Moderate Dry Eye Research Articles

New Possibilities for Hyposecretory Dry Eye Treatment

Purpose: to evaluate the effectiveness of a fixed combination of 0.24 % hyaluronic acid, carbomer, glycerol and a lipid component in the hyposecretory dry eye treatment. Patients and methods. We examined 35 hyposecretory moderate dry eye (DE) patients in conditions of lipidaquas-mucin deficiency and meibomian gland dysfunction (MGD). All patients included in the study received instillations of a fixed combination of 0.24 % hyaluronic acid (in the form of sodium hyaluronate), carbomer, glycerol and a lipid component (in the form of medium chain triglycerides) — Artelak Night (3 times a day, 2 months). The main criterion for the effectiveness of therapy was the tear film brake up time (TBUT, Norn’s test, s). In addition, the dynamics of the following indicators were taken into account: OSDI (scores), “lid-wiper’ symptom (LWS, scores), lower tear meniscus height (LTMH, μm; OCT, OptoVue), Bijsterveld`s xerosis index (XI, scores; lyssamine green stained). Control points: at inclusion in the study; examination after 1 and 2 months of therapy. Statistics: calculation of the mean and its standard deviation (M ± s); assessment of the reliability of differences in indicators characterizing the state of the ocular surface before and after therapy (Wilcoxon t-test). Results. The patients showed a statistically significant increase in TBUT at the second and third control points, which indicated the effectiveness of DE therapy. The increase in TBUT was accompanied by a significant decrease in the severity of DE subjective symptoms at the same control points (OSDI). On the background of therapy, a trend towards a decrease in LWS was recorded, which was statistically insignificant. Apparently, a significant increase in TBUT and a decrease in OSDI were associated with a significant increase in LTMH at the third control point (decrease in the severity of aqua-deficiency) and a significant decrease in XI at the second and third control points (decrease in the severity of mucose-deficiency). Conclusion. A fixed combination of 0.24 % hyaluronic acid, carbomer, glycerol and a lipid component proved to be effective in the treatment of hyposecretory moderate DE in conditions of lipid-water-mucin deficiency, which was accompanied by a significant increase in TBUT and LTMH, as well as a decrease in OSDI and XI.

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.

HUBUNGAN ANTARA PERILAKU MEROKOK DENGAN KEJADIAN SINDROM MATA KERING PADA MASYARAKAT KELURAHAN OESAPA KOTA KUPANG

Cigarette smoke can damage the lipid layer and cause tear hyperosmolarity that may lead to dry eye syndrome symptoms. This study aim to determine the relationship between smoking behavior and dry eye syndrome in the community of Oesapa Ward, Kupang City. This research is an observational analytic study with a cross sectional design. Data was conducted by filling out the Smoking Behavior questionnaire and Ocular Surface Disease Index (OSDI) questionnaire. Sampling was done by using stratified random sampling technique and the result was analyzed univariate and bivariate using Spearman Rank correlation test. Data from the 110 respondents, 96.4% had high smoking behavior, 3.6% had moderate smoking behavior and none had low smoking behavior. For dry eye, 49.1% had normal eyes, 21.8% had severe dry eyes, 19.1% had mild dry eye syndrome and 10.0% had moderate dry eye syndrome. The bivariate analysis with the Spearman Rank correlation test showed the results of p = 0.952 (p>0.05). The conclusion is there is no significant relationship between smoking behavior and dry eye syndrome in the community of Oesapa Ward, Kupang City.

Association Between Screen Time and Tear Film Stability

Tear film is a layer that nourishes, lubricates and protects the anterior surface of eye. The usage of electronic gadgets can affect the tear film stability causing ocular dryness. Recently, due to the increased frequency of online educational and leisure activities, there has been reported increase in the prevalence of dry eye among users of electronic gadgets. Objective: To evaluate association between screen time and stability of tear film. Methods: A descriptive cross-sectional study was conducted from January to august 2021 at The University of Lahore. 120 participants aged above 18 years were recruited using nonprobability sampling technique. After taking consent from the participant’s questionnaire was completed, followed by slit lamp examination for evaluation tear film breakup time (TBUT). Results: 120 healthy people of either gender who were at least 18 years old participated in this study, selected through random sampling, informed consent was acquired from all participants. The TBUT test was performed on all subjects, 74 had severe dry eyes, 21 had moderate dry eyes, and just 24 had normal eyes. Each subject's screen time was tracked after the subjects were divided into four groups. The Chi square was used to assess the relationship between screen time and tear film break up time. Results had a p value less than 0.01 and were statistically significant. Conclusions: This study concluded that as the screen time increases it effects the stability of tear film.

EFFECTS OF COMPUTER VISION SYNDROME ON TEAR FILM QUALITY OF INDIVIDUALS ACROSS VARIOUS AGE GROUPS AND OCCUPATIONS

Objective: Computers become a part of everyday life because it has to a greater extent, revolutionized most professions and their work performance. Spending uninterrupted and excessive time in computers and other display devices without taking precautions and prevention leads to significant ocular problems, which are being grouped together as - computer vision syndrome (CVS). The present study was conducted in a tertiary care center to evaluate the effects of CVS on tear film quality in individuals across various age groups and occupations. Methods: A cross-sectional study was conducted at a teaching institute from August 2021 to September 2022, in which 600 patients who worked on computers or digital devices for at least 3 h daily were included in this study. In all patients, a complete ocular examination was performed, including visual acuity, refraction, Schirmer’s test 1, tear film breakup, slit-lamp examination, intraocular pressure, and fundus examination by indirect ophthalmoscopy. Results: In the present study, most of the participants in this study belonged to 21–30 years of age. Among study participants with CVS and screen time of more than 8 h, 88% had moderate and severe dry eyes. On comparison of mean values of the Schirmer’s test between participants with CVS, it was observed that mean Schimers (4.5 mm in the right eye and 5 mm in the left eye) and tear film breakup time (4.9) were much lower among study participants with CVS whose screen usage time was more than 8 h. Conclusion: The present study found that computer vision conditions are very common. In addition, the likelihood of developing the same was higher among IT employees and engineering students.

Состояние системы глазной поверхности у детей с аномалиями рефракции

Purpose. To evaluate subjective signs and objective clinical symptoms of disorders of the ocular surface system in children with refractive errors. Material and methods. 76 children (152 eyes) with ametropia aged 8 to 18 years were examined. All patients were divided into 2 groups: group 1 – 30 patients aged 8 to 11 years, group 2 – 46 patients aged 12 to 18 years. The severity of the subjective signs of the "dry eye" syndrome and the state of visual comfort were assessed using an online survey developed by the authors. Objectively, the state of the ocular surface system was examined by invasive methods (Schirmer I test, Schirmer II test, Norn test), as well as non-invasive methods using a keratograph (non-invasive tear breakup time, tear meniscus height, meibography, assessment of the severity of hyperemia of the bulbar conjunctiva). In 20 patients (40 eyes) osmometry of the lower lacrimal meniscus was performed. Results. According to a survey of 76 patients, 34 patients (44.7%) had minor disorders of the ocular surface system, 25 patients (32.9%) had moderate disorders, 7 patients (9.2%) had severe disorders, and 10 patients (13.2%) – significantly severe disorders. The indicators of the main tear secretion in the younger age group differ slightly from the standards, while in the older age group they exceed them by 2 mm, the total tear production in both groups of the study was slightly lower than the age standards. The obtained values of reflex tear production are sharply reduced in both study groups, at the age of 12–18 years the deviation is more significant. The average tear film osmolarity in the group of 20 patients aged 12–18 years was 302.75 mOsm/l, which corresponds with adult standards, however, in 6 patients from this group, the values exceeded the standards up to 332 mOsm/l, which is typical for moderate severity dry eye syndrome. It has been established that the indicators of tear film stability measured by both invasive and non-contact methods have similar values. In the group of children from 12 to 18 years old, the indicators are at the lower limit of the norm, however, the spread of the results indicates that there were patients with reduced indicators in the group. The number of eyes with loss of meibomian glands ducts of the 1st degree in the group of children aged 12–18 years was 31.5%, while in the younger group it was 26.7%. A mixed injection of the conjunctiva in the form of hyperemia of the 2nddegree was observed in 10.8% of the eyes in the older group, while in the other group only in 3.4% of the eyes. If more significant subjective chnges were detected, in combination with a deviation from the norms in clinical trials, it was advisable to prescribe age-appropriate drug therapy to patients to correct these conditions. Conclusion. When evaluating the subjective signs of a disorder of the state of the ocular surface system in children, special attention should be paid to the procedure for collecting an anamnesis and quantitative assessment of symptoms. Even in the absence of complaints, it is necessary to conduct an objective, preferably non-invasive study of the stability of the tear film, the state of the meibomian glands, and, if necessary, tear production. When a complex of subjective signs of moderate severity is detected, it is necessary to conduct an explanatory conversation with patients and their parents, paying attention to the aspects of eliminating risk factors for the development of disorders of the ocular surface system. Key words: ocular surface system, tear secretion, tear film stability, meibography

Vitamin D Status Among Patients With Dry Eye Syndrome Attended In Bangabandhu Sheikh Mujib Medical University (BSMMU)

Background: Dry eye syndrome (DES) is a common ocular manifestation. Artificial tears provide relief of eye irritation in patients with aqueous tear deficiency, but do not treat the underlying inflammation in Dry eye syndrome. Aim: To assess the vitamin D status of the dry eye syndrome patients. Methodology: This cross-sectional study was conducted in the Department of Community Ophthalmology, BSMMU, Shahbag, Dhaka, from July 2019 to June 2020. Within the period a total of 50 cases of dry eye syndrome patients that met the inclusion criteria were taken as samples after receiving their informed consent. Detailed history, physical examination and Ophthalmological examination including Tear film Breakup Time (TBUT) of each patient was performed and recorded. Eye discomfort was assessed by the Ocular Surface Disease Index (OSDI) the score of which ranges from 0 to 100. A score of 12 was used as a cutoff for normal, 13–22 for mild dry eye, 23–32 for moderate dry eye, and ≥ 33 for severe dry eye. Tear film Breakup Time (TBUT) <10 s was taken as abnormal. Results: In this study, mean (±SD) fluorescein Tear film Breakup Time (TBUT) was 5.89±1.31 sec, Schirmer test without anesthesia was 7.45±2.31mm/5 min, Schirmer test with anesthesia was 9.06±2.06mm/5 min and Ocular Surface Disease Index (OSDI) was 34.44±5.64. Mean (±SD) serum vitamin D level ng/mL was 5.89±1.31 ng/mL. 14 (28%) cases were found as insufficient, 33 (66%) cases were deficient and only 3 (6%) cases found to have normal Vitamin D status. Vitamin D level was positively correlated with Tear Breakup Time (TBUT), Schirmer test1 and Schirmer test2 and negatively correlated with OSDI. This correlation was statistically significant for Tear film Breakup Time (TBUT), Schirmer test2 and Ocular Surface Disease Index (OSDI). Conclusion: Vitamin-D deficiency appears to have an effect on ocular surface parameters in patients with dry eye syndrome. The Journal of Ad-din Women's Medical College; Vol. 11 (2), July 2023; p 3-8

A Clinical Study on Severity of Dry Eye in Individuals with Pterygium at a Tertiary Hospital in South Kerala.

To assess the severity of dry eye in individuals with pterygium in a tertiary care hospital. This cross-sectional study was done on 70 individuals with pterygium who were attending the outpatient department of ophthalmology. Objective dry eye tests were done, including Schirmer's tests 1 and 2, tear film breakup time, and tear meniscus height (TMH). In this study, patients with one or more positive clinical tests were diagnosed to have dry eyes. Dry eye was graded as mild, moderate, severe, or severe disabling. Among 140 eyes, 79 eyes had pterygium. According to Schirmer's test 1 in eyes with pterygium, 29.1% of the eyes had mild dry eyes, and 26.6% had moderate dry eyes. According to Schirmer's test 2 in eyes with pterygium, 25.3% of the eyes had mild dry eyes, and 26.6% had moderate dry eyes. Tear film breakup time in eyes with pterygium showed a mild dry eye in 25.3% and moderate dry eye in 17.7%. TMH in eyes with pterygium was low at 7.6%. The majority of eyes with pterygium have mild or moderate dry eye according to Schirmer's test 1, Schirmer's test 2, and tear film breakup time. No eyes with pterygium have severe dry eyes. TMH was also low in a small proportion of eyes with pterygium. Dry eye evaluation by Schirmer's test and tear breakup time is, therefore, a crucial clinical tool for early detection and prompt management of dry eye syndrome in pterygium patients.

Effect of manual small incision cataract surgery on pre-corneal tear film at a tertiary care centre

A common adverse effect of cataract surgery is dry eye disease (DED), which lowers postoperative patient satisfaction and results in substandard visual acuity. Tear film is disrupted during cataract surgery which leads to dry eye disease. Very few studies are available for the assessment of dry eye following manual small incision cataract surgery (MSICS) among the South Indian population. Hence, this study was conducted to determine the prevalence of dry eye and to evaluate tear film following manual small incision cataract surgery.:A prospective study was carried out in the Department of Ophthalmology at a tertiary care hospital for the assessment of dry eye following MSICS using dry eye indices like tear meniscus height, tear film break up time, Schirmer’s Test 1 and Rose Bengal staining. The patients were assessed preoperatively and at one week, one month and three months postoperatively.:In the first week following manual small incision cataract surgery, 21 eyes (33.3%), 26 eyes (41.3%), and 2 eyes (3.2%) experienced mild, moderate, and severe dry eyes, respectively. One month after MSICS surgery, 22 eyes (34.9%), 19 eyes (30.2%) and 1 eye (1.6%) had mild, moderate and severe dry eye respectively. The mean values of dry eye indices were normal preoperatively and significantly reduced at the one-week and one-month postoperative review.The dry eye illness began to manifest immediately following cataract surgery and peaked on day seven. Over time, symptoms of dry eye was seen to decrease. Despite satisfactory visual recovery, dry eye illness is a typical post-cataract surgery complaint that negatively impacts patient satisfaction and must be assessed and treated promptly.

Description of screen time and dry eye syndrome in medical students of UIN Alauddin Makassar

Link of Video Abstract: https://youtu.be/-B5Z8H6e4o0 Background: During pandemic, the amount of screen time in individuals is tremendously expanding. Excessive screen time may result in eye blinks reduction, tears evaporation, and eventually dry eye syndrome (DES). This study aims to show the descriptions of the duration of screen time and dry eye symptoms in medical students during the pandemic. Methods: This study uses a descriptive and cross-sectional methods. The subjects were students of The School of Medicine at UIN Alauddin Makassar, who were undergoing online learning. The data were collected through a questionnaire containing subjects' activities using gadgets per day and the Ocular Surface Disease Index (OSDI) to assess dry eye symptoms. Ophthalmological examinations for DES (blink rate, tear meniscus height, tear break-up time, Schirmer test) were also performed on the study subjects. Results: Most of the subjects are female and 22 years old. The average screen time of the subjects was 17.7 hours per day. Two subjects (4.55%) had mild dry eye symptoms, 14 subjects (31.82%) had moderate dry eye symptoms, and 28 subjects (63.64%), had severe dry eye symptoms. This study also found that the average blink rate of the subjects was 11.36±7.45 times per minute, and the average TBUT value was 10.58±2.69 seconds. Schirmer 1 examination showed a value with a mean of 23.67±12.76 mm, and Schirmer 2 examination showed a value of 20.21±11.64 mm. Conclusion: The average screen time of the subjects was 17.7 hours. Most subjects had severe dry eye symptoms (63.64%) and low blink rate (59.09%).

Analysis of postoperative ocular surface changes and intervention effect after pars plana vitrectomy in meibomian gland dysfunction dry eye patients.

To observe ocular surface changes after phacovitrectomy in patients with mild to moderate meibomian gland dysfunction (MGD)-type dry eye and track clinical treatment response using a Keratograph 5M and a LipiView interferometer. Forty cases were randomized into control group A and treatment group B; the latter received meibomian gland treatment 3d before phacovitrectomy and sodium hyaluronate before and after surgery. The average non-invasive tear film break-up time (NITBUTav), first non-invasive tear film break-up time (NITBUTf), non-invasive measured tear meniscus height (NTMH), meibomian gland loss (MGL), lipid layer thickness (LLT) and partial blink rate (PBR) were measured preoperatively and 1wk, 1 and 3mo postoperatively. The NITBUTav values of group A at 1wk (4.38±0.47), 1mo (6.76±0.70), and 3mo (7.25±0.68) were significantly lower than those of group B (7.45±0.78, 10.46±0.97, and 11.31±0.89; P=0.002, 0.004, and 0.001, respectively). The NTMH values of group B at 1wk (0.20±0.01) and 1mo (0.22±0.01) were markedly higher than those of group A (0.15±0.01 and 0.15±0.01; P=0.008 and P<0.001, respectively); however, there was no difference at 3mo. The LLT of group B at 3mo [91.5 (76.25-100.00)] significantly exceeded that of group A [65.00 (54.50-91.25), P=0.017]. No obvious intergroup difference was found in MGL or PBR (P>0.05). Mild to moderate MGD dry eye worsens in the short term after phacovitrectomy. Preoperative cleaning, hot compresses, and meibomian gland massage as well as preoperative and postoperative sodium hyaluronate promote the rapid recovery of tear film stability.

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.

Subjective Dry Eye Symptoms in Pregnant Women-A SPEED Survey.

Multisystemic physiological changes in pregnancy can result in tear film and refractive changes in the eye. We report dry eye prevalence in pregnant women using Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire. The SPEED questionnaire was self-administered cross-sectionally to 428 pregnant women (mean age: 26.8 ± 4.4 years) with clinically confirmed pregnancy from two obstetric clinics in Chennai, India. Subjects with predisposing risk factors for dry eye were excluded from the study. Subjects were categorized as normal, moderate, and severe dry eye based on the SPEED score. Among the women, 48.5% of the subjects had symptoms like dryness, grittiness or scratchiness, soreness or irritation, burning or watering, or eye fatigue. About 2.3% had moderate dry eye according to SPEED questionnaire criteria. Eye fatigue was the most reported symptom and was present in 76.4% of women. The symptom frequency score and severity score had a strong and significant correlation (r = 0.95, P < .001). No significant correlation was noted among SPEED score vs age (r = -0.02, P > .05). No significant correlation was found between symptoms of dry eye and gravidity (ρ = -0.006, P > .05) and trimester (ρ = 0.38, P > .05). Binary logistic regression showed that only occupational status and systemic condition was significantly associated with dry eye symptoms. About half the pregnant women at the visit reported having one or more dry eye-related symptoms. As per the composite SPEED questionnaire score, dry eye was not prevalent among pregnant women irrespective of their age, gravidity, and the trimester, but we found a majority of pregnant women reported to have experienced dry eye-related symptoms, though tolerable. Awareness about dry eye during pregnancy will improve eye care seeking behaviour in pregnant women.

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

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

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.

Using diabetic patients once daily fingerprick autologous blood eye drops for diabetic dry eye disease- A modified regimen to treat and prevent diabetic dry eye disease

Purpose: Diabetic patients tend to suffer from dry eye disease due to associated various reasons. Autologous blood is both safe and effective for treating Dry Eye Disease (DED) according to studies. Several papers demonstrated feasibility and effectiveness of four times Fingerprick Autologous Blood (FAB) eye drops to treat dry eye disease. As some diabetic patients perform daily finger pricking to monitor blood glucose level, the blood that remains can be used to apply to eyes to treat and prevent dry eye disease. This study intends to investigate if once daily fingerprick autologous blood eye drop in conjunction with blood glucose test is feasible and effective for diabetic patients who suffer from mild to moderate dry eye disease also to avoid four times fingerprick. This may be the first study on using diabetic patients once daily fingerprick autologous blood eye drops for mild to moderate diabetic’s dry eye disease. Design, setting and participants: This case series study enrolled 25 diabetics patients with mild to moderate DED who received ophthalmological care at a single clinic in Honolulu, Hawaii. All patients were performing once daily finger prick tests to monitor their blood glucose level. Participants were instructed to instill the remaining FAB after blood glucose tests into the medial inner canthus of each eye for one month. Patients remained on their daily dry eye treatment regimen throughout the study. Main outcomes and measures: The OSDI (Ocular Surface Disease Index) scores to categorize severity of DED were used for comparison before and after using FAB eye drop daily for one month. A questionnaire was used to evaluate the acceptability and compliance. Result: 52% of patients after one month of the trial demonstrated improvement in categorization of the severity in DED and willing to continue in the future. Conclusion and relevance: FAB that remained after routine once daily blood glucose testing applied to the eyes may be feasible to enhance prevention and treatment of mild to moderate Diabetic DED. It may be disseminated and used in conjunction with the general practice in diabetic’s patient care.

Prevalence of Dry Eye Disease and Its Risk Factors Among the General Population of Saudi Arabia: A Cross-Sectional Survey.

Dry eye disease is a multifactorial chronic disorder of the ocular surface, which leads to symptoms of discomfort and distress. Dry eye disease is a global health concern and is one of the most frequent ocular diseases encountered in an ophthalmology clinic. The estimated prevalence of dry eye disease in the literature ranged from 7.4% to 93.2%. Saudi Arabia's population, especially in the eastern province, is at great risk of developing dry eye disease, however, there is hardly any nationwide study that assesses the prevalence of dry eye disease among the general population and its risk factors. The aim is to estimate the prevalence of dry eye disease and determine its risk factors among the general population of Saudi Arabia. This study was a cross-sectional study conducted on the general population of Saudi Arabia between September 2022 and November 2022. A convenient sampling technique was deployed for participant recruitment, where a self-administered questionnaire was created and dispersed to the general population all over the country with an invitation to participate in the study. Dry eye disease prevalence was assessed using Ocular Surface Disease Index survey. The Chi-square test was used to test for factors associated with the prevalence of dry eye disease, and undiagnosed dry eye disease. Multivariate logistic regression was also used to determine risk factors for dry eye disease. A total of 1,381 participants were included in this study. The prevalence of dry eye disease among the general population of Saudi Arabia was observed to be (17.5%). Among the participants (11%) had mild dry eye disease, (4.7%) had moderate dry eye disease, and (1.7%) had a severe dry eye disease. Among those observed to have a dry eye disease, (58.09%) were not previously diagnosed. The following factors were observed to be significantly associated with having dry eye disease, being female, having thyroid disease, having systemic lupus erythematosus/rheumatoid arthritis, using antidepressants, using antihistamine/decongestants, using electronic devices for a prolonged time, using contact lenses, having a history of eye surgery, history of conjunctival/eyelid infection, and history corneal abrasions/erosions/ulceration. This study revealed that the prevalence of dry eye disease among the general population of Saudi Arabia is notably lower than what was observed in other local studies and similar to what was found in some global studies. Adjusted binary multivariate logistic regression revealed that the risk factors were only: being female, using antidepressants, using antihistamines/decongestants, and prolonged use of electronic devices.

Clinical Efficacy, Tolerability and Safety of a New Multiple-Action Eyedrop in Subjects with Moderate to Severe Dry Eye.

Background: To assess the clinical efficacy, tolerability and safety of a new-generation ophthalmic solution containing cross-linked hyaluronic acid 0.15% trehalose 3%, liposomes 1% and sterylamine 0.25% (Trimix® Off Health Italia, Firenze, Italy) (CXHAL) versus trehalose 3% (Thealoz®, Thea Pharmaceuticals, Clermont-Ferrand, France) (TRS) in subjects with moderate to severe dry eye disease (DED). Patients and methods: In this prospective, observational cohort study, 41 subjects with moderate to severe dry eye were enrolled and divided into two age- and sex-matched groups. Group 1 was treated with CXHA eye drops, and group 2 was treated with TRS eye drops four times daily for 2 months. All subjects were evaluated at baseline (V0) and at day 60 ± 3 (V1). The examination comprised Best Corrected Visual Acuity (BCVA) and Symptom Assessment in Dry Eye (SANDE). Tear osmolarity was evaluated using the TearLab Osmolarity System®; Keratograph 5M (Oculus, Wetzlar, Germany) was performed to assess tear meniscus height (TMH), fluorescein tear break-up time (TBUT) and corneal and conjunctival fluorescein staining and meibography; furthermore, slit lamp evaluation was performed for eyelid erythema and edema, conjunctival chemosis and hyperemia and Meibomian gland secretion quality. Results: All patients completed the treatment. BCVA remained stable in both groups, and no adverse events were reported. After 2 months, both groups showed statistically significant improvements for SANDE (p = 0.001 and p = 0.012, respectively), TBUT values (p &lt; 0.001 and p &lt; 0.001, respectively) and staining (p = 0.004 and p = 0.001, respectively) as compared to baseline values. Group 1 showed a statistically significant improvement in SANDE frequency and tear osmolarity (p = 0.02 and p = 0.001, respectively), whereas chemosis was significantly reduced in group 2. The amount of TBUT improvement was statistically higher in group 1 compared to that in group 2 (p = 0.041). Conclusion: A new-generation multiple-action ophthalmic solution was safe and clinically effective in the treatment of moderate and severe dry eye, with significant improvements in the main ocular surface parameters.

Risk Factors Affecting Dry Eye Symptoms among Visual Display Terminal Users

Introduction: Dry eye symptoms are the common ocular complaints that are found at the ophthalmologic outpatient services. This research’s main purposes were to study the risk factors associated with dry eye symptoms and to evaluate the severity of dry eye among Visual Display Terminal (VDT) users. Methods: This study was a descriptive observational study involving 104 VDT users in 3 branches of the Social Security Offices and the Bureau of Labor Protection and Welfare in Samutprakarn province, Thailand. The study instruments used were: (1) questionnaires associated with VDT use and dry eye symptoms that were evaluated by using the Ocular Surface Disease Index (OSDI) and (2) Lux meter for desk-brightness and the angle of gaze measurement during VDT use. Data were analyzed using a Chi-square test and multiple logistic regression. Results: The results found that VDT users had severe dry eye symptoms, accounting for 51.9%, and experienced moderate and mild dry eye symptoms in the same number, which was 24.0%. In addition, dry eye symptoms were related to VDT use for 5-7 hours/day with statistically significant value. Other VDT use factors, including the desk-brightness or the angle of gaze during VDT use, were related to severe dry eye symptoms with no statistically significant difference. Conclusion: Based on the findings, VDT users should use VDT no more than 5 hours/day in order to reduce VDT-related dry eye symptoms. these factors were not statistically significant for the occurrence of severe dry eye symptoms.

Bilateral Effect of OC-01 (Varenicline Solution) Nasal Spray for Treatment of Signs and Symptoms in Individuals with Mild, Moderate, and Severe Dry Eye Disease

PurposeThis study compares outcomes of therapy with OC-01 (varenicline solution) for dry eye disease in study eyes and nonstudy fellow eyes of participants in 2 pivotal clinical trials. MethodsAll 891 patients randomized to receive OC-01 (varenicline solution) 0.03 mg, OC-01 (varenicline solution) 0.06 mg, or vehicle control (VC) in each nostril twice daily for 28 days in the Phase IIb ONSET-1 (Evaluation of the Efficacy of OC-01 Nasal Spray on Signs and Symptoms of Dry Eye Disease) and Phase III ONSET-2 trials were included in this post hoc analysis. One eye was designated as the study eye. The mean change from baseline in anesthetized Schirmer test score (STS) and the percentage of eyes achieving a ≥10-mm STS improvement were compared between treatments in study and fellow eyes overall and by baseline Eye Dryness Score. FindingsIn the study eyes, the mean STS improvement from baseline to day 28 was 10.4 mm, 10.5 mm, and 4.9 mm in the 0.03 mg, 0.06 mg, and VC groups, respectively; comparable values in nonstudy fellow eyes were 8.7 mm, 8.8 mm, and 2.7 mm, respectively. The percentages of study eyes achieving a ≥10-mm STS improvement were 48.1%, 48.4%, and 25.9%, respectively, whereas the comparable values in nonstudy eyes were 42.9%, 43.9%, and 19.7%, respectively. No significant treatment-subgroup interactions were observed in study or fellow eye STS outcomes by baseline Eye Dryness Scores <40 and ≥40 (p > 0.05 for all). ImplicationsOC-01 (varenicline solution) nasal spray had significant tear film production improvements compared with VC in both study and fellow eyes. These findings suggest efficacy across a broad spectrum of presenting disease severity.