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Syfte: Syftet med studien var att utvärdera NIBUT (Non-Invasive Break-Up Time) och TBUT (Tear Break-Up Time) hos heltidsstuderande vid Linnéuniversitetet samt bidra till en ökad förståelse av ögonhälsan hos denna grupp. Metod: Tårfilmens stabilitet kontrollerades med NIBUT och TBUT, tiden mättes direkt efter en blinkning till första uppsprickningen av tårfilmens yta eller ny blinkning. NIBUT utfördes icke invasivt i Sirius och TBUT mättes i biomikroskop med fluorescein. Deltagarna fick inledningsvis svara på en enkät som gjorde det möjligt att analysera insamlad data utifrån ålder, kön, termin, skärmtid och poäng på DEQ-5 (5-Item Dry Eye Questionnaire). Svaren från DEQ-5 möjliggjorde att resultaten från NIBUT och TBUT mätningarna kunde jämföras mot upplevda symtom på torra ögon. Resultat: Studien inkluderade 36 studenter i åldersspannet 18–39 år (medianålder 23 år, IQR 5,25 år). NIBUT och TBUT visade en positiv signifikant korrelation (p <0,001). En kortare TBUT korrelerade negativt med en högre totalpoäng på DEQ-5 (p = 0,004) samt antalet terminer som studerats (p = 0,025). NIBUT visade inte några liknande samband. Referensvärdet för torra ögon diagnostisering med hjälp av NIBUT och TBUT är en tid <10 sekunder. Över hälften av deltagarna i studien, NIBUT 58% och TBUT 53%, hade en nedsatt break-up time <10 sekunder. Vilket kan vara en indikation för torra ögon problematik. Slutsats: Denna studie visar att det finns ett signifikant samband mellan NIBUT och TBUT mätningarna. Kortare TBUT har visat en signifikant korrelation med högre totalpoäng på DEQ-5, likaså har signifikanta samband mellan TBUT och fler lästa terminer konstaterats. Trots korrelationen mellan NIBUT och TBUT påverkades resultaten av skillnader mellan de två mätmetoderna., Purpose: The purpose of the studies was to evaluate NIBUT (Non-Invasive Break-Up Time) and TBUT (Tear Break-Up Time) in full-time students at Linnaeus University and to contribute to an increased understanding of the eye health of this group. Method: The stability of the tear film was checked with NIBUT and TBUT, the time was measured directly after a blink to the first break-up of the tear film surface or a new blink. NIBUT was performed non-invasively in Sirius and TBUT was measured in a biomicroscope with fluorescein. The participants initially had to answer a questionnaire that made it possible to analyze collected data based on age, sex, number of semesters studied, screen time and score on the DEQ-5 (5-Item Dry Eye Questionnaire). The responses from the DEQ-5 allowed the results from the NIBUT and TBUT measurements to be compared against perceived symptoms of dry eye. Results: The study included 36 students in the age range 18–39 years (median age 23 years, IQR 5.25 years). NIBUT and TBUT showed a positive significant correlation (p <0.001). A shorter TBUT correlated negatively with a higher DEQ-5 total score (p = 0.004) as well as the number of semesters studied (p = 0.025). NIBUT did not show any similar correlations. The reference value for dry eye diagnosis using NIBUT and TBUT is a time <10 seconds. Over half of the participants in the study, NIBUT 58% and TBUT 53%, had a reduced break-up time <10 seconds. Which can be an indication of dry eye problems. Conclusion: This study shows that there is a significant connection between the NIBUT and TBUT measurements. Shorter TBUT has shown a significant correlation with higher total scores on the DEQ-5, likewise significant connections between TBUT and more semesters read have been established. Despite the correlation between NIBUT and TBUT, the results were influenced by differences between the two measurement methods.

Syfte: Syftet med studien var att utvärdera NIBUT (Non-Invasive Break-Up Time) och TBUT (Tear Break-Up Time) hos heltidsstuderande vid Linnéuniversitetet samt bidra till en ökad förståelse av ögonhälsan hos denna grupp. Metod: Tårfilmens stabilitet kontrollerades med NIBUT och TBUT, tiden mättes direkt efter en blinkning till första uppsprickningen av tårfilmens yta eller ny blinkning. NIBUT utfördes icke invasivt i Sirius och TBUT mättes i biomikroskop med fluorescein. Deltagarna fick inledningsvis svara på en enkät som gjorde det möjligt att analysera insamlad data utifrån ålder, kön, termin, skärmtid och poäng på DEQ-5 (5-Item Dry Eye Questionnaire). Svaren från DEQ-5 möjliggjorde att resultaten från NIBUT och TBUT mätningarna kunde jämföras mot upplevda symtom på torra ögon. Resultat: Studien inkluderade 36 studenter i åldersspannet 18–39 år (medianålder 23 år, IQR 5,25 år). NIBUT och TBUT visade en positiv signifikant korrelation (p <0,001). En kortare TBUT korrelerade negativt med en högre totalpoäng på DEQ-5 (p = 0,004) samt antalet terminer som studerats (p = 0,025). NIBUT visade inte några liknande samband. Referensvärdet för torra ögon diagnostisering med hjälp av NIBUT och TBUT är en tid <10 sekunder. Över hälften av deltagarna i studien, NIBUT 58% och TBUT 53%, hade en nedsatt break-up time <10 sekunder. Vilket kan vara en indikation för torra ögon problematik. Slutsats: Denna studie visar att det finns ett signifikant samband mellan NIBUT och TBUT mätningarna. Kortare TBUT har visat en signifikant korrelation med högre totalpoäng på DEQ-5, likaså har signifikanta samband mellan TBUT och fler lästa terminer konstaterats. Trots korrelationen mellan NIBUT och TBUT påverkades resultaten av skillnader mellan de två mätmetoderna., Purpose: The purpose of the studies was to evaluate NIBUT (Non-Invasive Break-Up Time) and TBUT (Tear Break-Up Time) in full-time students at Linnaeus University and to contribute to an increased understanding of the eye health of this group. Method: The stability of the tear film was checked with NIBUT and TBUT, the time was measured directly after a blink to the first break-up of the tear film surface or a new blink. NIBUT was performed non-invasively in Sirius and TBUT was measured in a biomicroscope with fluorescein. The participants initially had to answer a questionnaire that made it possible to analyze collected data based on age, sex, number of semesters studied, screen time and score on the DEQ-5 (5-Item Dry Eye Questionnaire). The responses from the DEQ-5 allowed the results from the NIBUT and TBUT measurements to be compared against perceived symptoms of dry eye. Results: The study included 36 students in the age range 18–39 years (median age 23 years, IQR 5.25 years). NIBUT and TBUT showed a positive significant correlation (p <0.001). A shorter TBUT correlated negatively with a higher DEQ-5 total score (p = 0.004) as well as the number of semesters studied (p = 0.025). NIBUT did not show any similar correlations. The reference value for dry eye diagnosis using NIBUT and TBUT is a time <10 seconds. Over half of the participants in the study, NIBUT 58% and TBUT 53%, had a reduced break-up time <10 seconds. Which can be an indication of dry eye problems. Conclusion: This study shows that there is a significant connection between the NIBUT and TBUT measurements. Shorter TBUT has shown a significant correlation with higher total scores on the DEQ-5, likewise significant connections between TBUT and more semesters read have been established. Despite the correlation between NIBUT and TBUT, the results were influenced by differences between the two measurement methods.

Indoor bacteria, mold, allergens, and selected volatile organic compounds (VOC) were measured at home in three Nordic cities. Data on self-reported tear film break-up time (SBUT), weekly oculo-nasal symptoms during the past three months, and allergic rhinitis of 159 adults were obtained. Among them, 58 % were females, 24.5 % were atopics, and 41 % reported home dampness. The median SBUT was 22.3 s. Oculo-nasal symptoms (15.3 %) and allergic rhinitis (32.7 %) were common. A higher level of 2-hexanone was linked to lower SBUT (p = 0.036). Higher levels of total mold (p = 0.038), allergen Fel d 1 from cat (p = 0.045), and allergen Der p 1 (p = 0.012) and Der f 1 (p = 0.036) from house dust mite (HDM), were related to more oculo-nasal symptoms. Higher levels of 3-methylfuran (p = 0.003), 2-hexanone (p = 0.037), 2-heptanone (p = 0.018), and 1-octen-3-ol (p = 0.001) were linked to oculo-nasal symptoms. Higher levels of viable bacteria (p = 0.015), 3-octanone (p = 0.049) and formaldehyde (p = 0.039) were linked to allergic rhinitis. The association between 2-heptanone and oculo-nasal symptoms (interaction p = 0.012), and between isobutyl acetate and allergic rhinitis (interaction p = 0.084) were more pronounced in women. The negative association between 2-hexanone and SBUT was stronger among atopics (interaction p = 0.098), and the links between viable bacteria and allergic rhinitis (interaction p = 0.003) and between Der f 1 and oculo-nasal symptoms (interaction p = 0.1) were more pronounced among non-atopics. In conclusion, airborne mold and bacteria, and allergens in dust were associated with oculo-nasal symptoms or allergic rhinitis. 3-Methylfuran, 2-hexanone, 1-octen-3-ol, and 2-heptanone were associated with adult oculonasal symptoms. Increased 3-octanone and formaldehyde were related to allergic rhinitis.

Indoor bacteria, mold, allergens, and selected volatile organic compounds (VOC) were measured at home in three Nordic cities. Data on self-reported tear film break-up time (SBUT), weekly oculo-nasal symptoms during the past three months, and allergic rhinitis of 159 adults were obtained. Among them, 58 % were females, 24.5 % were atopics, and 41 % reported home dampness. The median SBUT was 22.3 s. Oculo-nasal symptoms (15.3 %) and allergic rhinitis (32.7 %) were common. A higher level of 2-hexanone was linked to lower SBUT (p = 0.036). Higher levels of total mold (p = 0.038), allergen Fel d 1 from cat (p = 0.045), and allergen Der p 1 (p = 0.012) and Der f 1 (p = 0.036) from house dust mite (HDM), were related to more oculo-nasal symptoms. Higher levels of 3-methylfuran (p = 0.003), 2-hexanone (p = 0.037), 2-heptanone (p = 0.018), and 1-octen-3-ol (p = 0.001) were linked to oculo-nasal symptoms. Higher levels of viable bacteria (p = 0.015), 3-octanone (p = 0.049) and formaldehyde (p = 0.039) were linked to allergic rhinitis. The association between 2-heptanone and oculo-nasal symptoms (interaction p = 0.012), and between isobutyl acetate and allergic rhinitis (interaction p = 0.084) were more pronounced in women. The negative association between 2-hexanone and SBUT was stronger among atopics (interaction p = 0.098), and the links between viable bacteria and allergic rhinitis (interaction p = 0.003) and between Der f 1 and oculo-nasal symptoms (interaction p = 0.1) were more pronounced among non-atopics. In conclusion, airborne mold and bacteria, and allergens in dust were associated with oculo-nasal symptoms or allergic rhinitis. 3-Methylfuran, 2-hexanone, 1-octen-3-ol, and 2-heptanone were associated with adult oculo-nasal symptoms. Increased 3-octanone and formaldehyde were related to allergic rhinitis.

Indoor bacteria, mold, allergens, and selected volatile organic compounds (VOC) were measured at home in three Nordic cities. Data on self-reported tear film break-up time (SBUT), weekly oculo-nasal symptoms during the past three months, and allergic rhinitis of 159 adults were obtained. Among them, 58 % were females, 24.5 % were atopics, and 41 % reported home dampness. The median SBUT was 22.3 s. Oculo-nasal symptoms (15.3 %) and allergic rhinitis (32.7 %) were common. A higher level of 2-hexanone was linked to lower SBUT (p = 0.036). Higher levels of total mold (p = 0.038), allergen Fel d 1 from cat (p = 0.045), and allergen Der p 1 (p = 0.012) and Der f 1 (p = 0.036) from house dust mite (HDM), were related to more oculo-nasal symptoms. Higher levels of 3-methylfuran (p = 0.003), 2-hexanone (p = 0.037), 2-heptanone (p = 0.018), and 1-octen-3-ol (p = 0.001) were linked to oculo-nasal symptoms. Higher levels of viable bacteria (p = 0.015), 3-octanone (p = 0.049) and formaldehyde (p = 0.039) were linked to allergic rhinitis. The association between 2-heptanone and oculo-nasal symptoms (interaction p = 0.012), and between isobutyl acetate and allergic rhinitis (interaction p = 0.084) were more pronounced in women. The negative association between 2-hexanone and SBUT was stronger among atopics (interaction p = 0.098), and the links between viable bacteria and allergic rhinitis (interaction p = 0.003) and between Der f 1 and oculo-nasal symptoms (interaction p = 0.1) were more pronounced among non-atopics. In conclusion, airborne mold and bacteria, and allergens in dust were associated with oculo-nasal symptoms or allergic rhinitis. 3-Methylfuran, 2-hexanone, 1-octen-3-ol, and 2-heptanone were associated with adult oculonasal symptoms. Increased 3-octanone and formaldehyde were related to allergic rhinitis.

Indoor bacteria, mold, allergens, and selected volatile organic compounds (VOC) were measured at home in three Nordic cities. Data on self-reported tear film break-up time (SBUT), weekly oculo-nasal symptoms during the past three months, and allergic rhinitis of 159 adults were obtained. Among them, 58 % were females, 24.5 % were atopics, and 41 % reported home dampness. The median SBUT was 22.3 s. Oculo-nasal symptoms (15.3 %) and allergic rhinitis (32.7 %) were common. A higher level of 2-hexanone was linked to lower SBUT (p = 0.036). Higher levels of total mold (p = 0.038), allergen Fel d 1 from cat (p = 0.045), and allergen Der p 1 (p = 0.012) and Der f 1 (p = 0.036) from house dust mite (HDM), were related to more oculo-nasal symptoms. Higher levels of 3-methylfuran (p = 0.003), 2-hexanone (p = 0.037), 2-heptanone (p = 0.018), and 1-octen-3-ol (p = 0.001) were linked to oculo-nasal symptoms. Higher levels of viable bacteria (p = 0.015), 3-octanone (p = 0.049) and formaldehyde (p = 0.039) were linked to allergic rhinitis. The association between 2-heptanone and oculo-nasal symptoms (interaction p = 0.012), and between isobutyl acetate and allergic rhinitis (interaction p = 0.084) were more pronounced in women. The negative association between 2-hexanone and SBUT was stronger among atopics (interaction p = 0.098), and the links between viable bacteria and allergic rhinitis (interaction p = 0.003) and between Der f 1 and oculo-nasal symptoms (interaction p = 0.1) were more pronounced among non-atopics. In conclusion, airborne mold and bacteria, and allergens in dust were associated with oculo-nasal symptoms or allergic rhinitis. 3-Methylfuran, 2-hexanone, 1-octen-3-ol, and 2-heptanone were associated with adult oculonasal symptoms. Increased 3-octanone and formaldehyde were related to allergic rhinitis.

Indoor bacteria, mold, allergens, and selected volatile organic compounds (VOC) were measured at home in three Nordic cities. Data on self-reported tear film break-up time (SBUT), weekly oculo-nasal symptoms during the past three months, and allergic rhinitis of 159 adults were obtained. Among them, 58 % were females, 24.5 % were atopics, and 41 % reported home dampness. The median SBUT was 22.3 s. Oculo-nasal symptoms (15.3 %) and allergic rhinitis (32.7 %) were common. A higher level of 2-hexanone was linked to lower SBUT (p = 0.036). Higher levels of total mold (p = 0.038), allergen Fel d 1 from cat (p = 0.045), and allergen Der p 1 (p = 0.012) and Der f 1 (p = 0.036) from house dust mite (HDM), were related to more oculo-nasal symptoms. Higher levels of 3-methylfuran (p = 0.003), 2-hexanone (p = 0.037), 2-heptanone (p = 0.018), and 1-octen-3-ol (p = 0.001) were linked to oculo-nasal symptoms. Higher levels of viable bacteria (p = 0.015), 3-octanone (p = 0.049) and formaldehyde (p = 0.039) were linked to allergic rhinitis. The association between 2-heptanone and oculo-nasal symptoms (interaction p = 0.012), and between isobutyl acetate and allergic rhinitis (interaction p = 0.084) were more pronounced in women. The negative association between 2-hexanone and SBUT was stronger among atopics (interaction p = 0.098), and the links between viable bacteria and allergic rhinitis (interaction p = 0.003) and between Der f 1 and oculo-nasal symptoms (interaction p = 0.1) were more pronounced among non-atopics. In conclusion, airborne mold and bacteria, and allergens in dust were associated with oculo-nasal symptoms or allergic rhinitis. 3-Methylfuran, 2-hexanone, 1-octen-3-ol, and 2-heptanone were associated with adult oculo-nasal symptoms. Increased 3-octanone and formaldehyde were related to allergic rhinitis.

Producción Científica, Purpose: To assess the reliability and agreement of non-invasive break-up time (NIBUT) in symptomatic and asymptomatic contact lens (CL) wearers using automatic objective and conventional subjective techniques. Methods: In this prospective cross-sectional study, soft CL wearers, classified into symptomatic and asymptomatic based on the Contact Lens Dry Eye Questionnaire-8, underwent NIBUT assessment with the CL in situ. The CA-800 Corneal Analyzer and the EasyTear® VIEW+ Tearscope were used for objective and subjective evaluation, respectively. The within-subject repeatability and intraclass correlation coefficient (ICC) were calculated. The agreement between the devices was compared using the Bland–Altman method. Results: A total of 141 CL wearers (51 male and 90 female) with a mean age of 33.6 (SD = 12.2) years were included. The repeatability and ICC values obtained with the CA-800 device when measuring NIBUT were 5.4 s and 58.6% across the whole sample, 4.2 s and 48.8% for the asymptomatic group and 7.1 s and 68.4% for the symptomatic group. When using the subjective method (EasyTear®), the respective repeatability and ICC values were 7.3 s and 32.7% for the whole sample, 6.5 s and 30.4% for the asymptomatic group and 8.6 s and 35.9% for the symptomatic group. The CA-800 device provided significantly (p < 0.001) shorter NIBUT values compared with EasyTear® for the whole sample (3.3 [2.9] vs. 8.1 [3.4] s), the asymptomatic (3.3 [3.0] vs. 7.7 [3.6] s) and the symptomatic (3.8 [2.9] vs. 8.6 [3.0] s) groups. Conclusion: Objective (CA-800) NIBUT assessment provides more reliable measurements than the conventional subjective technique using the EasyTear® device. However, CL practitioners should also be aware that the objective method indicates shorter NIBUT values. Symptomatic CL wearers may also need a higher number of NIBUT measurements to obtain reliable estimations., Ministry of Universities and European Social Fund, Grant/Award Number: FPU19/01109

Indoor bacteria, mold, allergens, and selected volatile organic compounds (VOC) were measured at home in three Nordic cities. Data on self-reported tear film break-up time (SBUT), weekly oculo-nasal symptoms during the past three months, and allergic rhinitis of 159 adults were obtained. Among them, 58 % were females, 24.5 % were atopics, and 41 % reported home dampness. The median SBUT was 22.3 s. Oculo-nasal symptoms (15.3 %) and allergic rhinitis (32.7 %) were common. A higher level of 2-hexanone was linked to lower SBUT (p = 0.036). Higher levels of total mold (p = 0.038), allergen Fel d 1 from cat (p = 0.045), and allergen Der p 1 (p = 0.012) and Der f 1 (p = 0.036) from house dust mite (HDM), were related to more oculo-nasal symptoms. Higher levels of 3-methylfuran (p = 0.003), 2-hexanone (p = 0.037), 2-heptanone (p = 0.018), and 1-octen-3-ol (p = 0.001) were linked to oculo-nasal symptoms. Higher levels of viable bacteria (p = 0.015), 3-octanone (p = 0.049) and formaldehyde (p = 0.039) were linked to allergic rhinitis. The association between 2-heptanone and oculo-nasal symptoms (interaction p = 0.012), and between isobutyl acetate and allergic rhinitis (interaction p = 0.084) were more pronounced in women. The negative association between 2-hexanone and SBUT was stronger among atopics (interaction p = 0.098), and the links between viable bacteria and allergic rhinitis (interaction p = 0.003) and between Der f 1 and oculo-nasal symptoms (interaction p = 0.1) were more pronounced among non-atopics. In conclusion, airborne mold and bacteria, and allergens in dust were associated with oculo-nasal symptoms or allergic rhinitis. 3-Methylfuran, 2-hexanone, 1-octen-3-ol, and 2-heptanone were associated with adult oculonasal symptoms. Increased 3-octanone and formaldehyde were related to allergic rhinitis.

To evaluate the agreement and repeatability of an automated topography-based method for non-invasive break-up time (NIBUT) analyses in comparison with two other NIBUT procedures, the fluorescein procedure (fBUT), and with the manual assessment with the same device. In the first experiment, a semi-randomised crossover study was performed on forty-three participants (23.1 ± 2.1 years). NIBUT measurements were collected in a randomised order, in both eyes of participants with EasyTear View + (Easytear, Rovereto), Polaris, and Sirius + (CSO, Firenze). Then a fBUT was collected. The overall measurement procedure was repeated in a further session (retest) on the same day. In a second experiment, a retrospective randomised crossover study was performed on eighty-five NIBUT videos previously recorded by the Sirius+. Two observers assessed manually the videos and the NIBUTs were compared with the automatic ones. In the first experiment, ANOVA showed a significant difference between the four measures in both eyes (p < 0.001). Significant differences were found in the paired comparisons between each NIBUT procedure and fBUT (Wicoxon; p < 0.05). Sirius+ resulted in agreement only with Polaris in the left eye. Correlations between all NIBUT procedures resulted in statistical significance in both eyes. All procedures showed very good test-rest reliability. In the second experiment, a significant correlation between automated and manual NIBUT was found, but also a significant statistical difference between the two measurements, although clinically negligible (0.3 s). The investigated NIBUT devices perform differently from each other (and from fBUT), so they cannot be considered interchangeable. The automated measure of NIBUT with Sirius+ has a negligible clinical difference compared to manual assessment on the same device.

To evaluate the agreement and repeatability of an automated topography-based method for non-invasive break-up time (NIBUT) analyses in comparison with two other NIBUT procedures, the fluorescein procedure (fBUT), and with the manual assessment with the same device. In the first experiment, a semi-randomised crossover study was performed on forty-three participants (23.1 ± 2.1 years). NIBUT measurements were collected in a randomised order, in both eyes of participants with EasyTear View + (Easytear, Rovereto), Polaris, and Sirius + (CSO, Firenze). Then a fBUT was collected. The overall measurement procedure was repeated in a further session (retest) on the same day. In a second experiment, a retrospective randomised crossover study was performed on eighty-five NIBUT videos previously recorded by the Sirius+. Two observers assessed manually the videos and the NIBUTs were compared with the automatic ones. In the first experiment, ANOVA showed a significant difference between the four measures in both eyes (p < 0.001). Significant differences were found in the paired comparisons between each NIBUT procedure and fBUT (Wicoxon; p < 0.05). Sirius+ resulted in agreement only with Polaris in the left eye. Correlations between all NIBUT procedures resulted in statistical significance in both eyes. All procedures showed very good test-rest reliability. In the second experiment, a significant correlation between automated and manual NIBUT was found, but also a significant statistical difference between the two measurements, although clinically negligible (0.3 s). The investigated NIBUT devices perform differently from each other (and from fBUT), so they cannot be considered interchangeable. The automated measure of NIBUT with Sirius+ has a negligible clinical difference compared to manual assessment on the same device.

To evaluate the agreement and repeatability of an automated topography-based method for non-invasive break-up time (NIBUT) analyses in comparison with two other NIBUT procedures, the fluorescein procedure (fBUT), and with the manual assessment with the same device. In the first experiment, a semi-randomised crossover study was performed on forty-three participants (23.1 ± 2.1 years). NIBUT measurements were collected in a randomised order, in both eyes of participants with EasyTear View + (Easytear, Rovereto), Polaris, and Sirius + (CSO, Firenze). Then a fBUT was collected. The overall measurement procedure was repeated in a further session (retest) on the same day. In a second experiment, a retrospective randomised crossover study was performed on eighty-five NIBUT videos previously recorded by the Sirius+. Two observers assessed manually the videos and the NIBUTs were compared with the automatic ones. In the first experiment, ANOVA showed a significant difference between the four measures in both eyes (p < 0.001). Significant differences were found in the paired comparisons between each NIBUT procedure and fBUT (Wicoxon; p < 0.05). Sirius+ resulted in agreement only with Polaris in the left eye. Correlations between all NIBUT procedures resulted in statistical significance in both eyes. All procedures showed very good test-rest reliability. In the second experiment, a significant correlation between automated and manual NIBUT was found, but also a significant statistical difference between the two measurements, although clinically negligible (0.3 s). The investigated NIBUT devices perform differently from each other (and from fBUT), so they cannot be considered interchangeable. The automated measure of NIBUT with Sirius+ has a negligible clinical difference compared to manual assessment on the same device.

Producción Científica, Purpose To assess the reliability and agreement of non-invasive break-up time (NIBUT) in symptomatic and asymptomatic contact lens (CL) wearers using automatic objective and conventional subjective techniques. Methods In this prospective cross-sectional study, soft CL wearers, classified into symptomatic and asymptomatic based on the Contact Lens Dry Eye Questionnaire-8, underwent NIBUT assessment with the CL in situ. The CA-800 Corneal Analyzer and the EasyTear® VIEW+ Tearscope were used for objective and subjective evaluation, respectively. The within-subject repeatability and intraclass correlation coefficient (ICC) were calculated. The agreement between the devices was compared using the Bland–Altman method. Results A total of 141 CL wearers (51 male and 90 female) with a mean age of 33.6 (SD = 12.2) years were included. The repeatability and ICC values obtained with the CA-800 device when measuring NIBUT were 5.4 s and 58.6% across the whole sample, 4.2 s and 48.8% for the asymptomatic group and 7.1 s and 68.4% for the symptomatic group. When using the subjective method (EasyTear®), the respective repeatability and ICC values were 7.3 s and 32.7% for the whole sample, 6.5 s and 30.4% for the asymptomatic group and 8.6 s and 35.9% for the symptomatic group. The CA-800 device provided significantly (p < 0.001) shorter NIBUT values compared with EasyTear® for the whole sample (3.3 [2.9] vs. 8.1 [3.4] s), the asymptomatic (3.3 [3.0] vs. 7.7 [3.6] s) and the symptomatic (3.8 [2.9] vs. 8.6 [3.0] s) groups. Conclusion Objective (CA-800) NIBUT assessment provides more reliable measurements than the conventional subjective technique using the EasyTear® device. However, CL practitioners should also be aware that the objective method indicates shorter NIBUT values. Symptomatic CL wearers may also need a higher number of NIBUT measurements to obtain reliable estimations., Ministerio de Universidades y Fondo Social Europeo, Número de subvención (FPU19/01109)

Purpose: Inter-eye variability is a recognized characteristic of Dry Eye Disease (DED) and has been proposed as a diagnostic indicator in clinical practice. This study aimed to assess the diagnostic potential of the absolute difference between eyes in three key diagnostic tests recommended by the Tear Film and Ocular Surface Society Dry Eye Workshop II (TFOS DEWS II) Diagnostic Methodology report: tear film osmolarity, Fluorescein Break-Up Time (FBUT), and ocular surface staining. Methods: A total of 180 participants were included in a cross-sectional study. Before a dry eye examination, participants completed an online self-administered OSDI questionnaire. The TFOS DEWS II diagnostic criteria for DED assessment were used: along with OSDI, osmolarity, FBUT and ocular surface staining were measured in all participants in both eyes following standardized methodology. Based on signs and symptoms, participants were diagnosed as having No DED or DED. After diagnosis, parameters were computed as the right and left eyes' absolute inter-eye difference (|OD-OS|). Results: Receiver Operating Characteristics analyses for computed parameters were used based on the previous diagnosis. ROC analyses showed that Osmolarity|OD-OS| have a diagnostic capability to differentiate between No DED and DED participants with a cut-off value of 9.5 mOsm/L (AUC = 0.745 ± 0.052, p < 0.003), whereas FBUT|OD-OS| and Corneal Stainning|OD-OS| have not (AUC, both p ≥ 0.160). Conclusion: The present study found that the Osmolarity|OD-OS| parameter could be used as a diagnostic indicator for DED assessment, while the FBUT|OD-OS| and the Corneal Staining|OD-OS| parameters do not have this capability.

Ariesanti Tri Handayani,1 Clara Valentina,1 I Gusti Ayu Ratna Suryaningrum,1 Putu Dian Megasafitri,1 I Gusti Ayu Made Juliari,1 Ida Ayu Ary Pramita,1 Shintaro Nakayama,2,3 Eisuke Shimizu,2,3 Anak Agung Mas Putrawati Triningrat1 1Ophthalmology Study Program Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia; 2Department of Ophthalmology, Keio University School of Medicine, Shinjuku, Tokyo, Japan; 3OUI Inc ., Minato, Tokyo, JapanCorrespondence: Ariesanti Tri Handayani, Ophthalmology Study Program Faculty of Medicine, Udayana University, Jl. Diponegoro, Dauh Puri Klod, Kec, West Denpasar, Denpasar City, Bali, 80113, Indonesia, Tel +62818-375611, Email ariesanti@unud.ac.idIntroduction: Dry eye disease (DED) is a multifactorial disease of tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability leading to decrease of vision, productivity and quality of life, and blindness. DED diagnosis remains difficult and underdiagnosed regarding inconsistency between subjective symptoms and clinical findings. Tear break-up time (TBUT) is an objective indicator of tear film stability in diagnostic DED. A novel smartphone attachment, namely SEC (smart eye camera), could mimic conventional slit lamp to assess TBUT and beneficial in facilitating DED diagnosis. Reliability between a non and an ophthalmologist in TBUT assessment and DED diagnosis is observed in this study.Purpose: To determine interobserver reliability of TBUT measurement for diagnosing DED using SEC.Design: This a cross-sectional analytic study involving 99 participants (198 eyes) aged 40 years who visited Pratama Gema Santi Hospital, Nusa Penida, from September 2nd to 4th, 2022, with consecutive sampling technique.Methods: Fluoresceined eyes were filmed using the SEC device and apps, continued by masked ophthalmologist and resident assessing TBUT based on the video. The primary outcome is interobserver reliability for TBUT measurement and DED diagnosis

Dupilumab, blocking IL-4 and IL-13 signals, improves atopic dermatitis and Quality of Life but might be also associated with the occurrence of ocular adverse events (OAEs). The main objective of our prospective study was to characterize the cytokine and chemokine profile in the tear fluid of dupilumab-treated patients with moderate-to- severe atopic dermatitis and to identify biomarkers predicting the occurrence of ocular adverse events. Patients with moderate-to-severe AD underwent dermatological and ophthalmological evaluation at the baseline (T0) and week 16 or at the time of an eventual ocular adverse events (T1). A multiplex immunoassay measuring multiple cytokines and chemokines in the tear fluid extracted during ocular examination at both T0 and T1 was performed. Thirty-nine patients with moderate-to-severe AD and treated with dupilumab were included in the study. Baseline tear fluid levels revealed a significantly higher concentration of type 2 cytokines and chemokines in AD patients than healthy controls. The occurrence of ocular adverse events during dupilumab therapy was associated with a significant increase of IL-33 tear fluid levels and a significantly lower tear break-up time, this latter also identified as predictive factor. Our findings suggest that the ophthalmological examination should be considered a valid support to identify patients at risk of developing OAEs and to provide their appropriate management.

This study aimed to evaluate the non-invasive and subjective symptoms associated with Lehfilcon A water gradient silicone hydrogel contact lenses with bacterial and lipid resistance technology. A prospective, longitudinal, single-centre, self-controlled study was conducted among silicone hydrogel contact lens wearers. Non-invasive analysis of the pre-lens tear film was performed using the Integrated Clinical Platform (ICP) Ocular Surface Analyzer (OSA), and the meibomian glands were evaluated with the Cobra® HD infrared meibographer. After 30 days of contact lens wear, the subjects were re-evaluated to determine the changes in conjunctival redness, subjective dry eye disease, tear meniscus height, lipid pattern, and non-invasive break-up time. Results showed that the lipid layer thickness decreased significantly from 2.05 ± 1.53 to 0.92 ± 1.09 Guillon patterns, and the tear meniscus height decreased from 0.21 ± 0.04 to 0.14 ± 0.03. The mean pre-lens non-invasive break-up time (NIBUT) significantly increased from 15.19 ± 9.54 to 25.31 ± 15.81 s. The standard Patient Evaluation of Eye Disease (SPEED) score also decreased from 7.39 ± 4.39 to 5.53 ± 4.83. The results suggest that Lehfilcon A significantly reduced lipid and aqueous tear film volume but improved break-up time and subjective dry eye symptoms.

This study aimed to investigate the effect of palpebral fissure height in primary gaze position in healthy individuals on tear film stability. In this cross-sectional study, 120 subjects (60 male and female each) were enrolled and divided according to age into two groups, i.e., group 1 (aged 18-50 years) and group 2 (aged 51 and older). Palpebral fissure height on both eyes was measured in primary gaze position with a clear plastic ruler held in a central vertical position between the upper and lower lid margin, and the standard tear break-up time (TBUT) test was performed to evaluate tear film stability. Palpebral fissure height was significantly higher in younger than older subjects in all measurements on both eyes (p<0.001), and TBUT was shorter in older than in younger subjects. In all subjects included in the study, palpebral fissure height was not related to TBUT (p=0.589). However, analyzing the two age groups separately, a significant negative correlation was found between the palpebral fissure height and TBUT in both groups of younger (p<0.001) and older (p=0.009) subjects. In conclusion, an enlarged exposed ocular surface due to higher palpebral fissure height in healthy individual’s primary gaze position negatively affects tear film stability expressed by TBUT., Cilj ovog istraživanja bio je ispitati utjecaj visine vjeđnog rasporka u primarnom položaju pogleda kod zdravih osoba na stabilnost suznog filma. U ovo presječno istraživanje bilo je uključeno 120 ispitanika (60 muškaraca i 60 žena) i prema životnoj dobi podijeljeno u dvije ispitivane skupine: 1. skupina (u dobi od 18-50 godina) i 2. skupina (u dobi od 51 i više godina). Visina vjeđnog rasporka na oba oka mjerena je u primarnom položaju pogleda prozirnim plastičnim ravnalom koje se držalo u središnjoj okomitoj liniji između ruba gornje i ruba donje vjeđe, a standardni test pucanja suznog filma (tear break-up time, TBUT) primijenjen je za procjenu stabilnosti suznog filma. Visina vjeđnog rasporka bila je u svim mjerenjima na oba oka značajno veća u mlađih nego u starijih ispitanika (p<0,001), a TBUT je bio kraći u starijih nego u mlađih ispitanika. U svih ispitanika uključenih u istraživanje visina vjeđnog rasporka nije bila povezana s TBUT-om (p=0,589). No, analizirajući dvije dobne skupine odvojeno utvrđena je značajna negativna povezanost između visine vjeđnog rasporka i TBUT-a u obje skupine, u mlađih (p<0,001) i starijih (p=0,009) ispitanika. U zaključku, povećana izložena očna površina zbog veće visine vjeđnog rasporka u primarnom položaju pogleda u zdravih osoba negativno utječe na stabilnost suznog filma izraženu TBUT-om.

This study aimed to evaluate the non-invasive and subjective symptoms associated with Lehfilcon A water gradient silicone hydrogel contact lenses with bacterial and lipid resistance technology. A prospective, longitudinal, single-centre, self-controlled study was conducted among silicone hydrogel contact lens wearers. Non-invasive analysis of the pre-lens tear film was performed using the Integrated Clinical Platform (ICP) Ocular Surface Analyzer (OSA), and the meibomian glands were evaluated with the Cobra® HD infrared meibographer. After 30 days of contact lens wear, the subjects were re-evaluated to determine the changes in conjunctival redness, subjective dry eye disease, tear meniscus height, lipid pattern, and non-invasive break-up time. Results showed that the lipid layer thickness decreased significantly from 2.05 ± 1.53 to 0.92 ± 1.09 Guillon patterns, and the tear meniscus height decreased from 0.21 ± 0.04 to 0.14 ± 0.03. The mean pre-lens non-invasive break-up time (NIBUT) significantly increased from 15.19 ± 9.54 to 25.31 ± 15.81 s. The standard Patient Evaluation of Eye Disease (SPEED) score also decreased from 7.39 ± 4.39 to 5.53 ± 4.83. The results suggest that Lehfilcon A significantly reduced lipid and aqueous tear film volume but improved break-up time and subjective dry eye symptoms.

Syfte: Syftet med studien var att jämföra två metoder vid undersökning av tårfilmsanalys; tårflödesbeteende-metoden och fluorescein break-up mönster och om deras mätresultat överensstämmer med varandra. Detta för att diskutera om någon av metoderna kunde vara ett bättre alternativ att adaptera ute i praktiken för vårdgivare inom ögonvården. Metod: Initialt fick deltagarna besvara en OSDI-enkät (ocular surface disease index), därefter gjordes resterande mätningar i biomikroskopet. I biomikroskopet utfördes initialt dem icke-invasiva mätningarna som tillhörde tårflödesbeteende-metoden (mätning av TMH (tårmeniskhöjd), debrishastighet efter blinkning och mätning av lipidlagrets interferensmönster) även NiBUT (non-invasive tear break-up time) utfördes. Efter dem icke-invasiva mätningarna tillsattes fluorescein i inferiora temporala fornix och dem invasiva testerna; TBUT (tear break-up time) och FBUP (fluorescein break-up mönster) utfördes tre gånger. Alla mätningar dokumenterades med video. Tre oberoende bedömningar utfördes. Studien undersökte om resultatet av tårflödesbeteendet och FBUP hade ett samband och vilken utav metoderna som fick en högre intravaliditet utefter dem bedömningar som utfördes. Resultat: Totalt deltog 26 deltagare varav 4 exkluderades. Deltagarna var mellan 19–57 år gamla med en genomsnittsålder på 35 år och en standardavvikelse på ±12,3 år. Samtliga presenterade med en OSDI ≥13, alternativt hade en visuellt frekvent blinkfrekvens. Det återfanns ett samband mellan tårflödesbeteende-metoden och FBUP i studien, dock ingen av klinisk signifikans ((bedömare 1, Cramer’s V= 0,46 p=0,06) (bedömare 2, Cramer’s V=0,33 p=0,32) (bedömare 3, Cramer’s V=0,33 p=0,34)). Tårflödesbeteende-metoden (Fleiss kappa =0,29, p=0,40) och FBUP (Fleiss kappa =0,25, p=0,40) uppvisade båda på en mindre god intra-validitet Slutsats: Det finns ett samband mellan tårflödesbeteende-metoden och FBUP men ingen statistisk signifikans. Intravaliditeten är marginellt högre vid tårflöde, Aim: The aim of this study was to compare two methods used during tear-film analysis; tear-flow behaviour, and fluorescein break-up pattern and if their measured results are in an agreement. This in order to discuss which one of the methods would be more suitable to apply in clinical practice for healthcare workers in the field of optometry. Method: Initially the participants filled out an OSDI questionnaire (ocular surface disease index), thereafter measurements were done in the biomicroscope. Initially the non-invasive measurements such as the tear-flow behaviour method (measurements of TMH (tear meniscus height), speed of debris movement across the tear film after blinking and measurements of the lipid layer interference) and NiBUT (non-invasive break-up time) were measured. Afterwards fluorescein was applied in the inferior temporal fornix and the invasive measurements; TBUT (tear break-up time) and FBUP (fluorescein break-up pattern) were measured three times. All measurements done in the biomicroscope were documented with video and three independent assessments were done. This study looked at the results from the tear-flow behaviour and FBUP and if they agreed with one another. It also looked into which one of the methods presented a higher intra-validity in regard to the assessments made. Results: The study had a total of 26 participants, of which 4 were excluded. The participants were between the ages of 19-57 years old with an average age of 35 years with a standard deviation of ±12,3 years. The participants presented with an OSDI of ≥13, with exceptions made if a participant visually had a high blink frequency. A correspondence between the tear-flow behaviour method and FBUP could be observed, however none of statistical significance ((assessor 1, Cramer’s V= 0,46 p=0,06) (assessor 2, Cramer’s V=0,33 p=0,32) (assessor 3, Cramer’s V=0,33 p=0,34)). The intra-validity of the tear-flow behaviour method (Fleiss kappa =0,29, p=0,40) and FBUP (Fleiss kappa =0,2

Producción Científica, Purpose: This study aimed to assess the subjective and objective differences among the steps of the contact lens discomfort (CLD) progression classification established by the Tear Film & Ocular Surface Society (TFOS) using questionnaires and clinical signs, and to propose a simplified classification. Methods: Contact lens (CL) wearers were evaluated in a single visit. The Contact Lens Dry Eye Questionnaire (CLDEQ)-8, the Contact Lens Discomfort Index, and Visual Analog Scales for discomfort and dryness were administered. The non-invasive break-up time, the tear film lipid layer thickness, conjunctival hyperaemia and papillae, lid-parallel conjunctival folds, the fluorescein tear film break-up time, corneal and conjunctival staining,lid wiper epitheliopathy, and the Schirmer test were assessed. Sign and symptom scores were compared among TFOS CLD progression steps using analysis of variance or the Kruskal–Wallis H test. Steps 1 and 2 (reduced comfort), and steps 3 and 4 (reduced wearing time) of the TFOS classification were combined to obtain a simplified classification, and the same comparison was performed. A p-value ≤ 0.05 was considered statistically significant. Results: One hundred-fifty CL wearers (97 women and 53 men) aged 34.4 ± 12.6 years were included. In the TFOS classification, there were significant differences between step 0 (no CLD) and the rest of the severity steps for the scores obtained in all questionnaires (p ≤ 0.015). All steps were differentiated (p ≤ 0.032) based on the simplified classification for all questionnaires, except steps 1 and 2 for the CLDEQ-8 and dryness VAS (p = 0.089 and p = 0.051, respectively). There were no differences (all p ≥ 0.06) between the sign scores among the steps of either classification. Conclusion: CLD management is encouraged from its first appearance. Simplifying the phases of CLD severity may allow a more accurate classification and a better awareness of the problem by clinicians and CL wearers by using more, This study was partially supported by Grant FPU19/01109 from the Ministry of Universities and European Social Fund. Funders had no role in the study.

Syfte: Syftet med studien var att jämföra två metoder vid undersökning av tårfilmsanalys; tårflödesbeteende-metoden och fluorescein break-up mönster och om deras mätresultat överensstämmer med varandra. Detta för att diskutera om någon av metoderna kunde vara ett bättre alternativ att adaptera ute i praktiken för vårdgivare inom ögonvården. Metod: Initialt fick deltagarna besvara en OSDI-enkät (ocular surface disease index), därefter gjordes resterande mätningar i biomikroskopet. I biomikroskopet utfördes initialt dem icke-invasiva mätningarna som tillhörde tårflödesbeteende-metoden (mätning av TMH (tårmeniskhöjd), debrishastighet efter blinkning och mätning av lipidlagrets interferensmönster) även NiBUT (non-invasive tear break-up time) utfördes. Efter dem icke-invasiva mätningarna tillsattes fluorescein i inferiora temporala fornix och dem invasiva testerna; TBUT (tear break-up time) och FBUP (fluorescein break-up mönster) utfördes tre gånger. Alla mätningar dokumenterades med video. Tre oberoende bedömningar utfördes. Studien undersökte om resultatet av tårflödesbeteendet och FBUP hade ett samband och vilken utav metoderna som fick en högre intravaliditet utefter dem bedömningar som utfördes. Resultat: Totalt deltog 26 deltagare varav 4 exkluderades. Deltagarna var mellan 19–57 år gamla med en genomsnittsålder på 35 år och en standardavvikelse på ±12,3 år. Samtliga presenterade med en OSDI ≥13, alternativt hade en visuellt frekvent blinkfrekvens. Det återfanns ett samband mellan tårflödesbeteende-metoden och FBUP i studien, dock ingen av klinisk signifikans ((bedömare 1, Cramer’s V= 0,46 p=0,06) (bedömare 2, Cramer’s V=0,33 p=0,32) (bedömare 3, Cramer’s V=0,33 p=0,34)). Tårflödesbeteende-metoden (Fleiss kappa =0,29, p=0,40) och FBUP (Fleiss kappa =0,25, p=0,40) uppvisade båda på en mindre god intra-validitet Slutsats: Det finns ett samband mellan tårflödesbeteende-metoden och FBUP men ingen statistisk signifikans. Intravaliditeten är marginellt högre vid tårflöde, Aim: The aim of this study was to compare two methods used during tear-film analysis; tear-flow behaviour, and fluorescein break-up pattern and if their measured results are in an agreement. This in order to discuss which one of the methods would be more suitable to apply in clinical practice for healthcare workers in the field of optometry. Method: Initially the participants filled out an OSDI questionnaire (ocular surface disease index), thereafter measurements were done in the biomicroscope. Initially the non-invasive measurements such as the tear-flow behaviour method (measurements of TMH (tear meniscus height), speed of debris movement across the tear film after blinking and measurements of the lipid layer interference) and NiBUT (non-invasive break-up time) were measured. Afterwards fluorescein was applied in the inferior temporal fornix and the invasive measurements; TBUT (tear break-up time) and FBUP (fluorescein break-up pattern) were measured three times. All measurements done in the biomicroscope were documented with video and three independent assessments were done. This study looked at the results from the tear-flow behaviour and FBUP and if they agreed with one another. It also looked into which one of the methods presented a higher intra-validity in regard to the assessments made. Results: The study had a total of 26 participants, of which 4 were excluded. The participants were between the ages of 19-57 years old with an average age of 35 years with a standard deviation of ±12,3 years. The participants presented with an OSDI of ≥13, with exceptions made if a participant visually had a high blink frequency. A correspondence between the tear-flow behaviour method and FBUP could be observed, however none of statistical significance ((assessor 1, Cramer’s V= 0,46 p=0,06) (assessor 2, Cramer’s V=0,33 p=0,32) (assessor 3, Cramer’s V=0,33 p=0,34)). The intra-validity of the tear-flow behaviour method (Fleiss kappa =0,29, p=0,40) and FBUP (Fleiss kappa =0,2

Purpose This double-blinded randomized clinical trial aimed to evaluate the efficacy of injecting allogeneic adipose-derived mesenchymal stem cells (ASCs) into the lacrimal gland (LG) for the treatment of dry eye disease (DED) secondary to Sjögren's syndrome (SS). Methods Fifty-four participants with severe DED secondary to SS were included and allocated to either ASCs (n = 20), vehicle (n = 20), or a non-randomized observation group (n = 14). The intervention groups received a single injection of either ASCs or an active comparator (vehicle, Cryostor® CS10) into the LG in one eye, while the observation group received lubricating eye drops only. The primary outcome measure was changes in Ocular Surface Disease Index (OSDI) score and secondary outcome measures were non-invasive tear break-up time, tear meniscus height, Schirmer's test, and Oxford score within a 12-month follow-up. Results A significant reduction in OSDI score was observed in the ASCs and vehicle groups compared to the observation group. In addition, the ASCs group demonstrated a significant increase in non-invasive tear break-up time compared to the vehicle group at the 4-week follow-up and to the observation group at the 12-month follow-up. A significant improvement in ocular surface staining, tear osmolarity, and Schirmer test score from baseline was also observed in the ASCs group; however, these changes were not significant compared to the other groups. Conclusion Improvement of subjective and objective signs and symptoms of DED was observed in both intervention groups following injection into the LG compared to the observation group. Future studies should investigate the mode-of-action of both injection treatments., Purpose: This double-blinded randomized clinical trial aimed to evaluate the efficacy of injecting allogeneic adipose-derived mesenchymal stem cells (ASCs) into the lacrimal gland (LG) for the treatment of dry eye disease (DED) secondary to Sjögren's syndrome (SS). Methods: Fifty-four participants with severe DED secondary to SS were included and allocated to either ASCs (n = 20), vehicle (n = 20), or a non-randomized observation group (n = 14). The intervention groups received a single injection of either ASCs or an active comparator (vehicle, Cryostor® CS10) into the LG in one eye, while the observation group received lubricating eye drops only. The primary outcome measure was changes in Ocular Surface Disease Index (OSDI) score and secondary outcome measures were non-invasive tear break-up time, tear meniscus height, Schirmer's test, and Oxford score within a 12-month follow-up. Results: A significant reduction in OSDI score was observed in the ASCs and vehicle groups compared to the observation group. In addition, the ASCs group demonstrated a significant increase in non-invasive tear break-up time compared to the vehicle group at the 4-week follow-up and to the observation group at the 12-month follow-up. A significant improvement in ocular surface staining, tear osmolarity, and Schirmer test score from baseline was also observed in the ASCs group; however, these changes were not significant compared to the other groups. Conclusion: Improvement of subjective and objective signs and symptoms of DED was observed in both intervention groups following injection into the LG compared to the observation group. Future studies should investigate the mode-of-action of both injection treatments.

L’ull sec és una malaltia multifactorial i complexa que cada cop afecta a més persones i per això és important conèixer-la. En aquest estudi el que s’ha volgut és avaluar i analitzar la simptomatologia d’ull sec en usuaris portadors de lents de contacte d’hidrogel, en un establiment d’òptica o bé en un gabinet optomètric. S’ha analitzat una mostra de 30 pacients majors de 18 anys sense patologies oculars actives ni cirurgies i usuaris de lents de contacte d’hidrogel convencional o de silicona que manifestin tenir simptomatologia d’ull sec. Es realitzen 3 proves diferents: el qüestionari Ocular Surface Disease Index (OSDI), el temps de ruptura lacrimal no invasiu (NIBUT) i l’altura del menisc lacrimal utilitzant el VISIONIX model Vx120 i el biomicroscopi. L’anàlisi de dades s’ha fet a partir d’una estadística descriptiva de l’Excel. Pel que fa al test OSDI, els resultats obtinguts han estat que la simptomatologia d’ull sec afecta més a les dones que als homes i que augmenta amb l’edat. En referència al NIBUT, els resultats són molt similars ja que també són les dones que tenen un temps de ruptura lacrimal inferior però no hi ha una clara tendència amb l’edat. Finalment, els resultats extrets de l’altura del menisc lacrimal indiquen que les dones tenen un menisc menor que els homes i que els usuaris entre 40 i 50 anys són els que tenen un menisc lacrimal més baix. L’estudi de l’efecte del tipus de reemplaçament diari o mensual de les lents de contacte sobre la simptomatologia es fa correlacionant el tipus de reemplaçament amb els resultats del test OSDI. Es conclou que les dones pateixen més simptomatologia d’ull sec que els homes i amb un grau major i, existeix una tendència creixent de la simptomatologia a mesura que augmenta l’edat. Les lents de reemplaçament diari provoquen menys simptomatologia d’ull sec que les de reemplaçament mensual., El ojo seco es una enfermedad multifactorial y compleja que cada día afecta a más personas, y por ese motivo es importante conocerla. En este estudio se ha querido avaluar y analizar la sintomatología de ojo seco en usuarios portadores de lentes de contacto de hidrogel, en un establecimiento óptico o en un gabinete optométrico. Se ha analizado una muestra de 30 pacientes mayores de 18 años sin patologías oculares actives ni cirugías siendo usuarios de lentes de contacto de hidrogel convencional o de silicona que manifiesten tener sintomatología de ojo seco. Se realizan 3 pruebas distintas: el cuestionario Ocular Surface Disease Index (OSDI), el tiempo de ruptura lacrimal no invasivo (NIBUT) y la altura del menisco lacrimal usando el VISIONIX modelo Vx120 y el biomicroscopio. El análisis de datos se ha hecho a partir de una estadística descriptiva de Excel. Respecto al test OSDI, los resultados obtenidos han sido que la sintomatología de ojo seco afecta más a mujeres que hombres y que aumenta con la edad. En referencia al NIBUT, los resultados son muy similares ya que también son las mujeres que tienen un tiempo de ruptura lacrimal inferior pero no existe una clara tendencia con la edad. Finalmente, los resultados extraídos de la altura del menisco lacrimal indican que las mujeres tienen un menisco menor que los hombres y que los usuarios entre 40 y 50 años son los que tienen un menisco lacrimal más bajo. El estudio del efecto del tipo de reemplazamiento diario o mensual de las lentes de contacte respecto la sintomatología se hace correlacionando el tipo de reemplazo con los usuarios del test OSDI. Se concluye que las mujeres sufren más sintomatología de ojo seco que los hombres y con un mayor grado. Existe una clara tendencia creciente de la sintomatología a medida que aumenta la edad. Las lentes de remplazo diario producen menos sintomatología de ojo seco que las de remplazo mensual., Dry eye is a multifactorial and complex disease which affects more people every time, and for these reason is important to know about it. In this study I wanted to evaluate and analyse the symptomatology of dry eye in user of hydrogel contact lenses, in some optical stablish or optometric cabinet. It wanted to analyse 30 patients over 18 years old without any ocular active pathology or surgery, but they use hydrogel contact lenses, conventional or silicone, and manifest symptoms of dry eye. It realizes 3 different proves: Ocular Surface Disease Index (OSDI) test, no invasive tear break-up time (NIBUT) and lacrimal meniscus height using VISIONIX model Vx120 and biomicroscopi. The data analysis was done through descriptive statistics in Excel. Respect OSDI test, the results show that the dry eye symptomatology affects most woman than man and increase with age. With reference to NIBUT, the results are similar because woman are who have a less tear break-up time but there is no clear trend with age. Lastly, the results obtained from the height of the lacrimal meniscus indicate that women have a smaller meniscus than men and that users between 40 and 50 years of age are the ones with the lowest tear meniscus. The study of the effect of the type of daily or monthly replacement of contact lenses regarding the symptoms is done by correlating the type of replacement with the users of the OSDI test. It is concluded that women suffer more dry eye symptoms than men and to a greater degree. There is a clear upward trend in symptomatology as age increases. Daily replacement lenses produce fewer dry eye symptoms than monthly replacement lenses.

Background: Changes in blink parameters have been found to influence ocular surface exposure, eliciting symptoms of dry eye and ocular signs. The aim of the study was to highlight the relevance of including blink regularity as a new parameter to fully characterize blinking; (2) Methods: A novel characterization of blink parameters is described, including spontaneous eyeblink rate (SEBR), percentage of incomplete blinks, and blink regularity. A pilot study was designed in which tear film break-up time (TFBUT), blink parameters, and the time percentage of ocular surface exposure were determined in eight subjects (52.0 ± 16.6 years, 4 females) in three experimental conditions (baseline, reading a hard-copy text, and reading from an electronic display). Blink parameters were monitored through asynchronous image analysis of one minute video segments; (3) Results: All blink parameters were influenced by experimental conditions. A trend was observed in which both reading tasks resulted in an increase in ocular surface exposure, mainly related to a combination of reduced SEBR, increased percentage of incomplete blinks, and loss of blink regularity; (4) Conclusions: A complete characterization of blink parameters is relevant to better understand ocular dryness related to surface exposure and to advice patients towards a reeducation of their blinking habits., This research was supported by the Spanish Agencia Estatal de Investigación (project number PID2020-114582RB-I00), Postprint (published version)

The purpose of this study is to evaluate the tear film dynamics between individuals with low and high Contact Lens Dry Eye Disease Questionnaire (CLDEQ-8) scores when wearing Lehfilcon A silicone hydrogel water gradient contact lenses. In this study, we implemented a longitudinal, single-location, self-comparison investigation. Variables measured included conjunctival redness, lipid layer thickness, tear meniscus height, first and mean non-invasive break-up time, CLDEQ-8, and standard patient evaluation of eye dryness (SPEED). In the second phase, participants were re-evaluated after 30 days of wearing the contact lenses to assess the tear film wearing the lenses. In a longitudinal comparison by group, we found that lipid layer thickness decreased 1.52 ± 1.38 (p < 0.01) and 0.70 ± 1.30 (p = 0.01) Guillon patterns degrees in the low and high CLDEQ-8 group, respectively. MNIBUT increased in 11.93 ± 17.93 (p < 0.01) and 7.06 ± 12.07 (p < 0.01) seconds. Finally, LOT increased in 22.19 ± 27.57 (p < 0.01) and 16.87 ± 25.09 (p < 0.01). In conclusion, this study demonstrates the effectiveness of Lehfilcon A silicone hydrogel water gradient contact lenses in improving tear film stability and reducing subjective dry eye symptoms in individuals with low and high CLDEQ-8 scores. However, it also led to an increase in conjunctival redness and a decrease in tear meniscus height.

Purpose To assess the tear flm layers and Meibomian glands by a noninvasive ocular surface analyzer in patients with and without type 1 diabetes mellitus (T1DM). Methods Eighty-eight participants were enrolled in this study: 44 patients with T1DM without diabetic retinopathy, and 44 patients as a control group, between 18 and 49 years old. Limbal and bulbar redness classifcation, lipid layer thickness (LLT), tear meniscus height (TMH), frst and mean noninvasive tear break-up time (FNIBUT and MNIBUT, respectively), and Meibomian glands loss (MGL) were assessment through the ICP Ocular Surface Analyzer (OSA). Schirmer’s I test (SIT), the fuorescein tear break-up time test (TFBUT), OSDI and SPEED questionnaires, and percentage of glycosylated hemoglobin (HbA1c) were also tested. Results The T1DM group showed higher limbal and bulbar redness (p=0.010) and lower LLT (p<0.001), TMH (p<0.001), FNIBUT (p<0.001), MNIBUT (p<0.001), SIT (p=0.001), and TFBUT (p<0.001) than the control group. A higher percentage of MGL was found in the T1DM group in the upper (p=0.097) and lower (p<0.001) eyelids. No signifcant diferences were found in dry eye symptoms across the OSDI and SPEED questionnaires between the two groups. Conclusion Patients with T1DM without signs of retinopathy showed involvement of the mucoaqueous and lipid layers of the tear flm, as well as a higher percentage of MGL, using a noninvasive analyzer. Dry eye disease in people with T1DM cannot be ruled out by anamnesis and subjective symptom questionnaires alone; therefore, these patients should undergo regular anterior pole examinations.

Purpose To assess the tear flm layers and Meibomian glands by a noninvasive ocular surface analyzer in patients with and without type 1 diabetes mellitus (T1DM). Methods Eighty-eight participants were enrolled in this study: 44 patients with T1DM without diabetic retinopathy, and 44 patients as a control group, between 18 and 49 years old. Limbal and bulbar redness classifcation, lipid layer thickness (LLT), tear meniscus height (TMH), frst and mean noninvasive tear break-up time (FNIBUT and MNIBUT, respectively), and Meibomian glands loss (MGL) were assessment through the ICP Ocular Surface Analyzer (OSA). Schirmer’s I test (SIT), the fuorescein tear break-up time test (TFBUT), OSDI and SPEED questionnaires, and percentage of glycosylated hemoglobin (HbA1c) were also tested. Results The T1DM group showed higher limbal and bulbar redness (p=0.010) and lower LLT (p<0.001), TMH (p<0.001), FNIBUT (p<0.001), MNIBUT (p<0.001), SIT (p=0.001), and TFBUT (p<0.001) than the control group. A higher percentage of MGL was found in the T1DM group in the upper (p=0.097) and lower (p<0.001) eyelids. No signifcant diferences were found in dry eye symptoms across the OSDI and SPEED questionnaires between the two groups. Conclusion Patients with T1DM without signs of retinopathy showed involvement of the mucoaqueous and lipid layers of the tear flm, as well as a higher percentage of MGL, using a noninvasive analyzer. Dry eye disease in people with T1DM cannot be ruled out by anamnesis and subjective symptom questionnaires alone; therefore, these patients should undergo regular anterior pole examinations.

Purpose: The purpose of this study was to check the efficacy and safety of a novel tear substitute containing hyaluronic acid and low-dose hydrocortisone in the treatment of moderate dry eye disease. Methods: In this prospective randomized study, 38 patients with moderate dry eye disease were divided into two treatment groups: Group 1 received one drop of 0.2% sodium hyaluronate and 0.001% hydrocortisone four times daily for 3 months, while Group 2 received 0.15% sodium hyaluronate and 3% trehalose at the same dosage. OSDI and SANDE questionnaires, Non-Invasive Break-Up time (NIBUT), Tear Meniscus Height (TMH), meibography, Lipid Layer Thickness (LLT), Tear Break-Up Time (TBUT), Corneal Staining Score (CFS), and Intraocular Pressure (IOP) were evaluated at baseline and after 1, 2, and 3 months of treatment. Results: During the treatment period, Group 1 showed statistically significant improvement in OSDI score (p = 0.002), SANDE score (p = 0.01), NIBUT (p < 0.0001), LLT (p < 0.0001), TBUT (p = 0.01), and CFS (p = 0.02). In Group 2, significant improvement was observed only in the TBUT score (p < 0.05). Comparison of the two groups showed that NIBUT and LLT were significantly different at the end of treatment (p = 0.001 for both comparisons), with more favorable results for sodium hyaluronate and hydrocortisone than for sodium hyaluronate and trehalose. No significant variations in intraocular pressure were observed in either group during the treatment period (p > 0.05). Conclusions: The study confirms that a 3-months treatment with hyaluronic acid 0.2% in combination with low-dose hydrocortisone 0.001% improves the signs and symptoms of moderate DED and that a low-dosage 0.001% hydrocortisone can be helpful in preventing the progression to chronic stages of DED.

Masahiko Ayaki,1,2,&ast; Kazuno Negishi1,&ast; 1Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; 2Otake Eye Clinic, Kanagawa, Japan&ast;These authors contributed equally to this workCorrespondence: Masahiko Ayaki, Email mayaki@olive.ocn.ne.jpPurpose: We aimed to determine the seasonal variation in the tear meniscus level on strip meniscometry and its association with ocular parameters and symptoms. In Japan, there are four distinct seasons characterized by marked differences in temperature and humidity, which may contribute to an observed seasonality of ocular surface symptoms.Methods: We conducted a cross-sectional study in two Japanese clinics and recruited first-visit patients for 3 years. Tear strip meniscometry, tear break-up time (BUT), Schirmer test, and corneal staining were examined, and major ocular symptoms (dryness, irritation, pain, fatigue, blurred vision, and photophobia) were determined through interviews.Results: The 1196 participants had a mean age of 58.9± 15.2 years; 37.1% were of male sex. Strip meniscometry values and BUT revealed significant seasonality with one-way analysis of variance. The mean strip meniscometry value (mm) was 2.15± 2.59 in spring (p=0.025 vs winter), 2.37± 2.79 in summer (p< 0.001), 2.38± 2.80 in fall (p< 0.001), and 1.64± 2.29 in winter. Regression analysis indicated that strip meniscometry levels were correlated with BUT (p< 0.001), Schirmer test values (p< 0.001), corneal staining scores (p=0.022), and presence of dryness (p< 0.001).Conclusion: Strip meniscometry values exhibited distinct seasonality, being lowest in winter when the ambient condition is dry and cool, and were correlated with BUT, Schirmer test values, corneal staining scores, and the presence of subjective dryness.Keywords: dry eye, seasonality, strip meniscometry, Schirmer test, tear break-up time

[Purpose] To conduct a review of the literature in order to identify the potential association between physical activity or exercise and the objective signs and/or subjective symptoms of dry-eye disease., [Methods] A review of PubMed and Web of Science databases was performed, according to the PRISMA guidelines. The papers included in the review addressed the relationship of physical activity or exercise with dry-eye associated signs (changes in tear volume, osmolarity or biochemical composition) and/or subjective symptoms., [Results] A total of 16 papers were included. In eight, the changes in tear film volume, osmolarity and/or biochemical composition were studied after a single, acute bout of aerobic exercise. In another eight, changes in dry-eye associated symptoms were studied in relation to the habitual practice of physical activity or to prescribed exercise programmes. Acute responses of the tear film to exercise included: a) an increase of tear volume, without an increase of the tear break-up time; b) a trend to increase tear osmolarity, although within its physiological range; and c) a reduced concentration of several cytokines, and other molecular markers of inflammation or oxidative stress. Long-term exposure to physical activity or exercise programmes was associated with relief of dry-eye associated symptoms and a trend to increased tear break-up time., [Conclusions] Despite a high heterogeneity in the studied population, study designs and methods, the current body of evidence suggests a potential role for physical activity as a modulatory stimulus for the proper functioning of the tear film and/or the relief of dry-eye symptoms.

The purpose of this study is to evaluate the tear film dynamics between individuals with low and high Contact Lens Dry Eye Disease Questionnaire (CLDEQ-8) scores when wearing Lehfilcon A silicone hydrogel water gradient contact lenses. In this study, we implemented a longitudinal, single-location, self-comparison investigation. Variables measured included conjunctival redness, lipid layer thickness, tear meniscus height, first and mean non-invasive break-up time, CLDEQ-8, and standard patient evaluation of eye dryness (SPEED). In the second phase, participants were re-evaluated after 30 days of wearing the contact lenses to assess the tear film wearing the lenses. In a longitudinal comparison by group, we found that lipid layer thickness decreased 1.52 ± 1.38 (p < 0.01) and 0.70 ± 1.30 (p = 0.01) Guillon patterns degrees in the low and high CLDEQ-8 group, respectively. MNIBUT increased in 11.93 ± 17.93 (p < 0.01) and 7.06 ± 12.07 (p < 0.01) seconds. Finally, LOT increased in 22.19 ± 27.57 (p < 0.01) and 16.87 ± 25.09 (p < 0.01). In conclusion, this study demonstrates the effectiveness of Lehfilcon A silicone hydrogel water gradient contact lenses in improving tear film stability and reducing subjective dry eye symptoms in individuals with low and high CLDEQ-8 scores. However, it also led to an increase in conjunctival redness and a decrease in tear meniscus height.

Purpose: To determine the effects of a thermo-mechanical action-based peri-orbital fractional skin treatment (Tixel®) on dry eye disease. Methods: This prospective, controlled, open labelled study was conducted at two study centres: Midland Eye, Solihull, UK, and Vallmedic Vision, Andorra. Participants were screened at the baseline visit (visit-1), received three Tixel® treatments at 2-weeks intervals including further assessment (visits 2, 3 and 4). Participants were followed up for three months post-treatment (visit 5). Vision, intraocular pressure (IOP), dry eye symptomatology were assessed, including the Ocular Surface Disease Index (OSDI) questionnaire, non-invasive tear break-up time (NIBUT) and tear osmolarity as well as detailed ophthalmic assessments. Results: Seventy-four participants (41 in Birmingham and 33 in Andorra) with periorbital wrinkles and moderate to severe dry eye disease (DED) were enrolled. The mean age was 59.3 ± 13.3 years and 57 were females. No adverse events, no change in vision (p = 0.310) or IOP (p = 0.419) were observed. Tixel treatment was associated with clinically and statistically significant improvement in the DED symptoms, which was supported by a reduction of 21.40 ± 15.08 (P < 0.001) of the OSDI index. Non-invasive tear break-up time improved by 2.10 ± 0.91 s (p < 0.001) in the Birmingham cohort and 6.60 ± 2.13 s (p < 0.001) in the Andorra cohort. Tear osmolarity reduced from 299.8 ± 13.3 mOsm/L to 298.8 ± 15.6 mOsm/L following the Tixel treatment (p = 0.271). Conclusions: Thermo-mechanical action-based peri-orbital fractional skin treatment Tixel® could be an attractive, safe and effective treatment for DED. This treatment is associated with high clinical and statistically significant improvement in DED signs and symptoms with no adverse events.

Purpose: To determine the effects of a thermo-mechanical action-based peri-orbital fractional skin treatment (Tixel®) on dry eye disease. Methods: This prospective, controlled, open labelled study was conducted at two study centres: Midland Eye, Solihull, UK, and Vallmedic Vision, Andorra. Participants were screened at the baseline visit (visit-1), received three Tixel® treatments at 2-weeks intervals including further assessment (visits 2, 3 and 4). Participants were followed up for three months post-treatment (visit 5). Vision, intraocular pressure (IOP), dry eye symptomatology were assessed, including the Ocular Surface Disease Index (OSDI) questionnaire, non-invasive tear break-up time (NIBUT) and tear osmolarity as well as detailed ophthalmic assessments. Results: Seventy-four participants (41 in Birmingham and 33 in Andorra) with periorbital wrinkles and moderate to severe dry eye disease (DED) were enrolled. The mean age was 59.3 ± 13.3 years and 57 were females. No adverse events, no change in vision (p = 0.310) or IOP (p = 0.419) were observed. Tixel treatment was associated with clinically and statistically significant improvement in the DED symptoms, which was supported by a reduction of 21.40 ± 15.08 (P < 0.001) of the OSDI index. Non-invasive tear break-up time improved by 2.10 ± 0.91 s (p < 0.001) in the Birmingham cohort and 6.60 ± 2.13 s (p < 0.001) in the Andorra cohort. Tear osmolarity reduced from 299.8 ± 13.3 mOsm/L to 298.8 ± 15.6 mOsm/L following the Tixel treatment (p = 0.271). Conclusions: Thermo-mechanical action-based peri-orbital fractional skin treatment Tixel® could be an attractive, safe and effective treatment for DED. This treatment is associated with high clinical and statistically significant improvement in DED signs and symptoms with no adverse events.

Objectives: To assess the intra-observer repeatability of automated, objective and non-invasive measures obtained with the S390L Firefly WDR slit lamp. Methods: This cross-sectional study included fifty eyes of patients with dry eye disease (DED) with a mean age of 55.06 ± 12.96 years. Three consecutively repeated measures of the following variables were obtained: first non-invasive break-up time (F-NIBUT), average non-invasive break-up time (A-NIBUT), tear meniscus height (TMH), tear meniscus area (TMA), nasal ciliary hyperemia (NCIH), temporal ciliary hyperemia (TCIH), nasal conjunctival hyperemia (NCOH), temporal conjunctival hyperemia (TCOH), upper loss area meibomian gland (U-LAMG), lower loss area meibomian gland (L-LAMG), upper meibomian gland dysfunction grade (U-MGD grade) and lower meibomian gland dysfunction grade (L-MGD grade). Intra-observer repeatability was estimated with coefficient of variation (CoV), intra-subject standard deviation (Sw) and Bland-Altman plots. Results: All variables showed no statistically significant differences in the repeated measures analysis except for L-MGD grade (P = 0.045). F-NIBUT and A-NIBUT obtained the highest CoV with an average value of 0.48 ± 0.41 [0.02 to 1.00] and 0.34 ± 0.25 [0.02 to 1.00], respectively. The remaining variables showed CoVs between 0.04 ± 0.11 [0.00 to 0.43] and 0.18 ± 0.16 [0.00 to 0.75]. A-NIBUT, TMA, NCOH and L-LAMG obtained a Sw of 2.78 s, 0.21 mm2, <0.001 and 4.11 %, respectively. Bland-Altman plots showed a high level of agreement between pairs of repeated measures. Conclusion: The S390L Firefly WDR slit lamp has moderate intra-observer repeatability for F-NIBUT and A-NIBUT, which suggests that they are tests with high variability. The remaining variables show satisfactory intra-observer repeatability.

Xichen Wan,1– 3 Tong Lin,1– 3 Yunzhen Luo,4 Jiaxu Hong,1– 3,5 Jingyi Cheng,1– 3,&ast; Keqing Zhao6,&ast; 1Department of Ophthalmology and Visual Science, Eye & ENT Hospital, Fudan University, Shanghai, People’s Republic of China; 2NHC Key Laboratory of Myopia and Related Eye Diseases, Shanghai, People’s Republic of China; 3Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, People’s Republic of China; 4Department of Otolaryngology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China; 5Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guiyang, People’s Republic of China; 6Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Keqing Zhao, Department of Otolaryngology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, People’s Republic of China, Email rhinoresearch@163.com Jingyi Cheng, Department of Ophthalmology and Visual Science, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, People’s Republic of China, Email tippicjy@126.comPurpose: To evaluate the effect of vidian neurectomy (VN) on the ocular surface and the possibility of dry eye in the treatment of allergic rhinitis.Methods: Twelve participants were recruited in this prospective study. Prior to and after 1 and 6 months of VN, an ocular surface disease index (OSDI) questionnaire was obtained, and the Schirmer’s tear test (STT), break-up time (BUT), corneal fluorescence staining (CFS) score, and Keratograph 5M were used to evaluate the ocular surface condition.Results: Two patients (16.67%) met the dry eye diagnosis criteria one month after surgery; however, their symptoms were relieved after to 3– 4 months and none of them met the diagnostic criteria for dry eye after six month

Osama MA Ibrahim,1 Masahiko Ayaki,1,2 Erisa Yotsukura,1 Hidemasa Torii,1 Kazuno Negishi1 1Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; 2Otake Eye Clinic, Kanagawa, JapanCorrespondence: Osama MA Ibrahim; Masahiko Ayaki, Department of Ophthalmology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan, Tel +81-3-5363-2012, Fax +81-3-5363 3645 ; +81-3-5363-3087, Email osamaibrahim82@gmail.com; mayaki@olive.ocn.ne.jpPurpose: To investigate the relationship between dry eye disease (DED) and myopia in Japanese teenagers.Methods: This clinic-based, retrospective, cross-sectional study assessed DED condition in 10- to 19-year-old teenagers presenting at Japanese eye clinics. They included 106 high myopic patients (HM; mean age, 16.4 ± 2.2 years), 494 mild myopic patients (15.0 ± 2.6 years) and 82 non-myopic teenagers (NM; 13.8 ± 2.6 years). Subjective refraction and anisometropia were measured. Myopia grade was classified as HM (≤ − 6.00 D), MM (> − 6.00 D, < − 0.50 D), or NM (≥ − 0.5 D). The presence of DED-related symptoms including dryness, irritation, pain, fatigue, blurring and photophobia were assessed through a questionnaire. Tear film break-up time (BUT) and fluorescein corneal staining were investigated. Comparison among three groups and regression analysis of myopic error and other variables were conducted.Results: Anisometropia and astigmatic error were greatest in the HM group compared with the other groups (p < 0.001). The HM group reported less photophobia (p < 0.001) and less pain (p = 0.039) compared with the NM group. Regression analysis revealed that myopic error was correlated with astigmatic error (β = − 0.231, p < 0.001), anisometropia (β = − 0.191, p < 0.001), short BUT (β = − 0.086, p = 0.028) and the presence of diagnosed DED (β = − 0.112, p = 0.003). Dryness (β = − 0.127 p = 0.004), photophobia (β = 0.117, p = 0.002) and pain (β =

AimTo evaluate changes in the ocular surface and tear film with age and mutational status in congenital aniridia. Methods45 participants with congenital aniridia (89 eyes) in a prospective, cross-sectional study. Whole-exome sequencing identified the causative mutation. Examinations included slit-lamp biomicroscopy, in vivo confocal microscopy, Ocular Surface Disease Index (OSDI) score, blink rate, Schirmer I test, Oxford Staining Score (OSS), tear film break-up time (TFBUT) and Ocular Protection Index (OPI). ResultsThere were age-dependent increases in OSDI (beta=0.34, 95% CI 0.03 to 0.66; p=0.030), blink rate (beta=0.18, 95% CI 0.08 to 0.27; p<0.001) and OSS (beta=0.05, 95% CI 0.03 to 0.07; p<0.001) and age-dependent reductions in tear production (beta=-0.23, 95% CI -0.43 to 0.02; p=0.029) and TFBUT (beta=-0.10, 95% CI -0.17 to -0.04; p<0.001). Perturbed OSDI, OSS, blink rate, tear production and TFBUT were noted after the age of ten and OSDI, OSS, blink rate and TFBUT correlated with deficient corneal nerves and limbal stem cell function. OSDI, blink rate, Schirmer, OSS, TFBUT and OPI were not associated with type of PAX6 mutation, but OSDI, OSS and blink rate associated with grade of aniridia-associated keratopathy. ConclusionsOcular surface damage and dry eye signs appear in congenital aniridia regardless of mutation, appearing after 10 years of age and progressing thereafter. An early treatment window may exist for therapies to protect the ocular surface homoeostasis and limbal function, to possibly delay keratopathy development and progression., Funding Agencies|Dr. Rolf M. Schwiete Foundation in Mannheim, Germany; European Union COST Action ANIRIDIA-NET; Aniridia Norway [CA18116]

AimTo evaluate changes in the ocular surface and tear film with age and mutational status in congenital aniridia. Methods45 participants with congenital aniridia (89 eyes) in a prospective, cross-sectional study. Whole-exome sequencing identified the causative mutation. Examinations included slit-lamp biomicroscopy, in vivo confocal microscopy, Ocular Surface Disease Index (OSDI) score, blink rate, Schirmer I test, Oxford Staining Score (OSS), tear film break-up time (TFBUT) and Ocular Protection Index (OPI). ResultsThere were age-dependent increases in OSDI (beta=0.34, 95% CI 0.03 to 0.66; p=0.030), blink rate (beta=0.18, 95% CI 0.08 to 0.27; p<0.001) and OSS (beta=0.05, 95% CI 0.03 to 0.07; p<0.001) and age-dependent reductions in tear production (beta=-0.23, 95% CI -0.43 to 0.02; p=0.029) and TFBUT (beta=-0.10, 95% CI -0.17 to -0.04; p<0.001). Perturbed OSDI, OSS, blink rate, tear production and TFBUT were noted after the age of ten and OSDI, OSS, blink rate and TFBUT correlated with deficient corneal nerves and limbal stem cell function. OSDI, blink rate, Schirmer, OSS, TFBUT and OPI were not associated with type of PAX6 mutation, but OSDI, OSS and blink rate associated with grade of aniridia-associated keratopathy. ConclusionsOcular surface damage and dry eye signs appear in congenital aniridia regardless of mutation, appearing after 10 years of age and progressing thereafter. An early treatment window may exist for therapies to protect the ocular surface homoeostasis and limbal function, to possibly delay keratopathy development and progression., Funding Agencies|Dr. Rolf M. Schwiete Foundation in Mannheim, Germany; European Union COST Action ANIRIDIA-NET; Aniridia Norway [CA18116]

AimTo evaluate changes in the ocular surface and tear film with age and mutational status in congenital aniridia. Methods45 participants with congenital aniridia (89 eyes) in a prospective, cross-sectional study. Whole-exome sequencing identified the causative mutation. Examinations included slit-lamp biomicroscopy, in vivo confocal microscopy, Ocular Surface Disease Index (OSDI) score, blink rate, Schirmer I test, Oxford Staining Score (OSS), tear film break-up time (TFBUT) and Ocular Protection Index (OPI). ResultsThere were age-dependent increases in OSDI (beta=0.34, 95% CI 0.03 to 0.66; p=0.030), blink rate (beta=0.18, 95% CI 0.08 to 0.27; p<0.001) and OSS (beta=0.05, 95% CI 0.03 to 0.07; p<0.001) and age-dependent reductions in tear production (beta=-0.23, 95% CI -0.43 to 0.02; p=0.029) and TFBUT (beta=-0.10, 95% CI -0.17 to -0.04; p<0.001). Perturbed OSDI, OSS, blink rate, tear production and TFBUT were noted after the age of ten and OSDI, OSS, blink rate and TFBUT correlated with deficient corneal nerves and limbal stem cell function. OSDI, blink rate, Schirmer, OSS, TFBUT and OPI were not associated with type of PAX6 mutation, but OSDI, OSS and blink rate associated with grade of aniridia-associated keratopathy. ConclusionsOcular surface damage and dry eye signs appear in congenital aniridia regardless of mutation, appearing after 10 years of age and progressing thereafter. An early treatment window may exist for therapies to protect the ocular surface homoeostasis and limbal function, to possibly delay keratopathy development and progression., Funding Agencies|Dr. Rolf M. Schwiete Foundation in Mannheim, Germany; European Union COST Action ANIRIDIA-NET; Aniridia Norway [CA18116]

Purpose: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.This was a prospective, cross-sectional study. This study included 21 patients in group 1 who had been diagnosed with type-1 DM, 20 patients in group 2 who had been diagnosed with type-2 DM, 19 patients in group 3 who had been diagnosed with MODY, and 20 healthy participants in the control group. This study was conducted in collaboration with the departments of ophthalmology, pediatric endocrinology and metabolism, and histology embryology in a tertiary hospital. The study was designed considering the stipulations given by the Declaration of Helsinki, and appropriate approval was obtained from the ethics committee (approval code 2021/07-33). The parents or legal guardians of the patients or participants provided written informed consent before they participated in the study. Patients with diabetes were selected from among ophthalmology clinic patients who had been referred by the pediatric endocrinology and metabolism clinic to undergo routine eye screening. The control group consisted of healthy participants who did not have any systemic or ocular

Purpose: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.This was a prospective, cross-sectional study. This study included 21 patients in group 1 who had been diagnosed with type-1 DM, 20 patients in group 2 who had been diagnosed with type-2 DM, 19 patients in group 3 who had been diagnosed with MODY, and 20 healthy participants in the control group. This study was conducted in collaboration with the departments of ophthalmology, pediatric endocrinology and metabolism, and histology embryology in a tertiary hospital. The study was designed considering the stipulations given by the Declaration of Helsinki, and appropriate approval was obtained from the ethics committee (approval code 2021/07-33). The parents or legal guardians of the patients or participants provided written informed consent before they participated in the study. Patients with diabetes were selected from among ophthalmology clinic patients who had been referred by the pediatric endocrinology and metabolism clinic to undergo routine eye screening. The control group consisted of healthy participants who did not have any systemic or ocular

Early screening for dry eye disease (DED) is crucial to identify and provide timely intervention to high-risk susceptible populations. Currently, clinical methods for diagnosing DED include the tear break-up time test, meibomian gland analysis, tear osmolarity test, and tear river height test, which require in-hospital detection. Unfortunately, there is no convenient way to screen for DED yet. In this paper, we propose SDE, a contactless, convenient, and ubiquitous DED screening system based on RF signals. To extract biomarkers for early screening of DED from RF signals, we construct frame chirps variance and extract fine-grained spontaneous blinking action. SDE is carefully designed to remove interference in RF signals and refine the characterization of biomarkers that denote the symptoms of DED. To endow SDE with the ability to adapt to new users, we develop a deep learning-based model of unsupervised domain adaptation to remove the influence of different users and environments in local and global two-level feature spaces. We conduct extensive experiments to evaluate SDE with 54 volunteers in 4 scenes. The experimental results confirm that SDE can accurately screen for DED in a new user in real environments such as eye examination rooms, clinics, offices, and homes. © 2024 ACM.

Christian Nilsen,1 Morten Gundersen,1 Per Graae Jensen,1 Kjell Gunnar Gundersen,1 Richard Potvin,2 Øygunn A Utheim,3– 5 Bjørn Gjerdrum1 1Ifocus Eye Clinic, Haugesund, Norway; 2Science in Vision, Frisco, TX, USA; 3Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; 4Department of Ophthalmology, Oslo University Hospital, Oslo, Norway; 5The Norwegian Dry Eye Clinic, Oslo, NorwayCorrespondence: Christian Nilsen, Ifocus Eye Clinic, Strandgaten 203, Bergen, 5004, Norway, Tel +47 97189598, Email christian@ifocusstord.noPurpose: The primary objective was to investigate if subjects with dry eyes had increased variability of keratometry measurements prior to cataract surgery compared to subjects with non-dry eyes. Secondary objectives were to determine which separate signs affected keratometry.Patients and Methods: This study was part of a prospective interventional randomized controlled trial. After dry eye diagnostics were performed (signs only) subjects were divided into sign of dry eye (SDE) positive and negative groups. To investigate variability, we performed two keratometry measurements for each subject with three different optical biometers: Anterion (OCT optical biometer), Eyestar (combined OCT and reflection-based optical biometer), and Lenstar (reflection based-optical biometer).Results: One hundred and thirty-one subjects were available for analysis. The variability of astigmatism was significantly higher for subjects with hyperosmolarity compared to normal eyes for the Lenstar, as was the percentage of eyes with variability of astigmatism greater than 0.25 D. The percentage of eyes with variability of average K greater than 0.25 D was higher for subjects with non-invasive keratograph break-up time < 10 seconds (NIKBUT positive) compared to normal eyes for the Lenstar.Conclusion: Combined diagnostic criteria (signs only) showed no statistically significant differences for keratometry measurements between SDE positive and negative. Ey

AimTo evaluate changes in the ocular surface and tear film with age and mutational status in congenital aniridia. Methods45 participants with congenital aniridia (89 eyes) in a prospective, cross-sectional study. Whole-exome sequencing identified the causative mutation. Examinations included slit-lamp biomicroscopy, in vivo confocal microscopy, Ocular Surface Disease Index (OSDI) score, blink rate, Schirmer I test, Oxford Staining Score (OSS), tear film break-up time (TFBUT) and Ocular Protection Index (OPI). ResultsThere were age-dependent increases in OSDI (beta=0.34, 95% CI 0.03 to 0.66; p=0.030), blink rate (beta=0.18, 95% CI 0.08 to 0.27; p<0.001) and OSS (beta=0.05, 95% CI 0.03 to 0.07; p<0.001) and age-dependent reductions in tear production (beta=-0.23, 95% CI -0.43 to 0.02; p=0.029) and TFBUT (beta=-0.10, 95% CI -0.17 to -0.04; p<0.001). Perturbed OSDI, OSS, blink rate, tear production and TFBUT were noted after the age of ten and OSDI, OSS, blink rate and TFBUT correlated with deficient corneal nerves and limbal stem cell function. OSDI, blink rate, Schirmer, OSS, TFBUT and OPI were not associated with type of PAX6 mutation, but OSDI, OSS and blink rate associated with grade of aniridia-associated keratopathy. ConclusionsOcular surface damage and dry eye signs appear in congenital aniridia regardless of mutation, appearing after 10 years of age and progressing thereafter. An early treatment window may exist for therapies to protect the ocular surface homoeostasis and limbal function, to possibly delay keratopathy development and progression., Funding Agencies|Dr. Rolf M. Schwiete Foundation in Mannheim, Germany; European Union COST Action ANIRIDIA-NET; Aniridia Norway [CA18116]

AimTo evaluate changes in the ocular surface and tear film with age and mutational status in congenital aniridia. Methods45 participants with congenital aniridia (89 eyes) in a prospective, cross-sectional study. Whole-exome sequencing identified the causative mutation. Examinations included slit-lamp biomicroscopy, in vivo confocal microscopy, Ocular Surface Disease Index (OSDI) score, blink rate, Schirmer I test, Oxford Staining Score (OSS), tear film break-up time (TFBUT) and Ocular Protection Index (OPI). ResultsThere were age-dependent increases in OSDI (beta=0.34, 95% CI 0.03 to 0.66; p=0.030), blink rate (beta=0.18, 95% CI 0.08 to 0.27; p<0.001) and OSS (beta=0.05, 95% CI 0.03 to 0.07; p<0.001) and age-dependent reductions in tear production (beta=-0.23, 95% CI -0.43 to 0.02; p=0.029) and TFBUT (beta=-0.10, 95% CI -0.17 to -0.04; p<0.001). Perturbed OSDI, OSS, blink rate, tear production and TFBUT were noted after the age of ten and OSDI, OSS, blink rate and TFBUT correlated with deficient corneal nerves and limbal stem cell function. OSDI, blink rate, Schirmer, OSS, TFBUT and OPI were not associated with type of PAX6 mutation, but OSDI, OSS and blink rate associated with grade of aniridia-associated keratopathy. ConclusionsOcular surface damage and dry eye signs appear in congenital aniridia regardless of mutation, appearing after 10 years of age and progressing thereafter. An early treatment window may exist for therapies to protect the ocular surface homoeostasis and limbal function, to possibly delay keratopathy development and progression., Funding Agencies|Dr. Rolf M. Schwiete Foundation in Mannheim, Germany; European Union COST Action ANIRIDIA-NET; Aniridia Norway [CA18116]

Introduction: To assess the efficacy and safety of the combination of microblepharoexfoliation (MBE), intense pulse light (IPL) and meibomian gland expression (MGX) for treatment of meibomian gland dysfunction (MGD). Methods: This was a prospective, parallel-control trial conducted from April 2022 to January 2023. Participants were assigned to receive either three sessions of MBE-IPL-MGX treatment and home-based therapy (treatment group) or home-based therapy alone (control group). Outcome measures were assessed at baseline and after 2-month follow-up. Results: Seventy eyes of 70 patients were enrolled. MBE-IPL-MGX treatment achieved better improvements than home-based therapy in ocular surface disease index (OSDI) and symptom assessment in dry eye (SANDE) scores, noninvasive tear film break-up time (NIBUT), lipid layer grade (LLG), loss area meibomian gland (LAMG) and meibomian gland yielding secretion score (MGYSS). The mean differences between the two groups were as follows: OSDI (– 11.23 ± 4.68 points, P \0.001), SANDE (– 24.63 ± 13.41 points, P \0.001), NIBUT (1.3 ± 1.57 s, P = 0.033), LLG (0.4 ± 0.04 points, P = 0.003), LAMG (– 2.85 ± 1.69%, P = 0.023) and MGYSS (7.5 ± 2.32 points, P \ 0.001). In addition, the increment (D) of MGYSS after MBE-IPL-MGX treatment was significantly higher in MGD grades 2 and 3 (all P \ 0.001). Conclusions: MBE-IPL-MGX treatment is an effective and well-tolerated procedure that improves dry eye symptoms and signs as well as meibomian gland secretions in patients with MGD. In addition, this treatment is recommended for MGD grades 2 and 3.

Purpose: To compare the effectiveness of meibomian gland expression (MGX) combined with home-based therapy versus home-based therapy alone for the treatment of dry eye disease (DED) caused by meibomian gland dysfunction (MGD). Methods: A systematic review of randomized controlled studies (RCTs), reporting the effects of MGX combined with home-based therapy in 2 databases, PubMed and Web of Science, was performed according to the PRISMA statement. The search period was until August 20, 2023. According to the heterogeneity, a random or fixed effects model was performed in the meta-analysis. The standardized mean difference (SMD) was calculated to analyze dry eye symptoms (DES) score, tear film break-up time (TBUT), total corneal fluorescein staining (tCFS) and meibomian glands expressibility (MGE). All analyses were performed by RevMan Web, version 5.7. The Cochrane risk of bias tool was used to analyze the quality of the studies selected. Results: Two RCTs with a total of 99 patients were included. The studies reported that MGX combined with home-based therapy improves DES score, TBUT, tCFS and MGE compared to the home-based therapy. However, the meta-analysis indicated that MGX combined with home-based therapy only seems to be beneficial in reducing DES score (SMD -0.49; 95 % CI: -0.89 to -0.08; P = 0.02; I2 = 0 %). In addition, although TBUT, tCFS and MGE reported a slight trend in favor of MGX combined with home-based therapy, it was non-significant. Conclusions: While MGX combined with home-based therapy seem to show some evidence of alleviating dry eye symptoms, there is insufficient evidence to conclude the effects of this treatment definitively particularly in improving dry eye signs caused by MGD, such as TBUT, tCFS and MGE. Therefore, further RCTs are needed to elucidate these results.

Thang Tran Tat,1 Ky Ngo Duc,2 Phuong Pham Hong,3 Huynh Nguyen Sa,1 Kien Nguyen Trung,4 Ha Nguyen Thi Thu,5 Khoa Le Ha,6 Dung Nguyen Huu,7 Thang Thai Doan,8 Thang Le Viet5 1Department of Cornea and Conjunctiva, Nghe An Eye Hospital, Nghe An, Vietnam; 2Department of Endocrinology, Nghe An Friendship General Hospital, Nghe An, Vietnam; 3Department of Cardiology, Nghe An Friendship General Hospital, Nghe An, Vietnam; 4Hematology and Blood Transfusion Center, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam; 5Organ Transplantation Center, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam; 6Hanoi Medical University, Ha Noi, Vietnam; 7Hemodialysis Center, Bach Mai Hospital, Ha Noi, Vietnam; 8Department of Epidemiology, TTH Vinh General Hospital, Nghe An, VietnamCorrespondence: Thang Le Viet, Military Hospital 103, Vietnam Military Medical University, 261 Phung Hung, Ha Dong, Ha Noi, Vietnam, Tel +84982249968, Email lethangviet@yahoo.co.ukAim: To determine the prevalence of dry eye (DE) and some related factors in patients with type 2 diabetic nephropathy (T2DN).Methods: 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.Results: 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 lev

Costanza Rossi,1,&ast; Sabrina Vaccaro,1,&ast; Massimiliano Borselli,1 Giovanna Carnovale Scalzo,1 Mario Damiano Toro,2 Vincenzo Scorcia,1 Giuseppe Giannaccare3 1Department of Ophthalmology, University Magna Graecia of Catanzaro, Catanzaro, Italy; 2Eye Clinic, Public Health Department, University of Naples Federico II, Naples, Italy; 3Eye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy&ast;These authors contributed equally to this workCorrespondence: Giuseppe Giannaccare, Ophthalmology, Chairman of Eye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy, Email giuseppe.giannaccare@unica.itPurpose: To report the outcomes of a novel microwave heating device (Blepha EyeBag®) used serially for the treatment of meibomian gland dysfunction (MGD).Patients and Methods: This prospective single center study was conducted at University Magna Graecia of Catanzaro. Patients were instructed to apply the compress twice daily for 15 days and once per day every two days, as reported in the package insert. Outcome measures were i) ocular surface disease index (OSDI) score, ii) tear meniscus height (TMH), iii) non-invasive keratograph break-up time (NIKBUT) (first and average), iv) meiboscore, v) bulbar redness. Evaluations were performed at baseline (T0) after 15 days (T1) and after 45 days of therapy (T2).Results: Overall, 19 patients with MGD (8 males, 11 females; mean age 64.58 ± 9.72 years) were included. The mean value of OSDI score showed a significant decrease from 28.16 ± 17.46 at T0 to 13.69 ± 7.62 at T2 (p=0.008). The mean value of NIKBUT first significantly increased from 6.67 ± 3.51 seconds (s) at T0 to 10.46 ± 4.64 at T2 (p=0.0121); in parallel, the mean value of NIKBUT average increased significantly from 11.09 ± 4.15 s at T0 to 14.95 ± 4.85 at T2 (p=0.0049). No significant differences were detected at each time point for bulbar redness, meiboscore and TMH. Throughout the entire study, no