Search

PurposeMethodsResultsConclusion\nSUMMARYWhat was known beforeWhat this study addsTo assess the tear film parameters associated with photophobia in dry eye disease (DED).Three hundred seventy-four patients with DED (mean age, 42.2 ± 12.8 years) had their tear film and OSDI scores evaluated using Oculus keratograph 5 M (TMH, NIBUT, Meibography), Lipiview interferometer (LLT), and TearLab osmolarity system. Photophobia scoring from OSDI sheets was used to calculate the odds ratio via multivariate logistic regression analysis. Data from the eye with severely affected NIBUT was used.Of 374, 127 had aqueous deficient dry eye disease (ADDE), and 247 had evaporative DED. The mean age, female sex, Schirmer I, TMH, NIBUT, LLT, and tear osmolarity values in patients with photophobia versus no or mild photophobia were 42.2. vs. 40.9 years, 42% vs. 40%, 11.6 vs. 10.5 mm, 0.27 vs. 0.29 mm, 4.6 vs. 4.7s, 60.3 vs. 60.9 nm and 305 vs. 307 mOsm/L, respectively. Multivariate analysis revealed no tear film parameters predictive of photophobia in evaporative DED, whereas tear osmolarity had a weak negative association with photophobia (odds ratio of 0.96, 95% C.I, 0.92–1, p = .04) in ADDE patients.Tear film parameters do not predict the presence or absence of photophobia in DED except for a weak inverse association with tear osmolarity in ADDE. This suggests the role of central sensitization in regulating photophobia in DED patients.Photophobia is a common dry eye symptom. The severity of photophobia correlates with dry eye severity and improves with treatment.1. Tear film parameters, such as tear break-up time, tear volume, meibomian gland loss and lipid layer thickness do not predict photophobia risk in dry eye disease.2. This study provides the basis for future research in understanding the central neural sensitization in DED patients with photophobia. [ABSTRACT FROM AUTHOR]

Purpose: The current study evaluated the lid margin microbiome of keratinized lid margins of patients with chronic Stevens-Johnson syndrome (SJS) and compared it with healthy controls and historically reported lid margin microbiome of patients with meibomian gland dysfunction (MGD)., Methods: Eyelid margin swabs of 20 asymptomatic adults (mean age = 29 ± 12 years) and 10 patients with chronic SJS (mean age = 31.2 ± 14 years) with lid margin keratinization were sequenced using next generation of 16S rDNA V3 to V4 variable region. Within SJS, the keratinized lid margin microbiome was compared with adjacent eyelid skin., Results: All patients had obstructive MGD, and mean Schirmer I value was 2.8 ± 1.9 mm. The phyla were similar in two groups, whereas at the genera level, an increase in the relative abundance of Corynebacterium, Haemophilus, Azotobacter, and Afipia and a decrease of Acinetobacter was noted in SJS compared to healthy lid margins. SJS-associated microbiota displayed lesser diversity and more heterogeneity than healthy controls. The Principal Components Analysis (PCA) plot revealed wide separation in the SJS and the control groups. Correlational network analysis revealed Corynebacterium and Sphingomonas forming a major hub of negative interactions with other bacterial genera in the SJS group. Significant differences exist in the prevalent genera between keratinized lid margins and historically reported meibum microbiome of patients with MGD. In addition, the eyelid skin of patients with SJS had predominant Staphylococcus, whereas Corynebacterium and Pseudomonas were more in the keratinized lid margins compared to the eyelid skin microbiome., Conclusions: Lid margin microbiome is significantly altered in the keratinized lid margins of patients with SJS compared to the eyelid skin of patients with SJS, normal lid margins, and patients with MGD.