Tear Film Break-up Time Values Research Articles

The Influence of Tear Film Quality on Visual Function.

The prevalence of dry eye disease (DED) is increasing globally, resulting in a variety of eye symptoms characterized by discomfort and visual disturbances. The accurate diagnosis of the disease is often challenging and complex, requiring specialized diagnostic tools. This study aimed to investigate the impact of tear film instability on visual function and to evaluate the value of post-blink blur time (PBBT) as an alternative method for assessing tear film stability. The study included 62 subjects: 31 with subjective symptoms of DED (Group A) and a control group consisting of 31 healthy participants (Group B). Symptoms were assessed using the standard Schein questionnaire, supplemented with additional questions. PBBT was measured using standard Snellen charts to investigate a potential association between PBBT and tear film dysfunction. Additional clinical assessments included tear film break-up time (TBUT). Statistically significant differences were observed in the average values of PBBT and TBUT between the examined groups. The average PBBT was 8.95 ± 5.38 s in the group with DED and 14.66 ± 10.50 s in the control group, p < 0.001. Group A exhibited an average TBUT of 4.77 ± 2.37 s, while Group B had a TBUT of 7.63 ± 3.25 s, p < 0.001. Additionally, a strong positive correlation was identified between PBBT and TBUT values (r = 0.455; p < 0.001). The research confirms that tear film stability has an important role in the refraction of light and the maintenance of optical quality of vision. PBBT could potentially function as an objective and clinically significant screening test for DED.

Interest and safety of a preservative-free carbomer 0.2Percentage eye gel on canine dry eye A case series

Dry eye is a common ophthalmic disorder in dogs that can lead to serious ocular complications. The objective of this case series was to evaluate a new preservative-free carbomer 0.2% eye gel in five dogs with dry eyes. Ophthalmic examination was performed on D0, D15, and D30, rating conjunctivitis, keratitis, ocular discharge and irritation from 0 to 3. Global ocular clinical (GOC) score was obtained by the sum of the individual scores. Tear film quantity and quality were measured using STT1 and tear film break-up time (TBUT). The dogs’ quality of life (QoL) was assessed by the owners. GOC, conjunctivitis, and ocular discharge scores decreased significantly on D15 and D30 compared to D0 (p = 0.0062, 0.0152, and 0.0152, respectively). QoL significantly improved at each time point compared to baseline (p = 0.0008). However, the decrease of keratitis and ocular irritation scores and the increase of STT1 and TBUT values were not significant. The use of the preservative-free carbomer 0.2% eye gel could be an interesting option for dry eye management in dogs by significantly improving clinical signs and tear production while avoiding potential sides effects of preservatives.

Dry Eye and Some Related Factors in Patients with Type 2 Diabetic Nephropathy: A Cross-Sectional Study in Vietnam.

To determine the prevalence of dry eye (DE) and some related factors in patients with type 2 diabetic nephropathy (T2DN). We performed a cross-sectional study on 338 people, who were divided into 2 groups: 169 T2DN patients and 169 patients diagnosed with type 2 diabetic mellitus (T2DM) without renal complications as a control group. The Ocular Surface Disease Index (OSDI) and test fluorescein tear-film break-up time (TBUT) were done in all 338 subjects. Patients with OSDI scores < 13 and TBUT values equal to or under 10 seconds were diagnosed with dry eye. The prevalence of DE in T2DN patients was significantly higher than T2DM group (55.6% versus 37.3%). The T2DN groups with dry eye had a median duration of DM, the proportion of hypertension, peripheral nerve complications, anemia, proportion of using insulin, and concentration of plasma glucose, HbA1C, urea, creatinine, CRP-hs significantly higher than those of T2DN without dry eye. Advanced age, high HbA1C level, and decreased eGFR were independent factors associated with dry eye in T2DN patients. Dry eye was a common condition associated with advanced age, high HbA1C levels, and decreased GFR in T2DN patients.

Study of tear film status in patients undergoing phacoemulsification surgery

The present study was undertaken to study the tear film status preoperatively and post-operatively in patients undergoing phacoemulsification surgery. The study was conducted as prospective study on 100 patients undergoing phacoemulsification surgery during the study period of 1 year. Work up for tear film status including Schirmer’s test, staining of cornea and conjunctiva with fluorescein dye, TBUT (tear film break up time) was done preoperatively and postoperatively after phacoemulsification. Mean Schirmer’s value at preoperative assessment was 27.45±4.95 whereas that at post operative day 7, 15 and 30 was 9.09±2.19, 16.73±5.12 and 24.45±4.05 respectively. Similarly, mean TBUT at preoperative level was 11.11±1.16 which reduced to 6.63±1.57 at day 7, 7.37±1.44 at day 15 and 9.77±0.91 at day 30. Test of significance (ANOVA) showed statistically significant difference in mean Schirmer’s and TBUT values at various follow ups post-operatively as compared to baseline (p&amp;#60;0.01). Cataract surgery can lead to dry eye due to incision itself as well as due to intra-operative exposure to the microscope light. Thus, artificial tears must be prescribed to improve the quality of life during immediate post-operative period. However, gradually, tear film status improved. We only followed up patients till one month, a long term follow up is recommended to assess the time taken for the tear film to recover to its preoperative status.

Evaluation of Dry Eye Disease Characteristics of Children With Type 1 and Type 2 Diabetes Mellitus and MODY.

To assess dry eye disease characteristics of pediatric patients with diabetes. Twenty-one patients with type-1 diabetes mellitus (DM), 20 with type-2 DM, 19 with maturity-onset diabetes of the young (MODY), and 20 control participants were included in the study. Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time (TBUT) analysis, Schirmer test with anesthesia, and conjunctival impression cytologic analysis were performed. In Group 1, the Schirmer test and TBUT values were lower than the control group. In groups 1 to 3, OSDI scores were higher than the control group. In Groups 1 and 2, the goblet cell density was lower than the control group. Dry eye parameters of all three diabetic groups were adversely affected in favor of dry eye disease. Children with MODY have increased OSDI scores. Alterations in the conjunctival impression cytology were observed more prominently in patients with type-1 DM.

The Effect of Oral Isotretinoin Therapy on Meibomian Gland Characteristics in Patients with Acne Vulgaris.

The aim of the study was to determine the effect of oral isotretinoin therapy on the functional and morphological condition of the anterior segment of the eye, with particular emphasis on the meibomian glands. Twenty-four patients (48 eyes) with a diagnosis of acne vulgaris were involved in the survey. All patients underwent a thorough ophthalmological examination at three time points: before therapy, 3months after the start of therapy, and 1month after the completion of isotretinoin therapy. The physical examination included the following elements: blink rate, analysis of the lid margin abnormality score (LAS), tear film break-up time (TFBUT) and Schirmer's test, meibomian gland loss (MGL), and the evaluation of the meibum quality score (MQS) and meibum expressibility score (MES). Additionally, the total score of an ocular surface disease index (OSDI) questionnaire was analysed. In comparison with pretreatment values, significant increases in OSDI during and after the treatment (p = 0.003 and p = 0.004, respectively) were observed. Substantial deterioration during the treatment was observed for MGL (p < 0.0001), MQS (p < 0.001) and LAS (p < 0.0001), while an improvement in those parameters after isotretinoin cessation was observed (p = 0.006, p = 0.02 and p = 0.0003, respectively). The frequency of using artificial eye drops was positively associated with MGL during (Spearman's rank correlation coefficient (Rs) =  + 0.31; p = 0.03) and after the cessation of the therapy (Rs =  + 0.28; p = 0.04). Meibomian gland atrophy correlated significantly with MQS during (Rs =  + 0.29; p = 0.04) and after treatment (Rs =  + 0.38; p = 0.008). The decrease in TFBUT values correlated with increased LAS (Rs = -0.31; p = 0.03) during the course of isotretinoin usage. We found no changes in Schirmer's test or blink rates. Isotretinoin therapy leads to increased ocular complaints related to lipid tear film component dysfunction. This is due to reversible changes in meibomian gland morphology and function observed during drug usage.

Tear film dysfunction after clear corneal phacoemulsification in diabetics and non-diabetics.

A prospective cohort study was conducted in a tertiary eye care centre to study the incidence of tear film dysfunction and its recovery in diabetics and non-diabetics after clear corneal phacoemulsification. A total of 50 diabetics and 50 non-diabetics underwent clear corneal phacoemuslfication. Schirmer's I test (SIT), tear film break-up time (TBUT), corneal staining, tear meniscus height (TMH), and ocular surface disease index (OSDI) assessment were done preoperatively, postoperatively at 7 days, 1 month, and 3 months in both groups to assess tear film function. Both groups showed decreased SIT and TBUT values on postoperative Day 7, after which they gradually improved. SIT and TBUT values in diabetics were significantly lower than that in non-diabetics postoperatively (P < 0.001). SIT in non-diabetics reached baseline levels at postoperative 3 months. OSDI scores reached peak levels in both groups on postoperative Day 7, but were higher in diabetics than non-diabetics (P < 0.001). OSDI scores gradually improved over 3 months but remained over baseline levels in both groups. Corneal staining was positive in 22% diabetics and 8% non-diabetics at postoperative Day 7. However, none of the patients had corneal staining at 3 months. Tear meniscus height (TMH) did not reveal any significant difference between the two groups at any time interval. We concluded that tear film dysfunction after clear corneal incision occurs in both groups, but is more severe and recovers more slowly in diabetics than non-diabetics.

Dry eye disease in diabetics versus non-diabetics: Associating dry eye severity with diabetic retinopathy and corneal nerve sensitivity.

To compare the prevalence of dry eye disease (DED) and assess corneal nerve sensitivity (CNS) in diabetic and non-diabetic patients. To study the association of severity of DED in patients with diabetic retinopathy (DR) and CNS in DED. A cross-sectional prospective comparative study was conducted on 400 patients attending the ophthalmology OPD. The patients above 18 years of age were divided into two groups-diabetic (T2DM) and non-diabetic. All patients were subjectively assessed for DED based on Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire and objectively, using Schirmer's II test and Tear Film Break-Up Time (TBUT). Visual acuity assessment, anterior segment, and posterior segment evaluation were done. Considering the SPEED score, Schirmer II values, TBUT values, and Dry Eye Work Shop (DEWS) II diagnostic criteria, mild DED was seen in 23% diabetic and 22.25% non-diabetic groups, moderate DED in 45.75% diabetic and 9.75% non-diabetic groups, and severe DED in 2% diabetic and 1.75% non-diabetic groups. Moderate DED was more common within all grades of DR. CNS was reduced more in diabetic group and also in patients with higher degree of DED. Prevalence of DED is more in the patients with T2DM. CNS was reduced more in patients with T2DM and in patients with moderate DED. Our study also correlated that severity of DR affects the severity of DED.

Diagnosis of dry eye patients with ocular irritation

Dry eye is often an under diagnosed condition of the eye that can cause discomfort, burning sensation and blurred vision. These symptoms are related to the alterations in the layers of tear film, insufficient production or excessive evaporation of tear film. The primary aim of this study is to diagnose and to find out the incidence of dry eye in patients presenting with symptoms of ocular irritation. A total number of 225 patients of both sexes aged between 20 and 80 years with complaints of ocular irritation were included in this study. Detailed history taking, slit lamp examination of the anterior segment, tear film breakup time (TBUT), Schirmer’s test, Fluorescein stain score and Rose Bengal stain score was done for all patients. Data was presented only for the worst eye of each patient. Dry eye was found in 46.67% of patients. Among symptomatic patients, 24% had TBUT value &amp;#60; 10 sec. Fluorescein score was ≥ 1 in 6.6% of symptomatic patients. RB score ≥3 was found in 28.4%. Both Schirmer test and TBUT were positive in 22.7% of the symptomatic patients. Only 4.9% of symptomatic patients were positive for all 3 tests including staining. This study firmly concludes that the Schirmer’s test, TBUT and staining should be done routinely for patients with ocular irritation for the early diagnosis of dry eye.

Effect of 0.15% sodium hyaluronate on tear film breakup time in healthy anesthetized cats.

This study aimed to evaluate the effect of 0.15% sodium hyaluronate (SH) on tear film breakup time (TFBT) in healthy anesthetized cats. Forty cats undergoing elective surgery were enrolled. TFBT was assessed before anesthesia to obtain baseline values. As a preanesthetic medication, cats received midazolam, tramadol, and cetamine combined in the same syringe. For anesthetic induction and maintenance, propofol and isoflurane were used. After a 15 min stabilization period to achieve the surgical anesthetic plane, one eye was treated with one drop of SH, while the other eye received saline and served as a control. TFBT was measured at the end of the general anesthesia (T40) and 35 (T75) and 80 min (T120) after the termination of the anesthesia. TFBT values were compared between the control and SH-treated eyes; both values were also compared with the baseline values (p < .05). In the control eyes, TFBT significantly decreased from baseline at all time points (p < .001), while in SH-treated eyes, TFBT significantly increased from baseline only at T40 (p < .0001). In SH-treated eyes, TFBT was significantly higher than that in the control eyes at all time points (p < .001). In healthy cats, TFBT decreases significantly after 40 min of general anesthesia, and one drop of 0.15% sodium hyaluronate was able to maintain the stability of the tear film for up to 75 min in treated eyes. However, the isolated effect of each drug used in our anesthetic protocol on TFBT should be executed in further studies.

Tear film breakup time and Schirmer tear test in normal dogs: Effects of age, sex, reproductive status, skull type, and nasolacrimal duct patency.

The present study aimed to determine the effects of age, sex, reproductive status, skull type, and nasolacrimal duct (NLD) patency on tear production and tear film breakup time (TBUT) in normal dogs. The ophthalmic data of 82 healthy adult dogs were evaluated in this study. Age, sex, breed, and reproductive status were recorded. Schirmer tear test (STT) and TBUT were assessed in all dogs, and interferometry was available for the selected dogs. The Jones test was used to evaluate NLD patency. The cephalic index (CI) was calculated for each dog (skull width/skull length ×100). Mean (SD) values for the STT results for the right (OD) and left (OS) eyes were 20.6 (2.7) and 20.2 (2.7) mm/min, respectively. Mean (SD) TBUT values for OD and OS were 6.5 (2.5) and 6.1 (2.3) mm/min in all dogs, respectively. Sex and reproductive status had no significant effect on STT and TBUT (P[OU]  > 0.05). Skull type significantly affected TBUT in both eyes (P(OD) =0.01, P(OS) =0.003), but had no effect on STT (P[OU]  > 0.3). Age had no correlation with STT and TBUT in either eye (P[OU]  > 0.05). STT and TBUT had no correlation in either eye (P[OU]  > 0.2). NLD patency had no significant effect on STT or TBUT (P[OU]  > 0.1). The results of this study showed lower TBUT values in brachycephalic breeds than in non-brachycephalic breeds. A compensatory increase in STT values was observed in dogs with low TBUT values.

OCULAR SURFACE AND TEAR FILM CHANGES AFTER MANUAL SMALL INCISION CATARACT SURGERY

BACKGROUND: Manual small incision cataract surgery (MSICS) continues to be the mainstay of cataract surgeries in developing countries like India. Dry eye related symptoms like constant foreign body sensation, ocular surface discomfort, redness, watering are frequent phenomenon after cataract surgery. SICS may worsen lid margin anatomy, cause corneal denervation, cause reduction in number of Goblet cells and perpetuate tear lm instabilities of a patient's eye after surgery. To analyzeOBJECTIVE: changes in tear lm indices after SICS This is a prospective observational study of 12 months duration from April 2020 toSTUDY DESIGN: March 2021 done on 110 different patients undergoing cataract surgery 45-70 years age group by MSICS method . 110 (48 male,METHODS: 62 female) patients who underwent MSICS during the aforementioned period were selected for the study. Tear Meniscus Height (TMH), Schirmer's Test 1(ST1), Tear Film Break Up Time (TBUT) evaluation was done 1 day preoperatively, 1 week, 1 month and 3 month post operatively and the values were noted. Collected data was analyzed by paired t test using MS EXCEL and SPSS V23. The mean ageRESULTS: of the 110 patients was 60.21years. The mean preoperative values of the tear lm indices ST1, TBUT, TMH were found to be respectively 19.15 ± 8.59 mm, 16.70 ± 5.27 seconds, 0.39 ± .13 mm. 1 month and 3 month post operatively mean ST1 values were found to be 14.89 ± 6.15 and 14.40 ± 5.48 mm; mean TBUT values were 13.37 ± 4.76 and 12.93 ± 4.74 seconds; mean TMH was found to be 0.30 ± 0.10 and 0.29 ± 0.09. The progressive deterioration of tear lm indices over our study period was found to be statistically signicant. SICS causesCONCLUSION: signicant deterioration of tear lm indices and perpetuates ocular surface discomfort and dry eye disease post operatively. Operating surgeons must pay attention to dry eye signs, symptoms post operatively even in a well operated healthy eye to ensure optimal post-operative comfort to the patient.

Effects of Upper Eyelid Surgery on the Ocular Surface and Corneal Topography

Objectives:To evaluate the effect of upper eyelid surgery on ocular surface and corneal topography.Materials and Methods:Patients who underwent upper eyelid blepharoplasty and/or blepharoptosis repair were evaluated prospectively. Tear film break-up time (TBUT), Schirmer tests, corneal staining pattern, Ocular Surface Disease Index questionnaire, corneal topography, and autorefractor parameters were measured preoperatively and at 1 day, 1 week, 1 month, 3 months, and 6 months postoperatively.Results:Thirty-two eyes of 20 patients (9 male, 11 female) were included in the study. The mean age was 44.8±18.9 years (range: 8-74). Patients were divided into the following 3 groups according to the type of surgery performed: upper eyelid blepharoplasty (group 1), upper eyelid blepharoplasty and levator advancement ptosis surgery (group 2), and levator advancement ptosis surgery (group 3). There was a significant decrease in Schirmer test results at 6 months in groups 1 and 2 but no change in group 3. TBUT values were decreased at 1 week in group 3 (p=0.028) and returned to baseline at 1 month. Corneal punctate staining was detected at 1 day and 1 week in all groups. On corneal topography, group 3 showed a significant change in K2 values (0.3 diopters) at 1 month (p=0.006). There was no statistically significant change in autorefractor measurements postoperatively compared to preoperative values (p>0.05).Conclusion:Depending on the type of surgical procedure performed, blepharoptosis repair and upper eyelid blepharoplasty can lead to dry eye of varying severity that may persist at postoperative 6 months.

Instability of tear film and loss of meibomian glands in patients with acne vulgaris.

In this prospective study, we compared ocular clinical variables in patients with acne vulgaris with those of healthy controls. These variables included tear film break-up time, meibomian gland dropout rate, and anterior chamber parameters. Our sample comprised 73 eyes from 73 patients with acne vulgaris and 67 eyes from 67 healthy controls. All participants underwent a non-invasive first tear film break-up time test and the average tear film break-up time was evaluated. Meibography was used to identify any meibomian gland dropout. The parameters of the cornea and anterior chamber were measured using Scheimpflug topography imaging. Finally, the ocular surface disease index questionnaire was administered to score each participant on their subjective experience of ocular complaints. The noninvasive first tear film break-up time values of the acne vulgaris Group and the control Group were 4.7 ± 2.8 and 6.4 ± 3.5 sec, respectively. There was a significant difference between the groups (p=0.016). The number of eyes with tear break-up at any time during the measurement period was also significantly higher in the acne Group (p=0.018). In the acne vulgaris Group, the mean meibomian gland dropout rates were 33.21 ± 15.5% in the upper lids and 45.4 ± 14.5% in the lower lids. In the control group, these rates were 15.7 ± 6.9% and 21 ± 9.7% respectively. Dropout was significantly higher in the acne group for both the upper and lower lids (p=0.000). We found impaired tear stability in patients with acne vulgaris and a high rate of meibomian gland dropout. These glands play a key role in tear stability and their dropout is likely to result in evaporative dry eye. Measurement of the variables in this study allows objective diagnosis of this condition using a non-invasive, dye-free methodology, with minimum contact.

Dry eye and Meibomian gland dysfunction evaluation in sarcoidosis patients.

To analyze the relation between Meibomian gland dysfunction, dry eye, and sarcoidosis. Twenty eyes of 10 sarcoidosis patients (Group 1) and 20 left eyes of 20 age-sex matched healthy volunteers (Group 2) were included. Presence of dry eye was evaluated with Schirmer 1 test, tear film break-up time (T-BUT), Oxford scale scoring, Ocular Surface Disease Index (OSDI) score assessments. A slit-lamp biomicroscope infrared filter (Topcon, SL-D701, IJssel, The Netherlands) was used to evaluate Meibomian glands. The drop-out ratio according to meibography was scored for each eyelid from grade 0 (no loss) through grade 3 (lost area >2/3 of the total Meibomian gland area). Among dry eye tests mean Schirmer 1 and T-BUT values were lower and OSDI score was higher in Group 1 compared to Group 2 and the differences were statistically significant (p = 0.017, p = 0.039, p = 0.003, respectively). In addition, the upper, lower and total meiboscores were statistically significantly higher in Group 1 (p = 0.047, p = 0.003, p = 0.005, respectively). A significantly higher presence of dry eye and Meibomian gland drop out ratios was detected in sarcoidosis patients. It is important to monitor sarcoidosis patients for dry eye and Meibomian gland dysfunction and when detected, to treat adequately to prevent ocular surface damage.

Intense Pulsed Light Treatment for Itch Associated with Allergic Keratoconjunctivitis: A Retrospective Study of 35 Cases.

Objective: To conduct a preliminary assessment of intense pulsed light (IPL) treatment for allergic keratoconjunctivitis (AKC)-associated ocular itch. Background: Current control measures for AKC rely primarily on drugs. IPL is effective for dry eye disease (DED). Furthermore, phototherapy is effective for managing skin inflammation and pruritus, suggesting that eye itching could decrease in some patients having AKC complicated with DED following IPL treatment to control dry eye symptoms. Methods: Thirty-five patients having DED complicated with mid-to-severe AKC were administered three IPL treatments to the periorbital skin. The eye scores of subjective symptoms and signs of AKC and tear film breakup time (TBUT) were retrospectively assessed before and after each treatment. Results: The scores for AKC-related symptoms and signs were determined four times: on Day 1 (time 0), Day 15 (time 1), Day 45 (time 2), and Day 75 (time 3) before each treatment. The average symptom score significantly decreased with treatments (time 0: 30.97, time 1: 15.03, time 3: 10). The average sign score for both eyes decreased after the first IPL treatment (left eye: 7.97 vs. 11.38; right eye: 8.1 vs. 11.1). There were no further improvements in the signs after the last treatment. The TBUT value in the right eye increased from times 0 to 3 (2.31 vs. 4.66 vs. 7.71 vs. 7.74). The TBUT value in the left eye increased from times 0 to 3 (2.50 vs. 6.97 vs. 7.57 vs. 8.24). Conclusions: Symptoms and signs improved after IPL treatment in patients with AKC. Eye itching was gradually controlled and rarely recurred. IPL may be effective for AKC treatment.

Ocular surface disorder among adult patients with type II diabetes mellitus and its correlation with tear film markers: A pilot study.

PURPOSE:The purpose is to study the ocular surface changes among patients with diabetes mellitus (DM) and to correlate them with tear film markers such as insulin-like growth factor (IGF)-1, interleukin (IL)-1β, and tumor necrosis factor (TNF)-α levels.MATERIALS AND METHODS:The study was carried out on diabetic patients (>5 years' duration) and healthy age- and gender-matched controls with 21 individuals in each group. Schirmer's test for basal and reflex tear secretion, tear film breakup time (TBUT) for tear stability, ocular staining score (OSS) for dryness severity, ocular surface disease index (OSDI) for symptomatic assessment of dryness and conjunctival impression cytology (IC) for epithelial cell integrity, keratinization, squamous metaplasia, and goblet cell density was studied. Thirty microliters of tears were collected to test IGF-1, IL-1β, and TNF-α levels.RESULTS:Patients with DM showed significantly low Schirmer's, TBUT, and OSS values than controls. OSDI score showed moderate-severe dryness in patients with DM and only mild symptoms among controls. An abnormal IC score was seen among cases and controls. The level of TNF-α was significantly increased in patients with DM and positively correlated with Schirmer and TBUT values (P < 0.05).CONCLUSION:Dry eye is more prevalent in patients with DM compared to controls as evidenced by poor OSDI score, Schirmer, TBUT, and OSS. TNF-α in the tears of patients with DM is a useful marker that showed a good correlation with Schirmer, TBUT, and dry eye symptoms. IC could not conclusively differentiate the dry eye status in patients with DM from controls.

Topical Cyclosporine in Treatment of Post-LASIK Symptomatic Dry Eye

Purpose:  To determine the role of 0.05% topical cyclosporine A (CsA) in treatment of symptomatic dry eye after LASIK (Laser-Assisted in Situ Keratomileusis).&#x0D; Study Design:  Interventional Case Series.&#x0D; Place and Duration of Study:  Ophthalmology Department, Sir Syed Hospital, Karachi, from July 2018 to Dec. 2019.&#x0D; Methods:  Seventy-five patients who underwent LASIK for myopic refractive error and presented with symptomatic dry eye and showed no response to artificial tears therapy after 1 month of LASIK were selected. The patient had ablation zone diameter of 6mm and flap diameter was 8.5mm to 9mm. Cyclisporine A 0.05% ophthalmic preparation was added to treatment regimen and response was observed at 1, 3 and 6 months. OSDI (Ocular Surface Disease Index) scores, Tear film break up time (TBUT), Schirmer's test (ST) values and Best Corrected Visual Acuity (BCVA) were recorded to analyze the treatment response at each visit. The statistical interpretation was done by using SPSS version 21. To interpret the correlation between pre-treatment and 6 month post treatment, Paired sample T test was applied with 95% Confidence Interval; CI and p-value of ≤ 0.05.&#x0D; Results:  The mean post-LASIK OSDI score of enrolled patients was 54.25 ± 10.81. After 6 months of treatment mean OSDI score was improved to 21.05 ± 5.13 (p &lt; 0.001). Post-LASIK mean ST value was 5.2 ± 1.2 mm and mean TBUT value was 5.6 ± 1.3 seconds, which changed to 9.8 ± 1.0 mm and 8.9 ± 1.1 seconds respectively. BCVA improved from Log MAR 0.14 ± 0.09 to 0.01 ± 0.03 (p &lt; 0.001).&#x0D; Conclusion:  Topical CsA 0.05% was effective in alleviating the symptoms of post-LASIK dry eye.&#x0D; Key Words:  LASIK, Dry eye, Ocular Surface Disease Index Score, Cyclosporine A.

Efficacy of Cathionic Emulsion and Carboxymethyl-Cellulose 0,5% for Dry Eye Treatment in Post Menopausal Women

&#x0D; &#x0D; &#x0D; Purpose : To evaluate the efficacy and safety of cationic emulsion and Carboxymethyl-Cellulose (CMC) 0,5% eye drops in post-menopausal women with dry eyeMethods : A randomized, double-masked clinical trial was conducted in polyclinic Ophthalmology Department during March-April 2009. Forty-six post menopausal women with dry eye were included in the study. The subjects were randomized into two groups. Group 1 received cationic emulsion and group 2 received CMC 0,5%. Tear Film Break-Up Time (TFBUT), Inter-Blink Interval (IBI) and Ocular Protection Index (OPI) were evaluated before treatment, day 1, 7 and 14 after treatment. The dry eye symptom severity score was evaluated before treatment, day 7 and 14 after treatment with Ocular Surface Disease Index (OSDI) questionnaire &#x0D; Results : The cationic emulsion had significantly better OPI score and TFBUT value on day 1, 7 and 14 compared to CMC 0,5% group (p&lt;0,001). There were no significant differences between groups on IBI value between groups on day 7 and 14 (p&gt;0,05). The severity symptom score on cationic emulsion group was significantly lower compared to CMC 0,5% on day 14 (p&lt;0,001). The subjective complaints after using both eye drops were visual disturbance, foreign body sensation, and itchy eyes. All complaints were only reported first follow-up (day 7). &#x0D; Conclusion : Cationic emulsion in this study had a clearly beneficial effect both in increasing OPI score and lowering subjective symptom score in the treatment of dry eye for post menopausal women. &#x0D; &#x0D; &#x0D;

A Multicenter Study of the Prevalence of Dry Eye Disease in Chinese Refractive Surgery Candidates

Objective: The aim of this study was to determine the prevalence of preoperative dry eye disease and evaluate tear film function in refractive surgery candidates in China. Methods: In this prospective noninterventional cross-sectional study, refractive surgical candidates from 13 preselected eye hospitals in China were recruited from July 2015 to February 2016. Patient histories, subjective symptoms, tear film breakup time (TBUT), ocular surface fluorescein staining, and Schirmer I tests (SIT), were assessed to conduct subgroup analysis. Results: A total of 1,849 patients were recruited, 41.4% were diagnosed with dry eye disease (766/1,849) and 44.9% (830/1,849) of subjects had a positive history of contact lens (CL) wear. The overall mean TBUT and SIT values were 7.3 ± 3.7 s and 15.2 ± 8.8 mm, respectively. The total prevalence of ocular surface fluorescein staining was 23.46% (422/1,849); 44.62% of patients had TBUT <5 s and 23.20% of patients had SIT <5 mm. CL wearers were observed to have a higher prevalence of dry eye than non-CL wearers (54.1 vs. 35.2%, OR = 2.17, 95% CI: 1.77–2.65). Conclusions: In this study, the most common abnormal finding in dry eye disease was tear film instability. A high proportion of refractive surgery candidates have preexisting dry eye disease and a history of CL wear prior to surgery. Careful attention should be given to the evaluation of preoperative dry eye in refractive surgery candidates.