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Purpose: Meibomian gland dysfunction disrupts tear film homeostasis and results in dry eye syndrome. The objective of this study is to determine whether transcutaneous radiofrequency (RF)-assisted meibomian gland expression, using the Envision platform and Forma-I handpiece is an effective treatment for dry eye syndrome. Methods: A multicenter prospective cohort study of patients with dry eye undergoing RF-assisted meibomian gland expression was completed from October 2019 to June 2022. The study was designed with multiple primary endpoints. These were defined as the change in Standard Patient Evaluation of Eye Dryness (SPEED) score, changes in Ocular Surface Disease Index (OSDI), Tear Breakup Time (TBUT), Corneal Fluorescence Score (CFS), and Meibomian Gland Score (MGS) at 1, 3, and 6 months after treatment. Secondary endpoints were measurements of patients' subjective improvement and subjective satisfaction with the treatment. Results: A total number of 47 patients were enrolled in the study at three separate institutions by three ophthalmologists (oculoplastics, refractive, and general). However, not all subjects had complete data on all observations at all time points following treatment. When a data point was missing, the entire patient’s outcome for that data set was excluded from the analysis. There was a significant improvement in SPEED score from baseline, 15.7 vs 11.4 at 1 month, 9.1 at 3 months, and 9.6 at 6 months (p Conclusion: This pilot study demonstrates that RF treatment with the Forma-I handpiece along with meibomian gland expression is an effective means to reduce the signs and symptoms of dry eye disease. The data support the conclusion that the treatment is safe and effective, lasting at least 6 months in most patients.

Background In recent years there has been growing interest in child and adolescent mental health and wellbeing, alongside increasing emphasis on schools as a crucial site for research and intervention. This has coincided with an increased use of self-report mental health and wellbeing measures in research with this population, including in school-based research projects. We set out to explore the way that children and young people perceive and experience completing mental health and wellbeing measures, with a specific focus on completion in a school context, in order to inform future measure and research design. Methods We conducted semi-structured interviews and focus groups with 133 participants aged 8–16 years following their completion of mental health and wellbeing measures as part of school-based research programmes, using thematic analysis to identify patterns of experience. Findings We identified six themes: Reflecting on emotions during completion; the importance of anonymity; understanding what is going to happen; ease of responding to items; level of demand; and interacting with the measure format. Conclusions Our findings offer greater insight into children and young people’s perceptions and experiences in reporting on their mental health and wellbeing. Such understanding can be used to support more ethical and robust data collection procedures in child and adolescent mental health research, both for data quality and ethical purposes. We offer several practical recommendations for researchers, including facilitating this in a school context.

Mitchell A Jackson1, Kim Burrell2, Ian B Gaddie3, Shana D Richardson4 1Jacksoneye, Lake Villa, IL, USA; 2Centennial Eye Associates, Centennial, CO, USA; 3Gaddie Eye Centers, Louisville, KY, USA; 4CYNACON/OCuSOFT, Richmond, TX, USA Purpose: To evaluate the effect of a new, prescription-only medical food supplement containing omega-3 and omega-6 essential fatty acids on dry eye signs and symptoms, with or without concomitant topical cyclosporine. Methods: A total of 43 subjects were randomized and followed for 6 months. Group 1 (n = 23) was assigned to take two soft geltabs of the medical food supplement by mouth twice daily for 6 months. Group 2 (n = 20) was directed to take the medical food supplement in the same manner, along with topical cyclosporine, instilled twice daily during the last 3 months of the study. Subjects were evaluated at baseline, month 1, month 3, and month 6. Primary outcome measures included tear breakup time (TBUT), conjunctival staining, corneal staining, and change in subjective symptoms. Results: Both groups had a statistically significant improvement in TBUT between baseline and month 6. In the food supplement only group, TBUT improved by 0.805 seconds from baseline to month 6. In the supplement/cyclosporine group, TBUT improved by 1.007 seconds from baseline. There was no statistically significant difference in TBUT between the two groups at baseline, month 3, or month 6. There were no significant differences in corneal or conjunctival staining between or within groups. Subjective symptoms were also improved in both groups. Conclusion: Supplementation with the proper balance of omega-3 and omega-6 essential fatty acids improved TBUT and relieved patient symptoms. The addition of topical cyclosporine did not convey any statistically significant improvement in TBUT beyond that achieved by the supplement. Keywords: omega-3, omega-6, essential fatty acids, TBUT, tear breakup time&nbsp