Background: The present study assesses the effectiveness and tolerability of preservative-free travoprost in patients with primary open-angle glaucoma (POAG), focusing on intraocular pressure (IOP) reduction and ocular surface health over a six-month period. Methods: The study was prospectively designed and conducted at the University General Hospital of Alexandroupolis, Greece. A total of 45 patients diagnosed with either POAG or ocular hypertension (OHT) were included in the study; all were either newly diagnosed or had previously discontinued prostaglandin therapy due to intolerance. Of these, 39 participants completed the study. All subjects were administered preservative-free travoprost once daily. Clinical evaluations were conducted at baseline (T0), and at 1 month (T1), 3 months (T3), 6 months (T6) and 12 months (T12) following treatment initiation. The primary outcomes encompassed reductions in intraocular pressure (IOP), Schirmer test values, tear break-up time (TBUT), conjunctival hyperemia, as well as measurements of retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness. Visual field parameters were also assessed. Results: A significant reduction in IOP was observed at T1, T3, T6 and T12 compared to baseline (p < 0.01). Schirmer test scores improved significantly from T0 to all subsequent time points (p < 0.01). Conjunctival hyperemia decreased significantly across follow-ups, while TBUT showed no significant change (p > 0.05). No significant changes were noted in mean deviation (MD), pattern standard deviation (PSD), RNFL, or GCC thickness over six months. Conclusion: Preservative-free travoprost effectively reduces IOP while improving ocular surface health, particularly in tear production and conjunctival hyperemia.

ObjectiveThis study aims to explore the correlation between ocular surface parameters and the location of lacrimal duct obstruction.MethodsThis retrospective comparative study included 74 patients (94 eyes) diagnosed with lacrimal duct obstruction (LDO) between December 1, 2022, and October 1, 2024. Based on the obstruction site, affected eyes were classified into an upper LDO group (29 eyes) and a lower LDO group (65 eyes). We collected ocular surface parameters, including mean non-invasive tear breakup time (NIBUT), Sjögren’s International Collaborative Clinical Alliance Ocular Staining Score (SICCA OSS), and Korb scores for the lid wiper. A comparative analysis was performed to evaluate differences in these parameters between the two groups.ResultsSignificant differences were observed in NIBUT and SICCA OSS between the two groups (PNIBUT=0.037, PSICCA OSS=0.010). Based on cutoff values, NIBUT was categorized into three intervals: ≤5 s (NIBUT1), 5–10 s (NIBUT2), and > 10 s (NIBUT3). A higher proportion of eyes with lower LDO fell into the NIBUT1 group (P < 0.05). Similarly, SICCA OSS was graded into three categories: SICCA.1 (≤ 1 point), SICCA.2 (1–2 points), and SICCA.3 (> 2 points). The distribution of SICCA OSS grades differed significantly between groups (P = 0.009). The SICCA.2 group contained a higher proportion of upper LDO eyes (P < 0.05), while the SICCA.1 group had more lower LDO cases (P < 0.05). The Korb score was also divided into three tiers: Korb1 (≤ 1 point), Korb2 (1–2 points), and Korb3 (> 2 points). Intergroup differences in Korb tier distribution were significant (P = 0.045), with the Korb3 group containing a higher proportion of upper LDO eyes (P < 0.05).ConclusionThe location of obstruction is associated with distinct ocular surface phenotypes. Upper LDO is linked to more severe ocular surface and lid margin damage but relatively preserved tear film stability. Lower LDO is characterized by more profound tear film instability. Therefore, surgical management should be tailored accordingly: procedures for upper LDO should be approached with caution, while prompt intervention is recommended for lower LDO presenting with epiphora.

Tacrolimus exerts anti-inflammatory effects in moderate to severe dry eye through activation of autophagy-lysosomal pathway.

Background and Objectives: Ankylosing spondylitis (AS) is a chronic inflammatory disorder frequently associated with acute anterior uveitis; however, it may also predispose individuals to dry eye disease. We aimed to evaluate dry eye in AS participants employing both conventional tests and conjunctival impression cytology (Nelson grading) to compare their sensitivity in detecting ocular surface changes. Materials and Methods: This prospective case–control study enrolled 24 patients with AS and 27 age- and sex-matched healthy controls. Dry eye was evaluated using the Schirmer I test (measuring tear production), fluorescein tear break-up time (BUT, assessing tear film stability), the Ocular Surface Disease Index (OSDI) questionnaire (evaluating symptoms), and conjunctival impression cytology (analyzing ocular surface changes). Intergroup differences were assessed using non-parametric statistical methods, and their correlations with clinical variables were examined. Results: Nelson conjunctival cytology scores were significantly higher in AS patients than control subjects (1.63 ± 0.92 vs. 0.74 ± 0.86; p = 0.001), indicating greater conjunctival goblet cell loss and squamous metaplasia. In contrast, Schirmer, BUT, and OSDI observations did not differ significantly between AS and control subjects (all p &gt; 0.05). Within AS, the Nelson cytology grade did not correlate accompanied by tear test observations or disease activity indices, and symptom scores did not align accompanied by Schirmer or BUT values. Conclusions: AS patients demonstrated evidence of subclinical dry eye changes detectable by impression cytology even when standard tests were normal. Conjunctival cytology was more sensitive than Schirmer, BUT, or symptom assessment in identifying ocular surface involvement in AS. Integrating such ocular surface evaluation into AS management could allow earlier diagnosis of dry eye and prompt intervention to improve patient quality of life.

Efficacy and Safety of SJP-0132 in Patients with Dry Eye Disease: A Phase 2b Randomized, Double-Masked, Dose-Finding Study.

Objectives: To compare the safety and efficacy of a prototype electronic heating device, Meiboleyes®, with the BRUDER Moist Heat Eye Compress for the treatment of Meibomian Gland Dysfunction (MGD). Methods: Adults with evidence of active MGD (Ocular Surface Disease Index [OSDI] score ≥ 13, fluorescein tear break-up time [TBUT] &lt; 10 s and meibomian gland secretion score ≤ 12 for 15 glands of the lower lid) were enrolled in this prospective, randomised, parallel group, investigator-masked dispensing study (Australian New Zealand Clinical Trials Registry–ACTRN12624000175572). Meibomian gland secretion (MGS) score and number of meibomian glands yielding liquid secretion (MGYLS), lipid layer thickness, TBUT, ocular physiology and subjective symptoms were measured at baseline, and 2 weeks and 6 weeks following treatment. Linear mixed model analysis was conducted to compare the two groups and changes over time. Results: Ten participants (average age 38.7 ± 14.5 years) in the Meiboleyes® test group, and 10 participants (average age 38.9 ± 14.8 years) in the BRUDER control group completed the study. MGS and MGYLS significantly improved in both treatment groups from baseline to the 2-week and 6-week follow-up visits (p ≤ 0.006). Significant improvements in TBUT (5.5 ± 1.8 vs. 8.3 ± 2.1 s, p = 0.044), OSDI scores (45.2 ± 15.1 vs. 27.4 ± 12.9, p = 0.027) and visual analogue scale dryness (55.3 ± 27.2 vs. 28.0 ± 23.9, p = 0.023) were observed in the Meiboleyes® group only after 6 weeks of treatment. No other significant differences were observed over time or between groups. Eight treatment-related adverse events were reported in the Meiboleyes® group compared to seven in the BRUDER group. All resolved without sequalae. Conclusions: The prototype Meiboleyes® device was safe and effective for use as an at-home treatment for MGD when used twice daily for six weeks. Improvements in meibomian gland function were comparable to the BRUDER Moist Heat Eye Compress, but significant improvements in tear film stability and subjective comfort after 6 weeks of treatment were observed in the Meiboleyes® group only.

Changes in gut microbial composition may influence mucosal immune responses and contribute to systemic autoimmune manifestations. In this pilot exploratory study, we investigated and compared the gut microbiome in patients with Stevens–Johnson syndrome (SJS), patients with Sjögren’s disease (SjD), and healthy controls, using next-generation sequencing (NGS), and assessed correlations with dry eye parameters. The study included 10 patients with SJS matched by age and sex to 10 healthy controls, and 10 patients with SjD matched to an additional set of 10 healthy controls. Dry eye parameters were employed to evaluate dry eye disease (DED). Microbiome profiles were determined using next-generation sequencing of the 16S V3-V4 region and analyzed using the Silva database. The gut microbiome exhibited significant differences in the SJS group, including a reduced Chao1 index (p = 0.01) that was progressively correlated with increased ocular severity and a decrease in Faecalibacterium (p = 0.048) compared to the healthy control group. In the SJS group, strong correlations were observed between increased Christensenellaceae with decreased DED DEWS (Dry Eye Workshop score) (p = 0.04), increased Subdoligranulum with decreased NEI (National Eye Institute) score (p = 0.04), and increased Clostridia and longer TBUT (tear break-up time) (p = 0.009). In contrast, the gut microbiome of SjD patients was similar to that of healthy controls. Patients with SJS exhibited distinct alterations in gut microbial composition, characterized by reduced microbial richness and depletion of Faecalibacterium. Furthermore, a significant association was found between specific bacterial taxa and milder dry eye severity, suggesting a possible link between changes in the gut microbiome and inflammation of the ocular surface.

To determine the critical blink frequency threshold for maintaining tear film stability in young participants with dry eye symptoms. In this two-phase study, 45 young participants (aged 19–28 years) with dry eye symptoms (Ocular Surface Disease Index, OSDI ≥ 13) underwent spontaneous blink measurements (Phase 1) and controlled blink experiments (Phase 2: spontaneous, 10 blinks/min, and 20 blinks/min). Tear meniscus height (TMH), non-invasive tear break-up time (BUT), bulbar redness (BR), and Standard Patient Evaluation of Eye Dryness (SANDE) scores were obtained and analyzed. Spontaneous blink frequency (27.75 ± 14.43 blinks/min) positively correlated with TMH (r = 0.48, p < 0.01). Reducing blink frequency to 10 blinks/min significantly worsened TMH (p = 0.0002), BUT (p < 0.0001), BR (p < 0.0001), and SANDE scores (p < 0.0001) compared to spontaneous blinking. No differences were found between spontaneous blinking and controlled 20 blinks/min. A blink frequency threshold of ≥ 20 blinks/min is critical for stabilizing tear film in young participants with dry eye symptoms. Interventions targeting blink frequency may mitigate symptoms exacerbated by digital device use.

PurposeThis study evaluated the effects of orthokeratology (Ortho-K) lenses on corneal endothelial morphology, anterior segment health, myopia progression, and potential complications in children over 12 months, compared with single vision spectacles (SVS).MethodsSeventy healthy myopic children aged 6–12 years, with 45 subjects in the Ortho-K group and 25 in the SVS group. Ortho-K lenses (Menicon Z) were worn overnight, while the SVS group wore single vision spectacles. Unaided VA, Spherical Equivalent (SE), axial length (AL), corneal curvature (FK), intraocular pressure (IOP), corneal endothelial morphology (endothelial cell density ECD, hexagonal cell percentage HEX, coefficient of variation COV), and central corneal thickness (CCT), Tear Break Up Time (TBUT) and corneal staining were assessed at baseline, 6 months, and 12 months.ResultsThe Ortho-K group demonstrated significant improvements in unaided VA and reductions in SE at 12 months (p < 0.05). At 12 months, corneal curvature and axial length decreased significantly in the Ortho-K group but increased in the SVS group (p < 0.05). Corneal endothelial morphology remained stable in both groups over 12 months. Mild corneal staining and occasional infections were more frequent in the Ortho-K group, though not statistically different from the SVS group.ConclusionOrtho-K lenses are effective in controlling myopia progression in children, leading to significant improvements in VA, reductions in corneal curvature, and slowing of AL without significant adverse effects on corneal endothelial health. Minor complications were comparable to SVS wear, and all corneal changes remained within safe, reversible limits, underscoring the safety of Ortho-K treatment.

Lid margin collarettes are a distinct clinical finding and their association with meibomian gland dysfunction (MGD) and dry eye symptoms and signs remains uncertain. We leverage the large cohort of subjects in the Dry Eye Assessment and Management (DREAM) study data to elucidate collarettes' impact on dry eye disease (DED). We performed secondary analysis of DREAM study data, a multicentre, double-blinded clinical trial evaluating omega-3 supplementation in patients with moderate-to-severe DED. DED symptoms (Ocular Surface Disease Index [OSDI] and Ocular Discomfort) and signs (conjunctival staining, corneal staining, tear break-up time (TBUT), Schirmer test, MGD grade) were compared by collarette presence and severity. Data from all visits (baseline, months 3, 6, 12) were assessed and adjusted for demographics and baseline comorbidities. Of 1070 eyes at baseline, 65.3% had no collarettes, 28.0% had 1-5, and 6.6% had 6-20. Over the 1 year period of the study, 67% of eyes had no change in collarette severity, while 19% had increased severity and 14% had decreased severity. Collarettes were more common in Whites (82.1% vs 69.9%, p = 0.001), non-Hispanics (92.3% vs 83.2%, p = 0.006), and those with facial rosacea (25.0% vs 17.7%, p = 0.05). Multivariate analysis showed collarettes were associated with increased corneal staining (5.06 vs 4.59, p = 0.01), decreased TBUT (3.24 vs 3.54 s, p = 0.01), decreased Schirmer test (7.92 vs 8.63, p = 0.04), more severe eyelid erythema (18.6% vs 12.2%, p < 0.001), and higher composite DED sign severity (0.51 vs 0.49, p = 0.03). However, they were not associated with conjunctival staining, MGD grade, or DED symptoms (p ≥ 0.30). Similar findings were observed in comparisons of collarette severity. Subjects with collarettes had lower tear levels of IL-1β (p = 0.04), IL-10 (p = 0.02), and INF-γ (p = 0.001). Collarettes were common in patients with moderate-to-severe DED, and most do not progress over time. Although they were associated with worse ocular surface signs, notably eyelid erythema, no association was found with dry eye symptoms. Our results will help physicians counsel and guide the approach to treating dry eye patients with collarettes, and generate pilot data for tear film biomarker identification.

Background: The widespread use of digital devices has led to an increasing prevalence of Digital Eye Strain (DES), characterized by ocular discomfort, dryness, and visual fatigue collectively known as Digital Eye Strain (DES). Objective: This study aimed to determine the prevalence and predictors of DES among university students and to propose interdisciplinary strategies for digital visual wellness. Methods: A cross-sectional analytical study was conducted among 300 university students using a structured questionnaire and basic ocular assessments. DES symptoms were evaluated using the Computer Vision Syndrome Questionnaire (CVS-Q), alongside Schirmer’s test and Tear Break-Up Time (TBUT) measurements. Statistical analysis was performed using SPSS v26 with Chi-square and logistic regression tests. Results: The prevalence of DES was 68.3%, higher among females (72%) than males (62%). Prolonged screen time (&gt;6 hours/day), inadequate breaks, poor lighting, and reduced blink rate were significant predictors (p &lt; 0.05). Mean TBUT was 7.1 ± 2.8 sec and mean Schirmer’s value 12.4 ± 3.6 mm, indicating mild tear instability. Behavioural factors and screen habits showed strong correlation with DES symptoms. Conclusion: Digital eye strain is highly prevalent among students, highlighting the need for interdisciplinary interventions combining optometric screening, ergonomic education, and behavioural modification.

The rapid rise in smartphone use has raised growing concern about its impact on ocular health. This narrative review explores current evidence on the visual consequences of prolonged smartphone exposure focusing on tear film instability, blink pattern alterations, accommodative stress, and intraocular pressure changes. Digital eye strain, increasingly prevalent across all age groups, presents with symptoms including dryness, visual fatigue, burning, and blurred vision. Reduced blink rate and incomplete blinking during screen use contribute to tear film instability and evaporative dry eye. Studies have documented decreased tear breakup time and increased ocular discomfort following even brief periods of smartphone use. In pediatric populations, prolonged screen exposure correlates with myopic progression. Diagnostic challenges arise due to temporary symptom amplification following recent device use warranting standardized preassessment protocols. Evidence-based interventions include blink training, screen time limitation, ergonomic modifications, and use of preservative-free lubricants. Blue light filters and nutritional supplements offer variable benefit with limited clinical validation. This review highlights the need for increased awareness and well-designed longitudinal studies to inform the diagnosis and management of smartphone-related ocular changes.

ABSTRACT Clinical relevance The relationship between vitamin D status and eyehealth is important, as vitamin D is known to play a role in maintaining theintegrity of the tear film, which is important for overall eye function. Background Vitamin D insufficiency has been associated withvarious ocular conditions, including dry eyes. This study aimed to examine thedifferences in tear meniscus parameters between patients with serum vitamin Dinsufficiency and healthy controls without symptomatic dry eye disease. Methods A total of 68 participants (34 in each group) wereincluded. Tear meniscus parameters were measured with anterior segment spectraldomain optical coherence tomography (SD-OCT) and images were analysed by ImageJsoftware. Tear meniscus parameters of individuals with low serum vitamin Dlevels were comprehensively evaluated and compared to healthy controls. Tearmeniscus height (TMH) was evaluated as the primary outcome measure. Tearmeniscus depth (TMD), turbidity (TMT), percentage of area covered by particlesin the meniscus (PAOP), ocular surface disease index (OSDI), tear break-up time(TBUT) and Schirmer test results were evaluated. Results OSDI, Schirmer, and TBUT parameters were within thenormal range in both groups. However, the OSDI score was significantly higherin the low serum vitamin D group, and Schirmer and TBUT scores weresignificantly better in healthy controls (p < 0.05 for all). Moreover, TMH andTMD values were significantly lower in the low serum vitamin D group (TMH:p = 0.033, Cohen’s d = -0.09; TMD: p = 0.041, Cohen’s d = -0.07). No significantdifferences were observed in PAOP and TMT values”. Conclusion Lower TMH and TMD levels were observed in tear meniscus parameters in patientswith vitamin D insufficiency compared to healthy controls, suggesting thatvitamin D status may play a role in ocular surface health.

Meibomian gland dysfunction (MGD) is a leading cause of evaporative dry eye disease (DED), and its exacerbation after cataract surgery has been reported. This study aims to evaluate meibomian gland (MG) morphological and functional changes following cataract surgery and identify influencing factors. This prospective, observational study included 132 patients who underwent phacoemulsification with intraocular lens implantation. Meibomian gland loss (MGL) and non-invasive tear break-up time (NI-BUT) were assessed preoperatively at postoperative week one, and at month one using a corneal topography device via infrared meibography (Sirius, CSO, Italy). Correlations between MGL, NI-BUT, cataract grade, and surgery duration were analyzed. Postoperatively, MGL increased at week one (32.0% ± 15.1) and month one (30.9% ± 14.5) compared to preoperative values (15.1% ± 7.0). NI-BUT decreased at both time points (week one: 6.8s ± 4.3; month one: 6.7s ± 4.6; preoperative: 9.4s ± 4.5). A significant correlation was found between increased MGL and longer surgery duration (p < 0.001). ROC analysis identified a surgical duration threshold of 11.5min, beyond which MGL changes were more pronounced. Cataract surgery induces significant MG changes, with increased MGL and reduced NI-BUT postoperatively. Longer surgical duration is a key risk factor for MG deterioration. These findings highlight the importance of ocular surface management in cataract surgery to improve postoperative outcomes.

To evaluate corneal epithelial thickness (CET) and tear break-up time (TBUT) in glaucoma patients receiving prostaglandin monotherapy and concurrent dry eye treatment, grouped according to the benzalkonium chloride (BAK) concentration levels of their eye drops, and to compare pre- and post-treatment measurements. Eighty-two glaucoma patients with dry eye development while receiving prostaglandin monotherapy were included in this study. Patients were divided into three groups based on BAK exposure: Group 1 used two BAK-containing drops, Group 2 used one BAK-containing and one BAK-free drop, and Group 3 used only BAK-free drops. CET was measured by anterior segment optical coherence tomography (AS-OCT) within a 6-mm corneal diameter divided into 17 sectors. Comprehensive ophthalmic examinations and TBUT measurements were performed at each visit. No significant differences were found among the groups in terms of age, sex, follow-up time, or intraocular pressure (p > 0.05). In Group 1, significant epithelial thinning was observed in the central 2mm, paracentral 2-5mm superior and nasal sectors, and mid-peripheral 5-6mm nasal and inferior sectors (p < 0.05). In Groups 2 and 3, minimal changes were not significant (p > 0.05). TBUT differed significantly between groups at both visits (p < 0.001) and showed a weak positive correlation with CET changes (r = 0.291, p < 0.05). Significant corneal epithelial thinning was found only in patients using two BAK-containing drops. Despite receiving dry eye treatment, TBUT remained below normal in this group, possibly due to BAK's toxic effects on the tear film and epithelial cells. Monitoring CET by AS-OCT may help detect early signs of dry eye in clinical practice.

To compare the effects of 5% povidone-iodine (PI) and 0.1% chlorhexidine gluconate (CHG) on ocular surface parameters and patient comfort following phacoemulsification cataract surgery. The study aimed to determine whether CHG offers advantages over PI in terms of ocular surface recovery and postoperative comfort. This prospective, randomized controlled trial included 61 patients undergoing phacoemulsification for senile cataract. Participants were randomly assigned to conjunctival irrigation with either 5% PI or 0.1% CHG for 3min before surgery. Ocular surface assessments included Schirmer test, tear break-up time (TBUT), tear meniscus height (TMH), and the Ocular Surface Disease Index (OSDI). Evaluations were performed preoperatively and postoperatively at Week 1, Month 1, and Month 3. Pain scores were recorded using a numerical rating scale within the first 24h. Baseline parameters were comparable between groups. At Week 1, OSDI scores were significantly higher in the PI group than in the CHG group (p = 0.029). Both groups showed significant early postoperative deterioration of ocular surface parameters, but recovery was faster in the CHG group. TBUT remained significantly reduced in the PI group at Month 3, whereas CHG eyes normalized. Schirmer values returned to baseline by Month 1 in both groups. Postoperative pain scores were significantly higher in the PI group (p < 0.001). Both PI and CHG caused transient ocular surface changes after cataract surgery. However, CHG demonstrated faster recovery of tear film parameters and improved early postoperative comfort, suggesting it may be a preferable antiseptic in patients with ocular surface sensitivity.

To compare visual, refractive, tear function, and ocular surface outcomes of accelerated corneal cross-linking (CXL) performed with transepithelial phototherapeutic keratectomy (t-PTK) versus mechanical epithelial debridement in fellow eyes of patients with keratoconus. This retrospective, comparative, fellow-eye study included 52 eyes of 26 keratoconus patients, each with a thinnest corneal thickness greater than 450µm before the procedure, who underwent accelerated CXL with two different epithelial removal techniques. One eye received t-PTK-assisted epithelial removal and the fellow eye mechanical debridement. Corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UCVA), refractive and topographic parameters, higher-order aberrations (HOAs), tear function tests, pain scores, epithelial healing time, and demarcation line depth were assessed up to 12months postoperatively. Epithelial healing time and pain scores were comparable between groups (p > 0.05). Demarcation line depth and endothelial cell counts showed no significant difference. At postoperative month 12, the t-PTK group demonstrated significantly improved CDVA and UCVA, reduced spherical equivalent, keratometric values, corneal astigmatism, and total HOAs, whereas no significant improvements were observed in the mechanical group. Tear break-up time significantly decreased in both groups, while Schirmer test results and corneal staining remained unchanged. No significant haze was detected in either group. While epithelial healing, ocular surface parameters, and safety outcomes were similar between techniques, t-PTK-assisted epithelial removal provided superior long-term visual, refractive, and topographic improvements compared with mechanical debridement. Accelerated CXL following t-PTK may offer enhanced therapeutic benefit for selected keratoconus patients.

PurposeVisual symptoms in older people may derive from presbyopia and dry eye (DE) with sex-specific pathology. Previous studies have suggested women may have a greater risk for presbyopia than men of the same age. However, the association between DE, which is more frequent in women, and presbyopia has not been determined. This study explored whether the relationship between DE and the severity of presbyopia differs by sex.MethodsThis cross-sectional retrospective cohort study included 1147 bilateral phakic patients, aged from 40 to 55 years (858 women and 289 men). Refraction, near add power at 30 cm, and DE-related clinical parameters (corneal staining score and tear break-up time [BUT]) were compared between the sexes. Correlation analyses and odds ratio comparisons of risk factors for reaching specific near add power (1.00, 1.25, 1.50, and 1.75 D) were performed.ResultsCorneal staining and tear break-up time (BUT) were worse in women. Correlation analysis stratified by sex revealed that near add power correlated with age (women: β = 0.80, P < 0.01; men: β = 0.80, P < 0.01), and astigmatic errors (women: β = 0.16, P < 0.01; men: β = 0.19, P < 0.01) in both sexes, BUT only in women (β = −0.10, P < 0.01), and corneal staining only in men (β = 0.20, P < 0.01). Women with short BUT and men with corneal staining were more likely to reach higher near add power.ConclusionThe current study suggests that men with corneal staining and women with short BUT may need more near add power. These DE-related clinical features are significant factors for presbyopia and should be managed to ameliorate presbyopia-related symptoms.

Background: Dry eye, a common complication after refractive surgery, can be treated with artificial tears, but these provide temporary relief and may have limitations. Chamomile tea, known for its anti-inflammatory and soothing properties, could serve as a natural alternative therapy. Objective: To compare the effects of chamomile tea and commercial artificial tears in post-refractive surgery in dry eye. Methods: This prospective, comparative interventional study involved 30 individuals who developed dry eye symptoms after undergoing refractive surgery. The study involved participants divided into two groups: one using chamomile tea as a natural remedy and the other using conventional treatment. Participants aged 18-35, with uncomplicated refractive surgery within the last six months, and showing signs of dry eye were included. The study used the Schirmer test and Tear Break-Up Time (TBUT) tests to assess treatment adherence. An ANOVA test was used to compare mean scores within and between groups, with a significance level set at p &lt; 0.05. Results: Participants in a study showed progressive improvement in TBUT and Schirmer scores from baseline to week 4. The Chamomile group showed higher mean TBUT (10.65 vs. 10.16) and Schirmer scores (10.62 vs. 10.06) compared to the Artificial Tears group, suggesting a potentially greater improvement in ocular surface health. The average Schirmer score was 7.43 mm (SD = 1.47), and the average TBUT was 7.56 seconds (SD = 1.51). However, no statistically significant differences were found between the two groups, indicating comparable efficacy. Conclusion: Artificial Tears and Chamomile showed progressive improvement in TBUT and Schirmer scores over four weeks, with Chamomile showing slightly higher mean scores, indicating comparable efficacy but showing no statistically significant differences.

To investigate ocular surface dysfunction in patients with benign essential blepharospasm (BEB) by evaluating lid wiper epitheliopathy (LWE) and ocular surface parameters and to compare these findings with those of normal and dry eye controls. Additionally, we aimed to assess the impact of botulinum toxin (BTX-A) injection on ocular surface parameters and LWE. This study included BEB patients and age- and sex-matched healthy and dry-eye controls. LWE grading and ocular surface parameters were assessed, including OSDI score, Schirmer's I test, tear break-up time (TBUT), corneal staining, eyelid margin abnormalities, and meibomian gland function. Patients with BEB received BTX-A injections, and measurements were repeated 1, 3, and 6months post-treatment. Compared to control groups, the BEB group exhibited significantly increased OSDI scores, corneal surface staining, eyelid margin abnormalities, meibomian expression, meibography scores, meibomian gland loss, and LWE grades of the upper and lower eyelid (p < 0.05) while TBUT and Schirmer's I test values were significantly decreased (p < 0.05). Significant positive correlations were observed between the severity and frequency of BEB and ocular surface dysfunction, including LWE (p < 0.05). LWE severity was significantly correlated with age, female gender, and ocular surface parameters (p < 0.05). BTX-A injection significantly improved ocular surface parameters for 6months, but LWE reduction was insignificant at 6months (p < 0.05). LWE was identified as a significant contributor to conjunctivocorneal damage in BEB. Furthermore, BTX-A injection effectively treats ocular surface dysfunction, including LWE.