Tear Quantity Research Articles

Randomized clinical trial: MGrx versus standard debridement and expression for meibomian gland dysfunction.

Evaporative dry eye disease, due to meibomian gland dysfunction, causes significant suffering for millions of people globally, yet satisfactory long-term treatment remains elusive for many. Investigation of potential therapies for meibomian gland dysfunction is therefore of high importance to clinicians and their patients. This study aimed to compare the efficacy of a new device for meibomian gland debridement and expression to that of the conventional way of providing this treatment. Thirty participants (mean age, 36.4 ± 15.4 years; 77% female) fulfilling current Tear Film & Ocular Surface Society diagnostic criteria for dry eye disease and meibomian gland dysfunction were recruited (Research Registry, 10340). Fifteen participants each were randomized to receive a single treatment with either traditional debridement (using a golf-club spud), heating (10 minutes of Blepha EyeBag, Théa Laboratories, Clermont-Ferrand, France) and expression (with forceps), or the multimodal MGrx, which comprises a handheld device with heated debridement, massage, and expression attachments. Symptomatology, tear film, and ocular surface measures were assessed at baseline and at 4 and 8 weeks post-treatment. Ocular Surface Disease Index, 5-Item Dry Eye Questionnaire, and Symptom Assessment in Dry Eye symptom questionnaire scores all improved significantly with both treatments (all p<0.001), with no subsequent deterioration for at least 8 weeks. The improvement was similar between treatment groups (all p>0.05). Clinical signs, of blink rate, tear film quality and quantity, ocular surface characteristics, and meibomian gland expressibility, were all unchanged with both treatments (all p>0.05) except for noninvasive tear breakup time, which deteriorated in the conventional treatment group (p=0.006) between 4 and 8 weeks post-treatment. No adverse reactions were reported, and all participants were able to tolerate treatment. A single application of meibomian gland debridement and expression resulted in sustained improvements in the symptoms of dry eye disease, in both treatment groups. The MGrx device provides a safe and effective in-office treatment for evaporative dry eye disease, and has time and space advantages compared with conventional treatment.

MAL À VISTA: CONSEQUÊNCIAS ASSOCIADAS AO USO DO TABACO PARA A SAÚDE DOS OLHOS

Introduction: Smoking is widely recognized as a risk factor for several eye diseases, including age-related macular degeneration (AMD), cataract, glaucoma, and dry eye syndrome. Toxic substances present in cigarettes, such as nicotine and carbon monoxide, directly affect ocular tissues, resulting in oxidative and ischemic damage. This study reviews the literature on the effects of smoking on ocular health, highlighting the main mechanisms involved and the implications for public health. Methodology: A descriptive and analytical literature review was carried out. Scientific articles published between 2000 and 2024 in the PubMed, SciELO, and BVS databases were included. The keywords used were "smoking", "eye health", "cataract", "AMD", "glaucoma", and "dry eye syndrome". Studies that addressed the impact of active and passive smoking on ocular health were selected. Furthermore, clinical trials, systematic reviews and meta-analyses were considered. Discussion and Results: The reviewed studies indicate that smoking significantly increases the risk of eye diseases. Smokers are two to four times more likely to develop AMD compared to non-smokers, in addition to a threefold increased risk of cataracts. Smoking also worsens glaucoma, contributing to progressive vision loss due to increased intraocular pressure. Dry eye syndrome has been identified as one of the most common conditions associated with smoking, with reduced tear quality and quantity. Secondhand smoke has also been shown to be harmful, especially in children, increasing the risk of diseases such as AMD and cataracts. Conclusion: Smoking represents an important and modifiable risk factor for the development of several eye diseases. Smoking cessation can significantly reduce the risk of these conditions and their complications. Awareness campaigns should include information on the impacts of smoking on eye health, both for active smokers and for the population exposed to secondhand smoke. Preventive measures, such as promoting eye health and encouraging smoking cessation, are essential for protecting vision.

Mass spectrometry (MS)-based metabolomics of plasma and urine in dry eye disease (DED)-induced rat model

ABSTRACT Dry eye disease (DED) is an ophthalmic disease associated with poor quality and quantity of tears, and the number of patients is steadily increasing. The aim of this study was to determine plasma and urine metabolites obtained from DED scopolamine animal model where dry eye conditions (DRY) are induced. It was also of interest to examine whether DED (scopolamine) rat model was exacerbated by treatment with benzalkonium chloride (BAC). Subsequently, plasma and urine metabolites were analyzed using liquid chromatography (LC) and gas chromatography (GC)-mass spectrometry (MS), respectively. Data demonstrated that DED indicators such as tear volume, tear breakup time (TBUT), and corneal damage in the DED groups (DRY and BAC group) differed from those of control (CON). Similar results were noted in inflammatory factors such as interleukin (IL-1β), IL-6, and tumor necrosis factor (TNF)-α. In the partial least squares-discriminant analysis (PLS-DA) score plots, the three groups were distinctly separated from each other. In addition, the related metabolites were also associated with these distinct separations as evidenced by 9 and 14 in plasma and urine, respectively. Almost all of the selected metabolites were decreased in the DRY group compared to CON, and the BAC group was lower than the DRY. In plasma and urine, lysophosphatidylcholine/lysophosphatidylethanolamine, organic acids, amino acids, and sugars varied between three groups, and these metabolites were related to inflammation and oxidative stress. Data suggest that treatment with scopolamine with/without BAC-induced DED and affected the level of systemic metabolites involved in inflammation and oxidative stress.

Elucidating the roles of electrolytes and hydrogen bonding in the dewetting dynamics of the tear film

This study explores the impact of electrostatic interactions and hydrogen bonding on tear film stability, a crucial factor for ocular surface health. While mucosal and meibomian layers have been extensively studied, the role of electrolytes in the aqueous phase remains unclear. Dry eye syndrome, characterized by insufficient tear quantity or quality, is associated with hyperosmolality, making electrolyte composition an important factor that might impact tear stability. Using a model buffer solution on a silica glass dome, we simulated physiologically relevant tear film conditions. Sodium chloride alone induced premature dewetting through salt crystal nucleation. In contrast, trace amounts of solutes with hydroxyl groups (sodium phosphate dibasic, potassium phosphate monobasic, and glucose) exhibited intriguing phenomena: quasi-stable films, solutal Marangoni-driven fluid influx increasing film thickness, and viscous fingering due to Saffman-Taylor instability. These observations are rationalized by the association of salt solutions with increased surface tension and the propensity of hydroxyl-group-containing solutes to engage in significant hydrogen bonding, altering local viscosity. This creates a viscosity contrast between the bulk buffer solution and the film region. Moreover, these solutes shield the glass dome, counteracting sodium chloride crystallization. These insights not only advance our understanding of tear film mechanics but also pave the way for predictive diagnostics in dry eye syndrome, offering a robust platform for personalized medical interventions based on individual tear film composition.

TFOS lifestyle report: Effects of the digital environment on the ocular surface and adnexa

This presentation summarizes the findings of the Digital Environment Subcommittee of the recent Workshop of the Tear Film &amp; Ocular Surface Society, entitled “A Lifestyle Epidemic: Ocular Surface Disease” (www.tearfilm.org). Digital environments are common in modern life and involve extensive screen time, often exceeding 4 h a day. Examples of digital devices include professional items, such as networked wayfinding systems or connected workstations, but also personal computers, televisions, and mobile phones. Although the prevalence of digital eye strain is very high, reaching 97% across the world, currently there is a lack of an agreed definition and established diagnostic criteria for the condition. Symptoms of digital eye strain are heterogeneous and non‐specific, may overlap with other ocular diseases, and include ocular tiredness, blur, ocular soreness, eye strain, ocular pain, burning, ocular dryness, and light sensitivity. They produce significant, chronic, and frequent discomfort that can affect the quality of life and reduce work and school performance. Although there is a large demand for treatments to relieve symptoms of digital eye strain, interventions are not well established. Proposed methods, such as incorporating rest breaks and the 20/20/20 rule, improving blinking, oculomotor exercises, and optimizing the work environment will be discussed. Also, the influence of such interventions as refractive correction, blue‐blocking filters, ocular surface disease management approaches to improve tear film quality and/or quantity and nutritional supplementation will be presented based on current, best evidence data. In conclusion, considering the ubiquitous use of digital technology, screening for digital eye strain should become incorporated into routine ocular assessments. The unified definition and diagnostic criteria proposed in the TFOS report will help standardize and improve the quality of future epidemiological studies.

EFFECTS OF MONDIA WHITEI ON THE TEAR FUNCTION OF RABBIT EYES

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Dry eye is a serious problem affecting up to 20% of the world’s population. &lt;em&gt;Mondia whitei&lt;/em&gt;’s rich androgenic properties create an interest in research focused on its efficacy as an alternative and complementary therapy for the treatment and control of the symptoms of dry eye-related diseases associated with androgen deficiency. &lt;strong&gt;Aim: &lt;/strong&gt;This study aimed to investigate the effect of &lt;em&gt;M. whitei&lt;/em&gt; on the quality and quantity of tears in rabbit eyes.&lt;strong&gt; Setting: &lt;/strong&gt;This study was carried out at the animal house at Masinde Muliro University of Science and Technology, Kakamega, Kenya. &lt;strong&gt;Materials and methods:&lt;/strong&gt; The study adopted an experimental study design with 16 New Zealand rabbits. A simple random sampling technique was used to place the rabbits into 4 groups, each group with 4 rabbits. They were tested for tear function to establish a baseline before administration of Benzalkonium Chloride (BAC) (to induce dry eye) and &lt;em&gt;M. whitei&lt;/em&gt; extract. Schirmer’s test and fluorescein staining were conducted to observe the tear quantity and quality over a period of 6 days after treatment. The data collected was then cleaned and analyzed. &lt;strong&gt;Results:&lt;/strong&gt; The researchers found that the average mean during baseline tear quantity measurement for the groups was 26.5mm, during instilling of BAC the mean dropped to 24.0mm and when &lt;em&gt;M. whitei&lt;/em&gt; was administered the mean rose to 27.94mm, indicating that &lt;em&gt;M. whitei&lt;/em&gt; greatly improved tear quantity. During baseline tear quality assessment, the average mean for the groups was 0.00 which dropped to 0.94 showing mild staining and when &lt;em&gt;M. whitei&lt;/em&gt; was administered dropped further to 1.67 indicating that &lt;em&gt;M. whitei&lt;/em&gt; did not improve the tear quality. &lt;strong&gt;Conclusion and Recommendations:&lt;/strong&gt; The researchers recommended that more research be done on &lt;em&gt;M. whitei &lt;/em&gt;with fewer limitations such as time, to ascertain its effectiveness on tear quality and quantity.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/soc/0065/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

After-effect on tear film quality and quantity of reading on laptop computer screen versus hardcopy

ABSTRACT Clinical relevance Electronic displays, including laptops, tablets, and smartphones, have dramatically altered the way information is accessed and become significant factors in human daily life. They interfere with the blink rate and increase dry eye symptoms, which lead to more discomfort compared to hard copy while reading. Background Digital eye strain occurs when an individual suffers from symptoms, or they are exacerbated, while performing a task requiring digital screen viewing. This study assessed the tear film status immediately following reading on a laptop computer screen versus an identical hard copy. Methods Thirty young adults with normal ocular health and reporting no significant symptoms of dry eye (ocular surface disease index (OSDI) score < 13 and non-invasive tear break-up time (NITBUT) > 10 seconds) read a text as hard copy and on a laptop computer screen for 30 min on separate days in a random sequence in a controlled reading experimental condition. The texts were matched in size and contrast and presented at a viewing distance of 40 cm. The NITBUT and strip meniscometry tube tests were administered at baseline and after reading in both conditions. Results The median baseline NITBUT decreased from 13.0 s to 10.0 s (P < 0.001) after hardcopy reading and to 7.0 (P < 0.001) after reading from a laptop computer screen, with a significant difference between the task medium (P = 0.001). The baseline strip meniscometry tube results decreased from 6.7 mm to 5.0 mm (P < 0.001) after hardcopy reading and to 5.0 mm (P < 0.001) after reading from a laptop computer screen, but there was no significant difference with the task medium (P = 0.085). Conclusion Reading in both conditions led to tear film instability in terms of the tear film quality and quantity. Additionally, the computer screen has a greater impact on the TBUT compared to hardcopy reading, while these two reading mediums had a similar effect on the tear volume.

Assessment of the Effect of Vitamin D Deficiency on Ocular Dryness

Background Dry eye syndrome (DES) is one of the most common ocular diseases and has been recognized as an important public health problem. Dry eye is associated with chronic eye pain and an increased risk of ocular surface diseases, such as corneal ulcers and corneal abrasions. DES is a multifactorial disorder of the tear film and ocular surface, Aim and objectives was two-fold: (i) to demonstrate the relation between vitamin D deficiency, dry eye and impaired tear function; (ii) to investigate the possible associations among clinical parameters of hypovitaminosis D, such as fatigue, functional impairment and pain, with dry eye parameters including quantity of tears, the stability of the tear film layer and symptoms of ocular irritation. Subjects and methods Our study was a prospective, non-randomized study which was conducted on 36 patients with Vitamin D deficiency; The 36 vitamin D deficiency patients were classified according to dryness of eye into 2 independent groups:(1) DES group (25 patients) according to Schirmer test without anesthesia with results &amp;lt;10mm and Tear break-up time TBUT &amp;lt;10s, (2) Non-DES group (11 patients) according to Schirmer test without anesthesia with results &amp;gt;10mm and Tear break-up time TBUT &amp;gt;10s.To evaluate the relation between vitamin D deficiency, dry eye and impaired tear function The following tests were done to patients in our study: Careful history taking, full ophthalmological examination, Schirmer test, Tear break-up time and Optical coherence tomography (anterior segment).Follow up for our patients in the study after taking vitamin D supplement for 3 month and all the previous tests were repeated again. Results the results revealed that Comparative study between the 2 groups revealed; highly significant decrease in follow up Schirmer test, tear breakup time and tear-film height in DES group; compared to Non-DES eye group (p &amp;lt; 0.01 respectively). Comparative study between the 2 groups revealed non-significant difference regarding follow up tear-film width and vitamin D level (p &amp;gt; 0.05), Conclusion Our work supports that vitamin D deficiency may lead to dry eye which may carry the risk in development conjunctival squamous metaplasia and loss of goblet cells on the ocular surface, and that vitamin D plays a protective role in the development of dry eye, probably by enhancing tear film parameters and reducing ocular surface inflammation.

Conjunctival Impression Cytology and Tear Film Changes in Sarcoidosis: A Subjective and Objective Diagnosis Study.

To evaluate sarcoidosis-induced tear film changes using subjective and objective diagnostic tests, particularly conjunctival impression cytology (IC), and to compare the results with healthy individuals. This study evaluated clinical data collected between January 2019 and January 2021 from 57 right eyes of 57 sarcoidosis patients without ocular involvement (Group 1) and 33 right eyes of 33 healthy individuals with similar demographic characteristics (Group 2). The Schirmer I test, tear break-up time (TBUT), fluorescein staining, and conjunctival IC were all performed as part of the conjunctival and corneal examinations following a thorough ophthalmological examination. The Ocular Surface Disease Index (OSDI) was used to assess subjective ocular symptoms. The mean ages in Groups 1 and 2 were 49.26±3.18 and 51.91±2.89 years, respectively (p=0.720). The mean Schirmer I test, TBUT, and OSDI scores differed significantly (p<0.05 for all), with Group 1 having a significantly higher percentage of dry eyes than Group 2. Group 1 had significantly higher Nelson's grading system grades than Group 2 based on conjunctival IC analysis (p=0.001). There were no significant differences in visual acuity (p=0.17) or intraocular pressure (p=0.14) between groups. Sarcoidosis patients had significantly higher Nelson grades in conjunctival IC, as well as significantly higher percentages of dry eye as determined by the Schirmer I test, TBUT, and OSDI. Reduced tear quantity and quality may destabilize the tear film layer, resulting in a variety of ocular symptoms.

Decellularized Porcine Conjunctiva in Treating Severe Symblepharon.

This prospective study aimed to evaluate the effectiveness of decellularized porcine conjunctiva (DPC) in the management of severe symblepharon. Sixteen patients with severe symblepharon were enrolled in this study. After symblepharon lysis and Mitomycin C (MMC) application, tarsus defects were covered with residual autologous conjunctiva (AC), autologous oral mucosa (AOM), or DPC throughout the fornix, and DPC was used for all the exposed sclera. The outcomes were classified as complete success, partial success, or failure. Six symblepharon patients had chemical burns and ten had thermal burns. Tarsus defects were covered with DPC, AC, and AOM in two, three, and eleven cases, respectively. After an average follow-up of 20.0 ± 6 months, the anatomical outcomes observed were complete successes in twelve (three with AC+DPC, four with AC+AOM+DPC, and five with AOM+DPC) (75%) cases, partial successes in three (one with AOM+DPC and two with DPC+DPC) (18.75%) cases, and failure in one (with AOM+DPC) (6.25%) case. Before surgery, the depth of the narrowest part of the conjunctival sac was 0.59 ± 0.76 mm (range, 0-2 mm), tear fluid quantity (Schirmer II tests) was 12.5 ± 2.26 mm (range, 10-16 mm), and the distance of the eye rotation toward the opposite direction of the symblepharon was 3.75 ± 1.39 mm (range, 2-7 mm). The fornix depths increased to 7.53 ± 1.64 mm (range, 3-9 mm), eye movement was significantly improved, and the distance of eye movement reaching 6.56 ± 1.24 mm (range, 4-8 mm) 1 month after the operation; the postoperative Schirmer II test (12.06 ± 2.90 mm, range, 6-17 mm) was similar to that before surgery. Goblet cells were finally found in fifteen patients by conjunctival impression cytology in the transplantation area of DPC, except for one patient who failed. DPC could be considered an alternative for ocular surface reconstruction of severe symblepharon. Covering tarsal defects with autologous mucosa is necessary for extensive reconstruction of the ocular surface.

Topical corticosteroids for dry eye.

Topical corticosteroids for dry eye.

The Extracts of Dendrobium Alleviate Dry Eye Disease in Rat Model by Regulating Aquaporin Expression and MAPKs/NF-κB Signalling.

Dry eye is one of the most common ocular surface diseases caused by tear film instability and ocular surface damage due to an abnormal quality or quantity of tears. Inflammatory factors can initiate relevant transduction signalling pathways and trigger the inflammatory cascade response, resulting in ocular surface inflammation. It has been shown that the active ingredients in Dendrobium, such as polysaccharides, alkaloids and phenols, have anti-inflammatory, anti-tumour and immunity-boosting effects, and Dendrobium officinale extract can improve glandular secretion function, increase salivary secretion and increase the expression level of water channel protein in salivary glands in patients with dry eye syndromes. We investigated the in vitro cytoprotective effect of Dendrobium extracts in sodium chloride induced hyperosmotic conditions in human cornea keratocytes (HKs). Results showed that Dendrobium officinale Kimura et Migo water extract (DOW) and Dendrobium loddigesii Rolfe water extract (DLW) could upregulate the expression of aquaporins (AQP)5 protein, thus exerting a repairing effect by promoting cell migration. Furthermore, oral administration of DOW and DLW enhanced tear production in rats and exerted a protective effect on ocular surface damage. DOW and DLW could upregulate the expression of AQP5 and mucin (muc)5ac proteins in the lacrimal gland and reduce the inflammatory response. DOW and DLW inhibited the activation of the corresponding mitogen-activated protein kinases (MAPK) and NF-KB pathway, thereby playing a role in improving dry eye symptoms. This study provides a new perspective on dry eye treatment, and DOW and DLW may be potential therapeutic agents for dry eye.

Evaluation of tear parameters and meibomian gland morphology in keratoconus patients after epithelial-on corneal cross-linking.

To evaluate the variations in tear parameters and meibomian gland morphology after epithelial-on (epi-on) corneal collagen cross-linking (CXL) in keratoconus (KC) patients. This prospective observational study included 38 KC eyes that underwent epithelium-on CXL. Thirty-three eyes of 33 stable KC patients with no prior CXL treatment formed the KC group and 35 eyes of 35 healthy volunteers were recruited as the control group. All participants were evaluated by Schirmer I test, first and average noninvasive tear break-up time (NITBUT), ocular surface disease index (OSDI) questionnaire, and meibography scores. The CXL patients were evaluated preoperatively and at the 1st, 3rd, and 6th months, and participants without any intervention (KC and control groups) were evaluated initially, at 1st, 3rd, and 6th months. The KC patients had significantly lower average NITBUT, higher OSDI scores, and impaired meibomian gland morphology than healthy individuals (NITBUT(seconds): KC, 12.8(2.4-17.6), healthy group (HG), 17.1(6.8-17.6); p = 0.012, OSDI: KC, 27.5(0.0-87.5), HG, 7.5(0.0-55.0); p < 0.001, p < 0.001, respectively). A significant difference was found in Schirmer values of the CXL group at 0-1st months, first NITBUT values at 1-6 months, and average NITBUT values at 1-3 and 1-6 months (p = 0.003, p = 0.001, p = 0.003, p = 0.001, respectively). All meibography parameters remained unchanged after CXL over a 6-month follow-up compared to initial measurements. Even though the KC patients had lower NITBUT, higher OSDI scores, and increased meibomian gland disfunction, the CXL treatment did not significantly affect tear quantity, dry eye symptoms, and meibomian gland morphology.

Autologous Platelet-Rich Plasma Drops for Evaporative Dry Eye Disease from Meibomian Gland Dysfunction: A Pilot Study.

PurposeTo evaluate the effects of autologous platelet‐rich plasma (PRP) drops for evaporative dry eye (EDE) disease from meibomian gland dysfunction (MGD).MethodsThis is a retrospective, consecutive case series of 20 eyes of 10 patients with EDE from MGD treated with PRP drops from November 2020 to November 2021 at a single outpatient clinic in Ontario, Canada. PRP drops were prepared from whole blood using a two-step centrifugation method. Patients were instructed to instill these drops six times daily for 4 weeks. The Canadian Dry Eye Assessment (CDEA) questionnaire score, patient subjective assessment (PSA) score, first and average non-invasive break-up times (f/a NIBUT), tear meniscus height (TMH), bulbar redness (BR), and meibograph grade (MG) were measured before and after the treatment course.ResultsSignificant improvements in dry eye symptoms and tear film parameters were observed. Dry eye symptoms significantly improved as per the CDEA (mean difference (MD) = −5.45, 95% confidence interval (CI) = [−7.9, −3.1], p<0.001) and PSA (MD = −2.6, 95% CI = [−3.9, −1.2], p<0.001). There were significant improvements in tear film parameters including fNIBUT (MD = 3.85s, 95% CI = [1.2, 6.8], p=0.006), aNIBUT (MD = −6.81s, 95% CI = [5.7, 11.1], p<0.001) and TMH (MD = 0.08, 95% CI = [0.003, 0.2], p=0.045). There was an improvement in conjunctival injection as measured by BR (MD = −0.36, 95% CI = [−0.4, −0.15], p=0.373). Five eyes experienced a one-grade improvement in MG (p=0.453), and none experienced worsening in MG with treatment. No temporary or permanent adverse effects were noted.ConclusionFour weeks of PRP therapy resulted in significant functional improvements in dry eye symptoms and tear film quality and quantity. Improvements in conjunctival injection and microstructural improvements in meibomian glands were also observed in some eyes. Overall, PRP is a promising treatment option for patients with EDE from MGD refractory to conventional treatments.

Topical applications of allogeneic adipose-derived mesenchymal stem cells ameliorate the canine keratoconjunctivitis sicca

BackgroundCanine keratoconjunctivitis sicca (KCS) is predominantly an immune-mediated disease. Current therapy of canine KCS is mainly by immunosuppressant, but the effectiveness was limited in some patients. In the past few years, some studies showed the results of the use of mesenchymal stem cells in treating canine KCS via periocular injections. However, the periocular injection procedure requires sedation or general anesthesia, and may lead to iatrogenic or incidental injury during the injection process. The aim of this study was to investigate the efficacy of topical allogenic canine adipose-derived mesenchymal stem cells (cAD-MSCs) in clinical patients of canine KCS.ResultsThe cAD-MSCs used in this study were characterized for their capability of tri-lineage differentiation and immunomodulatory properties. In addition, preparation methods for eye drops of cAD-MSCs was developed and its optimal preservation was tested. The canine KCS patients were recruited for clinical trial and divided into two groups based on their history of previous treatment. All patients received topical cAD-MSCs treatment once per week for 6 consecutive weeks and complete ophthalmic examinations were performed 1 week before treatment (week 0) and at 3rd, 6th, 9th weeks, respectively. The results showed that the quantity and quality of tears have improved significantly following topical cAD-MSCs treatment based on Schirmers tear test-1 and tear break-up time. More than half of all patients were found improved in the tear quantity. In particular, 56.5% of the patients that were unresponsive to prior immunosuppressant therapy had an effective increase in tear volume. The severity of clinical signs was also ameliorated according to the numeric rating scale score from both patient owners and the clinician.ConclusionTo sum up, topical cAD-MSCs may be beneficial especially in KCS patients with poor owner compliance for frequent daily use of eye drops or those who are unresponsive to immunosuppressant therapy.

Difference of Schirmer Test Results Before and After Using Smartphones with Various Screen Brightness Levels

Background : The use of smartphones and other digital devices such as laptops and tablets is familiar in Indonesian society. Excessive uses of the devices are associated with dry eye syndrome and tear film dysfunction. The intensity of blue light when penetrating the eye is believed to affect tear film stability. Thus it will encourage tear evaporation which proved by Schirmer test.Objective : To find out the difference of Schirmer test results before and after using a smartphone with various screen brightness levels.Methods : This study used pretest-posttest quasi-experimental study. The research subjects were students of the Faculty of Medicine, Diponegoro University (n = 30) who were selected by purposive sampling. In this study, the research subjects used smartphones for an hour with a predetermined screen brightness level, with the same room lighting. Before and after treatment the subject was measured the quantity of tears using the Schirmer test. Data were analyzed using the Wilcoxon test, Mann Whitney U test, and Kruskal Wallis test.Results : The average pretest result on low brightness was 25,60 ± 9,44 and the post-test result was 17,60 ± 8,45. The pre-test result on medium brightness was 27,90 ± 9,46 and the post-test result was 24,80 ± 10,46. The pre-test result on high brightness was 23,60 ± 6,80 and the post-test result was 19,10 ± 7,95. The Schirmer test results before and after using smartphones with low brightness showed a significant different (P&lt;0.05) and there was no significant difference for the pre-post test using smartphones with medium and high brightness. Comparison of Schirmer test results on low, medium and high screen brightness did not show a significant difference.Conclusion : There is no significant difference between the Schirmer test results among low, medium and high screen brightness after one hour of smartphone usage.

Effect of Blue Light Filters on Tear and Contrast Sensitivity in Individuals Using Electronic Devices.

To investigate the effect of contact lenses with blue light filters on contrast sensitivity and any alteration in tear quantity and quality. This prospective longitudinal pilot study required three visits by each participant. Monocular visual acuity, contrast sensitivity, phenol red thread test, and tear breakup time were measured at each visit. There were significant differences in logarithmic contrast sensitivity between the groups. The breakup time (BUT) was significantly lower after using video display terminals than before (P<0.05). No differences in BUT were found between groups video display terminals and contact lenses having the blue filter (P>0.05). However, higher mean values were observed in the group after video display terminal use with contact lenses having the blue filter than that with standard contact lenses (P>0.05 in both groups). Furthermore, the mean value of phenol red thread test on the group after video display terminal use with contact lenses having the blue filter was lower than the group before its use (P>0.05). The results establish a possible relationship between tear stability, improved contrast sensitivity, and the use of a blue filter in contact lenses.

Estudio descriptivo de la película lagrimal en personas fumadoras en GT óptica, Ecuador 2019

Dry eye is caused by the lack of enough lubrication and wetting on the ocular surface. A longitudinal and prospective study was conducted with the objective of knowing the clinical epidemiological characteristics of tear film in smoking patients in ÒPTICA GT. Ecuador 2019. Variables such as age, sex, results of the Schirmer I and But tests, ratio of the quantity and tear quality were measured according to the patients smoking time and the symptoms reported by the patients. A greater number of smokers were found between the ages of 29 and 33, in terms of sex there was a higher prevalence of smokers in the male sex, in the Schirmer I test the normal tear secretion predominated, the BUT test resulted in the altered tear film, in relation to the tear quantity with the time that smokes was obtained in the great majority normal tear quantity without being directly related to the years of exposure to nicotine, in the relation of tear quality with the time that smokes it was obtained an alteration of the tear film in all groups, with a higher prevalence in patients with smoking habits for more than 20 years. The symptom of dry eye that prevailed was eye irritation.

Morphological Changes in the Lacrimal Gland of Anophthalmic Socket in Relation to the Contralateral Normal Eye in Male Wistar Albino Rats: A Histopathology Study

ABSTRACT Purpose: The purpose of the study is to analyze the structural and functional alterations of the lacrimal gland and its tear secretion post-enucleation in Wistar rats. Method: Adult male Wistar rats (n = 15) of 8-week-old were randomly assigned into three groups viz. control, sham, and experimental group (n = 5). Rats of the experimental group were subjected to enucleation of the right eye. Under aseptic surgical conditions, with sterilized forceps, right eyeball of the rats of experimental group was exposed completely out of the socket by applying pressure on the lateral canthus of the eye. Enucleation was then achieved after holding the optic nerve tightly. The surgical procedure was similar in sham group without enucleation. Quantity of tears (Basal and reflex) secreted in both eyes in rats of all groups were measured by using Schirmer’s strip, pre- and post-three weeks of enucleation. The lacrimal gland was harvested to analyze histopathological (structural) alterations. Results: Pr- and post-enucleation there was no significant difference observed in the tear volume across the groups. Histopathology of the lacrimal glands from all groups showed preserved lobular architecture with serous acini arranged in lobules, intralobular and interlobular ducts, interstitial fibro collagenous tissue. There was no glandular distortion and atrophy in experimental group. Conclusion: Enucleation do not co-relate or affect the tear volume and lacrimal gland acinar microstructural changes in an anophthalmic socket co-relating to the contralateral normal functional eye.

ОКТ-менискометрия как метод количественной оценки баланса слезной системы

All diseases of the lacrimal apparatus of the eye disrupt the balance of the lacrimal system either due to changes in the production of tears, or due to the insufficiency of its removal, so the study of the quantity and quality of tears on the eye surface allows us to reliably assess the effectiveness of methods of treating the pathology of the lacrimal organs. OCT-meniscometry is the only non-contact, non-invasive, accurate method of examining the lacrimal apparatus, which is reflected in the publications of many authors. The aim of our study was to improve the accuracy and automate the process of calculating the area of the lacrimal meniscus, as well as to evaluate the correlation between the indicators of OCT-meniscometry and functional tests. Materials and methods. The study included 50 patients with dacryostenosis (group 1), who were examined before and 1 month after surgical treatment (recanalization of SOP), as well as 30 patients without pathology of the lacrimal organs, who did not complain of lacrimation and dry eyes (group 2). All patients underwent a Schirmer and Norn test according to the generally accepted method, and OCT-meniscometry was performed using an optical coherence tomograph. The resulting OCT-meniscogram was transferred to a special mathematical program. Green's formula was used to calculate the area. Results. Meniscometry data had a strong correlation with functional tests (p&lt;0.05) and high diagnostic sensitivity and specificity. Conclusion. The method of OCT-meniscometry has a higher sensitivity and specificity compared to routine tests, is less invasive, highly informative, which, of course, increases the reliability of the analysis of treatment results. Key words: meniscometry, TMA, lacrimal meniscus area, lacrimal system balance, dacryology.