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Purpose: We aimed to analyze the tears of patients with Benin Essential Blepharospasm (BEB) to explore possible corneo-conjunctival mechanisms for photophobia, tear deficiency and ocular pain., Methods: Using an observational cohort of 42 patients diagnosed with BEB, we performed Schirmer's testing, measurement of tear film pH, tear film protein electrophoresis and conjunctival impression cytology., Results: Schirmer's testing showed dry eye (8.4±9.7mm) with 71.3% eyes having a Schirmer's score<10mm. Surprisingly, the pH was basic (8.4±0.4) and was improved in patients receiving the standard treatment of quarterly botulinum toxin injections (8.32±0.36 for treated patients vs. 8.74±0.53 for untreated patients; P=0.045). Together, tear protein electrophoresis and conjunctival impression cytology showed conjunctival inflammation associated with BEB., Conclusion: For the first time, this study emphasizes corneo-conjunctival mechanisms to explain the photophobia, dry eye and pain in Benign Essential Blepharospasm. While encouraging, complementary studies remain necessary to evaluate the effect of correcting tear film pH and inflammation on the quality of life of blepharospasm patients., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Purpose: The goal of this study is to determine a link between benign essential blepharospasm and Sjogren's syndrome by analyzing the presence of extractable nuclear antigens in this population., Methods: Seventy-two patients with benign essential blepharospasm (BEB) were included in this study. We eliminated patients with hemifacial spasm or blepharospasm secondary to corneal pathology. We collected the values of the Schirmer I test and the results of the anti-SSA and anti-SSB antibodies., Results: Our study included 72 patients (144 eyes) whose 62 women (86.1%). Mean age was 74.3 years±10.73. Average Schirmer I test was 3.14mm±4.00mm. Five women (8% of this female population) had positive anti-SSA and SSB antibodies. Their mean age was 65.66 years±13.24 whereas the negative antibody patients had an average age of 75.42±9.27. There was no significant difference between their Schimer I test and the Schirmer I of negative antibody population., Conclusion: This study illustrates the possible association between the presence of Sjögren's syndrome and the occurrence of a BEB justifying the search for anti-SSA and anti SSB in blepharospasm patients., (Copyright © 2020. Published by Elsevier Masson SAS.)

Purpose: To investigate whether blood glucose regulation in patients with diabetes mellitus (DM) has an influence on the ocular surface disease index (OSDI) score and tear function tests such as tear film osmolarity (TFO), tear break-up time (TBUT) and Schirmer tests., Methods: Fifty diabetic patients with a fasting blood glucose (FBG) level greater than 200mg/dL and HbA1c level greater than 10% were recruited for this prospective study. All of the patients underwent a detailed ophthalmic examination including OSDI questionnaire, TFO test, TBUT test and Schirmer test initially. All tests were repeated after obtaining regulation of patients' blood sugar (approximately 6 weeks later)., Results: The mean age of the diabetic patients in the study was 54.96±12.48 years. Initially, the mean FBG, postprandial blood glucose (PBG) and HbA1c levels were 301.40±79.11mg/dL, 431.06±74.47mg/dL and 12.31±1.67%, respectively. After blood glucose regulation; the levels of all parameters (153.78±59.32mg/dL, 252.32±88.34mg/dL and 9.67±1.60%, respectively) statistically significantly decreased (P<0.001). The mean levels of OSDI score, TFO measurement, TBUT test and Schirmer test were 28.38±16.46 points, 349.66±13.09 mOsm/L, 6.44±1.91s and 8.66±3.57mm initially, and 17.82±11.70 points, 314.14±12.80 mOsm/L, 6.62±2.03s and 9.02±3.68mm after blood glucose regulation, respectively. Although the improvements in TBUT and Schirmer test values were not statistically significant (P>0.05), statistically significant reduction was obtained in OSDI scores and TFO levels (P<0.001, for each)., Conclusion: DM, which is a hyperosmolar disorder, appears to cause elevation in OSDI score and increase in TFO level, especially if blood glucose is poorly regulated., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)