Moderate Dry Eye Research Articles

Comparison of tear Matrix Metalloproteinase 9 (MMP-9) estimation with Schirmer's test in Ocular Surface Disorders.

Ocular surface disorder (OSD) is a vexed eye problem and a diagnostic conundrum. Diagnosis has traditionally depended upon symptoms and tests like Schirmer's, TBUT, staining with dyes, and tear meniscus height. Schirmer's test is the most popular. However, the test strips irritate with reflex tearing - producing false high results. Matrix Metalloproteinase 9 (MMP) in the tear is believed to be expressed by stressed epithelial cells of the corneal surface - a key pathology in dry eye disease. This study attempts to compare the results of Schirmer's test and MMP-9 so that the test can individually or severally add to a more definite diagnosis of dry eye disease. 100 eyes of 50 symptomatic patients underwent MMP-9 estimation and were divided into two groups (MMP-9+ve and MMP-9-ve). They were then sub-grouped as per DEWS-2007 based on Schirmer test levels and Ocular Symptomatology Score (OSS). The two groups were compared for severity of dry eye based on Schirmer's test and OSS. Mean Schirmer's value was 12.85 (SD 7.07) for MMP-9+ve and 19.18 (SD 8.94) for MMP-9-ve patients. 80% of patients with severe dry eye and 55.6% of moderate dry eye patients were positive for MMP-9. 85% of the MMP-9 patients had OSS values of 2 or 3. A higher OSDI and positive MMP-9 were shown to be correlated in a statistically remarkable way (p<0.001). The OSDI values of 0-12 for 3/44 (6.8%) positive results, 13-22 for 2/8 (25%) positive results, 23-32 for 4/14 (28.6%) positive results, and 33-100 for 13/35 (37.1%) positive results all showed an increase in MMP-9 positivity along with a rise in the subjective severity of the illness. MMP-9 compares well with Schirmer's values and DED categories based on Schirmer's. The result pointed towards the usefulness of this test in diagnosing patients who may have not yet manifested symptoms.

Effect of low-level light therapy in individuals with dry eye disease.

Low-level light therapy (LLLT) or photobiomodulation, the application of red light to the eye, is used for the treatment of dry eye. Limited studies have investigated the efficacy of LLLT as a stand-alone treatment. The investigation aimed to evaluate the effect of LLLT on signs and symptoms of dry eye. Participants with mild to moderate dry eye were recruited for this three-visit study. Visits were 7 (±3) days apart and all participants received 633 nm LLLT (eye-light®) for 15 min at each visit. Clinical measures including first and average non-invasive keratograph tear break-up time (NIKBUT), tear meniscus height (TMH), meibomian gland (MG) loss for upper and lower eyelids, ocular surface disease index (OSDI) score, tear film lipid layer thickness, meibum quality score, Schirmer's test, corneal fluorescein staining and eyelid temperature for external upper (EUL) and external lower (ELL) eyelids were measured from the right eye of participants before and after treatment. Thirty participants (mean [SD] age: 31.1 [9.5] years) completed the study. Treatment with LLLT resulted in significant differences in first and average NIKBUT, TMH, tear film lipid layer thickness, OSDI score, Schirmer's test, meibum quality score and eyelid temperature over time (all p < 0.05). Compared to baseline, TMH, tear film lipid layer thickness and eyelid temperature significantly increased by 0.06 mm (95% CI: 0.01-0.11), 12.9 nm (95% CI: 1.18-24.55), and 7.0°C, respectively,for both EUL (95% CI: 6.17-7.84) and ELL (95% CI: 6.17-7.73). The respective decrease in the OSDI score and Schirmer's test was 10.2 (95% CI: -15.15 to -5.26) and 4.4 mm (95% CI: -7.31 to -1.42; all p < 0.05). There was no significant difference in corneal fluorescein staining and MG loss after LLLT. Low-level light therapy treatment significantly improved signs and symptoms of dry eye in the early phases of treatment, suggesting its efficacy for dry eye management.

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 &lt; 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.

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.

Efficacy and safety of artificial tears containing Artemia salina extract with dinucleotides for dry eye

ABSTRACT Clinical relevance This clinical trial was conducted as part of the marketing procedures for a medical device comprising artificial tears containing Artemia salina extract with dinucleotides. These molecules previously demonstrated secretagogue properties by enhancing the production of aqueous, mucinous, and lipidic components of the tears. Background After confirming the efficacy of artificial tears containing Artemia salina extract in an animal model, this study proceeded to evaluate their efficacy and safety on dry eye participants. Methods A randomised controlled clinical trial was performed on 36 dry eye participants (41.6 ± 20.6 years). Half of the participants were treated with saline solution as a placebo for four weeks, while the other half were treated with artificial tears containing Artemia salina, randomly assigned. After a wash-out period of two weeks, the treatments were crossed for another four weeks. Participants were assessed at baseline and after one week, two weeks, and four weeks. Efficacy variables were: eye dryness frequency (primary), eye comfort, visual satisfaction, tear secretion, tear break-up time, corneal staining, conjunctival staining, and conjunctival hyperaemia. Safety variables were: high- and low-contrast visual acuity, intraocular pressure, and eye fundus images analysis. Results Compared with the baseline, the saline solution showed no significant changes in any of the studied variables after four weeks of treatment (p ≥ 0.05). However, the topical instillation of the artificial tears with Artemia salina for four weeks significantly improved eye dryness frequency (p = 0.014) and corneal staining (p = 0.010). No systemic or ocular adverse events were reported during the clinical trial. Conclusion The topical instillation of artificial tears containing Artemia salina in mild to moderate dry eye participants for four weeks slightly improved their symptoms related to eye dryness frequency and reduced corneal damage, with no undesirable side effects observed.

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.

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.

Immediate Impact on Tear Osmolarity Following the Application of Different Ocular Lubricants in Patients Experiencing Moderate Dry Eye Symptoms.

This study addresses the growing concern of Dry Eye Disease (DED), which has become increasingly prevalent due to modern lifestyles characterized by prolonged screen usage, global warming, polypharmacy, and extended life expectancy. Grounded in the Dry Eye Workshop II (DEWSII) diagnosis framework, the study focuses on DED as a multifactorial condition affecting the ocular surface's tear film homeostasis. The study evaluates the short-term impact of 5 commercially available ocular lubricants on disrupting the hyperosmolar environment and determine whether these lubricants can offer potential treatment benefits for DED. Conducted on 300 eyes (from 150 patients) with 5 preservative-free lubricants compared to a control group, the study reveals that all lubricants effectively reduced tear film osmolarity within 15 minutes of application. Notably, the control group exhibited an increase in average osmolarity (+0.98 mOsm/L) without lubricant use. Siccafluid demonstrated the most substantial osmolarity reduction after 15 minutes, with an average decrease of 11.54 mOsm/L. Statistical significance was observed for Siccafluid, Optive Fusion unique dose (UD), and Systane Ultra UD, while Hyabak and Freegen preservative free (PF) showed lower significance. Emphasizing the importance of disrupting the hyperosmolar environment to break the cycle of inflammation, the study concludes that ocular lubricants, at least as an immediate post-application effect, can interrupt this cycle and improve the hyperosmolar environment of the ocular surface.

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.

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.

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.

A Preservative-Free Approach - Effects on Dry Eye Signs and Symptoms After Cataract Surgery.

To compare the effect of treatment with preservative-free dexamethasone, NSAIDs and trehalose/hyaluronic acid eye drops with the preservative benzalkonium chloride containing dexamethasone and NSAIDs after cataract surgery in dry versus non-dry eyes. In this prospective randomized intervention study, dry eye tests were performed before and 6 weeks after cataract surgery. Patients were considered as having dry eye, SDE (sign of dry eye), if at least one of the following dry eye tests were abnormal; corneal fluorescein staining (CFS), non-invasive keratograph breakup time (NIKBUT) or tear osmolarity. Patients with SDE were randomly assigned to one of two groups. Group 1 patients were treated with dexamethasone and bromfenac eye drops with the preservative benzalkonium chloride (BAC). Group 2 patients were treated with preservative-free dexamethasone and preservative-free diclofenac, as well as a preservative-free lubricant with trehalose and hyaluronic acid both before and after surgery. Patients with normal tear film status acted as the control group (group 3) and received same treatment as group 1. A total of 215 patients were enrolled six weeks after surgery, the number of patients with SDE decreased significantly in groups 1 and 2 (p <0.001). Subjective symptoms and objective measures including osmolarity, NIKBUT, CFS, and tear film thickness (TFT) improved after surgery, tear production remained unchanged, while corneal sensitivity and meibomian gland dysfunction (MGD) parameters worsened. In the control group with normal tear-film status, SDE increased significantly after the surgery (p <0.001). There were no statistically significant differences in tear film parameters between the three groups after surgery. After cataract surgery, patients with mild to moderate dry eyes may experience improved tear film status and reduced symptoms. However, we found no additional beneficial effect on dry eye parameters with treatment with preservative-free dexamethasone, NSAIDs, and lubricants compared to preservative-containing eye drops.

Frequency of Dry Eye in Migraine Patients

Dry eye disease and migraine are prevalent conditions in the general population. While there is evidence of symptoms overlapping, few studies have quantified the occurrence of dry eye in migraine patients. The study was conducted to find the frequency of dry eye syndrome among individuals with migraines. Objective: To evaluate the “frequency of dry eye disease in migraine patients”. Methods: This descriptive cross-sectional study included 217 clinically diagnosed migraine patients between the ages of 18 to 29 at the University of Lahore Teaching Hospital. The study took place over four months, from February 2023 to May 2023. Dry Eye Disease was assessed using the dry eye symptoms questionnaire (Speed II Questionnaire) and Schirmer test 1 as the primary diagnostic tool. Results: The analysis included calculating descriptive statistics (percentages and means) and presenting results in tables and figures for clarity and understanding. Out of 217 migrainous patients, 38.2% of participants had normal eyes. Among the rest, 17.1% showed Mild, 2.3% Moderate dry eye. The Schirmer Test showed that 41.9% had suffered from severe dry eye. Overall, the study showed that 133 patients (61%) suffered from dry eye. Conclusions: The study's conclusion highlighted a notable rise in dry eye disease among migraine patients, in line with previous research. This underscores the need for further exploration into the underlying mechanisms and therapeutic interventions for individuals dealing with both conditions.

Managing the ocular surface after glaucoma filtration surgery: an orphan topic.

Ocular surface (OS) disorders before glaucoma filtration surgery (GFS) have been considered to play a crucial role influencing the surgical outcome. Conversely, the impact of surgery itself on the OS is almost completely overlooked, though evidence suggest that ocular surface disease (OSD) may be induced in patients by GFS. This review analyzes the determinants involved in the OSD development after GFS, the clinical features and related consequences, the main diagnostic hallmarks, as well as the therapeutic strategies for its management. The PubMed database was utilized for the literature examination. Keywords that were searched included ocular surface disease, glaucoma filtration surgery, filtration bleb, post-surgical management, and quality of life. After GFS, OSD is promoted by peri- and post-operative factors, such as the filtration bleb (FB) development, combined surgical approach with phacoemulsification, the use of antifibrotic agents and the reintroduction of antiglaucoma medications. This particular form of OSD that present similar clinical features to mild to moderate dry eye, can be named as post-glaucoma surgery-OSD (PGS-OSD). PGS-OSD may negatively affect the FB functionality, thus potentially hindering the disease control, and significantly worsen the patient quality of life (QOL). Clinicians are encouraged to routinely include the OS evaluation after GFS and to consider proper management when the occurrence of PGS-OSD worsen the patient's QOL or exert negative effects to the FB functionality. An outline summarizing the main risk factors and the most appropriate therapeutic options to mitigate the PGS-OSD was proposed to support the routine practice.

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.

Prolonged facemask wearing among hospital workers and dry eye – a mixed-methods study

BackgroundProlonged facemask wearing may have negatively affected essential workers with dry eye. We conducted a mixed-methods study to examine and understand the associations of the ocular surface, periocular environment, and dry eye-related symptoms among hospital workers across the job spectrum with prolonged facemask use.MethodsWe recruited clinical and non-clinical hospital workers with self-reported symptoms of dry eye and prolonged facemask use. We measured symptoms using the 5-item Dry Eye Questionnaire and the Ocular Surface Disease Index (OSDI). Objective ocular signs included corneal and conjunctival staining, fluorescein tear break up time (TBUT), meibography, tear film interferometry, and periocular humidity. We compared symptoms and signs across levels of periocular humidity, dry eye severity, facemask type, and job type. Participants with moderate or severe dry eye symptoms (OSDI > = 23) were invited for a semi-structured, one-on-one interview.ResultsWe enrolled 20 clinical and 21 non-clinical hospital workers: 27% were 40 years or older, 76% were female, 29% reported a race other than White, and 20% were Hispanic. Seventeen individuals participated in the semi-structured interviews. From the quantitative analyses, we found that 90% of participants reported worsened severity of dry eye at work due to facemasks. Although wearing facemasks resulted in higher periocular humidity levels compared with not wearing facemasks, 66% participants reported increased airflow over their eyes. Findings from the qualitative interviews supported the finding that use of facemasks worsened dry eye symptoms, especially when facemasks were not fitted around the nose. The data did not suggest that non-clinical hospital workers experienced a greater impact of dry eye than clinical workers.ConclusionsHealthcare providers and patients with dry eye should be educated about the discomfort and the ocular surface health risks associated with inadequately fitted facemasks. Wearing a fitted facemask with a pliable nose wire appears to mitigate the upward airflow.

REGENOPIA – PROMISING NEW TREATMENT FOR DRY EYE DISEASE

Dry eye syndrome is one of the main problems of modern ophthalmological pathology. Although the treatment of dry eye syndrome has made great strides, the development of new treatments continues to be a major challenge for scientists and ophthalmologists around the world. The development of highly effective and safe eye drops is especially important. The aim of the article is to conduct research on new eyedrops called Regenopia – the unique combination of three active substances: sodium hyaluronate, trehalose, and D-panthenol in the treatment of DED. Clinical observation of 128 patients (256 eyes) (85 women and 43 men 18-60 years age group with DED (patients with any chronic or autoimmune diseases were excluded from the research) treated with Regenopia was conducted from February 1-st to May 30-th, 2023. DED was diagnosed by anamnesis and instrumental clinical investigations (Visometry, Biomicroscopy, Schirmer’s test, Tear Break up time (TBUT)). Moderate dry eye - 75% (192 eyes), severe dry eye - 25% (64 eyes). In 24 eyes Superficial Punctate Keratitis (SPK) was determined after examination of the epithelial layer of the cornea and conjunctiva. One drop of Regenopia was instilled 3 times a day in both eyes by patients (in cases of SPK complex method of treatment was prescribed) and patients were called for a repeat visit in 3 weeks and 6 weeks after the start of treatment. The condition was assessed using the same methods as at the time of diagnosis. The bioprotective, osmoprotective, regenerative properties of trehalose significantly enhance hyaluronic acid’s ability to provide effective hydration and long-term symptom relief along with the regenerative action of dexpanthenol. Using Regenopia significantly reduced the intensity of symptoms, increased the patient’s ability to work, and improved the quality of life, which allows us to recommend Regenopia as an effective, safe and reliable treatment for moderate to severe dry eye disease.