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Aim The aim of this research is to study the role of oral linolenic acid (omega-3 fatty acids) dietary supplementation in posterior blepharitis and meibomian gland dysfunction (MGD) in patients attending the Outpatient Clinic at Fayoum University Hospital. Patients and methods Fifty patients with moderate to severe chronic blepharitis and simple obstructive MGD were included in the study. Patients received oral omega-3 dietary supplementation consisting of one 1000-mg capsule once daily and were examined every 6 weeks for 3 months. Objective clinical measures included tear production (Schirmer I with anesthesia), tear film stability (fluorescein tear break-up time), ocular surface health (fluorescein surface staining), tear meniscus height, plugged meibomian gland orifices, and eyelid telangiectasia. Results Twenty-four (48%) patients had an age between 45 and 60 years, 20 (40%) patients were more than 60 years old, and six (12%) patients were less than 45 years old. The male to female ratio was 1 : 2. Twelve (24%) male patients were smokers, whereas four (8%) female patients were using oral contraceptive pills. Twenty-two (44%) patients were hypertensive, whereas eight (16%) patients were diabetic. There was a significant improvement of dry-eye symptoms, signs, tear break-up time, Schirmer test, and meibomian gland orifices after 3 months of oral linolenic acid use. Conclusion The results after 3 months of treatment and follow-up were very satisfactory for the efficacy. Oral linolenic acid (omega-3 fatty acids) is effective in the treatment of moderate to severe chronic blepharitis and MGD.

Purpose: To compare dry eye signs and symptoms between patients with preoperative low and normal Schirmer test after Photorefractive keratectomy (PRK). Methods: In this prospective, nonrandomized, comparative case series, 76 eyes of 76 patients were preoperatively categorized into two groups according to selected criteria for characterization of tear film status: the low Schirmer test value (STV) group and the normal STV group. For the tear function assessment, we performed a Schirmer test with and without anesthesia, tear break-up time (TBUT) test, and measurement dry eye symptoms using the Farsi translation of Ocular Surface Disease Index (OSDI) questionnaire pre- and 3 months post-operation. Results: Postoperatively, the Schirmer and TBUT values were significantly lower in both groups than preoperatively (all p

Obstructive sleep apnea syndrome is a multisystemic disorder associated with a series of side effects. Obstructive sleep apnea syndrome (OSAS) includes hypoxemia and is correlated with an increased incidence for various neuronal conditions, including glaucoma, strokes, reduced mental ability, depressive disorders, peripheral neuropathy, and non-arteritic ischemic optic neuropathy. This study’s aims are the evaluation of the degree of ocular surface damage in obstructive sleep apnea patients (in the absence of the continuous positive airway pressure treatment) and the structural changes in the optic nerve, and to establish correlation between the degree of damage to the ocular surface (eye dryness by Schirmer test) and corneal biomechanics by ocular response analyzer. The subjects included in the study will be grouped as follows: a group of patients with glaucoma and obstructive sleep apnea syndrome that will be compared to patients with glaucoma only as well as identifying the evolution of structural changes in patients with glaucoma and sleep apnea syndrome. A prospective study included 65 eyes from 65 subjects diagnosed with obstructive sleep apnea (45 eyes of 45 subjects with glaucoma and OSAS as well as 20 subjects, 20 eyes with dry-eye syndrome and OSAS) who did not follow the continuous positive airway pressure treatment. The control group consisted of 45 subjects (45 eyes) with (mild or moderate) primary open-angle treated glaucoma without obstructive sleep apnea. All patients had ophthalmologic evaluations according to a standardized protocol. Moreover, respiratory functional parameters (apnea–hypopnea index—AHI) and the body mass index were recorded. Within the studied group, patients with mild or moderate primary open-angle glaucoma, with moderate or severe dry-eye syndrome, patients with floppy-eyelid syndrome, with optical non-arteritis ischemic neuropathy, and a patient with retinal central vein occlusion were identified. The increased rate of the apnea syndrome during sleep produces a severe disorder of the ocular surface and a retinal neuro-degenerative disorder. The eyes of patients with sleep apnea syndrome (SAS) and glaucoma have lower mean intraocular pressure than eyes with glaucoma without SAS. However, the mean C/D ratio in eyes with glaucoma correlates with the severity of SAS. There is a positive correlation between the severity of the apnea and the ocular disorder’s degree similar to the studies in the literature review. The joint cooperation between the sleep specialists and ophthalmologists can lead to the improvement of the vascular and ocular status for the obstructive sleep apnea patients.

Objective: To compare main lacrimal gland values through shear-wave elastography (SWE) in patients with low Schirmer value and unspecified Sjögren's syndrome (SS) with healthy controls., Material and Method: Admitted to the ophthalmology department with Schirmer value <10 mm, randomly selected 46 eyes of 46 patients evaluated for Sjögren's syndrome (SS) in the rheumatology department between December 2022 and April 2023 were classified as low Schirmer group (LSG). Randomly selected 48 eyes of 48 patients at a similar age with Schirmer value >10 mm were included as controls. Main lacrimal gland SWE measurements in LSG and control groups were recorded and compared as meter/second (m/sec)., Results: Mean SWE values of the main lacrimal gland were measured as 2.78 ± 0.66 m/sec and 2.26 ± 0.29 m/sec in LSG and controls. SWE measurements were significantly higher in LSG patients than in controls (p<0.001). No significant correlation was found in the analysis between the Schirmer and the main lacrimal gland SWE values in LSG patients (p=0.702, r=0.058). No significant correlation was also detected between the Schirmer and main lacrimal gland SWE values in controls (p=0.097, r=0.242). No significant relationship was also found between age, gender, body mass index (BMI), and SWE values (p=0.351, p=0.493, p=0.328, respectively)., Conclusion: Mean SWE value of the main lacrimal gland was determined as significantly higher in patients with aqueous lacrimal insufficiency without SS than in controls. We consider that SWE measurements may be an imaging method to support the diagnosis of aqueous lacrimal insufficiency and used in follow-ups of those with dry eye syndrome (DES) in the future., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

In our study we aimed to demonstrate the relationship between the serum iron levels, and tears quality and quantity in term newborns. This study was conducted at a single institution between March 2013 and May 2013. A total of 46 newborns were prospectively enrolled. Serum iron levels were measured via the umbilical cord blood. Infants were divided into two groups according to their serum iron levels. Group A, serum iron level ≤70 μg/dL (n = 27) and Group B, serum iron level > 70 μg/dL (n = 19). The evaluation of the osmolarity was tested by using the TearLab Osmolarity System (TearLab Co, San Diego, CA, USA). The assessment of quantity was performed by using Schirmer I test. Osmolarity testing and Schirmer I test (with/without anesthesia) were performed bilaterally on the 1st day of life by an ophthalmologist. The outcomes of Schirmer I and tear osmolarity showed no statistically significant difference between right and left eyes of any infant in the groups. Moreover, there was no statistical difference between sexes in these two groups. Osmolarity was found to have a moderate negative correlation coefficient with serum iron level (r = −0.4, p

Objective. To compare the prevalence of dry eye syndrome (DES) in diabetic and non-diabetics patients, knowing the basic Patho-physiology of dry eye Methodology: 100 diabetics and 100 non-diabetics (total 200) patients were enrolled for this study. A cross-sectional study at HBS Medical College & Hospital, Islamabad was carried out from May'2015 to July'2016. Approval of the Ethical Bord was obtained and written consent was obtained from all the participants, ranging from 50-80 years of age. Results.100 each patients were kept in group-A (with mean age of 60.4±4.0 and group-B of non-diabetics (with mean age of 60.9±4.0. Gender distribution showed males diabetics 44.0% in group-A and 58.0% in group-B, while females were 56.0% in group-A and 42.0% in group-B. Majority of the symptoms were significantly higher in diabetics group-A as compared to non-diabetics in group B (p<0.001). 40% of the men and 62% of the women classified as having dry eye. Women were found more frequently than men, with (P<0.0001). Conclusion: Diabetic patients had an elevated prevalence of Dry Eye Syndrome. [ABSTRACT FROM AUTHOR]

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Copyright of Istanbul Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Purpose: To evaluate and compare three tear sampling methods using two grading scales for administering the tear ferning test (TFT) to healthy dogs. Methods: In total, 90 dogs (180 eyes) were subjected to tear sampling using millimetered strips, reused after the Schirmer tear test (STT) (Schirmer group, SG). Then, the dogs were subdivided into three groups according to sampling approach: micropipette (MPG), microcapillary (MCG), and Schirmer sample 2 (S2G). The collected tears were dried on a clean microscope glass slide at room temperature and humidity. The ferning patterns were observed under a polarized light microscope and classified according to the Rolando and Masmali grading scales. Results: Although all three methods were feasible, the STT was easier to perform in clinical settings. Type I and Grade 1 were the most commonly observed (64.17% and 61.7%, respectively) regardless of collection method. There was no significant difference between the STT median values and the TFT classifications. Conclusions: The TFT is appropriate for dogs and can be performed using the three suggested sampling methods, with a higher frequency of Type I and Grade 1. Thus, it is possible to use both grading scales in the classification of tear ferning in dogs. [ABSTRACT FROM AUTHOR]

Aim: To find association of dry eye in diabetics. Material and Method: A cross sectional study was conducted in which 100 patients were included and data was collected through structured questionnaire. Dry eye syndrome was assessed with tear break up time tests and Schirmer. Sample was collected through non probability convenient based sampling. Multiple linear regression model is used to check the association of diabetes with dry eye. Results: Of 100 subjects, 60.3% suffer from dry eye syndrome. Although dry eye syndrome was more common in older and female patients, But there was significant association between dry eye syndrome and duration of diabetes (P = 0.01). Dry eye syndrome was more frequent in diabetic patients with DR (P = 0.04). 17.1% with mild non proliferative DR (NPDR), 17.1% with moderate NPDR, 11.1% with severe NPDR and 25.1% with proliferative DR (PDR). There were significant relation between age, sex and duration of diabetes and DR. The result illustrate that Diabetes is a major cause of dry eye. Conclusion: Diabetes and dry eyes appeared to have a common association. Further studies need to be undertaken to establish an etiologic relationship. Dry eye was maximum present in insulin dependent patients and maximum diabetes patients in current context were women [ABSTRACT FROM AUTHOR]

Pathogenic strains of Acanthamoeba are causative agents of a sight-threatening infection of the cornea known as Acanthamoeba keratitis (AK) which mainly affects contact lens wearers and it is commonly related to poor hygiene of contact lenses and their cases. Moreover, treatment of AK is complex due to the existence of a highly resistant cyst stage and if not diagnosed early has poor prognosis, leading to blindness and/or keratoplasty. Even though AK is increasing worldwide as well as awareness among patients and clinicians, it is still a poorly studied pathogen. Additionally, a remaining question to be answered is whether these opportunistic pathogens are present in the ocular surface of healthy contact lens wearers since they are the main group at risk.In order to carry out this study, sterile Schirmer strip tests were collected from a group of individuals all of them contact lens wearers who were attending a local ophthalmology clinic in Tenerife, Canary Islands, Spain. The collected samples (100 eyes of 50 patients) were cultured in 2% Non-Nutrient Agar (NNA) plates and positive plates (16) were then cultured in axenic conditions for further analyses. Molecular analysis classified all isolated strains belonged to Acanthamoeba genotype T4 and osmotolerance and thermotolerance assays revealed that all strains were potentially pathogenic. In conclusion, the ocular surface of contact lens wearers included in this study was colonized by potentially pathogenic strains of Acanthamoeba and should be considered as a risk for AK infection in this region and worldwide. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to demonstrate the effect of nasal steroid treatment on intraocular pressure and dry eye in allergic rhinitis patients with dry eye. Materials and Methods: Twenty-nine patients with a diagnosis of allergic rhinitis and dry eye were included. Symptoms and findings of patients before and after nasal steroid therapy were compared. Result: Ocular Surface Disease Index scores for dry eye symptoms showed significant improvement after nasal steroid treatment (p = 0.003). In the Schirmer test, no significant change was observed in the right or left eye (p = 0.167 and p = 0.489). For the tear film break-up time, no significant change was observed in the right or left eye (p = 0.076 and (p = 0.170). No significant change was observed in the right eye or the left eye in an intraocular pressure test (p = 0.893 and p = 0.495). Conclusion: In our study, symptoms of dry eye with allergic rhinitis were significantly improved with nasal steroid therapy, without affecting the intraocular pressure. [ABSTRACT FROM AUTHOR]

AIM: To determine the role of subjective assessment using McMonnies dry eye questionnaire in diagnosing dry eye disease and its association with clinical tests. METHODS: There were 500 patients screened for dry eye using McMonnies dry eye questionnaire between May to October 2013 at the outpatient Department of Ophthalmology of a medical college hospital. All 500 patients were subjected to clinical tests. Dry eye was defined as having one or more symptoms often or all the time. Positive signs were if one or both eyes revealed tear film breakup time (TBUT) of ≤10s, a Schirmer test score of ≤10 mm, a Rose Bengal staining score of ≥1, a Lissamine green staining score of ≥1 or existence of meibomian gland disease (≥grade 1). Statistical analysis was performed to describe the distribution of symptoms and signs, to assess the correlations between McMonnies score (MS) and variable clinical signs of dry eye, and to explore the association between dry eye symptoms and variable clinical signs. Analysis was performed using software package Epi info. A Probability (P) value using Chi-square test of RESULTS: Dry eye prevalence with symptoms (questionnaire), Schirmer test, TBUT, Rose Bengal staining and Lissamine green staining was 25.6%, 15.20%, 20.80%, 23.60%, and 22.60% respectively. Among those with severe symptoms (MS>20), 75.86% had a low TBUT (CONCLUSION: Subjective assessment plays an important role in diagnosing dry eye disease. There is strong correlation between MS and Schirmer test, TBUT, Rose Bengal staining and Lissamine green staining in normal as well as marginal and pathological dry eye.

Aim of the study The aim of the present study was to evaluate the severity of dry eye following laser in-situ keratomileusis (LASIK) and surface ablation (photorefractive keratectomy). Patients and methods This study was designed as a prospective, nonrandomized, comparative clinical study. In total, 40 eyes of 20 patients were divided into two equal groups (group A and B). In group A, 20 eyes underwent LASIK with mechanical microkeratome flap. In group B, 20 eyes underwent surface ablation with mechanical or laser epithelial removal. Dry eye was evaluated by tear breakup time (TBUT) and Schirmer test preoperatively, and then 1 week, 1 month, and 3 months postoperatively. Results Preoperative mean TBUT in LASIK patients was 13 ± 1.87 s and mean TBUT in surface ablation patients was 12.9 ± 1.79 s (P = 0.435). At 1 week postoperative, the mean TBUT in LASIK patients was 7.6 ± 1.93 s (P < 0.05) and in surface ablation patients it was 8.58 ± 1.79 s (P < 0.05). At 1 month postoperative, the mean TBUT in LASIK patients was 8.95 ± 2.06 s (P < 0.05) and in surface ablation patients it was 10.25 ± 1.58 s (range = 7-13 s) (P < 0.05). At 3 months postoperative, the mean TBUT in LASIK patients was 10.1 ± 1.89 s (P < 0.05) and in surface ablation patients it was 11.2 ± 1.72 s (P < 0.05). Preoperative mean Schirmer test score in LASIK patients was 15.25 ± 2.61 mm and mean Schirmer test score in surface ablation patients was 15.2 ± 2.84 mm (P = 0.475). At 1 week postoperative, the mean Schirmer test score in LASIK patients was 9.35 ± 2.37 mm (P < 0.05) and the mean Schirmer test score in surface ablation patients was 10.2 ± 2.09 mm (P < 0.05). At 1 month postoperative, the mean Schirmer test score in LASIK patients was 10.8 ± 2.23 mm (P

Introduction: Dietary consumption of omega-3 fatty acids has been found to be beneficial in patients with dry eye syndrome. Aim: To evaluate the efficacy of dietary omega-3 fatty acids (O3FAs) for dry eye in patients with psoriasis with and without meibomian gland dysfunction. Materials and Methods: An interventional, non-randomized, controlled, multi-center study was done. Psoriatic patients were recruited when they had either dry eye symptoms and/ or Schirmer

Objectives: To evaluate the dry eye symptoms based on objective test and subjective findings in children with chronic renal failure (CRF) and to compare the results with those in healthy subjects. Materials and Methods: Thirty-four children with CRF and 89 age- and sex-matched healthy subjects were included in this prospective study. Tear break-up time (TBUT) and Schirmer test, subjective symptoms (burning, foreign-body sensation, hyperemia, itching, tearing), calcification of the conjunctiva, and corneal staining were evaluated. In the study group, relation between TBUT and Schirmer test results and duration of disease, duration of dialysis, serum calcium, phosphorus, urea, creatinine, and total protein levels were recorded. For statistical analysis, t-test, chi-square test, and Pearson’s correlation test were used. Results: In the study group, burning sensation was statistically higher than in the control group. Except this, according to the other subjective tests and corneal staining, there were no significant differences between the two groups (p>0.05). Conjunctival calcification was seen in 3 patients in the study group. The mean Schirmer test result was 21.1±8.0 and 23.7±8.0 mm in the study and control groups, respectively (p=0.101). The mean TBUT was 12.5±5.2 seconds (s) in the study and 16.0±5.5 s in the control groups (p=0.002). None of the disease-related variables (the mean duration of disease and dialysis, serum calcium, phosphorus, urea, creatinine, and total protein levels) were associated with dry eye syndrome (p>0.05). Conclusion: TBUT was statistically significantly lower, but Schirmet test result was not significantly different between children with CRF and age- and sex-matched healthy subjects. The disease-related variables have no effect in the development of dry eyes. (Turk J Ophthalmol 2014; 44: 196-200)

AIM:To measure fundamental secretion of tears in young and middle-aged people with Han nationality in Xi'an, and the fundamental secretion of tears in the same samples after they inhabited in 4 300 meter region for 1mo, in order to provide the foundation for further research on prevention and interventions of dry eye in crowd from plain to high altitude region.METHODS:The 43 normal volunteers with 86 eyes were conducted with the Schirmer test to hang the test paper at 1/3 eyelid margin. The length of stained test paper was measured after 5min. After 1mo the volunteers lived in high altitude region, the same test was conducted binocularly. RESULTS:The length of stained test paper in young and middle-aged people with Han nationality was 14.21±3.32mm in Xi'an. And then significantly increased to 20.10±6.62mm after 1mo they lived in high altitudes region.CONCLUSION:There is significant difference of fundamental secretion of tears between the people in Xi'an and those in other areas. Also there is significant difference of fundamental secretion of tears in people before and after living in Plateau.

Background: Dry eye disease DED is a little-known symptom of menopause. According to the International Society for Women's Health Research, 61 percent of perimenopausal and menopausal women suffer from dry eyes but only 16 percent blame menopause. Aim: To know the tear film changes in menopausal women as the target group. Methods :In a cross sectional study of 12 months duration (Jan'2012-Dec'2012), 992 willing female patients aged over 40 years attending Eye department Federal Government Services Hospital Islamabad and all perimenopausal women from the Obstetrics and Gynecology department were invited to undergo the dry eye (DE) tests after approval from Ethical committee. Dry eye questionnaire and perimenopause symptoms questionnaire administered by a trained interviewer while tear break-up time test (TBUT), Schirmer test ST, corneal fluorescein staining (CFS) and Slit lamp examination of the lids were performed by a single surgeon under the same physical conditions. The diagnosis was made on the presence of three out of five parameters. SPSS 17 was used to analyzed the data. Results :Among 992 patients, urban 705(71.1%) and rural 287(28.9%), teachers 170(17.2%), office workers 276(27.8%), housewives 36(37.2%) and 176(17.8%) were laborers. In this population, 49% (486/992) patients were symptomatic defined as presence of one or more dry-eye symptoms often or all the time. Among those, 75.3% (366/486) had a low TBUT, 60.6% (295/486) had a low ST result, 58.8% (286/486) had abnormal anatomic features of the meibomian glands and 51% showed CFS. Of the 49 % women having dry eyes, 32% had mild, 2% moderate and 5% severe dry eyes. Age adjusted prevalence was more for older women. Commonly seen DE symptoms in these women were burning 60.7%, foreign body sensation 60.2% and the hormone-related symptoms were 67% hot flashes/sweats, 62% sleep disturbances, 51% mood changes and 43% fatigue. Conclusion: DED is one of the main reasons that patients visit eye specialist in the United States. Majority of patients attending tertiary care hospital have DED. It is a multifactorial disease, is frequent in elderly women, especially menopausal and postmenopausal. [ABSTRACT FROM AUTHOR]

Purpose The goal of this research is to find out the incidence of any ophthalmic adverse effects associated with sofosbuvir − ribavirin combination therapy in comparison with sofosbuvir − ribavirin − interferon combination therapy in patients having chronic hepatitis C. Patients and methods A prospective nonrandomized comparative study was carried on 80 eyes of 40 patients with a documented diagnosis of chronic hepatitis C referred by the Internal Medicine and Hepatogastroenterology Department. Study group 1 (20 patients; 40 eyes) patients enrolled in the dual-therapy delineation (a 24-week regimen of 400 mg/day sofosbuvir and a 600 mg/day ribavirin) and study group 2 (20 patients; 40 eyes) patients registered in the triple-therapy planning (12-week regimen of sofosbuvir and ribavirin plus 180-µg peginterferon α-2a subcutaneously weekly). All recorded patients were subjected to entire ophthalmic examination before the medicaments strategy inauguration with periodic examination at 3 and 6 months during the treatment plan using Schirmer test and tear film breakup time test. Results Retinopathy has been evidenced at 3 months after treatment onset in 15% of group 2 candidates and receded at 6 months, which dates 3 months after treatment termination, with no cases of retinopathy in group 1 patients; the difference was statistically insignificant. Schirmer test and tear film breakup time results changed significantly over the 6-month study period. In study group 1, values of both tests decreased at 3 months after the start of sofosbuvir antiviral drug therapy and continued to dwindle throughout the period of follow-up. On the contrary, in study group 2, they decreased at 3 months after treatment onset but came to the common standard values 3 months after treatment discontinuation. Conclusion In our research, both study groups show that the drug-induced dry eye effects were in any event reasonably mild and had trivial effect on one’s daily performance. The retinal lesions in our patients were peacefully asymptomatic, as there were no effects on the best corrected visual acuity (BCVA) in all patients throughout the 6-month study period. [ABSTRACT FROM AUTHOR]