Risk Of Dry Eye Syndrome Research Articles

Comparative Analysis of Visual Outcomes and Complications in Intraocular Collamer Lens, Small-Incision Lenticule Extraction, and Laser-Assisted In Situ Keratomileusis Surgeries: A Comprehensive Review.

This review provides a comparative analysis of visual outcomes and complications associated with three prominent refractive surgical techniques: intraocular collamer lens (ICL) implantation, small-incision lenticule extraction (SMILE), and laser-assisted in situ keratomileusis (LASIK). Refractive surgeries aim to correct myopia, hyperopia, and astigmatism, offering patients an alternative to corrective lenses. The review highlights the importance of comparing these procedures to guide clinical decision-making effectively. Each technique is described, emphasizing its unique advantages and considerations. While LASIK remains widely favored for its rapid visual recovery and high patient satisfaction, ICL is suitable for patients with higher refractive errors or corneal irregularities. Although relatively newer, SMILE shows promise with potential benefits such as corneal biomechanical stability and a reduced risk of dry eye syndrome. However, each procedure carries its distinct complications, reinforcing the need for personalized patient care and informed decision-making. Understanding these techniques' relative efficacy and safety profiles is essential for optimizing outcomes and enhancing patient satisfaction. Continued advancements in technology and surgical techniques promise further improvements in refractive surgery outcomes, underscoring the importance of ongoing research and innovation.

Corneal Epithelial Changes in Diabetic Patients: A Review.

The relationship between diabetes mellitus and ocular complications has been extensively studied by many authors. Diabetic keratopathy has already been well characterized and defined as a clinical entity. This review focuses on exploring corneal epithelial changes in diabetic patients, aiming to provide a pragmatic overview of the existing knowledge on this topic. The paper systematically examines alterations in corneal epithelial structure and their impact on diabetic patients. Advanced imaging techniques are also discussed for their role in precise characterization and improved diagnostics. Additionally, the paper explores the mechanisms behind corneal epithelial changes in diabetes, looking at factors such as hyperglycemia, oxidative stress, and Advanced Glycation End-Products. The impact of altered corneal epithelial integrity on barrier function and susceptibility to external issues is considered, addressing potential links to heightened proteolytic enzyme activities and delayed wound healing observed in diabetic individuals. The review also covers the practical implications of corneal epithelial changes, including the association with corneal erosions, persistent epithelial defects, and an increased risk of dry eye syndrome in diabetic patients.

Impact of Dietary Nutrients on the Prevalence of Dry Eye Syndrome among Korean Women Aged 40 and above: Evidence from the Korea National Health and Nutrition Examination Survey.

This study aimed to assess the prevalence of dry eye syndrome among Korean women aged 40 and above and explore the correlation between the syndrome and daily dietary nutrient intake. We analyzed data from 92,888 female participants (mean age: 63.35 ± 8.86 years) from the 8th Korea National Health and Nutrition Examination Survey (KNHANES 2019). Dietary intake was evaluated using a personalized 24 h recall method for 21 nutrients, including macronutrients, macro- and micro-minerals, and both water- and fat-soluble vitamins. Associations between nutrient intake and dry eye syndrome were determined using odds ratios from multivariate logistic regression. We found a 7.7% prevalence of dry eye syndrome in the population studied. Intake of dietary fiber (adjusted OR: 0.72), protein (adjusted OR: 0.84), omega-3 fatty acids (adjusted OR: 0.90), water (adjusted OR: 0.76), calcium (adjusted OR: 0.82), phosphate (adjusted OR: 0.87), potassium (adjusted OR: 0.88), magnesium (adjusted OR: 0.87), vitamin A (adjusted OR: 0.78), vitamin C (adjusted OR: 0.73), and vitamin E (adjusted OR: 0.86) was inversely associated with dry eye syndrome prevalence (p < 0.0001 for all). Conversely, a higher intake of carbohydrates (adjusted OR: 1.23), sugar (adjusted OR: 1.30), fat (adjusted OR: 1.25), cholesterol (adjusted OR: 1.32), sodium (adjusted OR: 1.18), iron (adjusted OR: 1.28), and zinc (adjusted OR: 1.26) correlated with an increased risk (p < 0.0001 for all). No significant associations were found between the prevalence of dry eye syndrome and the intake of omega-6 fatty acids and vitamin D. Our study identified significant associations between specific dietary nutrients and the risk of dry eye syndrome among Korean women aged 40 and above. These findings suggest that dietary choices could influence the likelihood of developing dry eye syndrome, indicating a potential role for dietary intervention in its management. However, it is important to note that these observations are preliminary, and further research is necessary to confirm these relationships and explore their implications for dietary recommendations in dry eye syndrome prevention and management.

The Effects of mmW and THz Radiation on Dry Eyes: A Finite-Difference Time-Domain (FDTD) Computational Simulation Using XFdtd.

The importance of investigating the health effects of RF radiation on the cornea cannot be overstated. This study aimed to address this need by utilizing a mathematical simulation to examine the absorption of millimeter wave (mmW) and terahertz (THz) waves by the cornea, considering both normal and pathological conditions. The simulation incorporated variations in tear film thickness and hydration levels, as these factors play a crucial role in corneal health. To assess the impact of RF radiation on the cornea, the study calculated temperature rises, which indicate heating effects for both dry and normal eyes. XFdtd, a widely used commercial software based on the Finite-Difference Time Domain (FDTD) method, was employed to evaluate the radiation absorption and resulting temperature changes. The outcomes of this study demonstrated a crucial finding, i.e., that changes in the water ratio and thickness of the tear film, which are associated with an increased risk of dry eye syndrome, directly impact the absorption of mmW and THz waves by the cornea. This insight provides valuable evidence supporting the interconnection between tear film properties and the vulnerability of the cornea to RF radiation.

Corneal Refractive Surgery Considerations in Patients on Dupilumab

Dupilumab is a biologic approved by the United States Food and Drug Administration (US FDA) for the treatment of atopic dermatitis. While it is an effective medication for eczema, ocular side effects are common in patients receiving dupilumab therapy. Greater consideration is needed when evaluating these individuals for corneal refractive surgery. Dupilumab patients may suffer from atopy, a condition that also merits consideration in those desiring refractive surgery. Additional testing and careful consideration are needed, as these patients have an increased risk of dry eye syndrome, keratoconus, cataracts, diffuse lamellar keratitis, viral keratitis, and perioperative infection. This commentary discusses the current understanding of dupilumab ocular side effects and investigates factors to consider when evaluating these patients for corneal refractive surgery.

Exposure to Ambient NO2 Increases the Risk of Dry Eye Syndrome in Females: An 11-Year Population-Based Study.

Previous studies have indicated that women suffer from dry eye syndrome (DES) more significantly than men. Therefore, we specifically explore the associations between air pollutant levels and the risks of DES for women. The study obtained 27,605 participants from the 29 recruitment centers of the Taiwan Biobank, which was established in October 2012. A large scale cross-sectional study involving DES sufferers and age- and education-matched control groups without DES was designed. Based on the municipality of residence, the predicted concentration levels of various air pollutants, including PM2.5, sulfur dioxide (SO2), ozone (O3), and nitrogen dioxide (NO2) were estimated by using hybrid kriging/LUR model. Multiple logistic regressions were applied to estimate the prevalence ratios (PR) of DES and 95% confidence interval. Hormone supplementations, DBP, allergies, and arthritis were considered as important comorbidities for increased PR risk of DES. In addition, with each standard deviation (SD) increment of PM2.5 and temperature, women had significant increases in PRs of DES of 1.09- and 1.07-fold, respectively; conversely, each SD increment of relative humidity (RH) had a protective effect against the risk of DES. After considering hormone supplementation, arthritis, and allergy, the SD increment of NO2 and temperature were associated with the PRs of DES. In conclusion, significant associations of ambient NO2 concentration, RH and temperature with DES indicated the importance of increased environmental protection in the female population. Female exposure to high levels of NO2 when receiving hormone supplementation, or suffering with allergies or arthritis, had significantly increased risk of DES.

Risk of Dry Eye Syndrome in Patients with Orbital Fracture: A Nationwide Population-Based Cohort Study.

This study aimed to investigate whether orbital fracture increases the risk of dry eye syndrome (DES) and identified the profile of prognostic factors. We studied a cohort from the Taiwan National Health Insurance Research Database (NHIRD). Overall, 46,179 and 184,716 participants were enrolled in the study and control groups, respectively. Each patient in the case group was age- and gender-matched to four individuals without orbital fracture that served as the control group. Cox proportional hazards analysis regression was used to estimate the risks of incident DES. During the follow-up period, the case group was more likely to develop incident DES (0.17%) than the control group (0.11%) (p = 0.001). Multivariate Cox regression analysis demonstrated that the case group had a 4.917-fold increased risk of DES compared to the controls. In the stratified age group, orbital fracture had the highest impact on patients aged 18–29 years. Furthermore, patients with orbital roof fracture have a greater risk of developing DES. Regardless of whether having received surgery or not, the patients with orbital fracture have higher risks of DES. Our study demonstrated that orbital fracture increases the risk of developing subsequent DES. Early recognition by thorough examinations with raised awareness in the clinical setting could preserve visual function and prevent further complications.

Ocular Complications in School-Age Children and Adolescents after Allogeneic Bone Marrow Transplantation

To determine the ocular complications in school-age children and adolescents surviving at least 1 year following allogeneic bone marrow transplantation. Retrospective cohort study. In this institutional study, 162 patients (7-18 years old) met our inclusion criteria with a mean age of 13.4 years at bone marrow transplantation. Follow-up ranged from 13months to 12 years (mean 4 years; median 3.2 years). Patient charts were screened for cataract formation, dry eye, and other anterior and posterior segment diseases. Cataract formation was noted in 57 patients. Univariate analysis showed that fractionated total body irradiation, race, and use of cytarabine significantly increased the incidence of cataract formation (P < 0.05). Multivariate analysis of significant variables showed that total body irradiation was a risk factor for cataract formation. Of the 57 patients (97 eyes) who developed cataracts after bone marrow transplantation, 4 patients (6 eyes) required cataract surgery. After surgery, all patients had visual acuities of 20/20 to 20/25. Of the 162 patients, 51 developed dry eyes. Univariate analysis showed that age at transplantation; steroid use, chronic graft-versus-host disease; use of fludarabine, melphalan, and thiotepa; and receiving no pre-transplantation conditioning regimen prior to bone marrow transplant significantly increased the risk of dry eye syndrome (P < 0.05). In multivariate analysis, chronic graft-versus-host disease was a significant risk factor for dry eye syndrome. Due to the high incidence of cataract formation and dry eye disease in this population, this study proposes these patients be screened using examinations by a pediatric or general ophthalmologist at least every year.

Risks of ophthalmic disorders in patients with systemic lupus erythematosus \u2013 a secondary cohort analysis of population-based claims data

BackgroundSystemic lupus erythematosus (SLE) can directly affect various part of the ocular system, but there was no comprehensive analysis of ophthalmic disorders of patients with SLE using population-based data. The aim of this study was to investigate the frequency and prevalence of ophthalmic disorders for ophthalmologist visits in adult patients with SLE and to evaluate the risk of dry eye syndrome, cataracts, glaucoma, episcleritis and scleritis, and retinal vascular occlusion in these patients.MethodsThe Taiwan’s National Health Insurance Research Database was used to assemble a SLE cohort consisting of newly diagnosed SLE between 2000 and 2012. A comparison cohort was also sampled from the same database and it consisted of 10 patients without SLE for each patient with SLE, based on frequency matching for sex, five-year age interval, and index year. Both cohorts were followed until either the study outcomes have occurred or the end of the follow-up period.ResultsPatients with SLE (n = 521) exhibited a significantly higher prevalence (68.1% vs. 60.5%, P = 0.001) and frequency (median 5.51 vs. 1.71 per 10 years, P < 0.001) for outpatient ophthalmologist visits compared with patients without SLE. The risk of dry eye syndrome (adjusted incidence rate ratio [IRR] 4.45, P < 0.001), cataracts (adjusted IRR 3.18, P < 0.001), and glaucoma (adjusted IRR 2.23, P = 0.002) were significantly higher in patients with SLE. In addition, the risk of several SLE related ophthalmic disorders, including episcleritis and scleritis (adjusted IRR 6.11, P < 0.001) and retinal vascular occlusion (adjusted IRR 3.81, P = 0.023) were significantly higher in patients with SLE.ConclusionsThe increased risk of dry eye syndrome, cataracts, glaucoma, episcleritis and scleritis, and retinal vascular occlusion in patients with SLE deserves vigilance.

Risk Difference Analysis of Using Goggles Benefits for Dry Eye Syndrome in Swimming Sub Laboratory, The State University of Surabaya (Unesa)

Dry eye syndrome is one of the eye health risks frequently suffered by swimmers who swim without goggles. It is initiated by direct contact of eyes with irritants from the disinfection process in the swimming pool. The purpose of this study was to analyze risk differences of using goggles for dry eye syndrome in the Sub Laboratory FIO Surabaya State University (Unesa). This research was an observational with cross sectional study design. The results of statistical tests showed that there were significant differences between swimmers using goggles and without goggles (p = 0,000). An examination of water found that the level of residual chlorine was (&lt;1 mg / l), pH (&lt;7), and alkalinity (&gt; 200 mg / l). It calls the needs for strengthen the precaution for the presence of chemical risks. The result showed that the parameters did not satisfy the requirements of Permenkes RI No. 32 of 2017 about Standard for Environmental Quality and Water Health Requirements for Sanitary Hygiene Needs, Swimming Pools, Solus Per Aqua, and Public Baths. It can be concluded that there are differences in the risk of dry eye syndrome between swimmers who used goggles and without goggles. Swimmers is recommended to wear goggles while swimming to avoid the risk of dry eye syndrome. Furthermore, managers need to monitoring pool water quality in to order comply with term and reduce the risk of dry eye syndrome.

Diabetes mellitus is associated with dry eye syndrome: a meta-analysis.

Dry eye is the most common eye disorder of tears and ocular surface. However, the extent to which diabetes mellitus may confer risk of dry eye remains uncertain. The aim of this study was to perform a meta-analysis that synthesizes the association between diabetes mellitus and dry eye. Case-control studies were selected from the Medline, Embase, Cochrane database from January 2000 to March 2018. Two reviewers screened potential studies, and eligible studies were included according to keywords and predefined criteria. We calculated the overall risk estimates by using a fixed-effect model or a random-effects model in relation to heterogeneity. A total of four studies were included in our meta-analysis consisting of 2,504,794 persons. Our study showed a significant association between diabetes mellitus and the risk of dry eye syndrome (OR 1.30; 95% CI 1.08-1.57; P value = 0.006). However, the heterogeneity was observed (P value < 0.001, I2 = 95.2%). Our meta-analysis suggests that diabetes mellitus has a significant association with the risk of dry eye. However, this result is limited by heterogeneity. Further prospective and concise studies are needed to confirm the association between diabetes mellitus and dry eye.

SMILE keratorefractive surgery technique

Small incision lenticule extraction (SMILE) keratorefractive surgery technique is a laser surgery alternative to common methods that doesn't require laser ablation of the cornea. Despite its novelty, SMILE technique has already demonstrated positive clinical results comparable to Photorefractive Keratectomy (PRK) and Laser-Assisted in Situ Keratomileusis (LASIK), which led to its widespread application in clinical practice. Compared with other keratorefractive techniques, SMILE has a number of distinct advantage including high biomechanical stability of the cornea, low risk of dry eye syndrome, absence of a corneal flap and associated complications, preservation of corneal epithelium. The article describes the most common SMILE modifications, its weak points and possible complications, as well as methods of additional correction of remaining ametropy.

Relationship between Dry Eye Syndrome and Frequency of Coffee Consumption in Korean Adults: Korea National Health and Nutrition Examination Survey V, 2010-2012.

BackgroundDry eye syndrome is a common health problem in the adult population. Many risk factors including age, sex, prior eye surgery, various chronic diseases, and lifestyle factors can affect its development. We have evaluated the risk of dry eye syndrome based on the frequency of coffee consumption among Korean adult population.MethodsA total of 9,752 adults with age 19 years and older were randomly selected between 2010 and 2012. They have all participated in the National Health and Nutrition Examination Survey V of Korea. Dry eye syndrome was being diagnosed by the physicians at some points in the participant’s lifetime. The average daily coffee intake was divided into the following: less than 1 cup, 1 to 2 cups, and 3 cups or more. Various physio-environmental factors and medical conditions were used as correction variables to assess the risk of dry eye syndrome in relation to the frequency of coffee consumption.ResultsThe prevalence of dry eye syndrome decreased to 9.2%, 8.8%, and 6.3% as coffee consumption increased from less than 1 cup to 1–2 cups and more than 3 cups, respectively. However, there was no significant relationship between the frequency of coffee consumption and the risk of dry eye syndrome after adjusting various risk factors.ConclusionThere is no relationship between the frequency of coffee consumption and risk of dry eye syndrome.

Lower Serum Vitamin D Level Was Associated with Risk of Dry Eye Syndrome.

BackgroundTo determine the association between serum 25(OH)D and dry eye syndrome (DES) incidence. This study was also designed to determine whether serum 25(OH)D levels were associated with ocular parameter of DES patients.Material/MethodsThis is a case-control study with 70 DES cases and 70 healthy controls. Clinical data included body mass index (BMI, kg/m2), smoking history, diabetes, and blood pressure. Serum 25(OH)D was chosen as the main parameter and reflected the level of vitamin D. The DES parameters included ocular surface disease index (OSDI) scales, tear film breakup time (TBUT) and Schirmer test I. The differences in each parameter between case and control groups were detected and the association of serum 25(OH)D and DES parameter were detected.ResultsIt was shown that 25(OH)D levels were lower in patients with DES than in healthy controls. When the 25(OH)D levels was stratified, vitamin D deficiency was more common in the DES cases. In advanced studies, it was found that there were statistically significant associations between serum 25(OH) D levels and the Schimer test, TBUT, and OSDI scales.ConclusionsA significant association between serum 25(OH)D level and DES incidence was detected in this study. Considering the relatively small sample size of this study, larger studies are needed in the future.

Analysis of Prevalence and Risk Factors for Dry Eye Syndrome in Korean Adults; Based on the 5th National Health and Nutrition Examination Survey (2012)

Purpose: The purpose of present study was to investigate the prevalence and risk factors for dry eye syndrome in Korean adults using data from the 5th National Health and Nutrition Examination Survey (2012). Methods: We analyzed the prevalence and risk factors for dry eye syndrome according to characteristics of sociodemographic, systemic diseases, and health related behaviors of 5,698 adults, men 2,368(41.6%) and women 3330(58.4%), aged 19 years and older, who were diagnosed with the dry eye syndrome by ophthalmologists. Results: The prevalence of dry eye syndrome was 13.5% in this population. The prevalence of dry eye syndrome in the sociodemographic characteristics was significantly higher in women than in men, in 50 years and older than under 50 years people, and in urban area than in rural area residents. The prevalence of dry eye syndrome by systemic diseases was significantly higher in subjects with hypertension, dyslipidemia, osteoarthritis, rheumatoid arthritis, depressive disorder, and renal failure. The prevalence of dry eye syndrome by health related behaviors was higher in non-smokers, non-drinkers, and short time sleepers. The dry eye syndrome was more frequent in women (OR 2.29, CI 1.89-2.77), in 50 years and older people (OR 1.21, CI 1.01-1.46), and rural area resident s (OR 1.96, CI 1.56-2.47). After adjusting for all significant variables, independent risk factors for dry eye syndrome were renal failure (multi-variable odds ratio (OR) 2.82, 95% confidence interval (CI) 1.48-5.69), thyroid disease (OR 1.62, CI 1.16-2.26), rheumatoid arthritis (OR 1.54, CI 1.01-2.33), dyslipidemia (OR 1.42, CI 1.13-1.78), depressive disorder (OR 1.36, CI 1.11-1.66), and osteoarthritis (OR 1.27, CI 1.02-1.57). Conclusion: The prevalence of dry eye syndrome in adults aged 19 and over was 13.5%. The dry eye syndrome was more frequent in women, 50 years and older people, and in urban residents, as a socio-demographic factor. Systemic disease factors related to dry eye were renal failure, thyroid disease, rheumatoid arthritis, dyslipidemia, depressive disorder, osteoarthritis. We suggest that people with dry eye syndrome risk factors should be provided about dry eye symptoms through the education, so that they can be found early and appropriately treated dry eye.

Risk of dry eye syndrome in patients treated with whole-brain radiotherapy

With improvements in systemic therapy, patients with cancer treated with whole-brain radiotherapy (WBRT) are living long enough to develop late toxicities, including dry eye syndrome. In general practice, dose to the lacrimal gland (LG) is not constrained (maximum constraint <40 Gy) in WBRT. The purpose of this study was to measure dose to the LG in WBRT and determine methods for reducing radiation exposure. We conducted a retrospective review of 70 3-dimensional (3D) conformal plans; thirty-six plans with a radiation prescription of 30 Gy in 10 fractions and 34 plans with a prescription of 37.5 Gy in 15 fractions. LGs were contoured in accordance with Freedman and Sidani (2015). Biological effective dose (BED)3 maximum constraints were calculated from 40 Gy and 20 Gy to be 32.17 Gy (30 Gy) and 36.70 Gy (37.5 Gy). Both regimens demonstrated supraorbital blocking by 3 methods: T1, bordering the supraorbital ridge; T2, no contact with supraorbital ridge; and T3, coverage of the supraorbital ridge. Mean dose for the plans with a 30-Gy prescription and the plans with a 37.5-Gy prescription was 27.5 Gy and 35.2 Gy, respectively (p ≤ 0.0001). BED3 maximum constraint (Dmax) was violated 16 of 26 (61.5%) in T1 (average Dmax: 32.2 Gy), 13 of 28 (46.4%) in T2 (average Dmax: 32.1 Gy), and 5 of 18 (27.8%) in T3 (average Dmax: 31.8 Gy) for the 30-Gy prescription. Dmax was violated in 32 of 32 (100%) in T1 (average Dmax: 40.1 Gy), 22 of 22 (100%) in T2 (average Dmax: 40.3 Gy), and 14 of 14 (100%) in T3 (average Dmax: 39.4) for the 37.5 Gy prescription. Average Dmax for the 37.5-Gy prescription was highly significant in favor of T3 (p = 0.0098). Patients who receive WBRT may develop dry eye syndrome as a late toxicity. Constraints are commonly violated with a prescription of 37.5 Gy. Methods to reduce dose include T3 supraorbital blocking, an easily implementable change that may dramatically improve patient quality of life.

Compliance as an Integral Part of the Dry Eye Syndrome Prevention Using Silicone Hydrogel Contact Lenses

The probability of dry eye syndrome (DES) in the patients using the Silicone-Hydrogel Contact Lenses is examined in many researches. Therefore, adhering to clinical recommendations is an important factor for DES prevention. The urgent issue is also a comprehensive assessment of functional parameters as pathogenetic base of DES.The objective of the research was tostudy DES development depending on compliance of silicone hydrogel contact lenses users.Matherials and methods. 97 patients (194 eyes) were included into the research. They formed 2 groups: group I with incomplete compliance (36 persons) and group II with complete compliance (61 persons). All the patients underwent the Norn’s test, Schirmer’s test, Jones test, tear film stability was defined. The probability of the dry eye syndrome development due to the subjective signs was also analysed.Results. The reliable decrease in the total (р&lt;0.05) and basale lacrimation (р&lt;0.05) indexes, the increase in osmolarity (р&lt;0.05) and decrease in tear film stability (р&lt;0.05) were detected in the patients who did not follow the clinical guidance during the Silicone-Hydrogel Contact Lenses wearing. In the same group the higher risk of dry eye syndrome development was verified (р&lt;0.05).Conclusion. Compliance disorder in the patients using Silicone-Hydrogel Contact Lenses was found to induce the reliable decrease in total and basale lacrimation, increase in osmolarity and tear stability disorder. All of this factors increase the risk of dry eye syndrome.

Dry eye syndrome following proton therapy of ocular melanomas

PurposeSome institutions contra‐indicate proton therapy (PT) for ocular melanomas of temporal superior location (TS) owing to lacrimal gland irradiation and the risk of dry eye syndrome (DES) and advocate brachytherapy. We investigated whether PT can be safely performed in TS melanomas.MethodsLocation, DES grade and dose to the lacrimal gland estimated from Eyeplan blindly by two operators were correlated in consecutive patients treated from 1999 to 2014 with 52 GyResultsOf 1473 patients, 13.6% had DES, including 5.4% with severe DES (sDES). Temporal superior and temporal melanoma patients had a higher risk of DES than patients with melanomas in other quadrants (p &lt; 0.001). Severe DES was noted in 18.6% of TS melanoma patients (versus 5.4% in patients with melanomas in all other quadrants) and 12.3% of temporal melanoma patients (versus 3.0%) (p &lt; 0.001). sDES was more frequent in ciliary versus choroid melanomas, advanced versus early stage (p &lt; 0.001), and higher percentages of eye surface, lens periphery or ciliary body (p &lt; 0.001), cornea irradiated at any dose level (p = 0.002). sDES was associated with more eyelid dermatitis or alopecia (p &lt; 0.001), and glaucoma/rubeosis (p = 0.002). Vision changes were similar in patients with TS melanoma or other locations, including for patients experiencing severe DES (+1.15 vs. +1.14 logMAR). No patient underwent enucleation for complications of DES.ConclusionsDES and sDES were more frequent in TS melanomas incriminating the lacrimal gland but temporal melanomas experienced more DES. In addition to correlation sDES and lens, cornea and lid irradiation, this suggests involvement of such structures as the limbus cells, conjunctival glands and long ciliary nerves. Rates of sDES compared favorably with the literature and DES was manageable. Tumor location should not contraindicate PT.

Environmental Factors Affect the Risk of Dry Eye Syndrome in a United States Veteran Population

Dry eye syndrome (DES) is a prevalent condition whose manifestations negatively affect physical and mental functioning.1 Understanding which risk factors associate with DES is important because this information can augment our understanding of disease pathogenesis. Several environmental factors have been suggested to impact DES, including high altitude,2 wind,3 and air pollution.3 Despite these data, there is an important knowledge gap on how environmental factors (especially air pollution coupled with weather conditions) affect the frequency of DES in the United States.

The effects of different hormone replacement therapy regimens on tear function, intraocular pressure and lens opacity

Objective. Estrogen may have adverse effects on the ocular surface, intraocular pressure (IOP), lens opacity and tear function. The aim of the present study was to elucidate the effects of different hormone replacement therapy (HRT) protocols on tear function, IOP and lens opacity.Design and setting. This was a prospective, uncontrolled study carried out at the Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Faculty of Medicine, Uludağ University, Turkey.Patients and interventions. Thirty postmenopausal patients who had spontaneous or surgical menopause for at least 1 year and were not taking any medications were assigned to one of three groups. Group 1 comprised 19 patients (n = 38 observations) given conjugated equine estrogen 0.625 mg plus medroxyprogesterone acetate 2.5 mg (Premelle 2.5®) daily; Group 2 contained six patients (n = 12 observations) given tibolone 2.5 mg (Livial®) daily; and Group 3 comprised five patients (n = 10 observations) treated with estradiol patch, 3.9 mg/12 cm2 (Climara®). Tear function, evaluated with Schirmer's test, IOP and lens opacity were determined before treatment and at 6 and 12 months of treatment.Results. Mean Schirmer's test score in each group and all eyes (n = 60) did not change significantly after 6 months of treatment but decreased significantly at 12 months. The percentage decrease in tear function was greatest in the estrogen-only group (Group 3). Mean IOP did not change significantly in Groups 1 and 2; however, in Group 3, IOP showed a statistically significant decrease from 14.63 ± 0.84 mmHg before treatment to 12.60 ± 0.68 mmHg (mean ± standard error) at the end of treatment. Lens opacity in women of all groups did not change during treatment.Conclusions. HRT decreased tear production, the decrease being greater in the estrogen- only group. Woman who are taking or considering HRT should be informed of the potential increased risk of dry eye syndrome with this therapy. In addition, estrogen-only treatment decreased IOP while estrogen plus progesterone and tibolone had no effect. HRT did not affect lens opacity after 12 months of treatment.