Symptoms Of Ocular Discomfort Research Articles

Delayed diagnosis of ocular graft-versus-host disease after allogeneic hematopoietic stem cell transplantation

PurposeTo investigate the delayed diagnosis of chronic ocular graft-versus-host disease (coGVHD) after allogeneic hematopoietic stem cell transplantation (alloHCT), and further analyze potential confounding factors. MethodsThis cross-sectional study included 118 patients newly diagnosed as coGVHD after alloHCT at Zhongshan Ophthalmic Center, Sun Yat-sen University. All participants finished the flow path of medical history taking, detailed ophthalmological examination and questionnaire-based survey. coGVHD was diagnosed and graded by International Chronic Ocular GVHD Consensus Group (ICOGCG) criteria. Lag time of diagnosis was defined as interval between noting of ocular symptoms and confirmed diagnosis of coGVHD (TN-D). We further compared the clinical parameters between groups categorized by the median TN-D as medium and long delay groups. ResultsThe median TN-D was 6.3 [IQR 2.8–14.5] months. Most coGVHD patients underwent delayed diagnosis of coGVHD longer than 3 months (70 %, 83 of 118), with 90 of 118 diagnosed as severe coGVHD (76 %). The long delay group exhibited higher ICOGCG scores (10 [IQR 9–10.5] vs. 9 [IQR 8–10], P = 0.039) and more pronounced ocular signs, including conjunctival injection, meibomian gland loss, fibrotic tarsal conjunctiva, symblepharon, and corneal complications (all P < 0.05). Delayed diagnosis was strikingly correlated with seeking ophthalmic medical care twice or more prior to diagnosis (adjusted OR = 5.42, 95%CI: 1.40–21.06, P = 0.015) and accurate knowledge of ocular discomfort symptoms in coGVHD (adjusted OR = 0.29, 95%CI: 0.08–1.00, P = 0.050). ConclusionsDelayed diagnosis of coGVHD, associated with disease severity, was common among alloHCT recipients in southern China. Improving patient education and the awareness of ophthalmologists may facilitate early diagnosis of coGVHD.

Ayurvedic Management of Shushkakshipaka w.s.r. To Dry Eye Syndrome - A Single Case Study

Eyes are one of the most powerful tools that anyone can have; hence, all efforts should be made to protect the eyes. In today’s era, people depend more on machines like computers in all sectors of life. These cause some heat and radiation which certainly causes ill effects on the eyes. Tear (Ashru) secretion is an integral component of the ocular surface physiology; when compromised (quantitatively or qualitatively) leads to shushkakshipaka (dry eye syndrome) with various ocular discomfort symptoms and ultimately the patient may land in corneal blindness. Local, systemic, and environmental factors majorly affect its pathogenesis. Vata and Pitta/Rakta vitiation as per Ayurvedic viewpoint are the major contributing pathological factors in its manifestation. A 28-year-old female patient approached Shalakya OPD of SKGAC and H, Kurukshetra, complaining of irritation, foreign body sensation, eye fatigue, and pain in the periorbital region along with a feeling of dryness for 1 year. The patient had slight symptomatic relief but when medications were discontinued the condition used to reoccur, so she turned to Ayurvedic treatment for relief. In Ayurveda classics, specific treatment has been mentioned for Shushkakshipaka such as Snehana (~in-take of Ghee), Tarpana (~retention of ghee over eyes), Nasya (~Nasal medication), and Pariseka (~ocular irrigation). A patient of shushkakshipaka was treated with such treatment protocol, is presented as a case study in this article. Contrary to the available modern medical treatment Ayurveda propounds a systematic approach in the treatment of dry eye syndrome.

A Novel Ophthalmic Solution Containing Glicopro® Complex for the Treatment of Patients with Dry Eye Disease: Results from a Pilot Study.

(1) Background: Dry eye disease (DED) is a multifactorial ocular surface disease characterized by an imbalance in ocular surface homeostasis, and tear substitutes constitute the first line of treatment. The present study aimed to evaluate the changes in the signs and symptoms of patients with DED treated with a novel tear substitute containing the GlicoPro® complex. (2) Methods: Patients with DED not successfully responding to other tear substitutes were enrolled and treated with a novel ophthalmic solution (two drops four times daily). Patients were examined before starting the study treatment (T0) and after 30 (T1) and 60 (T2) days of treatment by means of Keratograph for the evaluation of the following: (i) tear meniscus height (TMH); (ii) noninvasive Keratograph break-up time (NIKBUT); (iii) bulbar redness; and (iv) infrared meibography. The SANDE questionnaire was administered to assess ocular discomfort symptoms. Analysis of the tear content of proenkephalin and Met/Leu-enkephalin was also performed. (3) Results: At T2, a significant improvement in NIKBUT first, average, and class, TMH, and SANDE score was found. The tear content of proenkephalins was significantly higher at T1, whereas processed active Met/Leu-enkephalins increased at both T1 and T2. (4) Conclusions: Our novel tear substitute based on GlicoPro® resulted in a significant improvement in ocular discomfort symptoms, tear volume, and stability in the patients treated. The increase in active peptides processed in tears may represent the pathophysiological substrate underlying this finding.

The Use of Venous Catheter and Irrigation with Povidone-Iodine 0.6% in Patients with Punctal and Proximal Canalicular Stenosis: Preliminary Report.

Background: This study aimed to evaluate the safety and efficacy of povidone-iodine 0.6% (PVI) irrigation for preventing recurrence of stenosis after punctoplasty in patients with punctal and proximal canalicular stenosis treated using a venous catheter as a stent. Methods: Twenty patients were enrolled and divided into two groups. Group 1 received irrigation of 1 mL 0.6% PVI, while Group 2 received 1 mL of balanced salt solution (BSS). The patients underwent baseline, 15-, 30-, and 90-day assessments using the Ocular Surface Disease Index (OSDI) questionnaire, Symptoms Assessment in Dry Eye (SANDE), Schirmer I test, tear meniscus height (TMH), bulbar redness, meibography, and non-invasive breakup time (NIKBUT) through Keratograph 5M (Oculus, Germany). Results: At three months, both groups demonstrated statistically significant improvements in symptoms and ocular surface parameters. However, Group 1 showed statistically significant improvements in OSDI, SANDE scores, bulbar redness, and NIKBUT compared to Group 2. Additionally, no patients in Group 1 presented a recurrence of stenosis, while three patients in Group 2 demonstrated stenosis relapse at the end of the follow-up period. Conclusions: The application of a venous catheter and PVI 0.6% irrigations proved to be effective in treating proximal lacrimal duct stenosis, reducing the risk of recurrence and improving tear film stability, ocular discomfort symptoms, and ocular surface parameters.

Noninvasive screening of ocular surface disease in otherwise healthy patients scheduled for cataract surgery.

To evaluate prevalence and characteristics of pathological ocular surface findings in healthy patients undergoing cataract surgery using a noninvasive ocular surface workup and a validated questionnaire. Prospective single-centre study (sub-analysis clinical trial no. NCT05754437). Healthy patients undergoing senile cataract surgery were screened preoperatively by Oculus Keratograph (K5 M; Oculus GmbH, Wetzlar, Germany) for the evaluation of tear meniscus height (TMH), non-invasive keratograph break-up time (NIKBUT), and meibomian gland dropout. Ocular discomfort symptoms were scored by ocular surface disease index (OSDI) questionnaire. 120 eyes of 120 patients (62 females, 58 males; mean age 73.85 years, range 47-91 years) were included. All patients had at least 1 abnormal finding, while 19 (15.8%; 95% CI [0.09-0.22]) had alterations of all parameters. In detail, 39 patients (32.5%; 95% CI [0.24-0.41]) had pathological TMH (mean 0,15 mm [0.03 SD]), 102 (85%; 95% CI [0.79-0.91]) had pathological NIKBUT (mean 3.64 s [2.63 SD]), 117 (97.5%; 95% CI [0.95-1]) had some degree of gland dropout (mean 1.62 [0.70 SD]), 78 patients (65%; 95% CI [0.56-0.74]) had pathological OSDI scores (mean 28.63 [15.08 SD]). Using TFOS DEWS II criteria, 66 patients (55%; 95% CI [0.42-0.60]) resulted affected by dry eye. This quick noninvasive screening documented the high prevalence of pathological ocular surface parameters in patients without risk factors or previous diagnosis of dry eye who are scheduled for cataract surgery.

Evaluation of early ocular discomfort after glaucoma surgery: trabeculectomy versus Ahmed glaucoma valve implantation.

This study aims to compare the initial ocular discomfort symptoms resulting from trabeculectomy and Ahmed glaucoma valve implantation surgeries. A prospective comparative study was conducted. The evaluation of ocular discomfort employed a questionnaire designed to identify the frequency and severity of distinct symptoms: ocular pain, general discomfort, tearing, foreign body sensation, and burning. This questionnaire was administered prior to surgery as a baseline, and subsequently at 7, 30, and 90 days post-surgery. Simultaneously, the Ocular Surface Disease Index (OSDI) was applied at these same time intervals. The study encompassed a total of 17 patients (9 undergoing trabeculectomy and 8 undergoing Ahmed glaucoma valve implantation). The Ahmed glaucoma valve implantation group exhibited higher tearing levels at baseline (p=0.038). However, no statistically significant differences in symptoms were observed between the two surgeries at 7 and 30 days post-surgery. At the 90-day mark following surgery, patients who had undergone trabeculectomy reported a significantly higher foreign body sensation (p=0.004). Although OSDI scores did not differ between groups at baseline, the trabeculectomy group showed significantly higher OSDI scores than the Ahmed glaucoma valve implantation group at 7, 30, and 90 days after surgery (p<0.05). Post-surgery, patients who had undergone trabeculectomy experienced increased foreign body sensation. Trabeculectomy appears to cause greater early postoperative ocular discomfort compared to the Ahmed glaucoma valve implantation group.

Visual analysis of autoimmune dry eye studies based on bibliometrics.

Dry eye is a chronic ocular surface disease caused by the instability of tear film or the imbalance of the ocular surface microenvironment which can lead to a diverse range of ocular discomfort symptoms. At present, the relevant mechanism of autoimmunity and treatment of dry eye is still unclear. Due to the proliferation of research papers in this field, visual analysis of existing papers can provide reference for future research. The academic papers of Web of Science were searched with the topics of "autoimmunity" and "dry eye," and the countries, institutions and keywords of the literatures selected in this domain were visualized by Citespace and Vosviewer software. A total of 787 valid international papers were detected, and the publication count exhibited a consistent upward trend year by year. Within this field, the US has produced the highest number of papers (363), with Baylor College of Medicine being the most prolific institution (28 publications). High-producing authors in this field include Artemis P. Simopoulos and Stephen C. Pflugfelder. International research in this field has focused on the pathogenesis, symptoms, and treatment of dry eye. It is predicted that the future international research hotspots will be the pathophysiology of autoimmune dry eye disease, data analysis of artificial intelligence-related diseases, and research on improving patients' quality of life.

Awareness About Dry Eye Symptoms and Risk Factors Among Eastern Province Population in Saudi Arabia.

Background Dry eye syndrome (DES), also known as keratoconjunctivitis sicca (KCS), is a common cause of patient's visits to the ophthalmologist. It is characterized by a defect in the tear film homeostasis, symptoms of ocular discomfort, and visual disturbance. Also, it increases the risk of ocular surface damage if complicated by tear film hyperosmolarity and ocular surface inflammation. The present study aims to measure awareness about dry eye disease and the risk factors among the Eastern region population in Saudi Arabia via an online questionnaire. Methods This is a cross-sectional community-based study conducted in Saudi Arabia that assessed knowledge and awareness of dry eye among the eastern province population using a self-administered online questionnaire. The minimum sample size was 385 adults. Statistical analysis was performed using SPSS software, version 21.0 (IBM Corp., Armonk, NY), and participants' overall awareness level was evaluated based on correct answers. Results In this study, a total of 522 participants fulfilling the inclusion criteria completed the study questionnaire. Participants ranged from 18 to 65 years, with a mean age of 27.2 ± 14.6 years old. Females represented a higher percentage of the sample, 341 (65.3%). Public awareness regarding dry eye diseases in the Eastern region, Saudi Arabia of 149 participants (28.5%) is overall a good awareness level while 373 (71.5%) of them had poor awareness. Conclusion Participants showed unsatisfactory results in awareness of risk factors of dry eye symptoms, where the most reported causes were prolonged concentration while using electronic devices, climatic factors, and lacrimal gland disorders.

Ocular surface in posterior segment surgery.

Nowadays, the technological breakthroughs of mini-invasive vitreo-retinal surgery improved the perioperative management and the outcomes of millions of patients. The most common procedures include pars plana vitrectomy, episcleral surgery, intravitreal injections, and laser photocoagulation. Potential sight and non-sight-threatening side effects have been reported during the follow-up period. Ocular surface disbalance can be induced by the aforementioned procedures, resulting in mild to severe ocular discomfort symptoms. This condition may recognize different causes such as pre-existing or concomitant diseases of the external eye, the surgical procedure damage of the anatomical or physiological structures of the ocular surface, the prolonged side effects induced by the chronic topical treatment that may be toxic to the external eye.In addition to the most frequent dry eye-related signs and symptoms, subconjunctival haemorrhages, corneal epithelium damage, partial loss of corneal sensitivity or changes in corneal nerve density could postoperatively affect our patients.In conclusion, any surgical trauma directed to the posterior segment of the eye may cause the loss of the ocular surface homeostasis. Ophthalmologists should not only recognise and treat, but possibly prevent, all patients' symptoms that could manifest in the postoperative time.

Clinical Profile of Patients of Dry Eye- A Prospective Observational Study

Introduction: Dry eye syndrome (DES) is a disorder of the preocular tear film that results in damage to the ocular surface and is associated with symptoms of ocular discomfort. It may be helpful to know that “sicca” is part of the English word “desiccate.” The dry eye syndrome in which the eyes do not produce enough tears is also known as “Sjögren’s syndrome”. Objective: To assess the clinical profile of patients of dry eye. Methods: This was a prospective observational study was conducted at Department of Eye, Barind Medical College and Hospital, Rajshahi, Bangladesh from January to June 2022. Total 101 eyes of 51 patients with dry eye complaining of burning, itching, foreign body sensation, grittiness, redness and pain,. Dry eye diagnostic tests were done in all the patients. Results: There were 20 males and 31 females and the age group taken was 30 to 75 years. 15 patients belonged to the age group of 30 to 45 years, out of which 9 were males and 5 were females. 29 patients belonged to age group of 46 to 60 years, out of which 8 were males and 22 were females. 7 patients belonged to the age group of 61 to 75 years, out of which 2 were males and 5 were females. Most common presentation in dry eye patients is foreign body sensation in 38% patients followed by itching in 29% patients, burning sensation in 23% patients, redness in 6% patients and pain in 4% patients. Conclusion: Most common presentation of dry eye is foreign body sensation and itching followed by burning sensation. Dry eye diagnostic tests like Tear film break up time was positive in 64% patients and Schirmers test was positive in 52% of patients along with other dry eye diagnostic tests.

Development and content validity assessment of the Dry Eye Disease Questionnaire in patients with dry eye disease, meibomian gland dysfunction, and Sjögren’s syndrome dry eye disease

BackgroundDry eye disease (DED), Meibomian gland dysfunction (MGD), and Sjögren’s syndrome dry eye disease (SS-DED) are eye dryness conditions that show significant overlap in various symptoms of ocular discomfort. The aim of this study was to qualitatively explore the patient experience and evaluate content validity of the newly developed Dry Eye Disease Questionnaire (DED-Q).MethodsSemi-structured interviews were conducted with 61 US adults who reported experiencing ocular symptoms due to their physician-confirmed primary diagnosis of DED (n = 21), MGD (n = 20), or SS-DED (n = 20). The open-ended concept-elicitation phase was followed by cognitive debriefing (CD) of the DED-Q to evaluate participants’ understanding and relevance of the instructions, items, response options, and recall periods. Interviews were also conducted with eight specialist healthcare professionals to assess clinical relevance of the concepts included. Verbatim interview transcripts were analyzed using thematic analysis in ATLAS.ti v8 software.ResultsA total of 29 symptoms and 14 impacts on quality of life were reported across participant interviews. Primary ocular symptoms reported included eye dryness (n = 61/61; 100%), eye irritation (n = 55/61; 90%), eye itch (n = 54/61; 89%), burning sensation (n = 52/61; 85%), and foreign body sensation (n = 51/61; 84%). The most impacted aspects of daily life were using digital screens (n = 46/61; 75%), driving (n = 45/61; 74%), working (n = 39/61; 64%), and reading (n = 37/61; 61%). CD findings showed most participants had good understanding of DED-Q items and confirmed most concepts were relevant to the lived experience of their condition. Aside from few minor changes to the items and examples to facilitate more accurate interpretation, the proposed instruction wording was modified for various symptom and impact modules to encourage participants to focus only on dry eye vision problems.ConclusionsThis research identified multiple prevalent symptoms and impacts of DED, MGD, and SS-DED, most of which were similar across the conditions. The DED-Q was confirmed to be a content-valid PRO measure suitable for use in clinical studies to assess the patient experience of DED, MGD, and SS-DED. Future work will focus on evaluating the psychometric properties of the DED-Q for use as an efficacy endpoint in clinical trials.

Prevalence of Dry Eye Disease Among Medical Students and Its Association with Sleep Habits, Use of Electronic Devices and Caffeine Consumption: A Cross-Sectional Questionnaire.

Dry eye disease (DED) is a common and multifactorial disease of the ocular surface which causes visual disturbance and feelings of discomfort among patients. The prevalence rate among medical students is an important issue to consider. This study investigates the relationship between caffeine consumption, sleeping habits, use of electronic devices, and DED among a convenient sample of medical students in Jordan. This cross-sectional online survey enrolled medical students from all six medical schools in Jordan. The questionnaire, which was shared via social media platforms, assessed socio-demographics, caffeine consumption amounts and patterns, sleep quality, and the use of electronic devices and their relation to ocular discomfort, DED, and related symptoms. The ocular surface disease index (OSDI) questionnaire was also administered to quantify the symptoms of DED. A total of 1223 students participated in this study (RR=24.46%); 64% were females, and 43% were in their clinical placement years. Of the participants, 317 (25.92%) had normal eyes, and 906 (74.08%) had symptomatic DED. Of the students, 1206 (98.6%) used electronic devices directly before bed, and only 399 (32.62%) used blue-light-protective glasses. Lower DED risk was linked to male gender (OR=0.535, 95% CI 0.392-0.73, p <0.01), clinical years of medical school (OR=0.564, 95% CI 0.424-0.75, p<0.01). Poor sleep quality corresponded to more incidence of DED, regardless of sleeping for 5-6 hours (OR=3.046, 95% CI 1.299-7.139, p=0.01) or for less than 5 hours (OR=3.942, 95% CI 1.824-8.519, p<0.01). Also, caffeine consumption only marginally affected its incidence, but the results were statistically insignificant. Female gender, basic science years, and spending more than 6 hours looking at screens were significantly associated with symptomatic DED. Caffeine consumption did not pose any significant risk to the incidence of DED.

Assessment of Tear Film Parameters in Patients with Type 2 Diabetes Mellitus

BACKGROUND&#x0D; Dry eye is a condition of tear film which occurs either due to tear deficiency or excessive evaporation of tears which causes damage to the interpalpebral ocular surface and is associated with ocular discomfort symptoms. This ocular disorder is common among general population with a prevalence of 28% among adults. Although diabetic retinopathy and diabetic cataracts are commonly known complications of diabetes, dry eye syndrome or keratoconjunctivitis sicca is also prevalent in diabetic individuals. The prevalence of dry eye in patients with type 2 diabetes mellitus has been reported to be 54%. The diagnosis of dry eye can be determined by decreased tear film stability, assessed by the tear film break up time (TBUT), and reduced tear secretion evaluated by Schirmer’s test.&#x0D; Aims and Objectives&#x0D; &#x0D; To assess the tear film parameters in patients with type 2 diabetes mellitus.&#x0D; To assess the co-relation of tear film parameters with duration of diabetes and HbA1c levels.&#x0D; &#x0D; METHODS&#x0D; A total of 100 eyes of patients with type 2 diabetes mellitus subjects and 100 eyes of non-diabetic age group and gender matched controls, were included in the study. The study was conducted from October 2021 to August 2022. Duration of diabetes mellitus and HbA1c values were documented on all subjects.&#x0D; RESULTS&#x0D; The mean age of the study group and the control group was 60.24 years and 58.32 years respectively. There were more males enrolled than females in both the study group and the control group. Among the study group, the mean values of Schirmer’s test-1 and Schirmer’s test-2 were 20.81±7.2 mm and 12.88±6.01 mm respectively. The values of both Schirmer’s test-1 and Schirmer’s test-2 were lower in the diabetics as compared to the controls. The mean value of TBUT (8.7±3.1 sec) was significantly reduced in diabetic patients as compared to the controls. There was a strong negative correlation of Schirmer’s test-1, Schirmer’s test-2 and TBUT with the duration of diabetes mellitus and with the levels of HbA1c.&#x0D; CONCLUSIONS&#x0D; The incidence of diabetes and dry eye syndrome as separate disease entities is on the rise at present. Dry eye syndrome in diabetes further compromises the quality of life of the patients and thus, should be diagnosed and treated early.

Changes in the meibomian glands in postmenopausal women with primary acquired nasolacrimal duct obstruction: a prospective study

BackgroundPrimary acquired nasolacrimal duct obstruction (PANDO) is frequently encountered in perimenopausal women, causing tear flow stagnation and resulting in a variety of ocular discomfort symptoms. However, little is known about the alterations in the meibomian gland in postmenopausal women with PANDO. Hence, this study investigated the changes in the meibomian gland and ocular surface in postmenopausal women with PANDO.MethodsThis prospective study included 60 eyes of 60 postmenopausal women with PANDO (PANDO group) and 30 eyes of 30 postmenopausal women without PANDO (control group). The PANDO group was further subdivided into incomplete and complete PANDO groups, based on the degree of nasolacrimal duct obstruction. The patients’ symptoms were evaluated using the ocular surface disease index questionnaire. The meibomian gland and ocular surface were assessed using the Keratograph 5 M. Other ophthalmologic examinations included the tear break-up time, corneal fluorescein staining, meibomian gland expression, and Schirmer I test. The correlations between the degree of nasolacrimal duct obstruction and other metrics were analyzed.ResultsThe loss ratio of the upper eyelid was greater in the incomplete PANDO group than in the control group (p = 0.023). Meibomian gland distortion of the upper eyelid was more severe in the control group than in the complete PANDO group (p = 0.022). The non-invasive tear meniscus height was greater, whereas the intensity of corneal fluorescein staining was lower in the PANDO group than in the control group (all p < 0.05). The degree of nasolacrimal duct obstruction was positively associated with the non-invasive tear meniscus height and ocular surface disease index scores (p < 0.001 and p < 0.001, respectively). Corneal fluorescein staining and meibomian gland distortion of the upper eyelid were negatively correlated with the degree of nasolacrimal duct obstruction (p = 0.01 and p = 0.007, respectively).ConclusionPostmenopausal women with PANDO exhibit significant morphological changes in the meibomian gland. More attention should be paid to meibomian gland loss in postmenopausal women with incomplete PANDO, as it is crucial for identifying meibomian gland impairments in patients with PANDO.

Meibomian gland secretion quality association with ocular parameters in university students during COVID- 19 restrictions

PurposeTo determine if the Meibomian Gland (MG) secretion quality is associated with symptoms of ocular discomfort, hours of Video Display Terminals (VDT) use, eyelid margin abnormalities, conjunctival hyperemia, and Meibomian Gland Loss Area (MGLA) in a sample of university students.MethodsAn online survey that included an Ocular Surface Disease Index (OSDI) questionnaire and an extra question about hours of VDT use recruited an initial sample of 183 participants. Only 120 participants that fulfilled the inclusion criteria were scheduled for a battery of ocular surface and MG specific exam. The tests include: 1) meibometry, 2) slit lamp exploration of eyelid margin abnormalities (irregularity, hyperemia and MG orifices plugging), MG secretion quality and conjunctival hyperemia, and 3) Meibography.ResultsSignificant positive correlations between the MG secretion quality and eyelid margin hyperemia, MG orifices plugging, MGLA, nasal conjunctival hyperemia, and temporal conjunctival hyperemia (Spearman Rho; all r>0.186, p<0.042) were found. Multivariate regression found association between OSDI with hours of VDT use (B=0.316, p=0.007), and eyelid hyperemia (B=0.434, p≤ 0.001). A statistical association between MG secretion quality and eyelid margin hyperemia, MG orifices plugging, MGLA and conjunctival hyperemia (Fisher’s exact; all p<0.039) were found. Multivariate regression found association between MG secretion quality with MG orifices plugging (B=0.295, p=0.004) and meibometry (B=-0.001, p=0.029).ConclusionParticipants with higher values in MG secretion quality have higher values in eyelid margin hyperemia, MG plugging, MGLA, and conjunctival hyperemia. No direct relationship between MG secretion quality and hours of VDT use or OSDI were found.

DRY EYE SYNDROME ASSOCIATED WITH DIABETES MELLITUS: AYURVEDIC AND MODERN VIEW

Dry eye syndrome (DES) also known as Keratoconjunctivitis sicca. Diabetes is more prone to dry eye disease and tear film dysfunctions. DM is a disease which affects both the anterior and posterior segment of the eye. DM patients more prone to Cataract, Glaucoma, Dry eye, Superficial Punctuated keratitis, recurrent corneal erosion syndrome, Persistent epithelial defects &amp; also cause microvascular complications like Neuropathy, Retinopathy. Dry eye is the disorders of the tear film due to tear deficiency or excessive evaporation which causes damage to the interpalpebral ocular surface and it is associated with symptoms of ocular discomfort. In diabetes due to poor control of DM damage to any component of lacrimal function unit leads to DES, Diabetic patients have classical symptoms of dry eye including irritation, foreign body sensation, redness, itching, burning sensation etc. In modern sciences it is treated with artificial tears drops. Frequent use of drops again leads to dryness hence alternative treatment is necessary. Ayurvedic classical text Acharya Sushruta describes Shukshkakshipaka under Sarvagata Netra Roga can be correlated with Dry eye. According to Acharya Sushruta it is Vatta vitiated disease, Acharya Vagbhata has quoted it as Vatta-pitta vitiated disease and Sharangadhara considered as Vataraktaja Vitiated disease. By analyzing different opinion of acharaya may cause dry eye by decreasing tear secretion. In Ayurveda many more treatment modalities are available for treating Shukshkakshipaka such as Snehapana, Netra Tarapana, Putapaka, Nasya, Anjana etc. This study enlightens the ayurvedic and modern review on dye eye syndrome in diabetes patient.

Face mask use and effects on the ocular surface health: A comprehensive review.

In the COVID-19 period, face masks increased exponentially. Several studies suggest that the rise in ocular discomfort symptoms during the pandemic is mostly part of dry eye disease and that these are due to the effect of face masks, resulting in the newly described term MADE, for "mask-associated dry eye". The most commonly proposed mechanism states that wearing a face mask creates an unnatural upward airflow towards the ocular surface during expiration, although the increased temperature, humidity and levels of carbon dioxide of the exhaled air, stress, increased use of video display terminals, as well as changes in the ocular microbiota may contribute. Evidence supports that the use of face masks causes an increase in dry eye disease symptoms, a decreased tear break-up time, corneal epithelial trauma, periocular temperature changes and inflammatory markers secretion. Given that the use of masks may be frequent in some settings in the near future, it is important to establish its effects and consequences on the ocular surface.

Prevalence of dry eye in postmenopausal women at a tertiary level hospital

BACKGROUND: Dry eye disease is a multifactorial ocular surface disease that causes symptoms of vague ocular pain, discomfort, grittiness, burning sensation, itching, and redness in the eyes. It is one of the most common disorders of the eye which is often underrecognized and can significantly affect the quality of life of patients. OBJECTIVES: The objective of this study is to assess how often postmenopausal women have dry eyes and to evaluate the relationship between dry eye disease and age in postmenopausal women. MATERIALS AND METHODS: During 3 months, postmenopausal women who attended the ophthalmology outpatient department at a tertiary level hospital participated in a hospital-based cross-sectional study. Four hundred postmenopausal women were conveniently selected as the sample. To identify the existence of dry eyes, Schirmer's test was performed. RESULTS: The study population's average age was 59.09 ± 8.46 years. In the research, the average age of menopause onset was 47.68 ± 2.67 years. Dry eye condition was found to be 39.75% prevalent. The vast majority of individuals with dry eye illness had moderate dry eyes (18.25%). Dry eyes became more common with age, which was statistically significant. CONCLUSION: The findings of the current study have shown that many postmenopausal women experience dry eye disease. The study emphasizes the value of routine eye examination for postmenopausal women to identify dry eye problems early, receive the proper treatment, and help these women improve their quality of life.

An Algorithmic Approach to Diagnosis in Patients with Ocular Surface Discomfort

Patients often present with symptoms of ocular surface discomfort. Although a significant proportion of these changes are related to problems of the tear film, other causes exist. Unfortunately, the nature of the symptoms expressed by the patient is nonspecific and does not have a diagnostic significance. In many instances, there is also a significant disconnect between patient-reported symptoms and physician-determined signs of disease. Hence, a methodical approach is required to properly diagnose and manage the problems in such patients. This includes an understanding of normal interrelationships between the various components that constitute the ocular surface, conditions that can impact these, and the resulting changes that can occur. The importance of recognising the other conditions that may coexist with and exacerbate tear film abnormalities, the history-taking process to determine these, and the examination of the eye and other systems is highlighted. Finally, an algorithmic approach that puts together all of the information from the above is discussed. Following this process can help arrive at the proper diagnosis in patients with ocular surface discomfort and help manage their condition appropriately.

Lid wiper epitheliopathy: Current knowledge and future directions

Abstract Lid wiper epitheliopathy (LWE) is a recently recognized clinical entity that involves the epithelial cells lining the lid wiper region of the upper and lower eyelids. LWE has gained attention in the field of ophthalmology due to its association with ocular discomfort, especially in contact lens wearers and individuals with dry eye symptoms. This review article aims to provide an overview of the current understanding of LWE, including its etiology, clinical implications, diagnosis, and potential treatment approaches. The etiology of LWE is believed to be multifactorial, with mechanical factors, contact lens wear, dry eye disease, and inflammation among the contributing factors. Clinically, LWE is diagnosed through the observation of the lid wiper region after staining with vital dyes. LWE is now recognized as a potential diagnostic sign of dry eyes, even in non-contact lens users. The condition has been linked to ocular surface discomfort and may explain a subset of dry eye cases where signs and symptoms do not correlate. Various grading scales have been used to assess the severity of LWE, with some studies exploring the potential of objective methods to complement subjective grading. While much progress has been made in understanding LWE, future research should focus on refining diagnostic criteria, exploring innovative treatment modalities, and investigating its association with other ocular surface conditions. A better understanding of LWE will contribute to improved management strategies and patient outcomes, particularly in individuals experiencing ocular discomfort and dry eye symptoms.