Risk Factors For Dry Eye Research Articles

Caffeine and Vision: Effects on the Eye.

Caffeine, commonly found in coffee and tea, affects various aspects of eye health as it blocks adenosine receptors, impacting tear production, intraocular pressure, macular perfusion, and choroidal thickness. However, its connection with eye conditions like glaucoma and cataracts remains uncertain due to conflicting research findings. Some studies suggest potential benefits for cataracts, while others warn against frequent caffeine intake in glaucoma and surgical scenarios due to possible increases in intraocular pressure. Conflicting evidence also exists regarding its effects on dry eye, macular degeneration, myopia/hyperopia, diabetic retinopathy, retinopathy of prematurity, and central serous retinopathy. Caffeine does not seem to be a risk factor for dry eye, although studies have shown that caffeine may offer protection against wet age-related macular degeneration, and the metabolite 7-methylxanthine could be a more promising treatment for myopia. Moreover, caffeine can potentially cause tremors and might hinder surgical performance, especially in less experienced surgeons. Recommendations from experts vary, highlighting the need for further research to fully understand how caffeine affects the eye. Individuals genetically predisposed to glaucoma should be cautious due to the possibility of clinically significant elevations in intraocular pressure with caffeine consumption. For delicate procedures like microsurgery, where tremors can be detrimental, caution should be exercised with caffeine. This review underscores the importance of additional studies to provide clearer insights and prudent recommendations regarding caffeine's impact on eye health.

Age-Related Differences in the Mouse Corneal Epithelial Transcriptome and Their Impact on Corneal Wound Healing.

Aging is a risk factor for dry eye. We sought to identify changes in the aged mouse corneal epithelial transcriptome and determine how age affects corneal sensitivity, re-epithelialization, and barrier reformation after corneal debridement. Corneal epithelium of female C57BL/6J (B6) mice of different ages (2, 12, 18, and 24months) was collected, RNA extracted, and bulk RNA sequencing performed. Cornea sensitivity was measured with an esthesiometer in 2- to 3-month-old, 12- to 13-month-old, 18- to 19-month-old, and 22- to 25-month-old female and male mice. The 2-month-old and 18-month-old female and male mice underwent unilateral corneal debridement using a blunt blade. Wound size and fluorescein staining were visualized and photographed at different time points, and a re-epithelialization rate curve was calculated. There were 157 differentially expressed genes in aged mice compared with young mice. Several pathways downregulated with age control cell migration, proteoglycan synthesis, and collagen trimerization, assembly, biosynthesis, and degradation. Male mice had decreased corneal sensitivity compared with female mice at 12 and 24 months of age. Aged mice, irrespective of sex, had delayed corneal re-epithelialization in the first 48 hours and worse corneal fluorescein staining intensity at day 14 than young mice. Aged corneal epithelium has an altered transcriptome. Aged mice regardless of sex heal more slowly and displayed more signs of corneal epithelial defects after wounding than young mice. These results indicate that aging significantly alters the corneal epithelium and its ability to coordinate healing.

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

Abstract
 Introduction & 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.
 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<0,05 is considered significant.
 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).
 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.

Administration of serotonin and norepinephrine reuptake inhibitors tends to have less ocular surface damage in a chronic stress-induced rat model of depression than selective serotonin reuptake inhibitors

Depressed patients who medicate with selective serotonin reuptake inhibitors (SSRIs) often report ocular dryness. Epidemiological studies have found that serotonin and norepinephrine reuptake inhibitors (SNRIs) are not risk factors for dry eye in depressed patients. However, the effect of SNRIs on the ocular surface is unknown. A depression rat model was induced by chronic unpredictable mild stress (CUMS), and SNRIs or SSRIs were administered to the rats for 3 or 6 weeks. The levels of norepinephrine (NE) and serotonin in tear fluid were tested by ELISA. The corneal fluorescence and lissamine green staining were used to evaluate ocular surface damage. NE and/or serotonin were administered to human corneal epithelial cells in vitro. RNA sequencing (RNA-seq) analysis was performed to investigate the mRNA expression profiles. Tear NE levels were higher in the SNRIs group, and ocular surface inflammation and apoptosis were significantly reduced compared to the SSRIs group. RNA-Seq indicated that NE significantly activate MAPK signaling pathway. NE can inhibit serotonin-induced activation of the NF-κB signaling pathway through α-1 adrenergic receptors and promotes the proliferation of corneal epithelial cells through activation of the MAPK signaling pathway. SNRIs administration have less ocular surface damage than SSRIs. NE protects human corneal epithelial cells from damage, and reduce inflammation on the ocular surface via activating the MAPK signaling pathway. SNRIs might be used as an appropriate treatment for depression-related DED.

Awareness, Prevalence, and Knowledge of Dry Eye Among Internet Professionals: A Cross-sectional Study in China.

To investigate awareness, prevalence, and knowledge of dry eye among Internet professionals in China. A cross-sectional study was conducted among 1,265 randomly selected Internet professionals aged ≥18 years. A self-administered questionnaire was used to assess dry eye awareness, dry eye symptoms, and knowledge about dry eye risk factors. Data on demographics and complete medical history were also collected. The primary outcome was the rate of dry eye awareness determined by the answer to the question "Have you seen or heard anything about dry eye recently?" Of the 1,265 included individuals aged 20 to 49 years, 519 (41.0%) were women. 54.4% (688 of 1,265) of participants had seen or heard something about dry eye recently and most had obtained information through Internet. 50.8% (643 of 1,265) of participants were identified as subjects with symptoms of dry eye. Dry eye awareness was greater in contact lens wearers (odds ratio [OR], 6.49; 95% confidence interval [CI], 3.70-11.38; P <0.001), those with a refractive surgical history (OR, 5.09; 95% CI, 2.34-11.08; P <0.001), relatives and/or friends of ophthalmologists (OR, 2.76; 95% CI, 1.39-5.49; P =0.004), those with symptoms of dry eye (OR, 1.87; 95% CI, 1.47-2.38; P <0.001) and female subjects (OR, 1.44; 95% CI, 1.13-1.86; P =0.004). Knowledge of nonmodifiable and modifiable risk factors for dry eye was poor in substantial numbers of the participants. The level of dry eye awareness and knowledge of its risk factors is suboptimal in Internet professionals, although the Internet professionals are at high risk of the disease.

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

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

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

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

The Association Between Dry Eye and Sleep Disorders: The Evidence and Possible Mechanisms.

Dry eye is a disease that severely affects patients' quality of life, increasing the global burden on public health and finance. There is growing evidence that a poor lifestyle is a significant risk factor for dry eye. Along with the development of society, sleep, as a way of life, is also constantly changing. The main manifestations of sleep disorders are reduced sleep time, circadian rhythm disturbances, and sleep breathing disturbances. Sleep disorders and their secondary systemic diseases have attracted wide attention in recent years. This review mainly explored the correlation between sleep disorders and dry eye, and found that sleep-related problems and other factors potentially leading from sleep disorders could be critical factors for dry eye. These results suggest that ophthalmologists should pay attention to the sleep health problems in patients with dry eye, and we hope that this paper can provide help for future research in this field.

The Incidence and Risk Factors for Dry Eye After Pediatric Strabismus Surgery.

This study aimed to investigate the incidence and risk factors for dry eye after pediatric strabismus surgery. Children aged 5-12years who underwent strabismus surgery were included in this single-center, prospective, cohort study. The ocular surface assessments were conducted 1day before and 1, 4, and 8weeks after surgery. The main outcome measures were the incidence of dry eye after strabismus surgery and associated risk factors. A total of 84 eyes (48 children) that underwent strabismus surgery were included in the study. The mean age at surgery was 7.21years. The incidence of dry eye was 47.62% at 1week, 10.71% at 4weeks, 0% at 8weeks after surgery. The preoperative tear breakup time (BUT) was lower in the dry eye group than that in the non-dry eye group (P ≤ 0.01). The univariate analysis showed that preoperative BUT was significantly associated with the incidence of dry eye after pediatric strabismus surgery (odds ratio [OR] 0.647, confidence interval [CI] 0.503-0.833, P ≤ 0.01). Dry eye commonly occurs after pediatric strabismus surgery. Tear film instability is more common than deficient aqueous tear production in patients with dry eye after surgery. Children with a low preoperative BUT are more likely to develop dry eye after strabismus surgery.

The Relationship Between Circadian Typology and Dry Eye Symptoms in Chinese College Students.

PurposeTo explore the relationship between symptomatic dry eye and circadian typology in college students.MethodsThis study included 269 students from 3 Chinese universities. All participants completed the ocular surface disease index (OSDI) questionnaire, the morningness-eveningness questionnaire (MEQ), and the Pittsburgh sleep quality index (PSQI) questionnaire. Participants were grouped into 3 types by the reduced MEQ (rMEQ) score:E-Type, N-Type, and M-Type. All these parameters were then analyzed for the effect on the severity of dry eye.ResultsThe occurrence rates of poor sleep quality (PSQI>5) and symptomatic dry eye (OSDI > 13) in the college students were 53.2% and 40.2%, respectively. The distribution of the circadian typology differed significantly among the college students with different dry eye severities (χ2 = 59.44, P = 0. 000), and E-type was associated with the most severe dry eye symptoms. The OSDI and PSQI scores were both significantly different among college students with different chronotypes (F = 22.14, P = 0.000; F = 15.21, P = 0.000; respectively). For both scores, the E-type scored the highest, followed by N-type, and M-type was the lowest. The circadian typology was an independent factor for dry eye. The risk of E-Type was 6.99 times higher than that of M-Type (P = 0.000), and the risk of N-types was 3.23 times higher than that of M-Type (P = 0.000). Sleep quality was also an independent risk factor for dry eye (P = 0.000). Gender and awareness of dry eye were not risk factors for dry eye.ConclusionThe severity of dry eye symptoms and sleep quality were associated with different circadian typologies. The more the circadian preference tended to be E-type, the worse the sleep quality and the more serious dry eye symptoms would appear.

Chinese expert consensus on dry eye: lifestyle-related dry eye (2022)

Epidemiological studies have confirmed that the incidence of dry eye is closely related to lifestyles. The Expert Consensus on Dry Eye in China: Definition and Classification (2020) incorporated lifestyle-related factors into the classification of causes and risk factors for dry eye. In order to improve the diagnosis, treatment and prevention of this type of dry eye, the experts from the Chinese Branch of the Asian Dry eye Society and other scientific organizations have formed a consensus on the definition, classification, incidence, epidemiology, pathological mechanism, clinical characteristics, diagnosis, treatment and prevention of lifestyle-related dry eye. This consensus can be used as a reference for clinical work.

Dry Eye-Related Risk Factors for Digital Eye Strain.

To evaluate dry eye-related lifestyle and demographic factors associated with digital eye strain (DES). An anonymous online survey was conducted in 851 university students. Participants were classified into DES (computer vision syndrome questionnaire [CVS-Q]≥6) or non-DES (CVS-Q<6). Respondents completed three dry eye questionnaires (Ocular Surface Disease Index [OSDI]; 5-item Dry Eye Questionnaire [DEQ-5]; 8-item Contact Lens Dry Eye Questionnaire) and were surveyed on dry eye risk factors contemplated by the Tear Film and Ocular Surface Society Dry Eye Workshop II. Six hundred twenty-eight participants were classified into the group with DES and 222 into the group without DES. Participants with DES slept fewer hours, spent more hours indoors with air conditioning, drank more caffeinated beverages, used the computer for longer periods, reported poorer health quality, and obtained a higher score in all questionnaires (P<0.025). A higher proportion of the participants were female, had several health disorders, and took several medications associated with dry eye (P<0.029). Multivariate logistic regression analysis revealed that stress (P=0.035), contact lens wear (P=0.011), hours of computer use per day (P=0.010), migraine headaches (P=0.013), and a higher OSDI (P<0.001) and DEQ-5 score (P<0.001) were associated with DES. Several dry eye-related risk factors and health conditions are associated with suffering from DES. Clinicians should acknowledge the relevance of triaging questions and dry eye disease risk factors when dealing with patients who view screens for extended periods.

Evaluation of Tear Evaporation Rate in Subjects with a High Body Mass Index.

This study evaluated the tear evaporation rate (TER) in subjects with a high body mass index (BMI) and tested the correlation between BMI and dry eye. Thirty male subjects aged 18 - 38 years (26.4 ± 4.0years) with a high BMI (26.4 - 47.0 kg/m2) were enrolled in the study. In addition, a control group of 30 males aged 20 - 36 years (24.0 ± 3.6 years) with a normal BMI (< 25 kg/m2) participated in the study for comparison. Each subject completed the ocular surface disease index (OSDI), followed by the TER measurement using a handheld VapoMeter. Significant differences (Wilcoxon test; p = 0.002 and 0.001) were found between the median scores of the OSDI (10.3 [3.7] vs. 5.9 [7.2]) and TER (35.5 [13.1] vs. 15.5 [12.8] g/m2 h) in the study and control groups, respectively. The OSDI indicated dry eye in 60.0% of subjects in the study group (n = 18). The TER measurements showed that 76.7% of subjects in the study group (n = 23) had dry eyes. A medium correlation (r = 0.569; p = 0.001) was found between the OSDI scores and TER measurements. The means of the tear evaporation rate and the ocular surface disease index scores are significantly higher in subjects with a high BMI compared with the control group. Therefore, a high BMI is considered a risk factor for dry eye. The measurement of the tear evaporation rate using a handheld VapoMeter is a simple and rapid method to detect dry eyes in combination with other tools.

Comparative study of tear film evaluation among healthy pregnant women and gestational diabetes: a cross-sectional study

Background: Diabetes mellitus (DM) is one of the risk factors for dry eye. This study aimed to estimate the characteristics of tear film by measuring the tear secretion, tear evaporation rate, conjunctival impression cytology and also ocular surface disease index (OSDI) scoring through a questionnaire for gestational diabetes mellitus (GDM) and healthy pregnant women (HPW).Methods: Total of 40 subjects which included 20 subjects who were HPW in group-1 and 20 subjects who were GDM in group-2. After examining their ocular status, the subjects were initially administered with OSDI questionnaire followed by dry eye evaluation procedures such as non-invasive tear breakup time (NIBUT), Schirmer’s 1 and 2, tear film break up time (TBUT) and conjunctival impression cytology (CIC).Results: The gathered data was checked for normality. Mean and standard deviation was compiled for each parameter for their respective groups. A statistical comparison with independent t test was performed between the groups which compared OSDI scores, NIBUT, Schirmer’s 1 and 2, TBUT and CIC for both HPW and GDM group women. Statistically significant difference (p&lt;0.01) was observed with OSDI scores, Schirmer's test 2, TBUT and NIBUT whereas Schirmer's test 1 and CIC were not statistically significant (p&gt;0.01). OSDI scores represented mild symptoms for GDM women.Conclusions: Tear film of GDM women was affected more than HPW suggesting evaporative dry eye. Assessing tear film as a part of routine eye examination for women with GDM is essential to avoid the occurrence of complications due to tear film abnormalities.

Assessment of Tear Film Parameters in Smokers and Subjects with a High Body Mass Index.

The current study compares the ocular tear film parameters in three different groups using a single noninvasive, practical, and easy-to-use tool. This study aimed to assess the tear film in smokers, those with a high body mass index (BMI), and healthy subjects using the EASYTEAR view+. Thirty men with a high BMI (>25 kg/m2; 24.4 ± 6.4 years), 30 smokers (25.1 ± 6.1 years), and 30 healthy subjects (22.2 ± 3.5 years) were recruited. Each subject completed the Ocular Surface Disease Index, followed by the assessment of noninvasive tear breakup time, tear meniscus height (TMH), and lipid layer patterns (LLPs). Significant differences were found in the median TMH scores between smokers and healthy subjects (P = .03) and between subjects with a high BMI and the healthy ones (P = .04). The median LLP score was significantly (P < .001) higher in normal subjects (4.0 [1.0]) than in smokers (2.4 [1.0]) and subjects with high BMI (2.0 [1.3]). For subjects with a high BMI, the noninvasive tear breakup time score was strongly correlated (Spearman rank correlation coefficient; r) with TMH (r = 0.552, P = .002) and LLP (r = 0.555, P = .001). The LLP showed that grade B (lipid layer thickness, 30 to 50 nm; more compact) was common in subjects with a high BMI, grade C (50 to 80 nm, gray waves) was predominant in smokers, and grade D (~80 nm, dense white-blue layer) represented the majority of normal eye subjects. Smokers and individuals with a high BMI showed significantly lower lipid layer grades and tear meniscus height scores compared with the control group. The assessment of tear film parameters using the EASYTEAR view+ supports the findings of previous studies that implicate smoking and high BMI as risk factors for dry eye.

Questionnaire Analysis on Incidence and Risk Factors of Dry Eye in Children From a Myopia Outpatient Clinic.

ObjectiveTo analyze the incidence and risk factors of dry eye in children from a myopia outpatient clinic via a questionnaire and Keratograph 5M.MethodsA cross–sectional study was performed. sThere were 214 children (428 eyes) selected from the myopia outpatient clinic of the affiliated Eye Hospital of Shandong First Medical University from July 2021 to September 2021, including 105 boys (210 eyes) and 109 girls (218 eyes), with an average age of 10.1 ± 2.5 years. The incidence rate and influence factors for dry eye were calculated.ResultsThirty–four of 214 children were diagnosed with dry eye, accounting for 15.9% of the patients. The correlation between fussy eating and the tear meniscus height was statistically significant (Z = −2.158, p = 0.039), along with the correlation between short–distance use of eyes and the tear meniscus height (Z = −2.135, p = 0.033). The degree of meibomian gland deficiency was graded. The meibomian gland was graded as grade 1 in 242 eyes (68.9%), grade 2 in 104 eyes (29.6%), and grade 3 in 5 eyes (1.4%). There was a significant difference in the correlation between eye rubbing and the incidence of dry eye in children (Z = −2.747, p = 0.008). There was also a significant difference in the correlation between picky eating and the incidence of dry eye in children (Z = −2.347; p = 0.024). There was a statistically significant correlation between the time of looking at electronic products and the morphology of the meibomian gland (Z = −2.201, p = 0.028). The results showed that the effect of mild and moderate ametropia on the non–invasive tear breakup time in children was statistically significant (Z = −2.027; p = 0.043).ConclusionThere is a high incidence of dry eye in children in the myopia outpatient clinic. There is a significant correlation between picky eating, eye rubbing, and the incidence of dry eye. Looking at electronic products for a long time will also affect the morphology of the meibomian gland in children.

Research advances in contact lens-associated dry eye

Dry eye is the most common disease in ophthalmic clinics besides refractive error, which seriously affects the life quality of patients and has become an important public health problem in China. Dry eye as a kind of multifactorial disease can be induced or accelerated by contact lens wear, which is considered as one of the risk factors of dry eye. Studies have shown that the incidence of dry eye is higher in contact lens wearers than in normal people. In 2017, the Tear Film and Ocular Surface Society included contact lens-associated dry eye (CLADE) in the iatrogenic dry eye for the first time, and its importance is evident. However, ophthalmologists mostly used to focus on serious complications such as keratitis caused by contact lens wear, and CLADE has not been well valued and understood. This article reviews the latest studies on the epidemiology, pathogenesis, diagnosis, prevention, and treatment of CLADE.

Prevalence and Risk Factors of Dry Eye Disease at a Tertiary Care Centre in Haryana, India: A Cross-sectional Study

Introduction: Dry Eye Disease (DED) is a multifactorial disease which causes ocular discomfort and visual disturbances. It is one of the major causes of patients’ visit to the clinic. The prevalence of DED has increased in recent times due to increased time spent on computers and mobile phones, ageing population and highly stressful social environment. Various studies done in past on DED prevalence have given the variable results. Aim: To determine the prevalence of DED and analyse the associated risk factors in a tertiary care centre in Sonepat, Haryana, India. Materials and Methods: Present study was a cross-sectional observational study done in outpatient Department of Ophthalmology at Bhagat Phool Singh Government Medical College for Women, Sonepat, Haryana, India, from April 2021 to December 2021. Total 820 patients, aged &gt;18 years were administered Ocular Surface Disease Index (OSDI) questionnaire. Patients with OSDI score &gt;12 and positive one or both of the dry eye objective tests of Schirmer’s and Tear film Break Up Time (TBUT) below cut-off value were labeled as DED and were evaluated for association with various risk factors. Data were statistically analysed by Chi-square test, Wilcoxon-Mann-Whitney U test and Fisher’s exact test. Results: The mean age of patients were 39.65±15.52 years ranging between 18-79 years. DED was found to be more prevalent in females 120 (56.1%) compared to males 94 (43.9%). The prevalence of DED was 26.1% (214/820). Maximum prevalence was found in the age group 18-40 years (43.9%). Out of the 214 DED patients, 113 (52.8%) had mild, 95 (44.4%) had moderate and 6 (2.8%) had severe dry eye. The risk factors significantly associated (p&lt;0.05) with DED were: more than 3.71 hours of Visual Display Terminal (VDT) use, occupational VDT users, homemakers, previous ocular surgery, uncorrected refractive error, diabetes mellitus, hypertension, Chronic Obstructive Pulmonary Disease (COPD), alcohol intake and mask use. Conclusion: DED is a significant cause of ocular morbidity, affecting more than quarter (26.1%) of the study population. Awareness and identification of risk factors for dry eye which are occupational VDT users, previous ocular surgery, uncorrected refractive error, diabetes mellitus, hypertension, COPD, alcohol intake and mask use is important for effective prevention and management of DED.

The Etiology of Dry Eye Syndrome in a Group of Patients visited Ophthalmic Department of Azady Teaching Hospital in Kirkuk

Purpose: To clarify the etiology of dry eye syndrome, distribution of age and gender among study group and to identify risk factors for dry eye. Method: A descriptive study done in Azady Teaching Hospital from 1 of July 2020 to 1 September 2021. The research included 946 patients above 40 years of mixed population. Result: the mean age of study group was 55,5 years, mean age of dry eye group was 57,2 years, The prevalence of dry eye in was 17.8 % and founded to be maximum in the elderly as majority of diagnosed dry eye patients were in their sixties 42%. Dry eye syndrome funded to be more common in female (19.4%) than in male (15.8%). The main etiological factors in our study were either:1-Ocular causes: eye lid diseases (blepharitis and MGD) 20%, abnormal ocular surface 12%, old trachoma 4.8%, ocular surgery (3.6%). 2-systemic disease: were founded to be rheumatoid arthritis (12%), diabetes (10.8%), thyroid disease (4.8%) Sjogren disease (2.4%) and pemphigus (1.2%). 3-Drug induced dry eye: Drugs that contribute to dry eye syndrome discovered to be mainly antihypertensive (15.4%), antiglaucoma (8.4%), antihistamine (2.4%) and anticholinergic (1.2%). Conclusions: Dry eye disease is more common in people over 40,and this should be taken into account when examining patients in ophthalmology clinics, Dry is more common in women, especially postmenopausal Dry eye is a frequent disease and correct diagnosis is the main line in treatment and, so we need to keep in mind those at higher risk.

Incidence and Risk Factors of Dry Eye in Children and Adolescents With Diabetes Mellitus: A 3-Year Follow-Up Study.

Purpose: To investigate the incidence and risk factors of dry eye in children with diabetes mellitus (DM) over a period of 3 years.Methods: Children and adolescents with DM (age: 3–14 years) from the Shanghai Children and Adolescent Diabetes Eye (SCADE) study cohort who did not have dry eye in January 2018 were followed-up for 3 years and re-examined in January 2021, and the incidence rate and risk factors for dry eye were calculated.Results: Forty children and adolescents with DM came for follow-up in 2021. Nine of them were diagnosed with dry eye, resulting in a 3-year incidence rate of 22.5% and an annual mean incidence rate of 7.5% for dry eye. Univariate regression analysis confirmed that decreased corneal sensation (OR [Odds Ratio] = 25.60; 95%CI [Confidence Interval] = 1.31~501.69; P = 0.03) was the risk factor for dry eye incidence. Long course of DM (OR = 1.80; 95%CI = 0.96~3.38; P = 0.07), eye pain (OR = 12.27; 95%CI = 0.65~231.48; P = 0.09), and dry eye in parents (OR = 15.99; 95%CI = 0.76~337.75; P = 0.08) may interfere with the incidence of dry eye in them.Conclusions: The incidence of dry eye in children and adolescents with DM is high.