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Purpose: To report the design of FLuorometholone as Adjunctive MEdical therapy for TT surgery (FLAME) trial., Design: Parallel design, double-masked, placebo-controlled clinical trial with 1:1 randomization to fluorometholone 0.1% eye drops twice daily or placebo twice daily for 4 weeks in eyes undergoing trachomatous trichiasis (TT) surgery for assessing the efficacy, safety, and cost-effectiveness of fluorometholone 0.1% in preventing recurrent postoperative trichiasis (PTT)., Methods: Up to 2500 eligible persons with trachomatous trichiasis undergoing lid rotation surgery were enrolled in the Jimma zone, Ethiopia. Participants, surgeons, study field staff, and study supervisors leading operational aspects of the trial are masked to treatment assignment. Randomization is stratified by the surgeon and is simultaneously stratified by the district. Study visits (in addition to programmatic follow-ups) are at the baseline/enrollment, at four-week post-enrollment, and after 6 months and 1 year. The primary outcome is cumulative one-year PTT incidence, defined as: ≥1 lashes touching the globe, evidence of epilation, and/or repeat TT surgery. Secondary postoperative outcomes include the number of trichiatic lashes, location (touching the cornea or not), evidence of post-operative epilation, entropion, changes in corneal opacity, IOP elevation, need for cataract surgery, visual acuity change from the baseline, eyelid contour abnormality, granuloma, eyelid closure defect, and the occurrence of adverse events. Health economic analyses center on calculating the incremental cost per case of PTT avoided by fluorometholone treatment., Conclusion: The FLAME Trial is designed to provide evidence of the efficacy, safety, and cost-effectiveness of adjunctive topical peri-/postoperative fluorometholone 0.1% therapy with trichiasis surgery, which is hypothesized to reduce the risk of recurrent trichiasis while being acceptably safe., Clinical Trial Registration: https://www.clinicaltrials.gov/study/NCT04149210.

Background: Symptomatic dry eye disease is a growing public health challenge especially among those who are visual display unit (VDU) users and other long-time near activity workers. Globally, computer user adults experience a surge in the prevalence of dry eye. Data is insufficient on the prevalence of dry eye disease among postgraduate students in Ethiopia. Therefore, the present was aimed to assess the prevalence of dry eye and its associated factors among postgraduate students at the University of Gondar, Northwest Ethiopia. Methods: A cross-sectional study was conducted on a total of 423 postgraduate students who were selected based on a simple random sampling technique. Data was collected through online symptom-based ocular surface disease index questionnaire. Binary logistic regression was used to test the association and p-value of <0.05 was considered to determine the significance of the association. Results: From the total postgraduate students, 404 completed the study with a response rate of 95.5%. The prevalence of symptomatic dry eye disease was 50.5% (95% CI, 45.1%-54.9%). Average continuous visual display unit use for 2-4hours per day[AOR = 2.57 (95% CI, 1.27–5.21)] and for> 4hours per day[AOR = 3.77 (95% CI 1.87–7.59)], duration of visual display unit use for 3–5 years [AOR = 2.24 (95% CI, 1.17–4.31)], 6–8 years [AOR = 2.46 (95% CI,1.31–4.62)] and > 8 years [AOR = 3.25 (95% CI, 1.63–6.48)], average sleeping hour < 7 hours/day within last week [AOR = 2.17 (95% CI, 1.35–3.49)] and current known allergic conjunctivitis [AOR = 5.42 (95% CI, 2.43–12.10)] were significantly associated with symptomatic dry eye disease. Conclusion and recommendation: In this study, about half of postgraduate students faced symptomatic dry eye disease. Significant association was observed between symptomatic dry eye disease and average continuous hours of visual display unit use, duration of visual display unit use in years, shortage of sleep and current known allergic conjunctivitis. It is advisable for postgraduate students to limit screen exposure hour and establish regular breaking time along their exposure. It is also advisable to have optimum sleep as possible. It is also important to explore dry eye disease on a large sample incorporating clinical tests. [ABSTRACT FROM AUTHOR]

Background: Dry eye disease is a multifactorial disease; causing various ocular symptoms with potential damage to the ocular surface. Applying hypotensive eye drops are presumed to initiate or exacerbate existing dry eye disease. The purpose of this study was to determine the frequency of signs and symptoms and severity of dry eye disease among glaucoma patients on topical hypotensive medications and controls.Methods: A cross-sectional comparative study, involving 320 glaucoma patients and controls. Ocular Surface Disease Index (OSDI) symptoms score and Schirmer, tear breakup time and corneal staining tests were used to assess dry eye disease. Data was analyzed using SPSS version 24 software; p-value less than 0.05 was considered as statistically significant.Results: Among the 160 study glaucoma patients, the mean duration of topical hypotensive medication use was 5.2 ± 5.21 years (range, 4 months - 32 years). Mild to severe level of OSDI score was found in 122 (76%) glaucoma patients and in 137 (86%) controls (p = 0.033). Mild to sever abnormal clinical tests in the glaucoma patients and control, respectively, were 106 (66%) vs 80 (50%) corneal staining (p = 0.045), 79 (49%) vs 72 (45%) TBUT (p = 0.021), and 91 (57%) vs 83 (52%) Schirmer test (p = 0.242). Test results at the level of sever: 2 (1%) vs 0 (0%) corneal staining, 50 (31%) vs 39 (24%) TBUT and 65 (41%) vs 60 (38%) Schirmer test in the glaucoma patents and controls, respectively. Corneal staining and TBUT had correlation with the number of drugs (p = 0.004 and 0.031, respectively), and more relationship of the two tests with total number of drops applied per day (p = 0.01 and p <  0.001, respectively). Patients on pilocarpine and timolol had more corneal staining and lower TBUT [(p = 0.011 and p <  0.001) and (p = 0.04 and 0.012), respectively].Conclusions: The study has identified glaucoma patients to be more affected by dry eye disease than non-glaucoma patients, and presence of significantly lower TBUT and higher corneal staining in the glaucoma patients on multidrops and multidose per day. We recommend consideration of evaluation and management of DED for glaucoma patients on multidrops and multidose hypotensive medications. [ABSTRACT FROM AUTHOR]