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Purpose: to evaluate the effectiveness and safety of complex therapy in patients with demodex blepharitis and dry eye. Methods. 25 patients with mixed demodex blepharitis and dry eye (50 eyes; 10 men, 15 women; 61.9 ± 5.6 years) were examined before and after treatment with 0.5 % levofloxacin instillation (5 times a day, 5 days); sulfur and metronidazole gel applications (Blefarogel-forte) as part of therapeutic eyelid hygiene (Blepharogel-cleansing, Blepharolotion; starting from day 6, 2 times a day, 45 days); 0.24 % sodium hyaluronate instillation (3 times a day). Therapy effectiveness criteria were as follows: D. folliculorum mite population reduction; positive dynamics of blepharitis objective signs and meibomian gland dysfunction severity (MGD-S, points). Therapy safety criteria included the absence of negative dynamics of OSDI, tear film breakup time (TBUT, s), inferior tear meniscus height (ITMH, µm) and xerosis index (XI, points). Results. As a result of the therapy, statistically significant changes were noted, including mite population reduction (from 9.23 ± 0.81 to 3.54 ± 0.80 imagos); eyelid margins edema intensity decrease (from 3.18 ± 0.39 to 1.30 ± 0.45 points) and hyperemia decrease (from 2.90 ± 0.29 to 0.9 ± 0.3 points); MGD-S decrease (from 2.1 ± 0.3 to 0.95 ± 0.21 points); OSDI decrease (from 43.23 ± 4.70 to 25.10 ± 2.65 points); TBUT increase (from 4.05 ± 0.50 to 5.55 ± 0.50 s); XI decrease (from 5.36 ± 0.49 to 4.04 ± 0.60 points). Conclusion. The treatment of demodex blepharitis and dry eye treatment, including sulfur and metronidazole gel applications, therapeutic eyelid hygiene and 0.5 % levofloxacin and 0.24 % sodium hyaluronate instillation demonstrated a high efficiency and a good safety profile.

Kento Yokobori,1,* Masahiko Ayaki,1,2,* Motoko Kawashima,1 Hidemasa Torii,1 Erisa Yotsukura,1 Sachiko Masui,1 Kazuno Negishi1 1Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; 2Otake Eye Clinic, Yamato City, Kanagawa, Japan*These authors contributed equally to this workCorrespondence: Masahiko Ayaki, Email mayaki@olive.ocn.ne.jpPurpose: To evaluate the effect of eyelid hygiene after cataract surgery on eyelid and ocular surface findings, subjective symptoms and visual function, including functional visual acuity (FVA) and higher order aberration, in a randomized controlled study.Methods: Fifty patients who underwent cataract surgery at a single institution were involved. Twenty-five patients were instructed to wipe their eyelids twice a day from one to four weeks postoperatively, whereas the other 25 patients did not perform any eyelid hygiene. Optical measurement, FVA, meibomian glands, the grade of meibum, lid margin findings, fluorescein corneal staining findings, dry eye-related subjective symptoms and surgical satisfaction were assessed both preoperatively and one month postoperatively.Results: In the eyelid hygiene group, the visual maintenance ratio of FVA improved significantly (p = 0.048) and the higher order aberration of the 4th + 6th order deteriorated less (p = 0.027) compared with the control group. Multiple regression analyses showed that the change in visual maintenance ratio was associated with surgical satisfaction (p = 0.003), change in corneal staining score (p = 0.007), history of eye diseases (p = 0.029) and eyelid hygiene (p = 0.048).Conclusions: Eyelid hygiene after cataract surgery may be effective for visual function measured with an FVA test.Keywords: cataract surgery, dry eye, eyelid hygiene, functional visual acuity, higher order aberration, meibomian gland dysfunction, visual maintenance ratio

Purpose: to evaluate the ocular surface changes (OSC) in seasonal and chronic allergic blepharoconjunctivitis (ABC) under dry eye (DE) conditions and to consider therapeutic possibilities.Materials and methods. 60 patients with seasonal ABC and mild DE syndrome (group 1) and 50 patients with chronic ABC and moderate DE syndrome (group 2) were tested for lipid deficiency (LD; negative lipid-interference test), aqua-deficiency (AD; inferior tear meniscus height < 250 fim), and mucose deficiency (Bijsterveld`s xerosis index > 3 scores; XI, scores), Ocular surface disease index (OSDI), tear film break-up time (TBUT, seconds), meibomian gland dysfunction (MGD) according to Korb, taking into account the proportion of MGD (%) and its severity (MGDS, scores), and the “lid-wiper” symptom (LWS, scores) Statistics: M ± s; Mann — Whitney U-test; differences were statistically significant at p < 0.05.Results. LD was diagnosed in 65% of the 1st group patients (OSDI 32.3 ± 4.2, TBUT 6.5 ± 0.6, TMH 363.4 ± 43.96, XI 2.1 ± 0.4, MGDproportion — 41.02 %, LWS 1.1 ± 0.2). LD and MD were detected in 35 % of 1st group patients (OSDI 41.3 ± 5.7, TBUT 5.7 ± 0.5, TMH 332.9 ± 29.9, XI 4.2 ± 0.7, MGD proportion — 61.9 %, LWS 1.24 ± 0.4). The differences in OSDI, TBUT and XI values between DE patients with LD and DE patients with LD and MD were statistically significant. LD and AD were diagnosed in 48 % of 2nd group (OSDI 48.5 ± 6.4, TBUT 5.5 ± 0.6, TMH 192.3 ± 20.8, XI 2.5 ± 0.5, MGDS 1.8 ± 0.4, LWS 1.9 ± 0.3). LD, AD and MD were detected in 52 % of the 2nd group patients (OSDI 57.5 ± 5.8, TBUT 4.6 ± 0.6, TMH 177.7 ± 16.9, XI 5.5 ± 0.6, MGD-S 2.2 ± 0.4, LWS 2.3 ± 0.4). The differences in OSDI, TBUT and XI values between DE patients with LD-AD combination and DE patients with LD-AD-MD were statistically significant.Conclusion. OSC included lipid deficiency (65 %) and lipid-mucose deficiency (35 %) in S-ABC patients; OSC were represented by lipid-aqua-deficiency (48 %) and lipid-aqua-mucose-deficiency (52 %) in C-ABC patients. In our opinion, the diagnostics of these clinical variants of OSP diagnosis, opens up opportunities for differentiated tear replacement therapy. MGD was diagnosed in one half of S-ABC patients and in all C-ABC patients, which we believe determines another possible therapy direction — eyelid therapeutic hygiene aimed at MGD relieving and lipid deficiency compensation.

PURPOSE: Incidences of ocular conditions, including meibomian gland dysfunction (MGD), blepharitis, and dry eye have been increasing globally. Eyelid hygiene is key to maintaining ocular surface health and improving ocular symptoms. This study investigated the awareness of eyelid hygiene among the Saudi population. METHODS: This cross-sectional survey was conducted between April 2020 and May 2020 across all regions of Saudi Arabia through the distribution of an electronic self-administered questionnaire among the Saudi population. RESULTS: A total of 1102 responses were received (women, 76.3%; men, 23.7%). Only 33.2% respondents reported consciously washing their eyelids, while 70.1% had never heard about MGD; however, most of the respondents (93.2%) had heard about dry eye. Based on the questionnaire results, the Saudi population had suboptimal (18.4%) level of awareness of eyelid hygiene. At least one ocular symptom was reported by 98.1% of the respondents. CONCLUSION: The level of awareness of eyelid hygiene in Saudi Arabia was found to be suboptimal, particularly among patients with MGD and dry eyes. Poor knowledge about the benefits of daily eyelid hygiene was the primary barrier to its practice. We recommend that ophthalmologists raise awareness of good eyelid hygiene among patients with MGD and eye dryness. Despite the current findings, further studies and evidence are required before recommending daily eyelid hygiene practices in the general population, including those without clinical symptoms of MGD or eye dryness. [ABSTRACT FROM AUTHOR]

Purpose: To investigate if the application of Blephagel, an eyelid cleansing gel, causes subjective and/or objective cooling effects by measuring ocular symptomology and temperature.Methods: Twenty-five healthy subjects underwent baseline non-invasive temperature measurements on the closed upper eyelid (centrally, nasally, and temporally) and ocular surface temperature (OST) on both eyes using an infrared camera. A standard application of Blephagel was then applied to the closed upper eyelid and eyelashes with a sterile cotton-wool to one eye selected at random. Temperature measures were then repeated on both eyes after 30-60, 120-150, and 180-210 s. At each interval, subjects rated the comfort and any cooling sensation of each eye on a 0-10 scale.Results: After application of the gel, there was a significant difference in temperature at all locations on the eyelid between the test and control eyes over time (F = 9.322, p < 0.001). Post hoc analysis revealed this was significant from 30 to 60 s interval (36.3 ± 1.1 °C versus 37.2 ± 0.7 °C; p < 0.001) and the 120-150 s interval (36.8 ± 0.8 °C versus 37.2 ± 0.6 °C; p < 0.001). There was no significant variation between the OST locations over time (F = 3.350, p = 0.07). With respect to symptoms, there was a significant increase in cooling sensation in the test eye compared to the control eye over time (F = 10.438, p < 0.001), that remained throughout the experiment.Conclusions: Blephagel produces a reduction in temperature of the eyelids that is accompanied with a subjective cooling sensation. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the antimicrobial activity of a novel preservative-free lid wipe formulation containing Aloe vera gel and hyaluronic acid that is commercialized for the hygiene of the periocular area.Methods: In vitro susceptibility testing of the solution contained in wipes against bacteria and fungi commonly colonizing the periocular area, both reference strains and multidrug-resistant (MDR) clinical isolates, was assessed following the CLSI M07-A9 and M27-A3 broth methods, respectively. The solution was 2-fold serially diluted in broth from 25 μL (25% v/v) to 0.012 μL (0.012% v/v) in microtiter plates. Plates were incubated and minimal inhibitory concentrations (MICs) were read visually. The antimicrobial effectiveness test was performed by inoculating the wipe solution with microbial suspensions at the initial concentration of 105-106 CFU/mL, as recommended by the international Pharmacopoeias. At different time intervals, samples were tested for microbial count.Results: The MIC value of the solution ranged from 25% to 12.5% for bacteria and was 6.25% for Candida albicans. The MIC for MDR isolates was 12.5%. By assessing antimicrobial effectiveness, we found that the solution meets the criteria reported by the European Pharmacopoeia and United States Pharmacopeia for its preservative effect.Conclusions: This study demonstrates that the novel wipes herein tested possess antimicrobial activity against bacteria and yeast commonly found in the periocular area, and against MDR clinical isolates. The microbial death curves obtained following deliberate contamination of the wipe solution revealed potent bactericidal and fungicidal activity of the formulation. [ABSTRACT FROM AUTHOR]