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Purpose: Reliable assessment is critical for diagnosing and managing meibomian gland dysfunction. Multi-functional diagnostic devices, such as meibographers, streamline clinical workflows by integrating multiple ocular assessments. Ensuring reproducibility across examiners is vital for accurate diagnosis and monitoring of treatment. This prospective study determined the inter-examiner reproducibility (IER), inter-rater reproducibility (IRR) and within-subject variability (WSV) of the Huvitz HRK-9000A meibographer., Methods: Meibomian glands (MGs) of both eyelids of healthy participants were captured during the same session by Examiner 1 (E1) and Examiner 2 (E2) in a counter-balanced design. The images were rated offline by E1, E2 and an Independent rater (R1). The inter-examiner reproducibility (IER between E1 vs. E2) and inter-rater reproducibility (IRR between E1 vs. R1 and E2 vs. R1) were determined based on non-parametric Bland-Altman plots, intraclass correlation coefficients (ICCs) and weighted Kappa (κ) values. Within-subject variability (WSV) was determined using ICCs., Results: Mean MG loss of the upper (E1: 1.0 ± 0.8 vs. R1: 0.9 ± 0.8, E2: 1.2 ± 0.8 vs. R1: 0.9 ± 0.7) and lower eyelids (E1: 1.9 ± 0.9 vs. R1: 2.1 ± 1.1, E2: 1.5 ± 1.0 vs. R1: 1.8 ± 1.0) of 35 participants (mean age 22 ± 3 years, range 19-30) was significantly correlated (p < 0.001) for all pairs of examiners (E1-E2, E1-R1 and E2-R1), but was significantly different for the upper eyelids of E2 vs. E1 (p < 0.002) and E2 vs. R1 (p < 0.003). Median differences between pairs of raters for both eyelids were close to zero, with >74% of comparisons falling within the interquartile range, except for the upper eyelids of E2 vs. E1 and E2 vs. R1 (63% and 66%, respectively). IRR demonstrated moderate agreement (0.43-0.57) with good reliability (ICC range 0.76-0.86) for the upper eyelids and good agreement (0.60-0.65) with good reliability (ICC range 0.85-0.88) for the lower eyelids. The WSV was excellent (ICCs for repeated measurements > 0.90)., Conclusions: The HRK-9000A meibographer demonstrated excellent reliability, with good inter-examiner and inter-rater reproducibility. It is suitable for meibographic assessment, follow-up or treatment., (© 2025 College of Optometrists.)

Background: The ocular surface is directly exposed to environmental influences. Noxae that have already been identified for the ocular surface are heat, air dryness, pollutant gases, fine dust particles and ultraviolet radiation., Methods: The current literature was used to investigate the relationship between frequent ocular surface diseases and various environmental factors and to analyze their development over the years., Results: Epidemiological studies on dry eye disease and allergic conjunctivitis have shown an increase in the incidences in recent years. Environmental pollutants have been identified as disease triggers. In addition, the prolonged pollen season and increased pollen concentrations are also risk factors. There is also a higher prevalence of pterygium in population groups with high UV exposure. Other diseases with potential environmental pathogenesis are acute photokeratitis, photoconjunctivitis and malignant melanoma of the conjunctiva., Conclusion: For ocular surface diseases, large epidemiological cohorts have shown climate-related increases in the incidence. A further increase in environmentally associated noxious substances can be expected in the coming decades. In addition to measures to mitigate climate change, the underlying mechanisms of disease development and new approaches to prevention and treatment, such as room humidification, air filters or contact lenses with UV filters, should be investigated., Competing Interests: Einhaltung ethischer Richtlinien. Interessenkonflikt: A.V. Schilcher und G. Geerling geben an, dass kein Interessenkonflikt besteht. Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Für Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, über die Patient/-innen zu identifizieren sind, liegt von ihnen und/oder ihren gesetzlichen Vertretern/Vertreterinnen eine schriftliche Einwilligung vor., (© 2025. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Objective: Determine the outcomes in children with recurrent sialadenitis after establishment of a multidisciplinary pediatric otolaryngology and rheumatology clinic., Study Design: Retrospective review., Setting: Single-center tertiary medical center., Methods: We reviewed all children presenting to a multidisciplinary pediatric otolaryngology/rheumatology clinic with recurrent parotitis between December 2019 and April 2023., Results: Thirty-three children presented with recurrent parotitis to a multidisciplinary clinic. Seventy-seven percent of those with childhood Sjögren's disease (cSjD) had xerophthalmia, and 67% had xerostomia. The cSjD group was more likely to have both abnormal parotid and submandibular findings when compared to the non-cSjD group (P < .001). Sixteen percent of the cSjD group had a positive SSA/SSB autoantibody and 47% were antinuclear antibody positive. Fifty percent of the cSjD cohort had a focus score of ≥1 from a minor salivary gland biopsy. There were no significant differences from sialendoscopy outcome between the 2 groups. Seventy percent with juvenile recurrent parotitis showed partial response (PR) or complete response (CR) to sialendoscopy. In the cSjD cohort 3 (27%) reported a CR and 5 (45%) reported a PR. In the non csSjD cohort 5 (42%) reported a CR and 3 (25%) reported a PR. Ten of the 12 cSjD patients on hydroxychloroquine have shown symptom improvement., Conclusion: The establishment of a multidisciplinary otolaryngology and rheumatology clinic can provide a more comprehensive evaluation and treatment of the child with recurrent or persistent parotitis than from a regular ENT clinic., (© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.)