Tear Film Break-up Time Research Articles

Investigation of corneal topographic and ocular surface parameters in ocular rosacea based on skin subtypes.

To compare the corneal topographic parameters and ocular surface parameters of ocular rosacea (OR) patients across skin subtypes of the disease and healthy controls. This prospective study included 180 eyes of 90 OR patients and 60 eyes of 30 healthy controls. Among the OR patients, 30 had phymatous (60 eyes), 30 had erythematotelangiectatic (60 eyes) and 30 had papulopustular skin types (60 eyes). We measured the mean keratometry (Kmean), maximum keratometry (Kmax), thinnest corneal thickness (TCT), central corneal thickness (CCT) and corneal volume (CV) with a topography device (Sirius, Italy). Additionally, we measured tear-film breakup time (TBUT), Meiboscore and Schirmer's test from all participants. We compared parameters across OR skin groups as well as with controls. Kmean and Kmax were significantly steeper in the OR group compared to controls (p<0.05). We found significant correlations between "Kmean-Kmax", "CV-TCT", "CV-CCT", and "TCT-CCT" in both groups, while significant correlations between "age-Kmean", "age-Kmax", and "Meiboscore-Kmax" were present only in OR patients. When patients were divided into subgroups according to their skin subtypes, the papulopustular and phymatous subgroups had steeper Kmean and Kmax compared to the erythematotelangiectatic and control groups (P<0.05). The papulopustular subgroup had lower CCT, lower TBUT and higher Meiboscore compared to the phymatous, erythematotelangiectatic and control groups but lower TCT compared to controls (P<0.05). In addition, there were significant correlations between "Kmax-CV", "Kmax-TCT", and "Kmax-meiboscore" only in the papulopustular subgroup (P<0.05). It appears that the corneas of OR patients are steeper than those of healthy controls; corneal thinning and abnormalities of ocular surface parameters are more pronounced in papulopustular skin types.

Comparison of the Effect of and Compliance With Cyclosporine 0.1% After Various Pretreatments in Dry Eye Disease.

Purpose: We sought to compare the effect of cyclosporine 0.1% after various pretreatments in patients with dry eye disease. Methods: Two hundred seventy-four eyes of 137 patients diagnosed with dry eye disease were retrospectively enrolled. Thirty patients (Group 1, 60 eyes) were not pretreated, while 68 patients (Group 2, 136 eyes) were pretreated with fluorometholone 0.1%, and 39 patients (Group 3, 78 eyes) were pretreated with cyclosporine 0.05% before treatment with cyclosporine 0.1%. The Ocular Surface Disease Index Questionnaire (OSDI) score, Schirmer I test result, noninvasive tear film break-up time (NItBUT), corneal staining score, matrix metalloproteinase-9 (MMP-9) grade, meibography result, meibum quality and expressibility scores, and tear meniscus height were examined before treatment and at 1, 2, and 3 months after treatment. Results: All dry eye signs and symptoms of all Groups at 1, 2, and 3 months were significantly improved compared to those before treatment with cyclosporine 0.1% (p < 0.05). Notably, the OSDI score, Schirmer I test result, NItBUT, corneal and conjunctival fluorescein score, and MMP-9 grade in Group 3 were significantly improved compared to those in Groups 1 and 2 at 1, 2, and 3 months after treatment with cyclosporine 0.1% (p < 0.05). The percentages of cases with treatment discontinuation in Groups 1, 2, and 3 were 20.0%, 7.4%, and 10.0%, respectively. Conclusion: Pretreatment with cyclosporine 0.05% can augment the anti-inflammatory effect of cyclosporine 0.1%. Pretreatment with a steroid or a lower concentration of cyclosporine can increase compliance in patients using a cyclosporine 0.1% eye drop.

A Comparative Analysis of the Clinical Outcomes of Two Surgical Techniques for the Treatment of Senile Lower Eyelid Entropion with Trichiasis

This study investigates the clinical efficacy of different surgical methods for treating senile entropion with trichiasis of the lower eyelid and their effectiveness in alleviating symptoms.A total of 54 cases of elderly patients with senile entropion and trichiasis of the lower eyelid were included as study subjects. They were divided into a control group (30 cases, 46 eyes) treated with eyelid skin and orbicularis oculi muscle excision, and an observation group (24 cases, 40 eyes) treated with orbicularis oculi muscle shortening combined with marginal inversion suture.The clinical efficacy of the two groups was compared, and improvements in ocular symptoms were assessed using specialized scales.Results: Both groups demonstrated high surgical efficacy with no statistically significant difference (P&gt;0.05). The observation group exhibited higher tear film breakup time (BUT) and tear meniscus height (TMH), and lower corneal fluorescein staining (CFS) and ocular surface disease index (OSDI) scores compared to the control group. These differences were statistically significant (P&lt;0.05).The incidence of postoperative complications was low in both groups, with no statistically significant differences (P &gt; 0.05).For elderly patients with lower eyelid entropion, the procedure of orbicularis oculi muscle shortening combined with marginal inversion suture can achieve definitive clinical efficacy and significantly alleviate ocular discomfort.

EXPRESS: Synergistic Efficacy of Orthokeratology and 0.01% Atropine in Controlling Pediatric Myopia Progression: A Retrospective Analysis.

This study investigates the combined efficacy of orthokeratology lenses and 0.01% atropine in controlling the progression of pediatric myopia. The study, conducted retrospectively on 33 children aged 8-14, measured key parameters, including axial length growth, uncorrected visual acuity (UCVA), intraocular pressure (IOP), tear film breakup time (TBUT), and pupil diameter. The results revealed a significant reduction in axial length growth with the combined treatment compared to orthokeratology alone, while UCVA and IOP remained stable. TBUT decreased, and pupil diameter increased post-treatment. The findings suggest that combining orthokeratology with low-dose atropine offers a safe and effective strategy for managing pediatric myopia, particularly in younger patients.

Automated non-invasive assessment of tear film break-up time in patients with open-angle glaucoma on antihypertensive therapy and in patients with newly diagnosed glaucoma after SLT

Automated non-invasive assessment of tear film break-up time in patients with open-angle glaucoma on antihypertensive therapy and in patients with newly diagnosed glaucoma after SLT

Keratoconjunctivitis sicca in intact Aksaray Malakli breed dogs: Evaluation of 50 cases.

Keratoconjunctivitis sicca (KCS) is characterized by decreased aqueous tear film components, leading to ocular surface damage. Diagnosis involves clinical examination, Schirmer Tear Test (STT1), and Tear Film Break-Up Time (TFBUT) measurement. This retrospective study aimed to assess dry eye syndrome in intact, purebred, Aksaray Malakli breed dogs, and investigate potential associations with hereditary ocular diseases due to inbreeding for phenotype preservation. Fifty healthy, purebred, intact Aksaray Malakli dogs of varying ages and sexes, all exhibiting conjunctival hyperemia and mucoid ocular discharge. Dogs with chronic diseases, systemic medication, or ongoing ophthalmic treatment were excluded. Demographic data, ophthalmic examination results, and ocular anomalies were recorded. STT1 and TFBUT assessments were performed to measure tear production and film stability. STT1 values were scored from 1 (normal) to 4 (severe dry eye), and TFBUT ≥20 s was considered normal. Statistical analyses were used to evaluate correlations and differences. The correlation between age and STT1 values (r = -.182, p = .206) was not statistically significant. Mean STT1 was higher in females than males, though not significantly (p = .849). Dogs without third eyelid gland prolapse had significantly higher STT1 and TFBUT measurements compared to those with prolapse (p = .027). No significant sex difference was found in the frequency of third eyelid prolapse (p = .289). A significant positive correlation was observed between STT1 and TFBUT (r = .924; p < .001). Aksaray Malakli dogs, particularly those with third eyelid gland prolapse, are predisposed to mild to moderate KCS. These findings suggest the need for further clinical and genetic investigations to better understand and manage dry eye syndrome in this breed.

Treatment of Meibomian Gland Dysfunction by Classical Eyelid Hygiene Measures With and Without Additional Lipid Substitution for Tear Film Stabilization.

This study aimed to document the treatment success of eyelid hygiene with liposomal suspension using new diagnostic tools and to determine whether additional lipid substitution provided measurable benefits in meibomian gland dysfunction. A single-center controlled, partially single masked study was conducted. Group A used eyelid hygiene only, whereas group B additionally applied a liposomal eye spray. Subjective perception using the Ocular Surface Disease Index (OSDI) questionnaire, measurement of tear film osmolarity, noninvasive tear film break-up time, assessment of the lipid layer, meibography, inspection of lid margins, assessment of the meibomian glands, and measurement of matrix-metallopeptidase-9 were collected at baseline and after 12 weeks. Eighty-two patients were included and randomized into two groups. Both groups showed a decrease in OSDI score (P<0.001), an increase in lipid layer thickness (P<0.001), significant improvement in the degree of loss of meibomian glands (P<0.001), in the damage pattern of the eyelid margins (P<0.001), in the quality of meibomian gland secretion, and in matrix-metallopeptidase-9 after 12 weeks. Our study confirms the success of treatment with eyelid hygiene measures using a liposomal suspension. The additional benefit of lipid substitution was not significant after 12 weeks of treatment.

Observation on the clinical effect of He's fire needle therapy combined with walnut-shell moxibustion on perimenopausal dry eye disease

To observe the clinical effect on perimenopausal dry eye disease treated with He's fire needle therapy combined with walnut-shell moxibustion. A total of 60 patients with perimenopausal dry eye disease were randomized into an observation group (30 cases) and a control group (30 cases). In the observation group, the pricking technique with fire needle was operated at bilateral Naokong (GB19), Feishu (BL13), Xinshu (BL15), Ganshu (BL18), Pishu (BL20), Shenshu (BL23), 3 times a week, for 4 weeks, and the walnut-shell moxibustion was combined, 30 minutes each time, 3 times a week, for 4 weeks. In the control group, hyaluronic acid sodium eye drops were used, one drop each time, 3 times a day, for 4 weeks. Before and after treatment, the scores of the questionnaire for dry eye disease in China, the result of lacrimal secretion test (Schimer Ⅰ test, SⅠT) and tear film break-up time(BUT), as well as the modified Kupperman score were evaluated in the two groups. The clinical effect was compared between the two groups. After 4 weeks of treatment, the results of SⅠT and BUT increased (P<0.001), while the scores of the questionnaire for dry eye disease in China, the modified Kupperman score decreased (P<0.001) in the two groups when compared with the baseline. In the observation group, the result of SⅠT and BUT were higher than those of the control group (P<0.05), while the scores of the questionnaire for dry eye disease in China, and the modified Kupperman score was lower (P<0.05). The marked effective rate (30/60, 50.0%) in the observation group was better than that (10/60, 16.7%) of the control group (P<0.05). In treatment of perimenopausal dry eye disease, the combined therapy of fire needling and walnut-shell moxibustion obtains the superior effect to hyaluronic acid sodium eye drops. This combined therapy can effectively relieve the eye symptoms, increase the secretion of tears, prolong BUT, and ameliorate systemic symptoms.

Smoking-Related Tear Film Abnormalities and Dry Eye Disease: A Meta-Analysis

Dry eye disease (DED) is a prevalent ocular condition characterized by tear film instability and ocular surface inflammation. Smoking has been identified as a potential risk factor for DED, but the impact of different smoking modalities (active, passive, and e-cigarette) on tear film and DED remains unclear. This meta-analysis aimed to evaluate the association between various forms of smoking and tear film abnormalities leading to DED. A systematic search of PubMed, Embase, and Cochrane Library databases was conducted for studies published between 2013 and 2024 investigating the effects of active smoking, passive smoking, and e-cigarette use on tear film parameters and DED diagnosis. Data extracted included tear film break-up time (TBUT), Schirmer's test results, tear osmolarity, and DED diagnostic criteria. Pooled effect estimates were calculated using random-effects models. Eight studies met the inclusion criteria, comprising 4 on active smoking, 2 on passive smoking, and 2 on e-cigarette use. Active smoking was significantly associated with reduced TBUT (standardized mean difference [SMD] = -2.87; 95% CI: -3.12 to -2.62; p&lt;0.00001), lower Schirmer's test scores (SMD = -2.79; 95% CI: -3.23 to -2.35; p&lt;0.00001), and increased tear osmolarity (SMD = 12.55; 95% CI: 8.17 to 16.93; p&lt;0.00001). Passive smoking and e-cigarettes showed a similar trend but with less pronounced effects. In conclusion, this meta-analysis provides evidence that active smoking significantly impairs tear film stability and contributes to DED. Passive smoking may also have detrimental effects, while the impact of e-cigarettes requires further investigation. These findings underscore the importance of smoking cessation in DED management and public health strategies for eye health.

PREVALENCE OF DRY EYE IN CHILDREN AGED 5 TO 15 YEARS AND ITS PATTERN WITH DURATION OF SCREEN TIME IN THE EASTERN PART OF BIHAR

Objectives: Dry eye disease (DED) is increasingly recognized as a significant health problem in children, particularly about screen time exposure. However, detailed epidemiological data on DED in young populations, especially in regions such as Eastern Bihar, are sparse. This study aims to assess the prevalence of DED among children aged 5–15 years and explore the relationship between the duration of screen time and the occurrence of DED. Methods: A cross-sectional study at M.G.M. Medical College and L.S.K. Hospital, Kishanganj, Bihar, examined 140 children with DED symptoms. Diagnostic tests such as tear film breakup time and Schirmer’s test were conducted during comprehensive ocular examinations. The association between DED prevalence and parental and self-reported screen usage was examined. Results: The prevalence of DED among the participants was 12.1%. There was a significant association between higher screen time and increased prevalence of DED, with the severity of symptoms correlating positively with a longer duration of screen exposure. Children with severe DED reported significantly more screen time compared to those with milder forms. Conclusion: The study confirms a notable prevalence of DED among children in Eastern Bihar, closely linked to excessive screen time. These findings highlight the need for public health strategies to manage screen exposure in children to prevent the onset of DED.

Dry eye syndrome associated with meibomian gland dysfunction in the context of isotretinoin use: a clinical case

Introduction. Acne is a chronic, recurrent, and inflammatory skin disease that that can have significant aesthetic and psychological impacts on patients. The first-line treatment for acne is isotretinoin, which exerts systemic effect, reducing sebum production and alleviating inflammation However, one of the most common complications associated with prolonged systemic retinoid use is dry eye syndrome, linked to meibomian gland dysfunction, warranting special attention from ophthalmologists. Purpose: to present a clinical case of a patient who underwent four months of systemic isotretinoin therapy for acne and subsequently developed ocular complaints. Methods. Comprehensive ophthalmological diagnostics were conducted, including patient history, biomicroscopy, and corneal staining with fluorescein. Additional assessment included non-invasive tear film breakup time, measurement of tear meniscus height, evaluation of the lipid layer thickness of the tear film, meibography, eyelid margin photography, conjunctival hyperemia analysis, and corneal fluorescein staining. Treatment included various groups drug classes such as moisturizing drops, reparative gels, corneal protectors, and glucocorticosteroids. A therapeutic eyelid massage was also performed. Results. After three months of active therapy, the patient exhibited significant improvement, with a marked reduction in subjective complaints, no corneal epithelial defects, and an increase in tear film breakup time. Long-term symptom remission was achieved after five months of therapy. Conclusion. This case highlights the importance of interdisciplinary collaboration between ophthalmologists and dermatologists in managing patients undergoing long-term systemic retinoid therapy for acne. Comprehensive ophthal- mological assessment using specialized diagnostic methods is essential for accurately evaluating the clinical picture of ocular conditions and administering timely, multi-faceted therapy. This approach enhances patients’ quality of life and helps prevent severe complications.

Preliminary clinical evaluation of the treatment efficacy of a temperature-adjustable cryotherapy device for chronic, recurrent blepharitis in dogs.

To preliminarily evaluate the treatment efficacy of a temperature-adjustable cryotherapy device for chronic, recurrent blepharitis in dogs. Five dogs (eight eyes) of different breeds with blepharitis, which was unresponsive to systemic steroids. The dogs were subjected to ophthalmic examination, including Schirmer tear test-1 (STT-1), tear film break-up time (TFBUT) test, and slit-lamp biomicroscope examination. Cryotherapy was performed using a device featuring precise low-temperature control. A bandage lens and ointment (2% hypromellose) were applied before cryotherapy to protect the cornea. Carbon dioxide gas at 0°C was sprayed on the lesion for 10 s. In all patients, only topical antibiotics and corticosteroid were applied twice a day; systemic corticosteroids were not used. Pruritus and ocular discharge were scored based on the visual analog scale (VAS) before and 3 weeks after cryotherapy. Qualitative changes in tear film were measured using STT-1 and a TFBUT test. The effects on erythema and swelling were evaluated by ophthalmic examination. Pruritus improvement was confirmed in all eight eyes (five dogs). After cryotherapy, the average VAS score of pruritus significantly decreased from 4.12 ± 2.64 to 0.37 ± 0.51 (p < .001), and the average TFBUT significantly increased from 5.75 ± 4.80 to 13.75 ± 4.43 (p = .010). STT-1 and the VAS score of ocular discharge did not significantly differ. Erythema and swelling were improved in three out of eight eyes. Cryotherapy is effective in treating blepharitis with pruritus and may become a new treatment option in patients in whom systemic corticosteroids are difficult to administer.

Efficacy of 0.05% Cyclosporine-A eye drops (II) and 3% Diquafosol ophthalmic solution in the treatment of dry eye after cataract surgery.

To compare the efficacy of 0.05% cyclosporine A (CsA) eye drops (II) and 3% Diquafosol ophthalmic solution (DQS) in the treatment of dry eye (DE) after cataract surgery (CS). Clinical data of 123 patients with DE after CS treated at the Fourth Hospital of Hebei Medical University from June 2022 to August 2023 were retrospectively analyzed. Patients were divided into three groups based on the treatment: Conventional group (tobramycin & dexamethasone eye drops combined with pranoprofen eye drops, n=41), DQS group (3% DQS based on the conventional treatment, n=42), and CsA group (0.05% CsA eye drops(II) based on the conventional treatment, n=40). The therapeutic effects; Schirmer I test (SIt), tear film breakup time (TBUT), levels of serum inflammatory factors, and tear cytokine levels before and after treatment were compared between the groups. Chief complaint score, conjunctival congestion score, corneal fluorescein staining score, and ocular surface disease index score of the DQS group and the CsA groups were significantly lower than those of the conventional group (P<0.05). After treatment, the improvement in SIt, TBUT, serum inflammatory factors, and tear cytokine levels in the DQS group and the CsA group was significantly better than that in the conventional group (P<0.05). However, these indexes were comparable in the DQS and the CsA group (P>0.05). Compared to the conventional treatment alone, the addition of 3% DQS or 0.05% CsA eye drops (II) to the conventional treatment both are effective and might more effectively alleviate DE in patients undergoing CS.

Geometrical Features of Sub-basal Corneal Whorl-like Nerve Patterns in Dry Eye Disease: An In Vivo Confocal Microscopy Study

PurposeTo investigate the geometrical feature of the whorl-like corneal nerve in dry eye disease (DED) across different severity levels and subtypes, and to preliminarily explore its diagnostic ability. DesignCross-sectional study. ParticipantsThe study included 29 healthy subjects (51 eyes) and 62 DED patients (95 eyes). MethodsAll subjects underwent comprehensive ophthalmic examinations, dry eye tests, and in vivo confocal microscopy to visualize the whorl-like corneal nerve at the inferior whorl (IW) region and the straight nerve at the central cornea. The structure of the corneal nerve was extracted and characterized using the fractal dimension (CNDf), multi-fractal dimension (CND0), tortuosity (CNTor), fiber length (CNFL), and numbers of branching points (CNBP). Main outcome measuresThe characteristics of quantified whorl-like corneal nerve metrics in different groups of severity and subtype defined by symptoms and signs of DED. ResultsCompared to the healthy controls, the CNDf, CND0, and CNFL of the IW decreased significantly as early as grade 1 DED (P<0.05), while CNTor increased (P<0.05). These parameters did not change significantly in the straight nerve. As the DED severity increased, CNDf and CNFL in the whorl-like nerve further decreased in grade 3 DED compared to grade 1. Significant nerve fiber loss was observed in aqueous-deficient DED compared to evaporative DED (P<0.05). Whorl-like nerve metrics correlated with ocular discomfort, tear film break-up time, tear secretion and corneal fluorescein staining, respectively (P<0.05). Furthermore, merging parameters of whorl-like and linear nerve showed an area under the curve value of 0.910 in diagnosing DED. ConclusionsGeometrical parameters of IW could potentially allow optimization of the staging of DED. Reliable and objective measurements for the whorl-like cornea nerve might facilitate patient stratification and diagnosis of DED.

Application of OSA-VET® and qualiquantitative tear tests in brachycephalic dogs with and without keratoconjunctivitis sicca.

The aim was to compare the outcomes acquired from the OSA-Vet® device with conventional quantitative and qualitative tear tests and between groups within each test, in brachycephalic dogs both healthy and those diagnosed with keratoconjunctivitis sicca. The dogs were divided into four groups: healthy dogs (HD), with mild KCS (MIKCS); moderate KCS (MOKCS); severe KCS (SKCS). All patients underwent ocular surface diagnostic examination in the following order, with a 10-minute interval between tests: non-invasive tear film breakup time (TBUTNI - OSA-Vet®), tear meniscus height (TMH-OSA-Vet®), meniscometry (I-Tear® test), Schirmer Tear Test-1 (STT-1), and tear film breakup time (TBUT). Kruskal-Wallis H tests were performed to establish the difference between the groups and Spearman´s correlation coefficient test to assess the correlation between tests. And an analysis of variance (ANOVA) followed by Tukey-Kramer post-hoc test was performed for TMH. Results with (p <.05) were considered statistically significant. The correlation of conventional tests in relation to those obtained by OSA-Vet® proved to be low, except between TBUTNI (OSA-Vet®) and TBUT in MOKCS, with a strong correlation (r =.925). In the comparison between TBUTNI (OSA-Vet®) and TBUT in MIKCS the correlation was moderate (r =.547) as well as STT-1 and I-Tear® test in MOKCS (r =.416). In the comparison between groups, the main result observed was a significant difference between all the KCS groups and HD, in the TBUT and TBUTNI (OSA-Vet®) test. The OSA-Vet® and conventional tests are useful for evaluating the ocular surface of brachycephalic dogs. However, the OSA-Vet® does not correlate well with conventional standardized tests.

Long-term outcomes of sural nerve vertical cross-face graft for lacrimal gland neurotization in neurodeprivative dry eye.

We recently described a novel surgical procedure to reinnervate the lacrimal gland in neurodeprivative dry eye disease and reported the 1-year outcomes of patients treated accordingly. The purpose of this paper is to describe the long-term outcomes of this innovative surgical technique. Monocentric cross-sectional study including consecutive patients affected by facial palsy with an absolute deficiency of tear secretion (Schirmer test 0mm/5min) who underwent lacrimal gland neurotization, as previously described. Before surgery (T0) and at the last follow-up visit (T1), the following parameters were evaluated: tear film break-up time (TBUT), corneal fluorescein staining (Oxford score), Schirmer test type I, usage of tear substitutes (daily number of instillation). At T1, subjective satisfaction with surgery was collected and tear film osmolarity (TFO) was measured in both operated and contralateral eye. Corneal sensitivity was performed at T0 and T1 in patients who underwent neurotization of both lacrimal gland and cornea due to the concomitant presence of neurotrophic keratopathy (trigeminal nerve palsy). Data from 9 patients (4M, 5 F; mean age 47.1 ± 17.1years) who underwent lacrimal gland neurotization and were followed up for an average time of 87months (± 15) (range 60-108) were analyzed. The study procedure was combined in all cases with facial reanimation, while corneal neurotization was performed in 4 cases. At T1, the mean value of Schirmer test was significantly higher compared to T0 (5.8 ± 2.0 vs 0 ± 0mm/5min; p < 0.0001). TBUT and corneal fluorescein staining were significantly better compared to baseline (respectively, 2.4 ± 1.8 vs 1.2 ± 0.6s, p = 0.04 and 1.7 ± 0.8 vs 3.1 ± 0.6, p = 0.0004). TFO was not significantly different between operated eye and contralateral one (306.7 ± 9.5mOsm/L vs 308.9 ± 11.3mOsm/L, p = 0.67). The mean daily number of tear substitute instillations was lower at T1 compared to T0 (12 ± 7 vs 21.8 ± 4.3; p = 0.011).Overall, all patients were satisfied with surgery at T1 (very satisfied: n = 3 and satisfied: n = 6). No major postoperative complications were recorded throughout the entire follow-up. Lacrimal gland neurotization through the sural nerve is a safe and effective procedure with stable favorable outcomes in the long term.

Ophthalmic Formulations for the Treatment of Allergic Conjunctivitis and Their Effect on the Ocular Surface: A Review of Safety and Tolerability Assessments in Clinical Trials.

Allergic conjunctivitis (AC) is the most common allergic eye disorder. Antiallergic eyedrops are the first line of pharmacological treatment. However, the application of antiallergic eyedrops can potentially alter tear homeostasis and affect the ocular surface, which may result in iatrogenic diseases such as dye eye disease (DED). Long-term treatment of AC with eyedrops containing preservatives and other components may increase the risk of DED and ocular surface damage. Here, we examined 20 clinical trials published during the past ten years with antihistamine ophthalmic formulations in the treatment of AC, to evaluate the extent of evidence about their safety and tolerability. Remarkably, we find that most trials lack an evaluation of the critical ocular surface parameters, such as tear film break-up time, tear volume, corneal and conjunctival damage, and inflammation, to properly assess the state of the ocular surface state after prolonged treatment. There is a need to increase awareness of the use of specific formulations that do not increase the risk of iatrogenic DED.

Assessment of meibomian gland morphology and tear-film lipid layer using noncontact infrared meibography and meibometry, respectively, and tear-film osmolarity in healthy dogs.

To further investigate quantitative and qualitative tear-film dynamics through tear-film osmolarity, meibometry, meibography, and non-invasive tear-film break-up time and to describe a survey of parameters in normal eyes of healthy non-brachycephalic dogs. Thirty-two veterinary hospital staff and student owned dogs between 1 and 7 years with no known comorbidities or ocular disease. Complete ophthalmic examination, tear-film osmolarity (I-PEN® VET), meibometry (Meibometer MB560), meibography, and non-invasive tear-film break-up time (handheld Ocular Surface Analyzer) were performed. Significance threshold was 0.05. Q-Q plots and histograms were used to assess normality of measurements. Data were summarized descriptively with mean, standard deviation, median, and interquartile range (IQR). Pearson and Spearman's correlations were used to test for correlations between diagnostics with each other and tear-film break-up times. Thirty-two dogs (64 eyes) met the inclusion criteria. Mean tear-film osmolarity level was 293.6 ± 14.1 mOsm/L (IQR 282.5-302.3). Median meibomian lipid level was 30.4 Meibometry Units (MU) (IQR 11.5-59.1). Median percent loss of meibomian glands in the upper eyelids was 25.3% (IQR 13.5-26.8). Median percent loss of meibomian glands in the lower eyelids was 26.0% (IQR 13.5-52.3). Automatic assessment of meibomian gland loss showed that grade 0 was present in 4/128 (3.1%) eyelids, grade 1 in 78/128 (60.9%) eyelids, grade 2 in 30/128 (23.4%) eyelids, and grade 3 in 16/128 (12.5%) eyelids. Tear-film osmolarity, meibometry, meibography, and non-invasive tear break-up time can easily be incorporated into routine ophthalmic examinations to provide clinical information about meibomian gland morphology and function.

Evaluation of meibomian gland morphology in keratoconus patients wearing scleral contact lenses.

We aimed to evaluate the morphological changes in meibomian glands in keratoconus patients using scleral contact lenses and compare them with keratoconus and healthy controls. The study included 34 eyes of 20 patients who were wearing scleral contact lenses due to keratoconus, as well as 31 age- and sex-matched keratoconus controls and 31 healthy controls. Slit-lamp biomicroscopy, non-invasive tear film break-up time assessment, Schirmer I test, meibography, and corneal staining with fluorescein were performed. Subjective symptoms were assessed using the Ocular Surface Disease Index. In this study, the lower and upper percentage meibomian gland loss was statistically higher in the scleral contact lens group than in the keratoconus and healthy control groups (p < 0.001 and p = 0.013, respectively). There was a positive correlation between scleral contact lens wear duration and the lower eyelid percentage meibomian gland loss and upper eyelid gland curling scores (rho: 0.396; p = 0.021 and rho: 0.344; p = 0.047, respectively). The lower and upper eyelid percentage meibomian gland loss, and upper eyelid gland curling values were higher, and the Schirmer 1 values were found to be lower in patients who used scleral contact lenses for more than three years than those who wore them less than three years. In patients using scleral contact lenses for more than three years, meibomian gland curling values and percentages of meibomian gland loss in both eyelids are higher.

Short-term variability in ocular biometry and the impact of preoperative dry eye.

This study aimed to investigate the short-term variability of ocular biometric measurements and to analyze the factors associated with high variability of biometric values in patients with cataract. This retrospective study included 60 eyes of 60 patients who underwent ocular biometry twice with the IOLMaster 700 (March to November 2023). Ocular surface parameters included tear film break-up time (TBUT), corneal and conjunctival staining scores (CSS/ConSS). Refractive surprise was defined as a mean absolute error exceeding 0.5 diopter (D). Participants included 22 men and 38 women with a mean age of 70.6 ± 8.4 years. The variability of mean keratometric (K) values and astigmatism showed notable variability compared to axial length (mean K: 0.18 ± 0.17D, astigmatism: 0.21 ± 0.26D, axial length: 0.01 ± 0.01mm). A decreased TBUT and increased CSS were significantly associated with high variability (≥ 0.25D) of mean K (p = 0.040/0.008). The high K variability group (≥ 0.25D) revealed a significantly higher incidence of refractive surprise (> 0.5D) compared with the low K variability group (< 0.25D) (45.5%/17.9%, p = 0.037). Preoperative lower TBUT and higher CSS influenced the variability of K values in ocular biometry and may be related with postoperative refractive surprise due to erroneous K values.