Risk Of Dry Eye Disease Research Articles

Impact of dry eye disease on psychological symptoms among Chinese doctoral students studying abroad.

This study aimed to evaluate the impact of dry eye disease (DED) on depression, anxiety, and stress among Chinese doctoral students studying abroad. This is a cross-sectional study. This study enrolled 185 Chinese doctoral students pursuing education in the Philippines. DED was assessed using the Ocular Surface Disease Index, while psychological symptoms were evaluated using the abbreviated version of the Depression, Anxiety, and Stress Scale-21 questionnaire. A survey encompassing demographic information, potential DED risk factors, and individual habits was also administered. Of the 185 students, 129 completed the survey, of which 40 (31.0%) were male and 89 (69.0%) were female. The average age was 36.3 ± 7.0 (mean ± SD; range, 22-57) years. The prevalence of DED, depression, anxiety, and stress was 73.6% (95/129), 43.4% (56/129), 50.4% (65/129), and 22.5% (29/129), respectively. Univariate analysis revealed that aging (P < .001), prolonged visual display terminal (VDT) use (P = .004), extended paperwork time (P < .001), higher depression score (P = .006), higher anxiety score (P < .001), and higher stress score (P < .001) were associated with increased influence of DED. After adjusting for age, duration of VDT use, duration of paperwork, and depression score, age (P = .030) had significant association with DED. Additionally, after adjusting for age, duration of VDT use, duration of paperwork, and anxiety score, age (P = .026) and anxiety score (P = .047) were significantly associated with DED. Moreover, after adjusting for age, duration of VDT use, duration of paperwork, and stress score, age (P = .035) and stress score (P = .028) showed significant associations with DED. In the multivariate analysis of variance, there was a significant impact of DED severity classification on psychological distress (V = 0.19, F(9, 375) = 2.83, P = .003). Univariate analysis of variances indicated that DED severity had a significant impact on anxiety F(3, 125) = 6.06, P = .001 and stress F(3, 125) = 3.00, P = .033. A higher influence of DED was related to stress and anxiety. Anxiety and stress levels increase with the severity of DED.

Moderate-severe peripheral neuropathy in diabetes associated with an increased risk of dry eye disease.

This study establishes an increased risk of developing dry eye disease (DED) in patients with diabetic peripheral neuropathy using validated diagnostic criteria for both conditions. The disruption of ocular surface homeostasis has been associated with diabetes. However, it remains unclear if this association is independently influenced by peripheral neuropathy secondary to diabetes. This study aimed to investigate the clinical signs and symptoms of DED and their association with the severity of peripheral neuropathy in participants with type 2 diabetes. This prospective cross-sectional study recruited 63 participants with type 2 diabetes. All participants underwent a detailed assessment of DED using dry eye questionnaires (Ocular Surface Disease Index, Dry Eye Questionnaire-5), tear osmolarity, lipid layer thickness, noninvasive keratographic tear breakup time, phenol red thread test (PRT), and ocular surface staining. Corneal nerve morphology was imaged using corneal confocal microscopy. Based on the Total Neuropathy Scale, participants were stratified into no/mild (n = 48) and moderate/severe (n = 15) neuropathy groups. Dry eye disease was diagnosed in 31 participants (50%) of the total cohort, and the odds of developing DED in the moderate/severe neuropathy group were four times (95% confidence interval, 1.10 to 13.80; p=0.030) higher compared with the no/mild neuropathy group. The Dry Eye Questionnaire-5 scores were significantly higher (p=0.020), and PRT values (p=0.048) and corneal nerve fiber length (p<0.001) were significantly reduced in the moderate/severe neuropathy group compared with the no/mild neuropathy group. In regression analysis, neuropathy scores were independently associated with PRT measurements (β = -0.333, p=0.023) and nerve fiber length (β = -0.219, p=0.012) while adjusting for age, gender, hemoglobin A1c, and duration of diabetes. Type 2 diabetic patients with peripheral neuropathy have a risk of developing DED, which increases with the severity of neuropathy. The observation that worsening peripheral neuropathy is associated with reduced tear secretion suggests that it may contribute to aqueous insufficiency.

Epidemiology and Risk Factors of Dry Eye Disease: Considerations for Clinical Management.

Dry eye disease is a multifactorial condition characterised by tear film instability, hyperosmolarity and ocular surface inflammation. Understanding the epidemiology of dry eye disease and recognising both modifiable and non-modifiable risk factors can assist eye care practitioners in assessing, treating, and managing patients with the condition. This review considers current knowledge surrounding its incidence and prevalence, as well as associated demographic, systemic, ocular, and iatrogenic, and lifestyle-related modifiable risk factors. Population-based prevalence estimates vary according to the diagnostic criteria used to define dry eye disease, as well as severity and demographic characteristics of the population. Considering recent data and variable population demographics, conservative prevalence estimates suggest that 10-20% of the population over 40 years of age report moderate to severe symptoms and/or seek treatment for dry eye disease. Individuals with specific non-modifiable demographic risk factors may be at increased risk of developing dry eye disease. Advanced age, female sex and East Asian ethnicity have been identified as key non-modifiable demographic features predisposing individuals to dry eye disease. Systemic conditions that have been associated with an increased risk of dry eye disease include migraine, Sjögren syndrome, connective tissue disorders, mental health disorders, diabetes mellitus and androgen deficiency. Medications that may contribute to this risk include antidepressants, antihistamines, and hormone replacement therapy. Ocular and iatrogenic risk factors of dry eye disease include blepharitis, Demodex infestation, ocular surgery, blink completeness, contact lens wear, and topical ophthalmic medications. A range of modifiable lifestyle factors that can increase the risk of dry eye disease have also been identified, including low humidity environments, digital screen use, quality of sleep, diet, and eye cosmetic wear. Dry eye is a common disease affecting millions globally. Increasing knowledge regarding its associated risk factors can better prepare the eye care practitioner to successfully manage patients with this ocular surface disease.

Sleep Disturbances and Dry Eye Symptoms and Signs, Systemic Conditions, and Inflammatory Markers in the Dry Eye Assessment and Management Study

Purpose: To investigate the association between sleep disturbances, dry eye disease (DED) severity, and DED risk factors. Methods: We conducted a secondary analysis of the Dry Eye Assessment and Management (DREAM) study, a randomized trial of 535 patients with moderate-to-severe DED. Participants self-reported sleep disturbances at baseline. DED symptoms were assessed using the Ocular Surface Disease Index and Brief Ocular Discomfort Index. DED signs were assessed using tear film break-up time, Schirmer test, corneal and conjunctival staining, tear osmolarity, and meibomian gland dysfunction assessment. Immune cells were assessed using conjunctival impression cytology. Outcomes were compared between participants with ongoing and no history of sleep disturbances, adjusting for confounders. Results: The mean age was 58 years, and 81% were women. Ongoing sleep disturbances (n = 113) were significantly associated with older age (mean 60.5 vs. 57.4; P = 0.03), smoking (39.8% vs. 28.7%; P = 0.02), and DED treatment. Systemic conditions associated with sleep disturbances included thyroid dysfunction (26.5% vs. 15.7% P = 0.007), irritable bowel (18.6% vs. 5.4%; P &lt; 0.0001), osteoarthritis (38.9% vs. 21.6%; P = 0.0007), and depression (30.1% vs. 11.5%; P &lt; 0.0001). Sleep disturbances were associated with lower conjunctival staining scores (2.46 vs. 2.77; P = 0.03) and higher concentrations of dendritic cells in ocular surface white blood cells (12.0% vs. 8.1%; P = 0.01). Conclusions: Sleep disturbances were associated with older age, smoking history, systemic diseases, and higher dendritic cell concentration among patients with moderate-to-severe DED. These findings support further investigation of sleep disturbances as a comorbidity of patients with DED. Additional research is needed to understand the mechanisms behind this relationship.

Dry eye disease in systemic lupus erythematosus: a cross sectional study.

To explore ocular surface manifestations of dry eye disease (DED) and its influencing factors in systemic lupus erythematosus (SLE) patients. Ophthalmological examinations were conducted in SLE patients (n=43) and controls (n=41), including Ocular Surface Disease Index (OSDI), objective scatter index (OSI), tear meniscus height (TMH), lipid layer thickness (LLT), non-invasive Keratograph tear breakup time (NIKBUT), corneal fluorescein score (CFS), Schirmer I test. DED was diagnosed according to the Tear Film and Ocular Surface Society Dry Eye Workshop II Criteria. SLE patients were further divided into DED group and non-DED group, the disease activity, clinical manifestations and laboratory investigations were compared between the two groups. The disease activity was evaluated by Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K). Receiver operative characteristic (ROC) curve and multiple-factor binary logistic regression were performed. SLE patients showed higher OSDI [9.1 (2.8-15.9) vs 6.3 (2.2-7.5), P=0.035], higher OSI [1.67 (1.09-2.60) vs 0.96 (0.87-1.60), P=0.001], higher CFS [1 (0-2) vs 0 (0-1), P=0.001], lower LLT [65 (42-100) vs 100 (79.5-100), P=0.010], and lower NIKBUT [8.03 (4.02-9.73) vs 9.67 (5.26-12.71), P=0.030] than controls. The 32.6% of SLE patients had DED, which was higher than 12.2% of healthy controls. DED group showed higher SLEDAI-2K score [9.7±6.1 vs 5.4±3.4, P=0.025], higher anti-cardiolipin antibody (ACL) [8.7 (3.5-13.2) vs 3.6 (2.0-6.9), P=0.035], and higher proportion of patients with cutaneous eruption [42.9% vs 6.9%, P=0.015] than non-DED group. According to multiple-factor binary logistic regression analysis, the SLEDAI-2K score (OR=1.194, P=0.041) and cutaneous eruption (OR=7.094, P=0.045) could be consider as risk factors for DED in SLE patients. The ROC curve of the combined factors including age, disease duration, SLEDAI-2K score, ACL, and cutaneous eruption was analyzed, with a sensitivity of 0.786, a specificity of 0.793, and an area under curve of 0.820. Ocular surface affection is frequent in SLE patients, and patients with high disease activity and cutaneous eruption show increased risk of DED.

Association of digital device usage and dry eye disease in school children.

To investigate the influence of digital device use (computers, laptops, tablets, smartphones) on dry eye disease (DED) in a pediatric population. This was a cross-sectional study. School children studying in grades 5-9 at two private schools in the city of Ahmedabad, the capital city of Gujarat, India were invited to participate in the study. In this study, 462 children underwent ocular examination including tear film breakup time (TBUT) and Schirmer's test. Questionnaires were administered for collecting information on the type and duration of digital device usage separately for academic and leisure activities and the Ocular Surface Disease Index (OSDI) score. The mean age of participants was 11.2 + 1.4 years, and 63% were boys. The mean OSDI score was 37.2 + 11.8, and 90.5% had symptoms of DED. Children with moderate to severe DED (n = 88, 19%) had longer daily duration of device use and lower Schirmer's test and TBUT values compared to children with mild DED (P = 0.001). A cumulative exposure time of more than 3-3.5 h per day had a significantly increased risk of DED. Multivariable logistic regression analysis showed that increment in computer usage (odds ratio [OR] 1.94 for every half an hour increase, 95% confidence interval [CI] = 1.2-3.1) and children studying in higher grades (OR 1.30, 95% CI = 1.1-1.6) had a higher risk of moderate to severe dry eye. Cumulative device exposure time of more than 3-3.5 h per day had a significantly increased risk of pediatric DED. Children with an increment in computer usage by half an hour per day had a higher chance of experiencing moderate to severe dry eye. Policymakers should aim to restrict the screen time below 3 h on a daily basis.

Predicting Risks of Dry Eye Disease Development Using a Genome-Wide Polygenic Risk Score Model.

The purpose of this study was to conduct a large-scale genome-wide association study (GWAS) and construct a polygenic risk score (PRS) for risk stratification in patients with dry eye disease (DED) using the Taiwan Biobank (TWB) databases. This retrospective case-control study involved 40,112 subjects of Han Chinese ancestry, sourced from the publicly available TWB. Cases were patients with DED (n = 14,185), and controls were individuals without DED (n = 25,927). The patients with DED were further divided into 8072 young (<60 years old) and 6113 old participants (≥60 years old). Using PLINK (version 1.9) software, quality control was carried out, followed by logistic regression analysis with adjustments for sex, age, body mass index, depression, and manic episodes as covariates. We also built PRS prediction models using the standard clumping and thresholding method and evaluated their performance (area under the curve [AUC]) through five-fold cross-validation. Eleven independent risk loci were identified for these patients with DED at the genome-wide significance levels, including DNAJB6, MAML3, LINC02267, DCHS1, SIRPB3P, HULC, MUC16, GAS2L3, and ZFPM2. Among these, MUC16 encodes mucin family protein. The PRS model incorporated 932 and 740 genetic loci for young and old populations, respectively. A higher PRS score indicated a greater DED risk, with the top 5% of PRS individuals having a 10-fold higher risk. After integrating these covariates into the PRS model, the area under the receiver operating curve (AUROC) increased from 0.509 and 0.537 to 0.600 and 0.648 for young and old populations, respectively, demonstrating the genetic-environmental interaction. Our study prompts potential candidates for the mechanism of DED and paves the way for more personalized medication in the future. Our study identified genes related to DED and constructed a PRS model to improve DED prediction.

Therapeutic potential of vitamin supplements in dry eye disease: A comprehensive review

Dry eye disease (DED) stands as a widespread global health issue that impacts people's quality of life, productivity at work, and financial stability significantly. It is identified by either a decrease in tear production, heightened evaporation of tears, or the presence of low-quality tears. These factors collectively contribute to inflammation, damage to the surface of the eye, and unusual perception of pain. The development of DED involving instability in the tear film, increased tear fluid concentration (hyperosmolarity), and inflammation. This cycle tends to sustain itself. Conventional treatments like artificial tear replacements and corticosteroids have proven to be ineffective in addressing this condition. Alongside conventional anti-inflammatory medications, nutrients that possess both anti-inflammatory and antioxidant properties have gained attention as potential DED treatments. Emerging data shows a connection between vitamin deficiencies and a significant DED risk, highlighting the role of vitamins in ocular health. Evidence supports that vitamins may interrupt the vicious cycle of DED pathogenesis and ameliorate inflammation. The review explores the efficacy of vitamins like vitamin A, vitamin D, vitamin C, and vitamin E in mitigating the Complications of DED. The findings suggest that vitamin supplementation holds promise as a complementary approach to managing DED.

Time-series analysis of the association between air pollution exposure and outpatient visits for dry eye disease: a case study in Zhengzhou, China.

Dry eye disease (DED) is a prevalent ocular surface disease that significantly impacts patients' quality of life. The association between air pollution and the risk of dry eye disease remains uncertain. Data on outdoor air pollutants, meteorological information, and outpatient visits for DED were collected from July 1, 2014, to December 31, 2019. The relationship between ambient air pollutants and DED outpatient visits was analyzed using a generalized additive model with a Poisson distribution. Among the 5,204 DED patients included in the study, 63.76% were female and 36.24% were male. The single-pollutant model revealed a significant association between a 10 μg/m3 increase in concentrations of fine-particulate matter with a median aerometric diameter of less than 10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) and outpatient visits for DED. Fine-particulate matter with a median aerometric diameter of less than 2.5 μm (PM2.5) showed a significant association with DED outpatient visits in males and the 19-59 years age group. The strongest associations between air pollutants and outpatient visits were observed in male patients and during the cold season. The noteworthy correlation between air pollutants and DED outpatient visits can offer evidence for policy makers and underscore the significance of reinforcing environmental protection.

Decoding and reconstructing disease relations between dry eye and depression: a multimodal investigation comprising meta-analysis, genetic pathways and Mendelian randomization

IntroductionThe clinical presentations of dry eye disease (DED) and depression (DEP) often comanifest. However, the robustness and the mechanisms underlying this association were undetermined. ObjectivesTo this end, we set up a three-segment study that employed multimodality results (meta-analysis, genome-wide association study [GWAS] and Mendelian randomization [MR]) to elucidate the association, common pathways and causality between DED and DEP. MethodsA meta-analysis comprising 26 case−control studies was first conducted to confirm the DED-DEP association. Next, we performed a linkage disequilibrium (LD)-adjusted GWAS and targeted phenotype association study (PheWAS) in East Asian TW Biobank (TWB) and European UK Biobank (UKB) populations. Single-nucleotide polymorphisms (SNPs) were further screened for molecular interactions and common pathways at the functional gene level. To further elucidate the activated pathways in DED and DEP, a systemic transcriptome review was conducted on RNA sequencing samples from the Gene Expression Omnibus. Finally, 48 MR experiments were implemented to examine the bidirectional causation between DED and DEP. ResultsOur meta-analysis showed that DED patients are associated with an increased DEP prevalence (OR = 1.83), while DEP patients have a concurrent higher risk of DED (OR = 2.34). Notably, cross-disease GWAS analysis revealed that similar genetic architecture (rG = 0.19) and pleiotropic functional genes contributed to phenotypes in both diseases. Through protein−protein interaction and ontology convergence, we summarized the pleiotropic functional genes under the ontology of immune activation, which was further validated by a transcriptome systemic review. Importantly, the inverse variance-weighted (IVW)-MR experiments in both TWB and UKB populations (p value <0.001) supported the bidirectional exposure-outcome causation for DED-to-DEP and DEP-to-DED. Despite stringent LD-corrected instrumental variable re-selection, the bidirectional causation between DED and DEP remained. ConclusionWith the multi-modal evidence combined, we consolidated the association and causation between DED and DEP.

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.

Dry Eye Disease: An Overview of Its Risk Factors, Diagnosis, and Prevalence by Age, Sex, and Race.

This short review focuses on the significance and prevalence of dry eye disease (DED) in the arena of ophthalmology. DED can be identified as one of the most common optical morbidities affecting about one-fourth of the patients visiting ophthalmology clinics. The perception of the cytology and disease evolution of DED has shown a noteworthy advancement in the last decade by recognizing two diverse mechanisms of the disease: tear desertion and deficient tear production. The role of these two components independently or concurrently in the prevalence of DED was also understood. Several studies in different parts of the world have projected that DED is more common in women as compared to men and this difference increases with ageing. Aged people, especially women in the menopausal and post-menopausal stages, are more prone to DED. This ailment is more prevalent in patients suffering from autoimmune diseases with a higher percentage of women getting affected. Various everyday activities as well as social and dietary behaviors like smoking might set off DED symptoms. Extensive visual tasking while using a computer, watching television, and doing a lot of reading also increase the risk of DED. Although DED occurs in all age groups, it is seen in very few children in comparison to adults. In fact, DED in children may be related to diverse factors such as congenial, inflammatory, and autoimmune disorders as well as environmental conditions and nutritional deficiencies. A significant relationship has also been found between DED and racial differences among individuals. A few studies have suggested that the Asian population is more susceptible to DED as compared to the Caucasian population, but this concept needs further research and investigation. Climatic conditions and environmental challenges, such as relative humidity (RH), internal atmosphere, effluence, travel by air, and intense temperatures, are equally important in the occurrence of DED. The present review aims to examine the prevalence of DED in relation to age, sex, and race by analyzing several relevant studies and also have an overview of the diagnosis and risk factors of the disease.

Assessment of dry eye using Schirmer test in patients attending a tertiary hospital eye clinic in Nigeria

Background: Dry eye disease (DED) is a frequently encountered ocular morbidity seen among adult patients attending ophthalmic clinics in Nigeria. It can be assessed using different methods although there is differing consensus on reliable tests for accurate diagnosis.&#x0D; Aim: The aim of this study was to assess DED using Schirmer 1 without anaesthesia among adult patients attending the Eye Clinic in a tertiary hospital in Calabar.&#x0D; Methodology: This was a cross sectional study among adult patients who attended the Eye Clinic of University of Calabar Teaching Hospital who were recruited consecutively from January 1st to March 31st, 2019. All consenting participants had comprehensive eye examination and were assessed for DED using the Schirmer 1 Test. Test values of less than 10mm were diagnostic of aqueous tear deficiency. Initial data categorization yielded frequencies, percentages and proportions. Categorical variables were analysed using Chi-square test and continuous variables using Student’s t-test. Statistical significance was found where p-values were &lt;0.05 at one degree of freedom.&#x0D; Results: Overall, 73 participants were included in the study 29 males and 44 females with male-female ratio of 1:1.5, and the prevalence of DED was 28.8%. Most participants had normal distance visual acuity in both eyes. There was a statistically insignificant inverse linear relationship between age and Schirmer 1 test. The relationship between gender and Schirmer 1 test values and consequently for dry eye was statistically significant, p 0.04.&#x0D; Conclusion: This study showed no significant association between DED and age. Female gender was associated with a higher risk of DED but a significant association between DED compared to the male gender. Its assessment in persons with other ocular complains is important. Primary and secondary prevention strategies are recommended.

Tear film ocular surface lifestyle report: Lifestyle challenges

This presentation summarizes the findings of the Lifestyle Challenges Subcommittee of the recent Workshop of the Tear Film &amp; Ocular Surface Society, entitled “A Lifestyle Epidemic: Ocular Surface Disease.”Lifestyle includes different societal, physical and mental aspects, which have a deep impact on dry eye disease (DED).Specifically, among societal factors, the use of tobacco is robustly associated with tear film instability, cocaine reduces corneal sensitivity, alcohol promotes DED symptoms and alterations of the tear film. Among physical factors, extensive mask wear or obesity are associated with Meibomian gland alterations. Moreover, depression, anxiety‐associated or sleep disorders, and medications used for their treatment, have been linked with DED symptoms. Finally, diseases associated with chronic pain, including migraine and fybromyalgia, appear to increase the risk of DED. Further studies are needed to better dissect the role of chronic pain in different DED subtypes.

Association between dyslipidaemia and dry eye disease: a systematic review and meta-analysis

PurposeTo report a systematic review and meta-analysis of the association between dry eye disease (DED) and dyslipidaemia.MethodsPubMed, Embase, Web of Science and Cochrane Library were systematically searched from January 2000...

Association of self-reported psychiatric and systemic risk factors in dry eye disease in adult Korean population.

To evaluate the association between dry eye disease (DED) and various psychiatric and systemic diseases in an adult Korean population aged 40 years or older. Population-based cross-sectional data of 6,732 participants aged ≥40 years was extracted from the Korea National Health and Nutrition Examination Survey 2017-2018 (KNHANES VII). Data including DED, demographic variables, behavioral factors, psychiatric conditions, and systemic diseases was analysed to determine the prevalence and psychiatric and systemic risk factors for DED. The weighted prevalence of DED was 7.9 ± 0.4% (mean ± SE). Multivariate analysis showed that female sex and urban residence were associated with an increased risk of DED. The prevalence of DED was lower in patients aged ≥70 years than in those aged 40-69 years. Self-reported psychological conditions including perceived stress and depression were associated with the risk of DED. Self-reported Systemic conditions, such as rheumatoid arthritis, degenerative arthritis, osteoporosis, ischemic heart disease, and chronic renal failure had association with an increased risk of DED. DED may be associated with several self-reported psychiatric and systemic conditions, which highlights the need for an integrated approach to manage these diseases for optimal treatment of DED.

Inflammatory bowel disease and the associated risk of dry eye and ocular surface injury: a nationwide matched cohort study

BackgroundInflammatory bowel disease (IBD) is associated with lacrimal gland dysfunction and ocular inflammation. The objective of this research was to elucidate the temporal relationships between IBD, dry eye disease (DED), and corneal surface damage.MethodsIn a matched nationwide cohort study, we evaluated the risk of DED and corneal surface damage associated with IBD. Multivariable Cox proportional hazards regression analyses were implemented to estimate the risk of ocular complications.ResultsA total of 54,293 matched pairs were included for analyses. The median follow-up time was 8.3 years (interquartile range: 5.5 – 10.5). The period incidence of DED was 8.18 and 5.42 per 1000 person-years in the IBD and non-IBD groups, respectively. After adjusting for confounders, statistically significant associations were found between IBD and DED [adjusted hazard ratio (aHR): 1.43, 95% confidence interval (CI): 1.35 – 1.51, p < 0.0001], Sjögren’s syndrome-related (aHR: 1.67, 95% CI:1.46 – 1.90, p < 0.0001) and non-Sjögren’s syndrome-related subtypes (aHR: 1.38, 95% CI: 1.30 – 1.46, p < 0.0001). Furthermore, increased risks of corneal surface damage (aHR: 1.13, 95% CI: 1.03 – 1.24, p = 0.0094) among the patients with IBD were observed when compared with the controls. Other independent factors associated with corneal surface damage were age (aHR: 1.003), sex (male vs. female, aHR: 0.85), and monthly insurance premium (501–800 vs. 0–500 U.S. dollars, aHR: 1.45; ≥ 801 vs. 0–500 U.S. dollars, aHR: 1.32).ConclusionsOur results suggested that IBD was an independent risk factor for DED and ocular surface damage. Clinical strategies are needed to prevent visual impairment or losses in these susceptible patients.

Prevalence and risk factors of dry eye disease in patients treated with aromatase inhibitors for breast cancer

ABSTRACT Clinical relevance Treatment with aromatase inhibitors (AIs) in patients with breast cancer can lead to dry eye disease (DED). Background The purpose of the study is to determine the prevalence and risk factors of DED in patients treated with AIs for breast cancer. Methods Participants in this cross-sectional study were patients with breast cancer treated with AIs. Demographic and clinical data, including age, sex, type of cancer, stage, grade, duration of treatment and adjuvant chemotherapy and/or radiotherapy were collected. All patients underwent a detailed ophthalmic examination, as well as Tear Break up Time (TBUT) and Schirmer test, while Ocular Surface Disease Index (OSDI) questionnaires were administered. Based on the clinical findings, a diagnosis of DED was made, and prevalence was calculated. Univariate analysis of the association of different variables with DED was performed. A logistic regression analysis was done to identify risk factors for DED among study population. Results A total of 102 participants were included in the study. The mean age of patients was 62.4 ± 10.8 years. A total of 77 out of 102 patients (75.5%) had ductal, 16 (15.7%) lobular and 9 (8.8%) other types of breast cancer. A total of 83 patients (81.4%) received chemotherapy and 70 patients (68.6%) received radiotherapy. The mean duration of treatment was 24.4 ± 18.9 months. The prevalence of DED in the study sample was 69.6%. Patients who received radiotherapy (OR = 3.31, 95%CI = 1.30–7.82, p = 0.01) or were under treatment with AIs for more than 24 months (OR = 3.53, 95%CI = 1.47–9.21, p = 0.002) were found to have an increased risk of DED. Conclusion There was a high prevalence of DED among the study population. Radiotherapy and duration of treatment with AIs were independently associated with DED.

Prevalence of dry eye disease among visual display terminal office users in Uyo, Nigeria

Context: Dry eye disease (DED) results from loss of tear film homeostasis. Increase use of visual display terminals (VDT) by individuals and professionals increases the risk of DED.&#x0D; Objective: This study is aimed to determine the prevalence of dry eye disease among office workers who use visual display terminals in Uyo.&#x0D; Methods: A descriptive, cross-sectional study of VDT office workers aged 19-65 years. Multi-stage sampling technique was used to recruit participants. Self-administered Impact of Dry Eye on Everyday Life (IDEEL) questionnaire and ocular examination was done to gather data; such data was analyzed using SPSS version 22.0&#x0D; Results: Prevalence of dry eye disease (DED) was 5.8% (95% CI 3.44 - 8.16). Mean Schirmer’s 1 was 21.60 ± 9.29mm, mean TBUT was 9.74 ± 2.48s, mean IDEEL score was 76.15 ± 25.47. There was a statistically significant association between DED and educational level 7.56(p-value 0.02), hours of visual display terminal use per day 10.72(p-value 0.013), and use of air conditioning 7.66(p-value 0.006). Multivariate regression analysis to identify predictors of dry eye was statistically significant for module 1(Symptom bother) of the dry eye questionnaire (p-value 0.01, odds ratio 12.71,), tear break up time in the left eye (p-value 0.00, odds ratio 38.67), and Schirmer 1 test in the right eye (p-value 0.00, odds ratio 30.83)`.&#x0D; Conclusion: The prevalence of DED increases with the number of hours spent on VDT Periodic medical and psychological evaluation of VDT users to identify office workers most at risk should be carried out by employers of labour.

The Calamity Among Medical Students: Sleep Deprivation and Dry Eye Disease

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Medical students’ burden upon academic and professional duties often blinded them from attending to themselves. Piling works and nightshifts interfere ferociously with their self-care behavior, including adequate sleep. The matter not only disrupts concentration and consciousness but also tolls the eye by reducing tear secretion. Hence, the present study urgently assesses sleep quality and dry eye disease (DED) among medical students.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The cross-sectional study observed 172 eyes among medical students in Indonesia. We assessed sleep quality and dry eye disease through Pittsburgh Sleep Quality Index and Schirmer test. Independent statistician analyzed the data with chi-square.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;From the eligible samples, there is a dominancy of females (55.8%) with poor sleep quality (55.2%). There is no significant difference in DED or sleep quality across gender though they lean toward females. Contrarily, poor sleepers significantly correspond to 2.96 times more risk of DED than an adequate sleeper.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Medical students’ well-being is crucial. Aside from the academic burden, institutions and individuals shall strongly emphasize better sleep habits and eye care.&lt;/p&gt;