Ocular Surface Disease Index Questionnaire Research Articles

Prevalence and Risk Factors of Dry Eye Disease in the South of Palestine.

The prevalence of dry eye disease (DED) is rising globally and needs to be urgently addressed by medical professionals because it lowers patients' quality of life. There are as yet no available data in the literature about the prevalence of and risk factors for DED in the Gaza Strip, a gap that the present study seeks to address. A cross-sectional study was carried out between March and August 2022 in Gaza governorates using a proportional stratified sampling technique. Only Gazan individuals ≥ 18 years old and able to follow the instructions were included. The Ocular Surface Disease Index (OSDI) questionnaire, which has previously been translated into Arabic and validated, was applied to evaluate DED symptoms. Subjective clinical tests for DED conducted were tear meniscus height (TMH), meibomian gland dysfunctions (MGDs), Marx line (ML), conjunctival Lissamine green staining (LGS), tear film break-up time test (TBUT), corneal fluorescein staining (CFS) and Schirmer II tear test (STT). DED was defined based on an Arab-OSDI score ≥ 13 and at least one positive clinical sign. A total of 426 participants were assessed from four areas (North Gaza Strip, 82; Gaza City, 147; Mid-Zone Gaza Strip, 62; South Gaza Strip, 135). The prevalence of DED in the present study was 31.5% (95% CI: 27.1, 36.1). Age > 50 years old (odds ratio [OR] = 10.45; 95% CI: 2.95, 37.05; P < 0.001), female gender (OR = 3.24; 95% CI: 1.40, 7.52, P = 0.006), menopause or pregnancy (OR = 2.59; 95% CI: 1.25, 5.35; P = 0.03) and pharmacotherapy (artificial tears; OR = 9.91; 95% CI: 2.77, 35.46; P < 0.001) were each associated with DED symptoms. South Gaza Strip (OR = 0.04; 95% CI: 0.01, 0.12; P < 0.001), unemployed (OR = 11.67; 95% CI: 1.43, 95.44; P = 0.02), non-consumption of caffeine (OR = 0.40; 95% CI: 0.19, 0.88; P = 0.02) and TMH < 0.2 (OR = 1.80; 95% CI: 1.02, 3.19; P = 0.04) were associated with TBUT < 5 s. LGS was associated with those > 50 years old (OR = 2.70; 95% CI: 1.38, 5.28; P = 0.004), previous refractive or ocular surface surgeries (OR = 2.97; 95% CI: 1.34, 6.59; P = 0.008) and CFS ≥ 1 (OR = 1.91; 95% CI: 1.07, 3.44; P = 0.03). Various aspects of DED were linked with different risk factors, suggesting that DED subtypes have different underlying pathophysiologies.

Assessment of tear film parameters post-treatment with commercial eyelid cleaning wipes: a pilot study.

To investigate the short-term effects of commercially available eyelid-cleaning wipes on film parameters. This study enrolled 48 healthy participants aged 20-35y (both males and females). Clinical assessment included the Ocular Surface Disease Index (OSDI) questionnaire, non-invasive tear break-up time (NITBUT), tear meniscus height (TMH), and lipid layer pattern (LLP). Based on these initial results, participants were categorized as either non-dry eye or dry eye. Participants in each group were randomly allocated to either Blephaclean® or Systane® treatments. Changes in NITBUT, TMH, and LLP levels before and after lid wipe treatment were assessed. The dry eye group exhibited significantly higher OSDI scores and lower NITBUT and TMH levels than in the non-dry eye group (P<0.001). Following the application of eyelid wipes (Systane® wipes), dry eye subjects experienced a significant improvement in NITBUT levels (P=0.0014) compared to the non-dry eye individuals. Although the remaining participants showed a marginal increase in TMH and NITBUT levels, these changes did not achieve statistical significance (P>0.05). Similarly, the LLP levels were significantly improved with Systane® (P<0.001) post-treatment compared to individuals in the non-dry eye group. However, the dry eye subjects showed higher post-treatment LLP levels than the untreated group (P<0.02). The short-term effects of Systane® eyelid wipes on tear film parameters suggest their effectiveness in dry eye disease. Nonetheless, further exploration of their long-term impact is essential to justify their cost effectiveness and efficacy in treating both aqueous deficiency and evaporative dryness.

Efficacy ofhydroxypropyl-guar dropsin improving tear film index and ocular surface dynamicsusing two treatment methods under a controlled desiccating environment.

This study aimed to assess the efficacy of hp-guar eye drops on tear film index and ocular surface dynamics under desiccating conditions using protection and relief treatment modalities. The 12 normal, non-dry eye participants were subjected to adverse environmental conditions using a Controlled Environment Chamber (CEC) where the relative humidity (RH) was 5% and the ambient temperature was 21°C. The participants were screened for ocular symptoms, tear osmolarity, ocular surface temperature (OST), tear production using the Ocular Surface Disease Index questionnaire (OSDI), OcuSense TearLab Osmometer, FLIR System ThermaCAM P620, and Schirmer strips. Tear production was calculated by the Tear Function Index test (TFI). The mean tear film osmolarity decreased significantly from 296mOsm/L at 40% RH to 285mOsm/L at 5% RH (p = 0.01). Conflicting responses were seen for osmolarity in protection and relief. Mean tear osmolarity was significantly higher in the protection method in comparison to the relief method (p = 0.005). The mean TFI increased from 557 at 40% to 854 at 5% (p = 0.02). A significant increase in TFI was observed in the relief method in comparison with both 40% (p = 0.001) and 5% (p = 0.04). In the relief method, the mean TFI score went up to 1139 when hp-guar was installed. A significant improvement in ocular comfort was experienced in both the protection (p = 0.041) and relief (p = 0.010) methods at 5% RH. The instillation of hp-guar drops in the relief method resulted in a significant reduction in OST. The mean OST dropped to 33.01 ºC, significantly lower than the recorded OST for both normal (p = 0.040) and dry (p = 0.014) environmental conditions. Hp-guar drops significantly improve tear film parameters under a desiccating environment, however, tear film parameters respond differently to the management modalities. In the protection method, tear film osmolarity was protected against a dry environment, while in the relief mode, an improvement in tear production and a decrease in ocular surface temperature were seen. Hp-guar performance could be maximized for the management of exposure to adverse environments by using a treatment protocol that targets the most affected parameters in each group of patients. Using CEC has the potential to provide researchers with a readily available method to evaluate the efficiency of tear supplementation.

A pilot study on Langerhans cells in keratoconus patients by in vivo confocal microscopy before and after corneal cross-linking and correlation with eye rubbing

PurposeThe aim of this study was to investigate the corneal microstructure and Langerhans cells using in vivo confocal microscopy in keratoconus patients before and after cross-linking, and to correlate the morphologic findings with clinical and patient-reported outcomes, including eye rubbing (ER) behavior. MethodsPatients with progressive keratoconus undergoing iontophoresis-assisted epithelium-on cross-linking (I-CXL) were consecutively enrolled. In vivo confocal microscopy was performed before and 6 months after treatment. Patients were asked to quantify their ER behavior on a Visual Analogue Scale (VAS) and completed the Keratoconus Outcomes Research Questionnaire and the Ocular Surface Disease Index questionnaires at the same time points. Visual acuity, tear osmolarity, topography, aberrometry, and pachymetry of both eyes were assessed. ResultsThirteen patients were included in this pilot study. Preoperatively, the mean Langerhans cells density was 35,615 cells per mm2, and the median morphology was 3. The mean ER VAS before treatment was 7,077 out of 10. The ER VAS showed significant positive correlations with both Langerhans cells density and morphology of the study eye. After treatment, a statistically significant reduction in ER VAS and in Langerhans cells variables was observed. The mean sub-basal plexus nerve density was comparable to pre-operative values 6 months after I-CXL. ConclusionsBased on this preliminary evidence, the presence of high density of mature Langerhans cells in the central cornea of keratoconus patients and its correlation with eye rubbing support the role of inflammation in keratoconus. The reduction in these markers after treatment may suggest a potential of CXL in moderating immune-related inflammation and eye rubbing in the medium term.

The impact of dry eye disease on retinal image quality in children

Background and ObjectivesDry eye disease (DED) is increasingly prevalent, resultinginhigher morbidityamong children. This study evaluates the impact of DED severity on visual quality using double-pass technology, focusing on dynamic observation of the ocular light scatter in pediatric DED cases. MethodIn this non-interventional, cross-sectional study, a mild DED group (37 cases, 37 eyes), a moderate DED group (40 cases, 40 eyes), and a control group of healthy children (35 cases, 35 eyes) were examined. Measurements included the Schirmer I test, tear film break-up time (BUT), and vision-related quality of life assessments using the Modified Ocular Surface Disease Index (OSDI) questionnaires. Participants underwent visual quality analysis using double-pass technology, which measured the modulation transfer function cut-off frequency value (MTF cutoff), Strehl ratio (SR), objective scatter index (OSI), and OQAS-II value (OQAS-II value OV100%, OQAS-II value OV 20%, and OQAS-II value OV 9%) under natural conditions. Additionally, dynamic changes in OSI post-blinking, Tear film mean-OSI (TFM-OSI), and the corresponding standard deviation OSI (SD-OSI) were recorded. ResultsStatistically significant differences were observed among the groups in modulation transfer function cutoff, Strehl ratio, OSI, OQAS-II value OV 100 %, OQAs-II value OV 20 %, OQAs-II value OV 9 %, tear film mean OSI, and standard deviation OSI (P < 0.05). As DED severity increased, tear film mean OSI significantly rose, while modulation transfer function cutoff, strehl ratio, OQAS-II value OV 100 %, OQAS-II value OV 20 %, OQAS-II value OV 9 % notably declined. All optical quality parameters were correlated with BUT, with no association observed with age, sex, or Schirmer I test. ConclusionDual-channel technology objectively assesses visual quality in pediatric DED, demonstrating that tear film scattering significantly affects retinal imaging and visual quality in children with DED.

State of the microbial spectrum (microbiome) of the ocular surface of patients with cataracts and glaucoma in the early postoperative period

Background. The occurrence of infectious complications in the early postoperative period in patients undergoing ophthalmic surgery remains a persistent challenge in contemporary clinical practice. Typically the treatment regimen involves the administration of a combination of antibiotics and corticosteroids, often utilized in a fixed-dose combination for simplicity. Despite the prevalent use of these regimens, there’s a notable disregard for comprehensive microbiological diagnostics of the conjunctiva in surgical patients, attributed to various socio-economic factors. However, the significance of such diagnostics in forecasting postoperative outcomes is indisputable. Purpose of the study: to determine the medical and economic feasibility of prescribing individual antibacterial and anti-inflammatory medications in fixed combinations (FC) in postoperative treatment regimens for patients scheduled ophthalmic surgeries. Materials and methods. The study included data from 99 patients (65 males and 34 females, mean age 74 (70–77) years) admitted for elective surgery to address cataracts or glaucoma from May to September 2023. Patients were randomly divided to 2 observation groups. The division into groups was carried out according to the drugs (medicines) used in the postoperative treatment regimens, each of which was further divided into 2 subgroups in accordance with ophthalmopathology. The first group of patients received postoperative therapy with the levofloxacin/dexamethasone FC (L-dexopt, RK.O. Rompharm Company S.R.L., RU LP-007490), the second group was treated with a tobramycin/dexamethasone FC (Tobrazon, Kadila Pharmaceuticals, RU P№015176/01). All subjects underwent a comprehensive ophthalmological examination, as well as a microbiological examination of the conjunctival cavity before surgery and 8 days after surgical treatment. Additionally, all patients completed the Ocular Surface Disease Index (OSDI) questionnaire. Results. Analysis of microbial flora changes during therapy revealed an increase in cultures exhibiting a “zero” degree of growth by 29 and 11,1 % in the “cataract” and “glaucoma” subgroups of the fi rst observation group, respectively. The second group showed a similar increase. “zero” degree of growth (11,7 and 28,6 %, respectively). The treatment costs for patients undergoing cataract surgery and receiving the FC levofloxacin/ dexamethasone were 105.9 rubles per treatment course, compared to 40.5 rubles for those undergoing surgery for glaucoma or complicated cataracts. The cost-effectiveness for those treated with the FC tobramycin/dexamethasone in the early postoperative period was 21,6 and 51,9 rubles. respectively. The OSDI scores across in all subgroups ranged from 16,6 to 25,0 points indicating normal values. The administration of FC levofloxacin/dexamethasone and tobramycin/dexamethasone in the early postoperative period for patients with cataracts and glaucoma was clinically effectively in managing the inflammatory process by influencing the microbial spectrum (microbiome) of the ocular surface. No significant differences were observed in the degrees of microflora growth during the preoperative period between the “cataract” and “glaucoma” subgroups, which does not support the hypothesis regarding the antiseptic action of topical antiglaucoma medications in patients with glaucoma at this stage. Conclusions. The conducted medical and economic analysis proved the feasibility of using both drug combination with a slight preference FC levofloxacin/dexamethasone in patients undergoing surgery for glaucoma and FC tobramycin/dexamethasone for those with uncomplicated cataracts in the early postoperative period.

The efficacy of bandage contact lens in relieving the aggravation of dry eye disease after complicated cataract or/and IOL surgery

PurposeIn the present study, we aimed to evaluate the efficacy of the bandage contact lens (BCLs) in the treatment of dry eye disease (DED) after complicated cataract or/and intraocular lens (IOL) surgery.MethodsIn this retrospective, single-centered, observational study, we collected data from 69 patients who underwent complicated cataract or/and IOL surgery. Of these, 35 cases wore their own BCLs immediately after the operation, while the other 34 cases did not have their own BCLs and were instead covered with gauze. The Ocular Surface Disease Index (OSDI) questionnaire, slit-lamp microscope examination, keratograph analysis, and Schirmer I test were measured at baseline, 1 week and 1 month postoperatively.ResultsIn the BCL group, the score of the OSDI questionnaire was significantly decreased at 1 week and 1 month postoperatively compared with baseline levels (P = 0.000, collectively). Moreover, the fluorescein staining score of the BCL group was remarkably decreased 1-week and 1-month postoperatively compared with the non-BCL group (P = 0.000 and P = 0.000, respectively). Furthermore, the redness score of the BCL group was also better compared with the non-BCL group at 1 week and 1 month postoperatively (P = 0.014 and P = 0.004, respectively).ConclusionsComplicated cataract or/and IOL surgery would intensify the DED. Early application of BCLs postoperatively improved patients’ comfort and alleviated dry eye-related symptoms and signs. Furthermore, this mechanism might involve the acceleration of corneal epithelial healing, the alleviation of ocular stress response and the stabilization of the tear film.Trial registrationTrial registration ClinicalTrials, NCT04120389. Registered 10 October 2019—retrospectively registered.

Evaluation of therapeutic efficacy of Emustil drops for ocular discomfort and tear film osmolarity using different treatment management modes under dry environmental conditions

BackgroundWe aimed to check the efficacy of Emustil (oil in water emulsion) drops on tear film index and ocular surface dynamics in dry environments through protection and relief treatment modalities.MethodsThe subjects were exposed to a dry environment using a Controlled Environment Chamber (CEC) where the relative humidity (RH) was 5% and the temperature was 21 °C and screened for ocular symptoms, tear osmolarity, ocular surface temperature (OST) and tear production using ocular Surface Disease Index questionnaire (OSDI), OcuSense TearLab Osmometer, FLIR System ThermaCAM P620 and Schirmer strips/phenol red test respectively. Tear production was calculated by the Tear Function Index test (TFI).ResultsThe mean tear film osmolarity decreased significantly from 296.8 mOsm/l at 40% RH to 291 mOsm/l at 5%. (p = 0.01). Instillation of Emustil resulted in a significant increase in tear osmolarity in the relief method compared with osmolarity seen at 5% RH when no drop was used. The mean PRT value decreased from 26 ± 9 in normal conditions (40% RH) to 22 ± 4 mm in dry conditions (5% RH). Emustil drops did not induce any significant change in tear production in the PRT test. No significant change was found in OST following exposure to 5% RH. OST did not show a statistically significant change with the emulsion when used for relief (p > 0.05). The mean score of ocular discomfort observed was 70 at 5% RH. Still, the instillation of the oil-in-water emulsion (Emustil) resulted in a noticeable decrease in visual discomfort to 37 (p = 0.00) in protection and 59 in relief (p = 0.05). Emustil drops substantially improved tear film parameters under a desiccating environment, however, tear film parameters respond differently to the management modalities. In the protection method, tear film osmolarity was protected against a dry environment, while in the relief mode, tear production was improved.ConclusionCEC allows for a thorough evaluation of tear film parameters and dry eye treatment protocols in labs, providing greater confidence when applying them to patients. In addition, our study showed that Emustil not only provides protection and relief for dry eyes but also helps to maintain ocular homeostasis in desiccating environments. This indicates a promising potential for improving dry eye treatment protocols.

Machine learning-based prediction of tear osmolarity for contact lens practice.

This study addressed the utilisation of machine learning techniques to estimate tear osmolarity, a clinically significant yet challenging parameter to measure accurately. Elevated tear osmolarity has been observed in contact lens wearers and is associated with contact lens-induced dry eye, a common cause of discomfort leading to discontinuation of lens wear. The study explored machine learning, regression and classification techniques to predict tear osmolarity using routine clinical parameters. The data set consisted of 175 participants, primarily healthy subjects eligible for soft contact lens wear. Various clinical assessments were performed, including symptom assessment with the Ocular Surface Disease Index and 5-Item Dry Eye Questionnaire (DEQ-5), tear meniscus height (TMH), tear osmolarity, non-invasive keratometric tear film break-up time (NIKBUT), ocular redness, corneal and conjunctival fluorescein staining and Meibomian glands loss. The results revealed that simple linear regression was insufficient for accurate osmolarity prediction. Instead, more advanced regression models achieved a moderate level of predictive power, explaining approximately 32% of the osmolarity variability. Notably, key predictors for osmolarity included NIKBUT, TMH, ocular redness, Meibomian gland coverage and the DEQ-5 questionnaire. In classification tasks, distinguishing between low (<299 mOsmol/L), medium (300-307 mOsmol/L) and high osmolarity (>308 mOsmol/L) levels yielded an accuracy of approximately 80%. Key parameters for classification were similar to those in regression models, emphasising the importance of NIKBUT, TMH, ocular redness, Meibomian glands coverage and the DEQ-5 questionnaire. This study highlights the potential benefits of integrating machine learning into contact lens research and practice. It suggests the clinical utility of assessing Meibomian glands and NIKBUT in contact lens fitting and follow-up visits. Machine learning models can optimise contact lens prescriptions and aid in early detection of conditions like dry eye, ultimately enhancing ocular health and the contact lens wearing experience.

Neuropathic Corneal Pain: Tear Proteomic and Neuromediator Profiles, Imaging Features, and Clinical Manifestations

To investigate the tear proteomic and neuromediator profiles, in vivo confocal microscopy (IVCM) imaging features, and clinical manifestations in neuropathic corneal pain (NCP) patients. Cross-sectional study. Twenty NCP patients and twenty age-matched controls were recruited. All subjects were evaluated by corneal sensitivity, Schirmer's test, tear break-up time, corneal and ocular surface staining, Ocular Surface Disease Index and Ocular Pain Assessment Survey questionnaires, as well as IVCM examinations for corneal nerves, microneruomas, epithelial and dendritic cells. Tears were collected for neuromediator and proteomic analysis using enzyme-linked immunosorbent assay and data-independent acquisition mass spectrometry. Burning and sensitivity to light were the two most common symptoms in NCP. A total of 188 significantly dysregulated proteins, such as elevated metallothionein-2, creatine kinases B-type, vesicle-associated membrane protein 2, neurofilament light polypeptide, and myelin basic protein, were identified in the NCP patients. The top 10 dysregulated biological pathways in NCP include neurotoxicity, axonal signaling, wound healing, neutrophil degradation, apoptosis, thrombin signaling mitochondrial dysfunction, RHOGDI and P70S6K signaling pathways. Compared to controls, the NCP cohort presented with significantly decreased corneal sensitivity (P<0.001), decreased corneal nerve fiber length (P=0.003), corneal nerve fiber density (P=0.006), nerve fiber fractal dimension (P=0.033), as well as increased in corneal nerve fiber width (P=0.002), increased length, total area and perimeter of microneuromas (P<0.001, P<0.001, P=0.019), smaller corneal epithelial size (P=0.017), and higher nerve growth factor level in tears (p=0.006). These clinical manifestations, imaging features, and molecular characterizations would contribute to the diagnostics and potential therapeutic targets for NCP.

Evaluating GlicoPro Tear Substitute Derived from Helix aspersa Snail Mucus in Alleviating Severe Dry Eye Disease: A First-in-Human Study on Corneal Esthesiometry Recovery and Ocular Pain Relief.

Background: To evaluate the effects of 10% GlicoPro tear substitute therapy in patients with severe dry eye disease (DED). Methods: In this prospective longitudinal study, 30 individuals receiving 10% GlicoPro four times daily for DED were evaluated. The ocular surface disease index (OSDI) questionnaire, average non-invasive break-up time (A-NIBUT), non-anesthetic and anesthetic corneal esthesiometry (CE), ocular pain, and the presence of conjunctivochalasis (CCH) were used as clinical endpoints. Treatment compliance using dosing diaries and AEs was assessed. Results: A significant improvement was observed in the clinical endpoints: the ΔOSDI questionnaire was -39.27 ± 13.22 [-65 to -15] points, ΔA-NIBUT was 3.10 ± 1.31 [1 to 5] s, Δnon-anesthetic CE was 14 ± 6.35 [5 to 25] mm, and Δanesthetic CE was 13 ± 5.35 [5 to 20] mm (p < 0.001 for all comparisons). Ocular pain was reduced in 92.5% of the patients at the end of the follow-up. However, there was no change in the presence of CCH. In addition, all the patients were fully compliant with the dosing and no AEs related to the use of the 10% GlicoPro tear substitute were reported. Conclusions: The 10% GlicoPro tear substitute has the potential to achieve beneficial effects in ocular surface treatments.

Safety and Tolerability of KIO-101 Eye Drops in Healthy Volunteers and Patients with Ocular Surface Disease-A Phase I Study.

Inhibitors of dihydroorotate dehydrogenase (DHODH) have been found to be potent anti-inflammatory agents. Recently, a topical formulation (KIO-101 eye drops) of a DHODH inhibitor has been developed. The aim of the present study was to evaluate the safety and tolerability of KIO-101 eye drops in Healthy Volunteers (HVs) and patients with conjunctival hyperemia. The study was carried out in a double-masked, placebo-controlled, randomized, parallel-group design with two parts. In part I, HVs received single and multiple instillations (four times daily for 12 consecutive days) of KIO-101 eye drops in ascending doses of 0.05%, 0.15%, and 0.30%, respectively. Part II was conducted in patients with conjunctival hyperemia who received 0.15% KIO-101 eye drops twice daily for 12 consecutive days. Ophthalmic and systemic safety examinations were performed on all participants. In part II, ocular hyperemia grading and an ocular surface disease index (OSDI) questionnaire were performed. 24 HVs participated in part I and 21 patients in part II. KIO-101 eye drops were well tolerated in all subjects. No serious adverse events (SAEs) occurred, and all AEs that were reported were transient and considered mild to moderate. In the highest dose cohort (0.30%), epistaxis occurred in two subjects after multiple instillations. In part II, after 12 days treatment with 0.15% KIO-101, conjunctival hyperemia decreased by -1.1 ± 0.27 points in the treatment and -0.6 ± 0.79 points in the placebo group (p = 0.0385). OSDI decreased from 47.9 ± 18.7 to 27.6 ± 19.13 points in the treatment group, while in the placebo group, a change from 41.3 ± 12.08 to 27.3 ± 18.63 points occurred. A 12-day treatment regimen with topical KIO-101 eye drops at low and mid doses was safe and well tolerated in both HVs and patients with conjunctival hyperemia. The obtained results point towards an early sign of reduction in conjunctival hyperemia.

Comparison of non-pharmaceutical treatments for evaporative dry eye: a randomised controlled study protocol

IntroductionThe lipid layer of the tear film is critical to maintaining the integrity of the tear film and absence in the tear film lipid layer (TFLL) is one of the...

Optimal cutoff value of the dry eye-related quality-of-life score for diagnosing dry eye disease

This retrospective study aimed to determine the optimal cutoff values of the Dry Eye-Related Quality-of-Life Score (DEQS) questionnaire for diagnosing dry eye disease (DED) and classifying DED severities. Participants completed the DEQS questionnaire, the Japanese version of the Ocular Surface Disease Index (J-OSDI) questionnaire, and DED examinations. DED was diagnosed according to the 2016 Asia Dry Eye Society diagnostic criteria based on DED symptoms (J-OSDI ≥ 13 points) and tear film breakup time ≤ 5 s. Receiver operating characteristic (ROC) analysis was used to calculate the optimal cutoff values of the DEQS summary score for detecting DED and grading its severity. Among 427 patients, 296 (69.3%) and 131 (30.7%) were diagnosed with DED and non-DED, respectively. ROC analysis determined an optimal cutoff value of 15.0 points for DED diagnosis, with 83.5% sensitivity, 87.0% specificity, and an area under the curve of 0.915. The positive and negative predictive values for DEQS ≥ 15.0 points were 93.6% and 69.9%, respectively. DEQS cutoff values of 15.0, 20.0, and 26.8 points could be accepted for severity classification of DED subjective symptoms in clinical use and represent mild, moderate, and severe DED, respectively. Conclusively, the optimal cutoff values of DEQS enable DED detection and subjective symptom severity classification.

The Use of Venous Catheter and Irrigation with Povidone-Iodine 0.6% in Patients with Punctal and Proximal Canalicular Stenosis: Preliminary Report.

Background: This study aimed to evaluate the safety and efficacy of povidone-iodine 0.6% (PVI) irrigation for preventing recurrence of stenosis after punctoplasty in patients with punctal and proximal canalicular stenosis treated using a venous catheter as a stent. Methods: Twenty patients were enrolled and divided into two groups. Group 1 received irrigation of 1 mL 0.6% PVI, while Group 2 received 1 mL of balanced salt solution (BSS). The patients underwent baseline, 15-, 30-, and 90-day assessments using the Ocular Surface Disease Index (OSDI) questionnaire, Symptoms Assessment in Dry Eye (SANDE), Schirmer I test, tear meniscus height (TMH), bulbar redness, meibography, and non-invasive breakup time (NIKBUT) through Keratograph 5M (Oculus, Germany). Results: At three months, both groups demonstrated statistically significant improvements in symptoms and ocular surface parameters. However, Group 1 showed statistically significant improvements in OSDI, SANDE scores, bulbar redness, and NIKBUT compared to Group 2. Additionally, no patients in Group 1 presented a recurrence of stenosis, while three patients in Group 2 demonstrated stenosis relapse at the end of the follow-up period. Conclusions: The application of a venous catheter and PVI 0.6% irrigations proved to be effective in treating proximal lacrimal duct stenosis, reducing the risk of recurrence and improving tear film stability, ocular discomfort symptoms, and ocular surface parameters.

Ocular surface changes in patients who have undergone head and neck radiation therapy.

Dry eye syndrome (DES) is a familiar sequelae of radiation therapy (RT) for head and neck cancers (HNC). Ocular surface changes such as DES occur due to injury to the conjunctival epithelium, goblet cells, corneal surface, lacrimal glands, and meibomian glands. This study aimed at the evaluation and early detection of changes in ocular surface parameters in patients receiving RT for extraocular HNC. Forty-two eyes of 21 patients undergoing HNC RT were evaluated. Radiation technique and dose of radiation to the lens and eye were recorded. Subjects were evaluated for meibomian gland changes by meiboscore grading, ocular surface disease index (OSDI) questionnaire, Schirmer's test, tear film break-up time (TBUT), and slit-lamp examination before RT, immediately post RT, and 6 weeks post RT. A comparison of the ipsilateral eye on the irradiated side to the contralateral eye was done. A significant reduction in TBUT was seen immediately post RT and 6 weeks post RT ( P < 0.001 and 0.008, respectively), with an increase in meiboscore at both visits ( P < 0.001). An OSDI score of >13 was seen in 23.80% of patients post RT, with a significant difference from baseline ( P < 0.001). On comparing ipsilateral and contralateral eye groups, a significant difference from baseline was seen in TBUT ( P < 0.001 and 0.033, respectively) and meiboscore ( P < 0.001 for both eyes). A significant change of >1 second in TBUT and >1.7 in meiboscore was seen with a mean dose of around 8 Gy to the lens. All patients undergoing HNC RT should be followed up for ocular surface and meibomian gland changes. The contralateral eye should also be evaluated. Patients receiving lower doses to the ocular structures should also be kept under follow-up.

OSDI Score Comparison between Sodium Hyaluronate, Carboxymethylcellulose and Polyvinylpirrolidone for Dry Eye in Medical Student during Online Learning

Abstract&#x0D; Introduction &amp; Objectives : Online learning during COVID pandemic increase medical students’ screen time. Prolonged screen time is known as a risk factor for dry eye. Health problems during online learning such as those induced by dry eye could affect students’ academic performance. This study aim to find the best solution for dry eye in medical student during online learning by comparing three artificial tears eye drops, namely sodium hyaluronate, carboxymethylcellulose and polyvinylpirrolidone.&#x0D; Methods : This is an experimental study with 48 respondents divided into three treatment groups : sodium hyaluronate (SH), carboxymethylcellulose (CMC) and polyvinylpirrolidone (PVP). Each group consists of 16 respondents. Each respondents use their eyedrops six times daily in both eyes for two weeks. This study use Ocular Surface Disease Index questionnaire to evaluate dry eye. Data were analyzed using SPSS software, with p&lt;0,05 is considered significant.&#x0D; Results : In SH group, mean OSDI score before treatment were 37,52 and after treatment 13,84 (p=0,001). In CMC group, mean OSDI score before treatment were 35,28 and after treatment 12,54 (p=0,000). In PVP group mean OSDI score before treatment were 38,17 and after treatment 13,15 (p=0,000). No significant differences of OSDI score was found between groups before treatment and after treatment (p=0,237).&#x0D; Conclusion : Sodium hyaluronate, carboxymethylcellulose and polyvinylpirrolidone eye drops could similiary improve dry eye symptoms significantly as measured by OSDI score in medical students during online learning.

The impact of prolonged face mask use on ocular surface health during COVID-19 pandemic: a clinical, and conjunctiva impression cytology study.

To investigate the relationship between prolonged face mask use and ocular surface health utilizing conjunctival impression cytology, the Schirmer test, the tear break-up time (TBUT) test, and the ocular surface disease index (OSDI) questionnaire. In this cross-sectional prospective study, individuals who used face masksfor at least eight hours per day for at least six months were compared to healthy volunteers who used face masks for no more than one hour per day. Each participant completed an OSDI questionnaire. The Schirmer test (under anesthesia), the TBUT test, and conjunctiva impression cytology analysis according to the Nelson classification method were performed on each participant. This study included 102 (49 male, 53 female) face mask users with an average age of 33.29 ± 7.71years and 110 (60 male, 50 female) healthy controls with an average age of 32.96 ± 7.10years (p = 0.746). The total OSDI score was significantly higher in face mask users than the control group (25.18 ± 3.54 vs 9.46 ± 2.13, p < 0.001). The mean Schirmer test value and TBUT were significantly lower in the study group than the control group (p < 0.001, p < 0.001). There was a statistically significant difference between the two groups in total score and stage of the Nelson classification system (p < 0.001, and p = 0.024, respectively). All conjunctiva impression cytology assessments, including cellularity, cell-cell contact, nucleus/cytoplasma ratio, goblet cell amount, and metaplasia, revealed statistically significant deterioration in the study group compared to the control group (p < 0.001, p = 0.025, p < 0.001, p < 0.001, and p < 0.001, respectively). The prolonged useof face masks leads to dry eyes. The findings of conjunctiva impression cytology indicate the role of inflammation in the pathogenesis of mask associateddry 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.

THE RELATIONSHIP BETWEEN DRY EYE SYNDROME AND THE USE OF PERSONAL PROTECTIVE EQUIPMENT (PPE) IN HOSPITAL MEDICAL WORKERS)

Introduction &amp; Objectives : Background: The need to wear personal protective equipment (PPE) during a pandemic can cause dry eye syndrome. It will increase sweating so reduce tear production and the use of masks increase air flow to the eye area so that tear evaporation increases. Objective: To determine the relationship between the incidence of dry eye syndrome and the use of PPE in hospital medical personnel.&#x0D; Methods : Methods: This was an analytic observational study with a cross-sectional design using the OSDI (Ocular Surface Disease Index) questionnaire. The research was carried out at the Cilacap Hospital in 2021. There were 49 samples (51% male and 49% female), with an age range of 20-50 years. The data was analyzed by using the Spearmans test.&#x0D; Results : Results: The incidence of dry eye syndrome was 69.5% (mild 18.4%, moderate 18.4%, severe 32.7%). As many as 53.1% of the incidence of dry eye syndrome occurred in wearing PPE for more than 4 hours and was more common in the use of PPE level 1 (40.8%), followed by level 3 (36.7%) and level 2 (22.5%). In the Spearman's test, it was found that there was a significant association between the incidence of dry eyes syndrome and the use of PPE (duration and level of PPE) (p&lt;0.05) but had a weak relationship strength (r=0.3).&#x0D; Conclusion : Conclusion: There is a significant relationship between the incidence of dry eyes syndrome and the use of PPE (duration and level of PPE use) but has a weak relationship strength.