participated. The age-sex-adjusted prevalence of mild, moderate, and severe DED was 21.7%, 13.1%, and 32%, respectively. The median ODSI score was 22.9 [Interquartile range (IQR) 10.4; 47.9)]. The score was significantly higher in females (Mann-Whitney U-test P = 0.038), residents of Taif city (KW P = 0.05), those with primary/middle school education (Kruskal-Wallis P = 0.004), comorbidities like hypertension, asthma (KW P < 0.001) and risk factors like past refractive surgeries, arthritis (KW P = 0.013). Education status (P <0.001) [B = -9.0 95%] and presence of comorbidity (P = 0.022), [B = -0.823] were significant predictors of DED. The prevalence of DED and severe grade was high. The level of education and presence of comorbidities significantly influenced DED in the adult urban Saudi population of cities at high altitudes.

Ocular microbiome changes in dry eye disease and meibomian gland dysfunction

The most common and chronic ocular problem of aging is dry eye disease (DED) and the associated condition of meibomian gland dysfunction (MGD). The resident ocular surface bacteria may have a role in maintaining homeostasis and perturbation may contribute to disease development. The aim of this study was to compare the microbiomes of the conjunctiva and eyelid margin in humans with mild and moderate DED and controls using 16 S rRNA gene sequencing. The conjunctiva and lid margin of three cohorts (N = 60; MGD, MGD with lacrimal dysfunction [MGD + LD] and controls) were swabbed bilaterally three times over three months. Microbial communities were analysed by extracting DNA and sequencing the V3–V4 region of the 16 S ribosomal RNA gene using the Illumina MiSeq platform. Sequences were quality filtered, clustered into amplicon sequence variants (ASVs) using UNOISE algorithm and taxonomically classified using a Bayesian Last Common Ancestor (BCLA) algorithm against the GTDB 2207 database. The overall microbial communities of the MGD, MGD + LD and control groups were significantly different from each other (P = 0.001). The MGD and MGD + LD dry eye groups showed greater variability between individuals compared to the control (PERMDISP, P < 0.01). There was decreased richness and diversity in females compared to males for the conjunctiva (P < 0.04) and eyelid margin (P < 0.018). The conjunctiva in the MGD + LD group had more abundant Pseudomonas azotoformans, P. oleovorans and Caballeronia zhejiangensis compared to MGD and control (P < 0.05), while the MGD group had more abundant Corynebacterium macginleyi and C. kroppenstedtii compared to control (P < 0.05). The lid margin in MGD was more abundant in C. macginleyi, C. accolens, and C. simulans compared to the MGD + LD and control (P < 0.05). There were differences in the overall microbial community composition and certain taxa, including increased levels of lipophilic bacteria, on the conjunctiva and eyelid margin in mild to moderate DED/MGD compared to controls. DED/MGD was also associated with a reduced bacterial richness and diversity in females.

Tear Fluid Biomarkers and Quality of Life in People with Type 2 Diabetes and Dry Eye Disease.

Dry eye disease (DED) can be extremely distressing and is common in type 2 diabetes (T2D). To investigate potential biomarkers of DED in T2D, panels of proteins in tears, alongside clinical signs and symptoms of DED, were assessed. Patients were classified into four groups: T2D + DED (n = 47), T2D-only (n = 41), DED-only (n = 17) and healthy controls (n = 17). All patients underwent the Ocular Surface Disease Index (OSDI) and Dry Eye-Related Quality of Life (DEQS) questionnaires, tear evaporation rate (TER), fluorescein tear break-up time (fTBUT), corneal fluorescein staining (CFS) and Schirmer 1 test assessments. Six metabolic proteins and 14 inflammatory cytokines were analyzed with multiplex bead analysis. Interleukin (IL)-6 and IL-8 concentrations in tears were significantly higher in the T2D + DED group, and these biomarkers were positively correlated with CFS. In addition, tear IL-6 was negatively correlated with fTBUT in the T2D + DED group. Clinical signs of DED in the T2D + DED group were similar to the DED-only group. The T2D + DED group had more patients with moderate and severe DED (versus the DED-only group), suggesting a different pathogenesis for DED in T2D versus DED-only. Therefore, IL-6 and IL-8 could potentially be diagnostic biomarkers of DED in T2D.

Dry eye disease in diabetics versus non-diabetics: Associating dry eye severity with diabetic retinopathy and corneal nerve sensitivity.

To compare the prevalence of dry eye disease (DED) and assess corneal nerve sensitivity (CNS) in diabetic and non-diabetic patients. To study the association of severity of DED in patients with diabetic retinopathy (DR) and CNS in DED. A cross-sectional prospective comparative study was conducted on 400 patients attending the ophthalmology OPD. The patients above 18 years of age were divided into two groups-diabetic (T2DM) and non-diabetic. All patients were subjectively assessed for DED based on Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire and objectively, using Schirmer's II test and Tear Film Break-Up Time (TBUT). Visual acuity assessment, anterior segment, and posterior segment evaluation were done. Considering the SPEED score, Schirmer II values, TBUT values, and Dry Eye Work Shop (DEWS) II diagnostic criteria, mild DED was seen in 23% diabetic and 22.25% non-diabetic groups, moderate DED in 45.75% diabetic and 9.75% non-diabetic groups, and severe DED in 2% diabetic and 1.75% non-diabetic groups. Moderate DED was more common within all grades of DR. CNS was reduced more in diabetic group and also in patients with higher degree of DED. Prevalence of DED is more in the patients with T2DM. CNS was reduced more in patients with T2DM and in patients with moderate DED. Our study also correlated that severity of DR affects the severity of DED.

Comparing the efficacy of sodium hyaluronate eye drops and carboxymethylcellulose eye drops in treating mild to moderate dry eye disease.

Aim of this study was to compare the efficacy of sodium hyaluronate (SH) and carboxymethyl cellulose (CMC) eye drops in treating mild to moderate dry eye disease in terms of relief of symptoms, mean change in tear film breakup time, Schirmer's test, and impression cytology of conjunctiva from baseline. An observational study was carried out during a 2-year period in our tertiary referral hospital. The study consisted of 60 patients randomly allotted to two groups to receive SH and CMC eye drops for an 8-week period. Ocular surface disease index, tear film breakup time, and Schirmer's test were performed at baseline visit and 4 and 8 weeks of treatment, and impression cytology of conjunctiva was performed at baseline and 8 weeks. Significant improvement in patient symptoms, tear film breakup time, and Schirmer's test from baseline was seen in both SH and CMC groups at 8 weeks posttreatment, whereas impression cytology of conjunctiva in both groups did not show significant improvement at 8 weeks of treatment. Data analysis using unpaired t-test showed comparable results. Both CMC and SH demonstrated equal efficacy in treating mild to moderate dry eye disease.