OSDI Questionnaire Research Articles

New Comprehensive Clinical Classification of Dry Eye Syndrome Severity 2024. Part 1

Over the past ten years, the scientific ophthalmological community has shown a significant interest increase in studying dry eye syndrome (DES), as the number of such patients is steadily increasing every year. According to research conducted by the international DEWS working group, which studies DES, there is no single “gold standard” for diagnosing DES, as its manifestations are very diverse. A set of diagnostic tests is used to diagnose DES, reflecting both subjective and objective indicators of tear production. Subjective diagnostic criteria include questionnaires, the most widely used of which are the OSDI and SPEED questionnaires. It should be noted that these questionnaires characterize only subjective indicators and do not take into account objective criteria. In addition, the peculiarity of DES is that the presence of complaints is already a sign of this disease. However, the symptoms, namely the complaints of patients, do not always coincide with the clinical manifestations of dry eye syndrome — objective indicators of the state of tear production, such as the indicators of tear production tests. Based on modern concepts of the etiology and pathogenesis of dry eye syndrome, the state of the tear-producing system directly depends on the state of the tissues of the ocular surface — the conjunctiva, cornea and eyelids. Any inflammatory process affecting the tissues of the ocular surface leads to a violation of the stability of the tear film, its evaporation and an increase in osmolarity, which in turn causes an inflammatory process. Therefore, it is necessary in diagnosing dry eye syndrome to take into account a set of indicators characterizing the state of the tissues of the ocular surface, including the inflammatory process, in particular, conjunctival hyperemia, as well as the stability of the tear film, which depends primarily on its lipid component. The comprehensive clinical classification of dry eye syndrome presented in this article reflects not only objective indicators of impaired tear production and inflammation of the ocular surface, but also subjective indicators — quality of life according to the SPEED scale, characterizing the intensity and frequency of complaints of dryness and discomfort in the eyes. The above indicators allow to differentiate the severity of dry eye syndrome, which is of fundamental importance for choosing treatment methods and the volume of drug therapy, and assessing its effectiveness in dynamics. The developed diagnostic algorithm does not require special skills when carried out by a doctor, so it can be recommended for its use in wide ophthalmological practice.

Improvement of contact lens-associated dry eye disease with the use of hydrogen peroxide.

The dropout rate of contact lens users has not decreased significantly over the years. Despite continuous improvements in contact lens (CL) designs, materials and surface treatments, the number of CL users who drop out remains similar to the number of new CL users. The aim of this study is to analyse the improvement in contact lens-associated dry eye disease (CLADE), quantified with the OSDI questionnaire when changing maintenance system solution from multipurpose solution to hydrogen peroxide. This study included contact lens users for over a year as the multipurpose solution for the maintenance system, suffering from CLADE, and those who scored over 13 in the ocular surface disease index questionnaire, and did not manifest any clinical signs over 3 in the EFRON scale. The non-parametric data distribution was verified with the Kolmogorov-Smirnov test and Wilcoxon signed-rank test, which was used to compare the visual acuity (VA), OSDI score and bulbar redness (EFRON scale) of the follow-up visit against the baseline value. Thirty-eight patients were included. Analysing the clinical parameters between the initial and final visit after one month of hydrogen peroxide use, a statistically significant improvement was found in the VA, bulbar hyperemia, OSDI scale and their subscales of the total sample (P<0.04). This study is intended as a first step towards a standardised protocol of actions to improve CLADE in an attempt to reduce contact lens dropout using OSDI as a tool for detection.

Effectiveness of preformed physical factors in the correction of dry eye syndrome after phacoemulsification: a randomized trial

Introduction. Currently, modern high-tech methods of small incision cataract surgery are not always immune to the development of iatrogenic «dry eye» syndrome. Currently, one of the common complications of the anterior segment of the eye after small incision cataract surgery is the development of iatrogenic dry eye syndrome, which leads to a decrease in the quality of medical and social rehabilitation of operated patients. Aim. Development and evaluation of the effectiveness of the complex use of preformed physical factors in the correction of «dry eye» syndrome in patients after phacoemulsification of cataract. Materials and methods. The open randomized controlled clinical trial involved 90 patients (90 eyes) aged from 58 to 75 years, who were diagnosed with «dry eye» syndrome (DES) on the 1st day after phacoemulsification (PE) of cataract. Patients, depending on the treatment, were divided into three groups of 30 people (30 eyes).In the control group, patients received standard tear replacement therapy (RT) with Stillavit 4 times a day for 7 days,in the comparison group — in addition to ST 7 procedures of low-frequency magnetic therapy in the orbital area and in the main group — TRT was expanded by the complex application of low-frequency magnetic therapy to the orbital area and medicinal electrophoresis (EP) of the Taufon using the orbital-occipital technique for 7 daily procedures performed daily. Evaluation of parameters of ocular xerosis included: tear film rupture time, total tear production, and ocular surface disease index according to the OSDI questionnaire. The duration of the study was 6 months. Results and discussion. Complete regression of the xerotic process was observed immediately after treatment in 76,7 % (23) of patients in the main group, in 40 % (12) patients in the comparison group and 20 % (6) of patients in the control group. After 6 months after surgery — in 96.7 % (29) of patients in the main group, in 83,3 % (25) of patients in the comparison group and 70 % (21) of patients in the control group. Conclusion. The developed comprehensive program for the treatment of postoperative «dry eye» syndrome, which includes low-frequency magnetic therapy and medicinal electrophoresis Taufon against the background of tear replacement therapy, helps to significantly improve the clinical outcome of treatment, reduce the recovery time of the ocular surface and improve the quality of life of patients.

Wirksamkeit transkutaner periorbitaler Elektrostimulation mittels Quantum-Molekular-Resonanz (QMR) bei Keratoconjunctivitis Sicca

Purpose. Transcutaneous periorbital electrical stimulation is a patented electrophysical method (QMR) for treating both the hyposecretory and hyperevaporative components of sicca syndrome, which is used as part of the Rexon-Eye procedure. The aim of the study is to determine the efficacy of this method in patients with keratoconjunctivitis sicca. Material and Methods. As part of a randomized, double-blind, prospective observational study, 56 patients (112 eyes) were examined. 29 patients were treated with the Rexon Eye Procedure. 27 patients belonged to the placebo group and therefore only received a sham treatment. Subjective symptoms (OSDI questionnaire) and objective parameters relating to the lacrimal gland, eyelids and ocular surface and the number of drops/drop frequency were recorded. The treatment interval was 4 applications, once a week. The follow ups were carried out one week and 3 and 6 months after the last treatment. Results. OSDI-Score: There was a significant improvement in all follow-up checks during treatment as well as in the placebo group. The OSDI score reduced from 54 initially to 40 points in the treatment group after 3 months (p = 0.001) and from 50 to 41 points in the placebo group (p = 0.03). The number of artificial tears used as well as their drop frequency was significantly reduced in both groups after 3 months of follow-up. The number of tear substitutes used decreased by −0.44 ± 0.89 (p = 0.017) in the treatment group and by −0.48 ± 0.95 (p = 0.009) in the placebo group after 3 months. The drop frequency also decreased significantly after 3 months, in the treatment group by −1.5 ± 3.65 (p = 0.006) and in the placebo group by −1.3 ± 2.3 (p = 0.013). A significant increase in BUT of 1.3 ± 2.6 (p = 0.02) was found in the treatment group after 3 months – but not in the placebo group. Signs of blepharitis appeared significantly lower in the treatment group initially or after 7 days with a reduction of 0.5 ± 0.71 (p = 0.05), but without persistence after 3 months. Conjunctival hyperemia showed a significant reduction in the placebo group after 3 months with a reduction of 0.38 ± 0.77 (p = 0.007), but not in the treated subjects. Lipcof, Schirmer-II-Test, Oxford-Grading-Scale as well as the Meibomian gland dysfunction showed no significant differences in either group. Similarly, the comparison of both groups showed no significant difference between the two subject groups for any of the parameters over the entire follow-up. Conclusion. The Rexon Eye Procedure is a procedure with a tendency to reduce sicca symptoms. A general recommendation for its use cannot be made based on the study results, although individual patients benefited from the treatment.

Light Exposure in Young University Students: Effect on Ocular Surface Health

Purpose: The ocular surface is the first structure to absorb light and transfer it to retina to form images. However, the effect of different wavelengths and light exposure timing could harm the eye. The current study aims to measure light exposure and its correlation to the ocular surface. Study Design: Cross sectional observational. Place and Duration of Study: Qassim University, from March to September 2023. Methods: Light sensor buttons (RGB) were used in the current study (LYS technologies); 53 subjects were asked to wear them on the collar for one week, followed by a visit to the optometry clinic for an eye examination by bio-microscopy and Schirmer I test. Consequently, readings from Kerato-graph 5M were obtained. Lastly, participants were asked to fill out a validated Arabic OSDI questionnaire. Results: Results of the dry eye symptoms scale revealed that 24.5% had mild symptoms, and 20.8% of participants reported severe dry eye symptoms. A negative correlation between the Schirmer test and OSDI scores was found. Blue light exposure at night was negatively correlated to tear meniscus height (P &lt;0.05). Moreover, tear meniscus height was lower in participants with higher exposure to the red component of light during the day and higher melanotic lux in the daytime (P&lt;0.05). Tear breakup time was lower in patients exposed to higher melanopic lux during nighttime (p&lt;0.05). Conclusion: Light exposure habits are associated with some dry eye parameters. Moreover, light at night, especially melanopic lux wave-length is a risk factor for developing dry eye disease.

Prevalence of Computer Vision Syndrome and Its Risk Factors in a Spanish University Population.

To determine the prevalence of digital eye strain or computer vision syndrome (CVS) and its risk factors in a university population (University of Valladolid, Spain). An anonymous cross-sectional online survey was conducted in a university population [staff (lecturers and administrative employees) and students (undergraduate, master's, and PhD)], including two validated questionnaires (Ocular Surface Disease Index [OSDI] and the 17-item Computer-Vision Symptom Scale questionnaire [CVSS17]) and questions about sociodemographic data and visual display terminal use. The prevalence and risk factors for CVS (CVSS17≥29) (multivariate logistic regression model) were calculated. One thousand nine participants responded to the survey (35.2±15.2 years; 64.1% women). The mean OSDI and CVSS17 questionnaire scores were 18.9±15.6 and 31.5±6.4, respectively, and 35.4% of the respondents had dry eye symptoms (OSDI>22). The total prevalence of CVS was 65.4% (95% CI 62.1-68.3). Undergraduate students showed the highest CVS prevalence (72.6%; P <0.01), which was significant. In addition, women, participants younger than 36 years old, contact lens wearers, and subjects with dry eye symptoms reported a statistically higher CVSS17 score ( P ≤0.01). In the multivariate model, significant factors associated with the presence of CVS ( P ≤0.03) were female sex (OR=2.10; 95% CI 1.54-2.88), dry eye symptoms (OSDI>22) (OR=16.98; 95% CI 10.36-27.84), VTD use ≥6 hr daily (OR=1.96; 95% CI 1.09-3.52), and being an undergraduate student (OR=2.23; 95% CI 1.54-3.24). A high prevalence (65.4%) of CVS was found among the Spanish university population, with the undergraduate student group having the highest prevalence (72.6%). Female sex, more than 6 hr/day of visual display terminal use, being an undergraduate student, and dry eye symptoms significantly increased the risk of CVS in the university population.

Ocular Surface in Bangle Makers of Firozabad

Purpose: The bangle-making industry in Firozabad, India, is a significant source of employment for thousands of workers. However, the occupational hazards associated with this industry, particularly the exposure to glass dust and chemical fumes, calcide powder, etc. have raised concerns regarding the ocular health of bangle makers. This study is aimed to evaluate and describe the status of ocular surface among the bangle makers in Firozabad. Method: This was an OSDI questionnaire based cross sectional descriptive study, consisting a series of 12 questions about symptoms as itching, redness, blurred vision, grittiness, watering etc. Torch light examination of each subject was performed to look for any ocular abnormalities. An unstructured survey regarding the work hours in the factory, working experience in the bangle making industry, ocular complaints, history of hospital visits and prior eye-check-ups was also done. The responses were represented with the help of tables and chart. Results: 74 participants were enrolled in this study, OSDI score ranging from 23-33 that comes in moderate value. Maximum workers reported with normal eye health but there were ocular morbidities and surface abnormalities prevailing in this population, i.e. pterygium (8%), cataract (5.3%), pinguecula (2.7%), itching (6.7%), redness (4%). Conclusion: There is a need to improve occupational safety measures amongst the industry workers, including the provision of proper eye protection and mandatory eye check-ups to minimize the adverse effects on the ocular health of bangle makers, also need to increase awareness to motivate the workers for regular eye check-ups. Keywords: Ocular Surface, Infrared radiation, Occupational hazards, Ocular morbidities, Bangle makers.

Beauty versus Health-How Eyelash Extensions May Affect Dry Eye Disease?

Background: Eyelash extensions (EEs) are among the most popular cosmetic procedures today. There is no prospective study demonstrating how this procedure affects the ocular surface and eye dryness in particular. The goal of this study is to evaluate the effect of EEs removal on dry eye symptoms and signs. Materials and Methods: The subjects were prospectively recruited from routine clinical examinations for dry eye complaints. Only subjects with an OSDI score above 31 were included in the study. The subjects also planned to have the EEs removed and agreed to abstain from makeup use and new cosmetic procedures for 4 weeks. The presence of dry eye was evaluated by an OSDI questionnaire, and objectively by tear breakup time (TBUT), staining (Oxford scale) and blinking intervals. All tests for dry eye were performed at baseline and 4 weeks after EEs removal. Results: The mean age of our patients, all female, was 28 years. The size and type of EEs was diverse. The decision process was mainly based on appearance and models. None of the subjects had any health conditions. The mean result from the score from the OSDI questionnaire at the baseline was 33.4 and improved to 26.7 points 4 weeks after EEs removal. Objectively, the mean TBUT increased from 11.25 to 13.96 s. For the same period, the blinks increased by two per minute, and the staining was reduced by 1.0 grade. Conclusions: Removal of EEs improves the symptoms and the objective signs of dry eye. The most popular beauty procedure regarding eyelashes might not be innocuous to eye health.

Efficacy and Safety of Plasma Rich in Growth Factor in Patients with Congenital Aniridia and Dry Eye Disease.

The included patients underwent two cycles of a 3-month PRGF treatment. At 6 months, symptomatology was evaluated using the OSDI and SANDE questionnaires, and ocular surface parameters were analyzed. The OSDI and SANDE values for frequency and severity demonstrated statistically significant improvements (p < 0.05). Ocular redness, corneal damage (corneal staining), and tear volume (Schirmer test) also exhibited statistically significant improvements (p < 0.05). No significant changes were observed in visual acuity or in the grade of meibomian gland loss. The use of PRGF in patients with congenital aniridia and ocular dryness symptoms led to significant improvements in symptomatology, ocular redness, and ocular damage. No adverse effects were observed during the use of PRGF.

Correlation between serum cytokine levels and the effect of allogeneic serum-based eye drops

IntroductionThe Institute of Hematology and Transfusion Medicine (IHTM) in Warsaw has produced autologous serum eye drops (ASEDs) for the treatment of Dry Eye Syndrome (DES) since 1991. In 2019, IHTM introduced allogeneic tears (alloSEDs) for patients on long-term treatment. Materials and methods114 patients who applied alloSEDs were included in the study.They were asked to complete the OSDI questionnaire before and after using ASEDs and 100 units of alloSEDs drops from each donation. The OSDI index rates DES severity (0 no symptoms; 100 severe). We also compared the content of IL-1β, IL-2, IL- 6, IL-10 and VEGF in ASEDs (38 samples) and alloSEDs (15 serum samples). The study data covered the 2019–2022 period. Results114 patients participated in the study. We compared the the effectiveness of ASEDs and alloSEDs. The average, OSDI dropped from 68.42 ± 5,86 (before application) to 51.05 ± 19,06 (after application). Data from the questionnaires (prepared at IHTM) completed and returned (41/114) present the most common indications for the use of serum drops, including DES with no underlying disease, DES secondary to GvHD (Graft versus Host Disease), Sjögren's Syndrome (SS). The study reported higher cytokine levels associated with disease entities such as SS. After application of drops with high cytokine levels, patients reported adverse reactions such as sand under the eyelids, impaired visual acuity, and worse eye lubrication. ConclusionsAlloSEDs with acceptably low values of pro-inflammatory cytokines and sufficiently high levels of VEGF growth factor may contribute to alleviation of inflammatory eye symptoms.

Clinical evaluation of tear substitute utility after anti-VEGF intravitreal injection.

The purpose of this study is to evaluate the role of a polyethylene glycol 400 - propylene glycol - hydroxypropyl guar - hyaluronic acid eye drops in relieving the symptoms of dry eye syndrome after anti-VEGF intravitreal injection. In this randomized, parallel-group study, patients were randomized to receive standard therapy alone or study eye drops plus standard therapy. Patients enrolled were older than 50 with exudative age-related macular degeneration, who have never had intravitreal injections, and without severe dry eye condition or severe ocular or systemic conditions. Patients had baseline preoperative evaluation (V0), and successively after 15 (V1) and 30 (V2) days. At VO and V1 T-BUT, Schirmer's test, fluorescein staining, DEQ5 and OSDI questionnaires were performed and at V2 (30) the OSDI questionnaire was administered. 80 patients were included in the study, of them 40 received standard therapy plus study eye drops. DEQ5 questionnaire showed an increase in the control group between the values at V0 and V1, while in the study group a decrease was observed. No changes in T-BUT, Schirmer, and fluorescein staining values between V0 and V1 were observed in both groups. OSDI data in the control group showed no statistically significant differences, while in the study group they showed a statistically significant difference. In our study patients undergoing for the first time intravitreal treatment presented dry eye symptoms in the postoperative period: in this group of patients the use of a tears substitute reduces postoperative ocular discomfort.

Uveitis and Dry Eye Disease in Children: A Cross-Sectional Comparative Study

ABSTRACT Purpose This study aims to evaluate the ocular surface characteristics in children diagnosed with uveitis and explore the association between uveitis and dry eye disease (DED). Methods We included 84 children, 42 with uveitis and 42 healthy children. We performed the OSDI questionnaire and several ocular surface tests, including osmolarity, NITBUT, Schirmer test, and vital staining. We used Fisher’s exact test and Mann-Whitney to compare variables and a binomial logistic regression to determine the factors associated with DED. Results The difference in the prevalence of DED between uveitis (54.8%) and healthy (31%) groups was statistically significant (p < 0.05). Most patients with uveitis had mixed DED, and none of the healthy subjects had a severe form of the disease. There were no statistically significant differences in most of the tear film tests. However, all parameters tended to worsen in the uveitis group, and lipid layer thickness was thinner (p < 0.036). The uveitis group exhibited significantly more symptoms (p < 0.05). In the multivariate logistic regression, uveitis was associated with an odds ratio (OR) of 3.0 (95% CI: 1.07–8.42, p < 0.05) for DED. Conclusions Our findings demonstrate a significantly higher prevalence of DED in children with uveitis compared to their healthy counterparts. Furthermore, our analysis indicates that the risk of DED in pediatric patients with uveitis is threefold higher than in healthy children. Therefore, it is crucial for clinicians to vigilantly monitor the development of DED in pediatric patients with uveitis and consider the implementation of preventive treatments.

THE DIFFERENCES OF MAXIMUM BLINK INTERVAL IN HYPERTENSION PATIENTS WITH AND WITHOUT DRY EYE DISEASE

Abstract&#x0D; Introduction &amp; Objectives : Hypertension and the use of antihypertensive drugs are thought to be one of the risk factors for dry eye disease due to a decrease in tear production. Maximum blink interval (MBI), which is the time during which the eye can remain unblinking, can be an easy method for assessing dry eye disease because local conditions in the eye can affect blinking patterns. This study aims to determine the difference in the average MBI in hypertensive patients with dry eye disease and hypertensive patients without dry eye disease.&#x0D; Methods : This study is a cross-sectional analytic study which was conducted in January 2022-June 2022. The sample of the study was hypertensive patients with dry eye disease and without dry eye disease who were treated at the Internal Medicine Polyclinic, Kidney-Hypertension Division at Sanglah Hospital (Prof I.G.N.G. Ngoerah Hospital). The sample selection technique was consecutive sampling and the total sample in the study was 81 people. Data were collected using the OSDI questionnaire and TBUT and Schirmer examinations to assess dry eye disease, blood pressure tests to assess hypertension, and MBI examination.&#x0D; Results : The results showed that the average MBI in hypertensive patients with dry eye disease twice shorter than in hypertensive patients without dry eye disease (p&lt;0.001).&#x0D; Conclusion : This shows that MBI can be used as a modality for screening and screening for dry eye disease in hypertensive patients. MBI can be an alternative for practitioners to objectively assess dry eye disease in primary health care where there is no complete ophthalmological facility.

Tear Break Up Time Pattern in Medical Students After COVID-19 Pandemic

Introduction &amp; ObjectivesCOVID-19 pandemic makes most activities are carried out online with using the VDT. Tear Break UpTime (TBUT) examination is a short and fast examination and is able to determine damage to thetear film and subjective examination using the OSDI Questionnaire. This study aimed to assess TBUTpattern in medical students after COVID-19 pandemic regarding VDT used for online learningactivities.&#x0D; MethodsThis study is an observational analytic study with a cross-sectional approach. The difference inproportion between TBUT results based on gender was analyzed using chi-square test. Statisticalanalysis was carried out using a multivariate test based on the results of data normality. The onewayANOVA test is used for normally distributed data, while Kruskall-Wallis is used if the data is notnormally distributed.&#x0D; ResultsA total of 75 subjects were included in the study, consisting of 53 females (70,7%) and 22 males(29.3%). Average use of VDT 8 hours per day. The average TBUT in both eyes were &lt; 10 secondsand random breaks was the most common pattern seen in this study (61,3% OD and 62,7% OS).There was no significant difference between TBUT and gender but there was statistically significantdifference between OSDI score and TBUT.&#x0D; ConclusionLongterm use of VDT may be affect TBUT and subjective symptoms shown by OSDI score. Randombreak was the most common pattern seen in young adults in relation with VDT use.

Peculiarities of local immunity in dry eye disease on the background of hormonal dysfunction.

Aim: to determine the state of local immunity in DED on the background of hormonal dysfunction. Materials and Methods: Of 32 women, 17 patients with diagnosed SM and 15 women of the control group were examined. The Ocular Surface Disease Index and the state of local immunity were defined by determining Ig As in lacrimal fluid (LF) by radial immunodiffusion in Mancini agar. Results: During the OSDI questionnaire, a mild degree of DED was detected in 21 (65.6%) women, and an average degree was observed in 11 (34.4%) patients with SM. On average, OSDI was 34.54 ±2.01. As a result of studies of the state of local immunity in patients with SM, a tendency to increase Ig As was noted, compared with the control group. An increase in Ig As in the lacrimal fluid in patients with SM to 0.34 ±0.09 g/l was found, compared with the control group (0.24 ±0.03 g/l). Conclusions: Using the OSDI questionnaire, the presence of DED was detected in women with SM, mainly mild and moderate degree. The obtained results of the state of local immunity indicate in favor of a nonspecific inflammatory process, accompanied by a decrease in local immune protection and leading to further changes in the ocular surface.

Changes in the precorneal tear film at various stages of keratoconus

This study assesses the changes in the state of the precorneal tear film in KC relative to the stages of the disease. The study included 50 patients (100 eyes) with bilateral non-operated KC from subclinical to stage IV. The following methods were used for a comprehensive assessment of the condition of the tear film: biomicroscopy of the anterior segment of the eye using vital dyes, functional tests (Norn, Schirmer, Jones tests), tearscopy of the lipid layer of the tear film with software processing of the results, OCT-meniscometry, as well as filling out the OSDI questionnaire by patients. The following significant changes were revealed as the KC stage progressed: an increase in the area of staining of the ocular surface with vital dyes, a decrease in the results of the Norn functional test and OCT-meniscometry, an increase in the areas of smaller thickness of lipids and areas of their complete absence according to tearscopy, as well as an increase in scores of the OSDI questionnaire. A comprehensive assessment of the condition of the tear film in KC indicates the relationship and the strengthening of the signs of DES as keratectasia progresses, and can be considered as justification for the need to prescribe tear replacement and reparative therapy that improves the condition of the ocular surface and stabilizes the precorneal tear film.

An attempt to evaluate the anterior surface homeostasis in patients with diabetic retinopathy

Aims/Purpose: The aim of our study was to verify the presence of dry eye disease (DED) in diabetic patients. We also tried to determine the relationship between diabetic neuropathy and the presence of ocular surface disease.Methods: 52 type 2 diabetic patients and 52 non‐diabetic, sex and age‐matched controls were included in the study. All participants completed the OSDI questionnaire and undergone the eye surface examination with IDRA analyser including interferometry, tear meniscus height, non‐invasive tear break‐up time (NIBUT), evaluation of blepharitis, blinking pattern, pupillometry and meibography. Corneal sensation in the centre of the cornea and its 4 quadrants was analysed with the Cochet–Bonnet aesthesiometer (CBE). Corneal confocal microscopy images of sub‐basal plexus were evaluated using ACCMetrics. The concentrations of the neurotrophic factors: beta‐NGF, BDNF, NT‐4 as well as inflammatory mediators (TNF‐α, VEGF, IL‐2, ‐1β, ‐4, ‐5, ‐6, ‐8, ‐10, ‐12, GM‐CSF, IFN‐γ) were measured in the tear film using Luminex 200 analytic platform.Results: The OSDI was significantly higher in diabetic patients compared to the controls (mean: 29.08 vs. 11.67 points; p &lt; 0.001). The groups did not differ in the results of the Schirmer test, interferometry, NIBUT and meibography values. Moreover, we did not find the elevation in the concentrations of the ocular surface inflammation indicators in tears of diabetics as compared to controls. There was a significant difference in tear meniscus between groups. Diabetics achieved significantly worse results than the control group in terms of corneal sensation, innervation parameters (average nerve length = 6.70 vs 11.54 mm/mm2; p &lt; 0.001, average density = 9.26 vs. 19.19/mm2; p &lt; 0.001), scotopic pupillometry and blinking interval. Tear film BDNF concentrations were lower in diabetic eyes as compared to controls (mean 1.85 vs. 2.29 pg/mg; p = &lt;0.001).Conclusions: The lack of proinflammatory response in diabetic eyes and no differences between groups in the terms of objective clinical features may suggest that there is no cause‐and‐effect relationship between diabetes and DED. Corneal innervation disorders, clinically noticeable as decreased corneal sensation, result in a number of complications, that have a direct impact on the subjective feelings of the patient.

Comparative Evaluation of the Efficacy and Safety of Brimonidine Generics in Glaucoma Therapy

Glaucoma is a chronic neurodegenerative disease that eventually leads to irreversible blindness. The main risk factor for the development and progression of glaucoma is elevated IOP. In cases where the use of prostaglandin analogues is limited, brimonidine is the most rational choice as initial therapy. It is the only molecule that both reduces aqueous humor production and enhances uveoscleral outflow. The use of several hypotensive drugs for a long time can lead to pronounced changes in the tissues of the anterior segment of the eye. In this case, there are complaints characteristic of the dry eye syndrome. The aggravation of this condition can affect the adherence of patients to treatment and worsen the course of the disease. Therefore, it is important to prescribe hypotensive drugs that have a sufficient hypotensive effect with a good safety profile. Purpose. To evaluate the efficacy and safety of Brimonidine SZ in combination therapy for glaucoma after changing the hypotensive regimen. Patients and methods. The study was conducted in a group of 50 patients (50 eyes) with initial or advanced drug-compensated primary open-angle glaucoma (mean age 64.8 years), among them there were 27 (54 %) women and 23 (46 %) men. In patients included in the study, brimonidine 0.15 % or 0.2 % was replaced with Brimonidine SZ as part of combination hypotensive therapy. To analyze the results obtained, data on corneal-compensated IOP, the degree of corneal staining with fluorescein, assessments of conjunctival hyperemia, indicators of the OSDI questionnaire and the level of adherence to treatment at the initial visit, as well as 1 and 3 months after changing the hypotensive regimen, were compared. Results. There were no statistically significant differences in the level of IOP at different times after changing the hypotensive regimen. Objective indicators of the state of the tissues of the anterior surface of the eye did not change. According to the results of the evaluation of the main signs of dry eye syndrome (OSDI) and the degree of adherence of patients to treatment, no significant changes were found either. Conclusion. Brimonidine SZ has a similar hypotensive efficacy with brimonidine 0.15 % and 0.2 % as part of combination hypotensive therapy. The safety profile of Brimonidine SZ is comparable to analogues, which allows us to consider this drug as a possible alternative when choosing hypotensive therapy.

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.

PENGARUH DURASI PENGGUNAAN GADGET TERHADAP DRY EYE SYNDROME PADA PEKERJA OPTIK KUDA MAS

Along with the development of information and communication technologies, the need for gadgets in daily life is also increasing. The survey states that the average time spent using gadgets and internet by Indonesian citizens is 7 hours and 42 minutes. Long-term use of the gadgets can lead to several problems, one of them is the development of dry eye syndrome. Complaints about dry eye syndrome are one of the most common eye health problems. A 2017 study in Indonesia reported that the number of dry eye syndrome patients in that year reached 30.6% of the total population. The purpose of this study was to investigate whether the duration of gadget usage has correlation with the appearance of dry eye syndrome in Optik Kuda Mas employees. Based on the OSDI questionnaire that was found and integrated with the gadget usage duration questionnaire, the severity of dry eye syndrome was found, namely normal 1 person (4.16%), mild 2 people (8.30%), moderate 0 people (0%), followed by severe degree 21 people (87.5%). There is a significant relationship between the duration of using gadgets in Optik Kuda Mas workers and the severity of dry eye syndrome.