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Purpose: To determine the prevalence of dry eye disease symptoms and contact lens wear in Mexican high school students. Methods: A cross-sectional association study included a group of high school students who were selected from a random sampling of classrooms. The authors used the Ocular Surface Disease Index (OSDI) questionnaire as a surrogate measure for dry eye disease symptoms, and contact lens wear was also investigated. Results: Seven hundred fifty-nine students with a mean age of 16.12 ± 0.96 years were surveyed and 55.7% of the students were girls (423 of 759). The average OSDI score was 25.11 ± 20.61 points. Girls had higher scores (28.25 ± 21.48 points) than boys (21.14 ± 18.74 points), and the difference was statistically significant ( P < .001). Forty-three students (6.1%) wore contact lenses and had higher OSDI scores (34.26 ± 23.13 and 24.51 ± 20.31 points, respectively) and the difference was also statistically significant ( P = .002). Conclusions: Symptoms of mild and moderate dry eye disease are prevalent in high school students and, as reported in previous studies, girls are more affected than boys. [ J Pediatr Ophthalmol Strabismus . 2021;58(5):287–291.]

We aimed to evaluate the characteristics and colonization by pathogenic microorganisms of the ocular surface in patients in a burn center and to determine their association with sedation, mechanical ventilation, and periocular burn. We prospectively evaluated 40 patients during an 8-mo period. Five evaluations where performed, at baseline and weekly on four more occasions or until hospital discharge or death. On each visit, we assessed periocular burn, lid position, Bell’s phenomenon, Schirmer’s test, presence of chemosis, conjunctival hyperemia, and exposure keratopathy; conjunctival fornix swabs were taken for microbiology culture. Also, we documented the level of sedation, mechanical ventilation status, and systemic and ocular treatment. Absent Bell’s phenomenon and chemosis were significantly different at baseline in patients under mechanical ventilation, sedation, and in those with a periocular burn. The cumulative incidence of exposure keratopathy was 22.5% and the cumulative incidence of ocular surface colonization by pathogenic microorganisms was 32.5%. Both outcomes were associated with mechanical ventilation and periocular burn. The most frequent pathogenic microorganisms on the ocular surface were Candida parapsilosis, Acinetobacter baumanii, and Pseudomonas aeuroginosa. We did not observe any case of a persistent epithelial defect, infectious keratitis, corneal perforation or corneal opacity in this cohort. Results from our study may benefit future patients by allowing better risk stratification and treatment strategies for the ocular surface care in burn units.

Purpose To present the process of cultural and psychometric adaptation, and clinical validation of a new version in the Spanish language of the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8). Materials and methods The translation-retro-translation method was applied to the CLDEQ-8 questionnaire. Two independent native Spanish-speaking translators adapted the questionnaire from English to Spanish, and then a committee of experienced clinicians (CE) evaluated the semantic equivalence and designed a Spanish version of the CLDEQ-8 questionnaire. The resulting translated version was tested conducting a pilot study in contact lens users and assessing their perception and overall understanding of the terminology. The results were analyzed and a final version was designed. The final version was retro-translated to English by a native English-speaking translator and compared with the original CLDEQ-8 version to confirm there were no meaningful differences. To clinically validate the new instrument, a prospective study was conducted to apply the new Spanish CLDEQ-8 to 50 contact lens users. Results Fifty patients were studied with an average age of 21.50 ± 1.66 years. The average CLDEQ-8 score was 13.28 ± 6.81 points (range 1–31). The internal consistency (Cronbach's alpha) was 0.89, with a corrected index of homogeneity >0.50 for all evaluated items. Conclusions The process of trans-cultural adaptation of the questionnaire CLDEQ-8 resulted in the elaboration of a reliable and much needed instrument capable of measuring frequency and intensity of dry eye symptoms in Spanish-speaking contact lens users.

To assess the repeatability and comparability of six anterior segment biometry parameters obtained with a novel Scheimpflug camera with a Placido disc topographer (Sirius) and slit-scanning tomography with a Scheimpflug camera (Pentacam), in a sample of 16 unoperated eyes of healthy subjects. The anterior segment was analyzed by a single examiner using the Sirius and the Pentacam analyzers. Mean simulated keratometry (Sim K), flat and steep axis keratometry (K f and K s ), central and thinnest corneal thicknesses (CCT and TCT), and anterior chamber depth (ACD) measurements were evaluated. Repeatability of three sets of measurements from each device was assessed using the coefficient of variation (CV), within-subject standard deviation, and intraclass correlation coefficient (ICC). Bonferroni-adjusted t-tests, and Bland and Altman plots were used to establish agreement between devices. For both devices the CV of repeated measurements was 0.95 in all measurements except for Sirius K s (ICC = 0.869). For all parameters evaluated, the Pentacam systematically yielded higher values, although differences were statistically significant in only three parameters—0.31 diopters for K s , 10.1 μm for CCT and 12.4 μm for TCT. In the assessment of normal corneas both devices showed overall high repeatability. Although good agreement was found in three parameters (Sim K, K f and ACD) these devices do not seem to be interchangeable for pachymetric determination.

To determine if chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (HSCT) is associated with stable or progressive dry eye disease and to determine the true incidence in patients with no prior history of dry eye disease.A nonconcurrent cohort study at a single institution with 136 patients who had no previous history of dry eye disease before HSCT. Survival analysis was used to estimate dry eye disease incidence. The incidence rate was calculated using life tables as the number of observed dry eye disease cases divided by the person-time at risk accumulated by the cohort. Transition probabilities were calculated from time of transplant to time of diagnosis, and then to last recorded visit.Incidence rate was 0.8 cases of dry eye disease per person-year, and half of the population at risk developed dry eye disease during the first 10 months post transplant. Time to develop dry eye disease was 2.5 months for mild dry eye disease, 9.6 months for moderate dry eye disease, and 13.2 months for severe dry eye disease. In terms of cumulative incidence, 73% of subjects developed dry eye disease (50% mild, 16% moderate, and 7% severe) at the time of diagnosis.Our findings suggest that dry eye disease associated with cGVHD is an extremely frequent event and shows a wide spectrum of severity, with a mild form presenting early and a moderate to severe form presenting later after HSCT. These findings need to be studied further to elucidate if these are two different pathophysiological entities or just different expressions of the same pathology.

PURPOSE: To study the outcomes of cataract surgery in patients with graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (HSCT). METHODS: Retrospective review of 72 eyes of 41 patients (age, 17-69 years at the time of surgery) with chronic GVHD after HSCT, who underwent cataract surgery between 2008 and 2012 at the Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan. Ophthalmic data collected included best-corrected visual acuity (BCVA), responses to Ocular Surface Disease Index (OSDI) questionnaire, dry eye severity, and postoperative complications. RESULTS: BCVA improved from 20/49 to 20/25 (P < 0.0001) after surgery. Eight patients (20%) had pretransplantation total body irradiation and 39 patients (95%) received systemic corticosteroids for the treatment of GVHD. Postoperative complications included cystoid macular edema (4 eyes), corneal ulceration with perforation (2 eyes: 1 infected and 1 sterile), and band keratopathy (1 eye). After surgery, subjective OSDI responses and dry eye disease (DED) did not change significantly from before cataract surgery, although OSDI showed a trend toward worsening. CONCLUSIONS: With careful monitoring and management of DED and concurrent ocular surface disease, cataract surgery generally has good visual outcomes in patients with GVHD. However, aggravation of the preexisting ocular surface disease is frequent, and despite meticulous postoperative maintenance therapy, vision-threatening complications may occur.

We report the case of a 32-year-old male with spontaneous crystalline lens dislocation into the anterior chamber with corneal touch and increased intraocular pressure. The case was handled in a conservative way: before bringing the patient to supine position, pharmacological pupil dilation with tropicamide plus phenylephrine was performed. One drop was instilled every 15 min for 1 hour. Once the posterior displacement of the lens behind the iris was confirmed, 2 % pilocarpine was used to reverse pupil dilation. The patient remained on topical 2 % pilocarpine and 5 % sodium chloride solution.