Eye Sensation Research Articles

The Role of Postoperative Bandage Contact Lens in Patients Undergoing Fasanella-Servat Ptosis Repair.

To determine whether a bandage contact lens (BCL) improves patient comfort in the postoperative period in patients undergoing ptosis repair using the Fasanella-Servat technique, compared with no BCL. In this prospective, randomized, double-masked, comparison study, all patients had bilateral Fasanella-Servat surgery. A total of 30 patients were randomized to receive a BCL in one eye and no BCL in the other eye. Patient discomfort was measured as the primary outcome using the Eye Sensation Scale. Blurred vision was measured as a secondary outcome using selected questions from the Ocular Surface Disease Index. The surgeries were performed by 2 surgeons (J.T.H and R.S.A). Outcomes were measured one week following the procedure. Patients reported significantly less discomfort in the eye receiving a BCL, with only 13.3% ranking discomfort as "moderate" or "severe," compared with the eye not receiving BCL, where 63.3% of patients rated discomfort as "moderate" or "severe" (p < 0.001). There was no significant difference in patient-reported blurred vision between the 2 groups (p = 0.520). The use of a bandage contact lens after Fasanella-Servat procedure for ptosis repair is recommended as it improves patient comfort. In addition, it has no detrimental effect on patient-reported blurring of vision.

EFFECT OF PANRETINAL PHOTOCOAGULATION ON CORNEAL SENSATION AND TEAR FUNCTION IN PATIENTS WITH DIABETIC RETINOPATHY.

To evaluate the early effects of panretinal photocoagulation (PRP) on corneal sensation and dry eye signs in patients with diabetic retinopathy. Fifty patients with Type 2 diabetes mellitus and very severe nonproliferative or non-high-risk proliferative diabetic retinopathy who required PRP for the treatment of their retinal condition were enrolled. All patients were treated using a pattern PRP device. Esthesiometry, tear breakup time test, Schirmer test, and corneal staining pattern were evaluated at baseline and 2 months after the last session of PRP. Data from 88 eyes of 50 patients (41 right eyes and 47 left eyes) were analyzed. The mean tear breakup time test (right eyes) was decreased from 9.51 at baseline to 7.66 seconds after PRP (P < 0.001). The post-PRP eyes showed more advanced grades of corneal staining than pre-PRP assessment (P < 0.001). The average value of Schirmer test was 14.39 versus 12.29 mm (without anesthesia; P < 0.001) and 8.17 versus 7.15 mm (with anesthesia, P < 0.001) for baseline versus post-PRP measurements, respectively. The corneal sensation also showed decrease after laser therapy (4.93 versus 4.31 cm; P < 0.001). This study demonstrates that decreased corneal sensation and signs of dry eye are more common immediately after PRP for diabetic retinopathy. These conditions should be discussed with the patient preoperatively and managed postoperatively.

Topical Pergolide Enhance Corneal Nerve Regrowth Following Induced Corneal Abrasion.

PurposeNeurotrophic keratopathy is a degenerative disease that may be improved by nerve growth factor (NGF). Our aim was to investigate the use of pergolide, a dopamine (D1 and D2) receptor agonist known to increase the synthesis and release of NGF for regeneration of damaged corneal nerve fibers.MethodsPergolide function was evaluated by measuring axon length and NGF levels by enzyme-linked immunosorbent assay in cultured chicken dorsal root ganglion (DRG) cells with serial doses of pergolide (10, 25, 50, 150, and 300 µg/ml) and with different concentrations of a D1 antagonist. Pergolide function was further evaluated by cornea nerve fiber density and wound healing in a cornea scratch mouse model.ResultsPergolide increased DRG axon length significantly at a dose between 50 and 300 µg/ml. Different concentrations of D1 antagonist (12, 24, 48, and 96 µg/ml) inhibited DRG axon length growth with pergolide (300 µg/ml). Pergolide (50 µg/ml) upregulated NGF expression in DRG cells at both 24 hours and 48 hours. Pergolide improved cornea nerve fiber density at both 1 week and 2 weeks. Pergolide also improved cornea wound healing.ConclusionsWe demonstrated that pergolide can act to promote an increase in NGF which promotes corneal nerve regeneration and would therefore improve corneal sensation and visual acuity in eyes with peripheral neurotrophic keratopathy.

SCOPE OF UNANI MEDICINE IN THE PROPHYLAXIS AND MANAGEMENT OF COVID-19

Coronavirus disease (COVID-19) is an acute infectious disease caused by infection with a novel coronavirus SARSCoV-2. The disease severity can range from mild to developing into critical with pneumonia and even life-threatening complications such as Acute Respiratory Distress Syndrome (ARDS), shock, or multi-organ system dysfunction. The clinical picture of Nazla-e-Wabaiya is almost similar to that of Covid-19 like body ache, sore throat, nasal irritation, burning sensation in eyes sneezing, cough, and fever. As per the Unani scholars, the prophylaxis and management include various single and compound drugs to be used orally. They also prescribed various drugs as disinfectants to be used for fumigation, incense, and spray. Ibn Sina advised that houses should be sanitized daily by spraying Arq Gulab (Rosa damascene), Arq Bed Sada (Salix caprea), or Arq Nilofer (Nymphaea alba) and recommended Bukhoor (incense) of Sa'ad Kufi (Cyperusrotundus), Habb-ul-Aas (Myrtuscommunis), Kundur (Boswelliaserrata), and Sandalwood (Santalum spp.). For the treatment of Nazla-e-Wabaiya, the decoction (Joshanda) of Unnab, Sapistan, and Behidana along with Sharbat Banafsha have been recommended by many eminent Unani scholars. They have also recommended using various types of Khamiras like Khamira Gaozaban, Khamira Abresham SheeraUnnabWala, Khamira Marwareed to improve general health and immunity.

ROLE OF UNANI MEDICINE IN THE PREVENTION OF CORONAVIRUS DISEASE-2019 (COVID-19): A REVIEW AND RESEARCH PERSPECTIVE

In December 2019 some patients with symptoms very much similar to SARS and MERS emerged in Wuhan city of China. In January 2020 a new type of coronavirus was isolated and name as 2019-nCoV, which later termed 'SARSCoV-2'. WHO declared the Covid-19 outbreak a Public Health Emergency of International Concern, and on March 11, the epidemic was upgraded to the pandemic. As on 02.04.2020, 827,419 confirmed cases are officially reported in more than 200 countries or territories with 40,777 deaths. The history of epidemiology typically starts with 'Hippocrates' in about 400 BC; he in his valuable book, Of the Epidemics introduced several concepts of epidemiology. In Unani Classical texts, both epidemics and pandemics have been described under a common term 'Waba'. Unani medicine have described Nazla Haar by the name of Nazla-e-Wabaiya (epidemic influenza) which is characterized by body ache, sore throat, nasal irritation, burning sensation in eyes sneezing &amp; cough, and fever. Unexplained general weakness is an early feature of Nazla-e-Wabaiya and the disease is often complicated by pneumonia and pleurisy, therefore, Nazla-e-Wabaiya (Nazla Haar) is very much similar to that of Covid-19. In such conditions Ibn Sina advised that houses should be sanitized daily by spraying different arqiyat, he recommended the use of Bukhoor(incense) of some anti-infective drugs. Zakariya Razi has prescribed several aromatic Unani drugs for prevention of Waba. For prophylaxis of epidemic diseases, Unani scholars also prescribed several drugs to augment the immunity (Quwwat-e-Mudabbira Badan). There is a long list of drugs suggested by Unani scholars to be used in different ways to combat epidemic and pandemic situations that need to be validated on current scientific parameters.

The fundamental study of the principle Rogan Rutujan Na Jatu in the treatment of Pittaj Shirahshul (headache) w.s.r. to Virechanopakrama

To prevent the recurrence of seasonal disorders Rutuvat Shodhanopakrama (Seasonal detoxification) is the ideal pathway. So in Varsharutu (Rainy season), Bastikarma (Enema therapy); Sharadrutu (Autumn season), Virechankarma (Purgation therapy) and in Vasantrutu (Spring sea- son), Vaman karma (Emesis therapy) is best for Shodhan (detoxification) of vitiated Vatadosha, Pittadosha and Kapha dosha respectively to avoid occurrence of seasonal disorders. Study is conducted only on Virechana karma (Purgation therapy) in Sharad Rutu (Autumn season) on sample size of 30 patients suffering from Pittaj Shirahshul (Headache). The chief symptoms of the disease are Shirodaha (Burning sensation in head), Shirovedana (Headache), Chakshudaha (Burning sensation in eyes), Trushna (Thirst), Bhrama (Giddiness) and Swedpravrutti (Sweating). Sharadkalin Trivrutadi Virechana yoga (purgative formulation used in Autumn) is most efficacious which acts as Pittaghna (reduces Pitta) and Rechana (purgative) which could be the beneficial line of treatment for Pittaj Shirahshul (Headache). Hence Virechana karma (Purgation ther- apy) should be carried out furthermore in every Sharad rutu (autumn season) to reduce the risk of relapse and to prevent rutujanya pittaj shirahshul (headache due to vitiated Pitta).

Pain and sensation in dry eye disease

AbstractThe recent definition of dry eye disease (DED) proposed by DEWS II includes, for the first time, neurosensory abnormalities in etiology of the disease. In DED, reduced tear secretion leads to inflammation and corneal nerve damage, which induce sensitization of corneal polymodal and mechano‐nociceptors, and an abnormal activity of cold thermoreceptors thus evoking pain and eye dryness sensations. Moreover, long‐term nerve damage and inflammation, modify the expression of ion channels involved in the stimulus detection (transduction) and excitability of ocular sensory neurons, changing their impulse firing and their connectivity at the CNS, which is the basis of neuropathic pain and dysesthesia referred to the eye surface in DED patients. These altered transducing and encoding ion channels are potential molecular targets to modulate neuropathic nerve activity in DED, currently under study. Although many subjective (surveys and questionnaires, corneal sensitivity measurement) and objective metrics (morphology and density of subbasal corneal nerves and immune cells, blink parameters, biomarkers in tears) are currently used to evaluate pain in DED patients, new instruments and procedures designed to obtain more reliable information on eye sensations and pain in DED need to be developed (SAF‐2017‐83674‐C2‐1‐R and 2‐R, Agencia Estatal de Investigación‐ERDF, Spain‐EU, and PROMETEO/2018/114, Generalitat Valenciana, Spain).

Transcorneal Electrical Stimulation for the Treatment of Retinitis Pigmentosa: A Multicenter Safety Study of the OkuStim® System (TESOLA-Study)

Background: Transcorneal electrical stimulation (TES) has been suggested as a possible treatment for retinitis pigmentosa (RP). Objective: To expand the safety assessment of repeated applications of an electrical current from a DTL-like electrode in patients with RP. Methods: This single-arm open label interventional safety trial included a total of 105 RP patients from 11 European centers, who received weekly TES for 6 months on 1 eye followed by observation for another 6 months without stimulation. The primary outcome measure was safety, indicated by the frequency and severity of adverse events. Secondary measures included intraocular pressure and central retinal thickness. Visual field and visual acuity were examined using the methods available at each site. Results: Dry eye sensation was the most common adverse event recorded (37.5%). Serious adverse events secondary to TES were not observed. Most adverse events were mild and all resolved without sequelae. The secondary outcome measures revealed no significant or clinically relevant changes. Conclusion: The present results confirm the excellent safety profile of TES. Transient dry eye symptoms were the most common adverse event.

PMU135 PATIENT-REPORTED OUTCOME MEASURES IN PATIENTS WITH CHRONIC OCULAR SURFACE PAIN : A LITERATURE REVIEW

Chronic ocular surface pain (COSP) is a persistent eye pain at the ocular surface lasting for a period longer than 3 months that interferes with regular daily activities, and is severely impacting patients’ health related quality of life (HRQoL).The aim of this study was to review the suitability of existing patient-reported outcome measures (PROMs) for use in clinical trials, assessing potential new therapies of COSP. Literature searches were performed in Medline and Embase using Ovid SP platform until March 2019. Specific search terms were used to identify studies assessing QoL in patients experiencing ocular pain. The review was complemented by searching relevant trials using PRO endpoints in ocular pain on clinicaltrials.gov. The measurement characteristics of the identified tools were reviewed in line with FDA’s 2009 PRO Guidance. A total of 1,130 abstracts were identified for initial screening and 177 were selected for full text review. In total 16 tools were identified, and of these, only four (Ocular Pain Assessment Survey (OPAS), Eye Sensation Scale (ESS), Neuropathic Pain Symptom Inventory (NPSI)-Eye and Brief Ocular Discomfort Inventory (BODI) specifically measured ocular pain. OPAS and ESS were originally developed for measuring ocular pain, whereas NPSI-Eye and BODI are modified versions of generic pain scales. As OPAS assesses the most critical HRQoL impacts of COSP such as impact on visual functioning, mood, sleep in addition to severity and type of pain assessment, it appears being the most adequate tool for its usage in future clinical trials. Among the PROMs identified for usage in future COSP clinical trials, OPAS appears to be the most suitable one. Further investigation is needed to ensure that OPAS is an appropriate and well-validated tool to assess new treatments for COSP in accordance with regulatory requirements.

Pathogenesis and complications of chronic eye rubbing in ocular allergy.

To review the updated literature regarding eye rubbing complications and its association with ocular allergy disorders. Atopy and ocular allergy disorders, mainly vernal keratoconjunctivitis (VKC), are strongly associated with rubbing-related complications, most probably via itching and watery eye sensations that trigger the habit of chronic eye rubbing. Vigorous and prolonged rubbing may lead to establishment of corneal remodeling and ectatic disorders, such as keratoconus. Keratoconus development in rubbed eyes can be caused by mechanical mechanisms of corneal thinning and its loss of rigidity, by elevated temperature of the epithelium during rubbing, by increased intraocular pressure (IOP) because of distending forces, and by inflammatory molecules that may serve as a causal mediator between eye rubbing and keratoconus. Other eye rubbing complications include acute hydrops and perforation, IOP spikes, iris prolapse and iridoschisis rupture of lens capsule and IOL dislocation, and even posterior segment disorders, such as glaucomatous optic neuropathy, retinal detachment and extrusion of implanted silicone oil in the eye. Chronic eye rubbing in allergic eye diseases can lead to progression of keratoconus, and to other rare anterior and posterior segment complications. Strategies eliminating eye rubbing and its consequences are vital, mainly among at-risk populations, such as young children and individuals with allergic ocular disorders or corneal transplants.

Dupilumab-induced ocular surface disease (DIOSD) in patients with atopic dermatitis: clinical presentation, risk factors for development and outcomes of treatment with tacrolimus ointment

AimTo identify risk factors for the development of dupilumab-induced ocular surface disease (DIOSD) in adult patients with atopic dermatitis (AD) and describe outcomes of treatment.MethodsA retrospective institutional cohort study performed...

Role of TRPM8 Channels in Altered Cold Sensitivity of Corneal Primary Sensory Neurons Induced by Axonal Damage.

The cornea is extensively innervated by trigeminal ganglion cold thermoreceptor neurons expressing TRPM8 (transient receptor potential cation channel subfamily M member 8). These neurons respond to cooling, hyperosmolarity and wetness of the corneal surface. Surgical injury of corneal nerve fibers alters tear production and often causes dry eye sensation. The contribution of TRPM8-expressing corneal cold-sensitive neurons (CCSNs) to these symptoms is unclear. Using extracellular recording of CCSNs nerve terminals combined with in vivo confocal tracking of reinnervation, Ca2+ imaging and patch-clamp recordings of fluorescent retrogradely labeled corneal neurons in culture, we analyzed the functional modifications of CCSNs induced by peripheral axonal damage in male mice. After injury, the percentage of CCSNs, the cold- and menthol-evoked intracellular [Ca2+] rises and the TRPM8 current density in CCSNs were larger than in sham animals, with no differences in the brake K+ current IKD Active and passive membrane properties of CCSNs from both groups were alike and corresponded mainly to those of canonical low- and high-threshold cold thermoreceptor neurons. Ongoing firing activity and menthol sensitivity were higher in CCSN terminals of injured mice, an observation accounted for by mathematical modeling. These functional changes developed in parallel with a partial reinnervation of the cornea by TRPM8(+) fibers and with an increase in basal tearing in injured animals compared with sham mice. Our results unveil key TRPM8-dependent functional changes in CCSNs in response to injury, suggesting that increased tearing rate and ocular dryness sensation derived from deep surgical ablation of corneal nerves are due to enhanced functional expression of TRPM8 channels in these injured trigeminal primary sensory neurons.SIGNIFICANCE STATEMENT We unveil a key role of TRPM8 channels in the sensory and autonomic disturbances associated with surgical damage of eye surface nerves. We studied the damage-induced functional alterations of corneal cold-sensitive neurons using confocal tracking of reinnervation, extracellular corneal nerve terminal recordings, tearing measurements in vivo, Ca2+ imaging and patch-clamp recordings of cultured corneal neurons, and mathematical modeling. Corneal nerve ablation upregulates TRPM8 mainly in canonical cold thermoreceptors, enhancing their cold and menthol sensitivity, inducing a rise in the ongoing firing activity of TRPM8(+) nerve endings and an increase in basal tearing. Our results suggest that unpleasant dryness sensations, together with augmented tearing rate after corneal nerve injury, are largely due to upregulation of TRPM8 in cold thermoreceptor neurons.

Improvement of dry mouth following intraductal irrigation of salivary glands.

To assess the effect of major salivary gland intraductal irrigations (IGs) to relieve mouth dryness. We retrospectively analyzed the records of patients with mouth dryness who underwent major salivary gland IG during 2013-2015. Records included demographics, medical background, dry mouth etiologies and symptomatology, and results of sialometry and sialo-cone-beam computerized tomography. Subjective improvement following the IG procedure (yes/no) and sustained subjective improvement (mouth dryness relief for ≥1month) were recorded. Objective improvement was assessed by comparing the mean unstimulated (USF) and stimulated (SSF) whole salivary flow (WSF) rate before and after the IG. Seventy-four patients were included [mean age: 59.08±12.46years]. Improvement was detected in the USF (p=.027), but not in the SSF (p=.878). Fifty-five (84.6%) noted subjective improvement, while 10 (15.4%) did not. Subjective improvement was positively associated with the USF following IG (p=.037), with salivary gland swelling episodes (p=.033), and with difficulties in swallowing dry foods (p=.014). Of those with subjective improvement, 45 (81.8%) reported sustained improvement, which was positively associated with lack of a gritty eye sensation (p=.042) and abnormal sialo-CBCT findings (p=.001). Major salivary gland IG is a simple and safe procedure that may relieve dry mouth for a relatively extended duration. Further studies are needed to confirm these preliminary findings and assess their underlying mechanisms.

Dry eye syndrome of deficient lacrima production treated with the acupoint thread-embedding therapy: a randomized controlled trial

To compare the therapeutic effects on the relevant symtoms in the patients with dry eye syndrome treated with the acupoint thread-embedding therapy versus topical artificial tears eye drops. A total of 88 patients with dry eye syndrome of deficiency lacrima production were randomized into an acupoint thread-embedding therapy group (thread-embedding group) and a control group with topical artificial tears eye drops (medication group), 44 cases in each one. In the thread-embedding group, 3 cases were dropped out. In the thread-embedding group, Ganshu (BL 18), Pishu (BL 20) and Shenshu (BL 23) etc. were selected and the acupoint thread-embedding therapy was operated once every 30 days, totally for two treatments. In the medication group, the topical artificial tears eye drops was used, 4 to 6 times a day, one drop each time, for 8 weeks totally. Separately, before treatment, after 4-week treatment and 8-week treatment as well as in 8 weeks and 12 weeks of the follow-up, the levels of lactoferrin in tears were determined and the scores of the relevant symptoms of ocular surface such as eye dryness, foreign body sensation in the eyes and eye fatigue were evaluated. In the thread-embedding group, after 4-week and 8-week of treatment as well as in 8-week and 12-week follow-up, the scores of eye dryness, foreign body sensation, burning sensation of eye, phengophobia and eye fatigue were reduced significantly as compared with those before treatment (all P<0.05). In the medication group, the relevant symptoms of ocular surface were reduced after 4-week and 8-week treatment as compared with those before treatment (all P<0.05). In the follow-up, the scores of the relevant symptoms of ocular surface in the thread-embedding group were significantly lower than the medication group (all P<0.05). Separately, after 4-week treatment and 8-week treatment as well as in 8 weeks and 12 weeks of the follow-up, the levels of lactoferrin in tears in the thread-embedding group were significantly increased as compared with those before treatment (all P<0.05). The change was not obvious as compared with that before treatment in the medication group (P>0.05). The levels of lactoferrin in tears at each time point after treatment in the thread-embedding group were higher than the medication group (P<0.05). The acupoint thread-embedding therapy effectively improves in the relevant symptoms of ocular surface, such as eye dryness, foreign body sensation, burning sensation of eye, phengophobia and eye fatigue, and increases the level of lactoferrin in tears in the patients with dry eye syndrome of deficiency aqueous production. In the follow-up, the therapeutic effects of the acupoint thread-embedding therapy are significantly better than artificial tears eye drops.

Patient satisfaction and self-reported dry eye symptoms in hyperopic patients treated with femtosecond laser in situ keratomileusis.

PurposeTo study self-reported patient satisfaction and dry eye symptoms in hyperopic correction with femtosecond laser-assisted in situ keratomileusis (FS-LASIK).Patients and methodsNinety-eight eyes (53 patients) were treated with FS-LASIK for hyperopia. Patients’ self-reported dry eye symptoms and satisfaction with near and far vision were graded on the visual analog scale (VAS) preoperatively and 1 month postoperatively.ResultsNinety-one percent of the eyes with the plano target (54 eyes) achieved an uncorrected distance visual acuity of 20/20 or better. Predictability, defined as spherical equivalent refraction within ±0.5 D of target, was 88% of all eyes. None of the eyes lost two or more Snellen lines of corrected distance visual acuity. There was no significant change in the self-reported dry eye sensation (VAS score from 2.7±2.0 to 2.8±2.0; P=0.66). In 44 monovision patients, satisfaction with both far vision (from 71.2±19.8 to 89.2±8.7; P<0.0001) and near vision (from 51.7±26.2 to 89.3±13.2; P<0.0001) increased significantly. In nine emmetropic patients, satisfaction with neither far vision nor near vision was significantly improved, although there was a clear tendency (from 73.7±23.7 to 86.9±15.3; P=0.22, and from 58.9±29.1 to 81.6±17.4; P=0.11, respectively). In the monovision patient group, far vision satisfaction decreased when dry eye symptoms increased. Monovision patients, as predicted, were more satisfied with their near vision, when postoperative spherical equivalent from target was on the myopic side.ConclusionFS-LASIK correction of hyperopia significantly improved patient satisfaction with both near and far vision in monovision patients. Hyperopic patients had no significant changes in postoperative dry eye symptoms compared to preoperative values.

Correction of myopia and myopic astigmatism by femtosecond laser in situ keratomileusis.

We analysed one-year refractive results and the incidence of complications in patients with correction of low-to-high myopia or myopic astigmatism by femtosecond laser in situ keratomileusis (FS-LASIK) using femtosecond laser LenSx® (Alcon, Fort Worth, Texas, USA) aexcimer laserExcimer Amaris 500 (Schwind eye-tech-solutions GmbH and Co KG, Kleinostheim, Germany). To the retrospective study were included 171 eyes of 87 patients (38 men, 49 women) who underwent correction of myopia and myopic astigmatism by FS-LASIK in the outpatient Department of Ophthalmology, University Hospital in Hradec Králové between 2013-2017. We assessed uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA), subjective refraction, central corneal thickness (CCT) in the thinnest point, patientssatisfaction and the incidence of complications in the one-year follow-up period. At the time of laser procedure the mean patientsage was 29,26 ± 6,47 years (range 18 to 46 years). In 21 eyes was corrected myopia (range -6,5 to -2,5 D sph) and in 150 eyes myopic astigmatism (range -8,75 to -0,25 D sph and -3,0 to -0,25 D cyl). The mean preoperative UCVA 0,06 ± 0,08 (range 0,02 to 0,8) got better to 1,12 ± 0,17 (range 0,8 to 1,5) at the end of follow-up period. There wasnt statistically significant change in BCVA between preoperative and postoperative values. Preoperative mean value of subjective refraction was -4,14 ± 1,43 D sph (range -8,5 to -1 D sph) and -0,57 ± 0,58 D cyl (range -3 to 0 D cyl) and after 12 months -0,02 ± 0,16 D sph (range -0,1 to 0,75 D sph) and -0,01 ± 0,1 D cyl (range -0,5 to 0,5 D cyl). The initial mean CCT was 554,76 ± 30,07 &#956;m (range 485 to 660 &#956;m), after 6 months 494,06 ± 34,99 &#956;m (range 421 to 594 &#956;m) and after 12 months 492,92 ± 34,55 &#956;m (range 411 to 592 &#956;m). We observed peroperative complications in 3 eyes. The suction loss of femtosecond laser occurred during flap creation due to sudden eye movement. Postoperatively in one case we enrolled flap pucker first postoperative day. In other case flap dislocation occurred after abdonimal surgery under general anesthesia which was performed 3 months after refractive procedure and we had to indicate flap reposition. The mean grade of patientssatisfaction was at the end of follow-up period 1,04. The most often complaints were the sensation of dry eye (10 patients) and blurry vision during computer working, inadequate lighting and fatique (6 pacients). According to our experience correction of low-to-high myopia or myopic astigmatism by using FS-LASIK is an effective, relatively safe and predictable method. The basic assumption of good postoperative results and patientssatisfaction is thorough and comprehensive preoperative examination with respect to indication criteria.

A study on prevalence of dry eyes among menopausal women attending a tertiary care centre in Hyderabad, Telangana

Background: Dry eye syndrome arises due to chronic lack of sufficient lubrication and moisture on the surface of the eye. Symptoms of dry eye syndrome includes burning sensation, itchy eyes, blurred vision, and fatigued eyes, redness of eyes, gritty and dry eye sensation / foreign body sensation. Studies reveal that post-menopausal women are at greater risk of developing dry eyes than men of same age. Aims and objectives were to determine the prevalence of dry eye syndrome among post-menopausal women at tertiary care center, Hyderabad and to assess the socio-demographic factors related to dry eye syndrome among study population.Methods: A cross sectional study was carried out from March to June 2017 among post-menopausal women attending Gandhi Hospital, in Hyderabad, Telangana. A convenient sample of 200 post-menopausal women was taken. Schirmer’s test was used to determine presence of dry eyes.Results: The mean age of study population was found to be 51.66±5.8 years. The mean age of onset of menopause in study subjects was 45.63±1.8 years. The prevalence of dry eye syndrome was found to be 39.5%. Mild dryness of eyes was most common among study subjects (20.5%). Prevalence of dry eyes increased with age and had significant association.Conclusions:Dry eye syndrome is not a life threatening disease, but causes ocular discomfort and compromises quality of life. If neglected, can even lead to blindness and debility due to complications arising due to dry eye.

Risk factors for ocular surface damage in Mexican patients with dry eye disease: a population-based study.

PurposeTo analyze potential risk factors for ocular surface damage in a representative population of Mexican patients with dry eye disease (DED).Patients and methodsA prospective and cross-sectional population-based epidemiologic cohort study was conducted through a survey of patients with symptoms, signs, known preexisting diagnosis, and clinical conditions related to DED. Fluorescein staining, tear break-up time (TBUT), and Oxford lissamine green staining were performed on both eyes of patients enrolled in the study.ResultsA total of 2,725 surveys including 1,543 (56.6%) women and 1,182 (43.3%) men were analyzed. Most common pre-existing diagnosis included dry eye (58%), chronic blepharitis (17%), and ocular allergy (15%). More than 70% of patients had a positive fluorescein test, and this prevalence increased proportionally to the number of reasons for consultation. The same was true for gender (P<0.001) and age (P<0.0001), with women showing a strong correlation with age (R2=0.93912, P=0.001). The association between positive fluorescein staining and diagnosis was significant for dry eye (P<0.0001), Sjögren’s syndrome (P<0.0001), and glaucoma (P<0.05). No significant association between TBUT and age or gender was found, but the shorter the TBUT, the larger the prevalence of fluorescein staining. Reduced TBUT was seen more frequently in patients with dry eye (57%), ocular allergy (16%), and chronic blepharitis (15%). Most patients (39%) with Oxford grades III and IV were older, complained of red eye (51.0%), foreign body sensation (47.0%), burning (46.0%), and were using eye drops (67%) and systemic medications (47%).ConclusionThe Mexican profile of patients with significant ocular surface damage related to DED includes women at older ages, complaining of red eye, foreign body, and burning sensation. Diagnoses of dry eye, Sjögren’s syndrome, and glaucoma were also risk factors for significant ocular surface damage, along with long-term use of preserved eyes drops and systemic medications.

Effect on blood pressure and eye health symptoms in a climate-financed randomized cookstove intervention study in rural India

BackgroundAir pollution from cooking with solid fuels is a potentially modifiable risk factor for increased blood pressure and may lead to eye irritation. ObjectivesTo evaluate whether a climate motivated cookstove intervention reduced blood pressure and eye irritation symptoms in Indian women. MethodsHouseholds using traditional stoves were randomized to receive a rocket stove or continue using traditional stoves. Systolic (SBP) and diastolic blood pressure (DBP), and self-reported eye symptoms were measured twice, pre-intervention and at least 124 days post-intervention in women > 25 years old in control (N = 111) and intervention (N = 111) groups in rural Karnataka, India. Daily (24-h) fine particle (PM2.5) mass and absorbance (Abs) were measured in cooking areas at each visit. Mixed-effect models were used to estimate before-and-after differences in SBP, DBP and eye symptoms. ResultsWe observed a lower SBP (−2.0 (−4.5, 0.5) mmHg) and DBP (−1.1 (−2.9, 0.6) mmHg) among exclusive users of intervention stove, although confidence intervals included zero. Stacking or mixed use of intervention and traditional stoves contributed to a small increase in SBP 2.6 (−0.4, 5.7) mmHg) and DBP (1.2 (−0.9, 3.3) mmHg). Exclusive and mixed stove users experienced higher post-intervention reductions, on average, in self-reported eye irritation symptoms for burning sensation in eyes, and eyes look red often compared to control. Median air pollutant concentrations increased post-intervention in all stove groups, with the lowest median PM2.5 increase in the exclusive intervention stove group. ConclusionsHealth benefits were limited due to stacking and lower-than-predicted efficiency of the intervention stove in the field. Stove adoption and use behavior, in addition to stove technology, affects achievement of health co-benefits. Carbon-financing schemes need to align with international guidelines that have been set based on health outcomes to maximize health co-benefits from cookstove interventions.

Ophthalmologic Findings in Congenital Generalized Lipodystrophy—A Possible Marker of Metabolic Disorders

Background and Aims: Metabolic disorders can present ophthalmologic changes. Congenital Generalized Lipodystrophy (CGL) is characterized by severe metabolic manifestations such as insulin resistance, diabetes and hypertriglyceridemia, but there are few data published about ophthalmologic findings in this condition. The purpose of this study is to describe ocular abnormalities in patients with CGL. Materials and Methods: It was a cross sectional study with 15 patients with CGL of both sex, aged between 2 and 29 years old. We evaluated the symptoms of surface eye disease and visual acuity. In the slit lamp, were evaluated the anterior segment of the eye, the break up time of the tear film with fluorescein and the corneal findings. Under mydriasis, the eye fundus examination was performed. Results: All subjects had dyslipidemia: 15/15 (100%) hypertriglyceridemia; 15/15 (100%) low HDL-c; 4/15 (26,7%) and high levels of LDL-c. Diabetes was presented in 7/15 (46,7%) cases. Symptoms of surface eye disease (blurred vision, pruritus, hyperemia or dry eye sensation) were presented in 9/15 (60%) patients and 8/15 (53%) had refractive errors: 5/8 (62,5%) astigmatism, 2/8 (25%) myopia and 1/8 (13%) myopia and astigmatism. In the slit lamp, 12/15 (80%) presented anterior blepharitis (seborrheic or meibomite), 13/15 (87%) decrease in the break up time of the tear (less than 8 seconds) and 5/15 (33,3%) keratitis. In the fundoscopy, 2/15 (13,3%) presented retinopathy (one with nonproliferative diabetic retinopathy and another presented proliferative diabetic retinopathy). Conclusion: These findings demonstrate high frequency of blepharites and its complications in patients with CGL, even in young subjects without diabetes. These data allow us to speculate that the presence of abnormalities in the anterior segment of the eye may be a marker of metabolic disorders as dyslipidemia and insulin resistance. Disclosure V.O. Fernandes: None. L.M.A. Gomes: None. A.D.R. Montenegro: None. C.M.M. Ponte: None. L.A.A. Batista: None. R.E.M. Aragão: None. J.V. Silva: None. R.M. Montenegro: None.