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A letter to the editor is presented that cites a case of two patients, a 53-year old male and a 73-year old female, with pterygium in their right eye who developed conjunctival graft dehiscence following pterygium surgery using fibrin tissue adhesive in Toronto, Ontario.

Purpose: Population-based cross-sectional survey in Ontario to estimate the 2016 prevalence of dry eye disease (DED) and associated risk factors among adults in Canada., Methods: We emailed the 5-Item Dry Eye Questionnaire (DEQ-5) to 124,469 Ontario adults (age ≥18 years) in the IQVIA E360 database, March-April 2017. Inclusion criteria were: ≥2 visits to an Ontario based clinic, ≥1 visits in the 1 year before the study; database record with email. DED was defined as a DEQ-5 score of >6/22. The crude prevalence by age/sex of the Ontario sample was adjusted to the 2016 Canadian population (mean age 41.0 years, 51% female). Significance of DED risk factors (age, sex, selected diseases/medical conditions and medications) was evaluated by logistic regression analysis., Results: Of the 5163 (4.1%) patients who completed the survey (59.5% female, median age, 46 years; 40.4% male, 56 years), 1135 respondents reported DED. Prevalence increased with age (p < 0.05) and was highest among those aged 55-64 years (24.7%; 95% CI, 22.1-27.3%) and lowest among those aged 25-34 years (18.4%; 95% CI, 15.9-21.0%). Prevalence was significantly higher (p < 0.001) among women (24.7%; 95% CI, 23.2-26.2%) than men (18.0%; 95% CI, 16.4-19.7%). Other risk factors were not significant. The age-/sex-adjusted Canadian DED prevalence estimate from this sample was 21.3% (95% CI, 19.8-23.2%), corresponding to ∼6.3 million people., Conclusions: Based on the Ontario sample, we estimate that >6 million Canadian adults may have DED, and that older people and females are more likely to be affected., (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: The objective of this study was to establish normative diffusion tensor imaging (DTI) eigenvalues (λ1,λ2,λ3), apparent diffusion coefficient, and fractional anisotropy in asymptomatic foot muscles., Methods: Ten healthy adults (mean [SD], 25.9 [4.3] years) were examined using a 3-T magnetic resonance imaging scanner. Diffusion tensor imaging indices were evaluated in 5 muscles in the foot: quadratus plantae, abductor hallucis, flexor hallucis brevis, flexor digitorum brevis, and abductor digiti minimi. Signal-to-noise ratio was also measured for each muscle., Results: In the various foot muscles, λ1 ranged from 1.88 × 10 to 2.14 × 10 mm/s, λ2 ranged from 1.39 × 10 to 1.48 × 10 mm/s, and λ3 ranged from 0.91 × 10 to 1.27 × 10 mm/s; apparent diffusion coefficient ranged from 1.48 × 10 to 1.55 × 10 mm/s; and fractional anisotropy ranged from 0.21 to 0.40. Statistical differences were seen in some eigenvalues between muscle pairs. Mean signal-to-noise ranged from 47.5 to 69.1 in the various muscles examined., Conclusions: Assessment of anisotropy of water diffusion in foot muscles was feasible using DTI. The measured DTI metrics in the foot were similar to those in calf and thigh skeletal muscles.