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Objective: To evaluate newly diagnosed vernal keratoconjunctivitis patients for their symptomatology, refractive errors and presence of dry eye disease along with its severity. Methods: A cross-sectional study was conducted after approval from the institutional ethics committee, among 100 patients of vernal keratoconjunctivitis, according to the inclusion and exclusion criteria. After obtaining informed consent, visual acuity and refraction, tear film break-up time, corneal fluorescein staining and Schirmer test (I and II) were performed. An ocular surface disease index questionnaire was filled out for symptomatic evaluation and was also graded on the basis of their ocular findings. The results were analysed by SPSS software. Results: In our study, the most common symptoms experienced were itching (87%) and redness (79%). Dry eye symptoms were present in 43% of patients with an ocular surface disease index (OSDI) mean score of 11.3 ± 4.67. Out of 100 patients, 45 patients had mild findings and 55 patients had moderate findings of VKC. The mean value of tear film break-up time (TBUT) was 8.15 ± 4.47 (P: 0.539), that of corneal fluorescein staining was 4.18 ± 3.4 (P: 0.885) and those of Schirmer’s test I and II were 13.4 ± 5.9 mm (P: 0.288) and 12.95 ± 5.8 mm (P: 0.615), respectively. Myopia was found to be the most common refractive error (35%) followed by hypermetropia (30%) and astigmatism (10%). Conclusion: The results concluded that patients of VKC showed a mild-to-moderate disease and are associated with dry eye having the values of TBUT, corneal staining and Schirmer test, proving the association. Refractive errors are not present in all patients of VKC but have a positive association with increasing severity of the disease.

Background: Psoriasis is a chronic inflammatory condition affecting the skin, nails, joints, and eyes. Ocular manifestations in psoriasis, such as dry eyes, blepharitis, conjunctivitis, and uveitis, are often overlooked despite their potential impact on quality of life. Objective: This study aimed to investigate the prevalence and types of ocular manifestations in psoriasis patients and their correlation with disease severity. Methods: This observational study was conducted at Government Medical College, Jammu, between March 2022 and March 2023. It included 50 psoriasis patients who underwent comprehensive ophthalmic evaluations, such as best-corrected visual acuity (BCVA), slit-lamp examination, tear film break-up time (TBUT), Schirmer test, and fundus examination. The Psoriasis Area and Severity Index (PASI) was calculated for each participant to assess disease severity. Results: The mean disease duration was 5.5 ± 3.8 years, and 62% of patients (n=31) exhibited ocular manifestations. Dry eyes were the most common finding (22%), followed by cataract/pseudophakia (14%), blepharitis (14%), chronic conjunctivitis (8%), and uveitis (4%). Patients with higher PASI scores were more likely to have ocular involvement. Conclusion: The study highlights that ocular manifestations are a significant complication of psoriasis, with dry eyes being the most prevalent. Routine ophthalmic evaluations are recommended for early detection and management of ocular conditions in psoriasis patients.

The aim of this study is to provide a comprehensive review and analysis of current diagnostic methods for Sjögren’s syndrome and to highlight the historical progress in diagnosing dry eye syndrome. The article is based on scientific publications, with relevant articles selected after an initial assessment and analysed using a non-systematic review method to ensure a concise synthesis of available information. Sjögren’s syndrome is a chronic autoimmune disease characterised by lymphocytic infiltration in exocrine glands. Sjögren’s syndrome remains a poorly understood disease, concealing many aspects. This disease often manifests through dryness of the mouth and eyes, as well as skin changes. Over the years, the diagnostic criteria for Sjögren’s syndrome have under-gone multiple modifications. In 2016, a consensus was reached that currently serves as the diagnostic foundation. The diagnostic process is challenging, leading to delayed diagnosis. Therefore, specialists employ supplementary tests, including the Schirmer test, scintigraphy, and histopathological examinations.

Background and Objectives: Human umbilical cord blood serum (HUCBS) stands out as a potent adjunct to conventional therapies for ocular surface disorders (OSDs) caused by, among many, autoimmune systemic syndromes. By expediting ocular surface regeneration and fostering epithelial integrity, HUCBS not only enhances subjective patient experiences but also improves objective clinical indicators. This makes it particularly useful in patients with corneal ulcers through ocular surface regeneration and anti-inflammatory activity. This study aims to explore the efficacy of HUCBS in patients who had previously received other treatments unsuccessfully. Materials and Methods: This study was a prospective, non-comparative, interventional case series study involving 49 patients (30 females and 19 males) aged 15–82 years with severe OSDs who were unresponsive to standard treatments. The study was conducted at the San Marco Hospital, Catania, Italy. Patients were categorized into four groups based on the etiology of their severe OSDs: Group I consisted of twenty four patients with filamentary keratitis and corneal ulcers associated with rheumatologic diseases such as Sjogren's syndrome and systemic sclerosis; Group II comprised thirteen patients with graft-versus-host disease; Group III consisted of nine patients with corneal neurotrophic ulcers; and Group IV included three patients with Steven–Johnson syndrome. The outcomes were evaluated before and after treatment using the following assessments: OSDI (Ocular Surface Disease Index) and SANDE (Symptom Assessment in Dry Eye) questionnaires, VAS (Visual Analog Scale), Slit Lamp Examination, Esthesiometry, Lissamine Green Staining, NIBUT (Non-Invasive Break-Up Time), BUT (Break-Up Time), Fluorescein Staining with Photography and Oxford Classification, The Schirmer Test, Best-Corrected Visual Acuity (BCVA), and Meibography. Results: We observed a significant improvement in the outcomes from the SANDE, VAS, and OSDI questionnaires, The Schirmer Test, BUT, BCVA, and Oxford Classification, after treatment with UCBS. Clinical variables, such as corneal inflammation, conjunctivalization, corneal neovascularization, and pain, were also considered individually. Nevertheless, pain and inflammation reduced markedly over time until complete healing was achieved in all cases. Conclusions: Our pilot study highlights the substantial efficacy of HUCBS in patients with systemic autoimmune diseases who have shown inadequate responses to prior treatments for dry eye. This underscores the need for further comprehensive investigations in this field. [ABSTRACT FROM AUTHOR]

Abstract Background Dry eye disease (DED) includes neurosensory abnormalities as part of its multifactorial etiology. Nerve growth factor is important for maintaining corneal nerve integrity and wound healing. Cenegermin (recombinant human nerve growth factor) is a topical biologic that promotes corneal healing in patients with neurotrophic keratitis. The purpose of this study was to evaluate efficacy and safety of cenegermin in moderate-to-severe DED and identify an optimal dosing strategy. Methods This was a phase II, multicenter, randomized, double-masked, vehicle-controlled, dose-ranging clinical trial in patients with moderate-to-severe DED, including Sjögren’s DED (NCT03982368). Patients received 1 drop of cenegermin 3 times daily (t.i.d.; 20 mcg/mL), cenegermin 2 times daily (b.i.d.; 20 mcg/mL) and vehicle once daily, or vehicle t.i.d. for 4 weeks. Follow-up continued for 12 additional weeks. The primary endpoint was change in Schirmer I score from baseline to week 4. Other key endpoints included rate of responders (Schirmer I test > 10 mm/5 min) after treatment and change in Symptoms Assessment iN Dry Eye (SANDE) scores from baseline to end of follow-up. A 1-sided test (α = 0.025) was used to evaluate statistical significance. Results At week 4, mean changes in Schirmer I scores were not statistically significantly different in either cenegermin group versus vehicle (cenegermin vs vehicle [treatment difference; 95% CI]: t.i.d., 2.60 mm and b.i.d., 3.99 mm vs 1.68 mm [t.i.d.: 0.93; −1.47 to 3.32, P = 0.078; b.i.d.: 2.31; −0.08 to 4.70, P = 0.066]). More patients responded to treatment with cenegermin t.i.d. and b.i.d. versus vehicle (t.i.d.: 25.9% [21/81, P = 0.028]; b.i.d.: 29.3% [24/82, P = 0.007] vs 11.9% [10/84]), with statistical significance (set at P

In this study, we aimed to investigate the effect of different hyaluronic acid (HA)-containing artificial tears on dry eye disease (DED) treatment in combination with intense pulsed light (IPL) therapy. A retrospective cohort study was conducted, and the participants received IPL therapy and HA-containing artificial tears. There were 42 and 40 eyes in the 0.10% and 0.15% HA groups after selection, respectively. The main outcomes were the postoperative non-invasive tear break-up time (NITBUT), Schirmer II test results, ocular surface stain, and numbers of DED-related symptoms. A generalized linear model was utilized to produce the adjusted odds ratio (aOR) and 95% confidence interval (CI) of the main outcomes between groups. At the three-month follow-up, the NITBUT was significantly higher in the 0.15% HA group (p = 0.023), and the NITBUT recovery was also significantly better in the 0.15% HA group compared to the 0.10% HA group (p = 0.039). The multiple DED-related symptoms significantly correlated with no DED symptom improvement in both the 0.10% and 0.15% HA groups (both p < 0.05), while the low pre-treatment NITBUT was marginally related to no DED symptom improvement in the 0.10% HA group (p = 0.047). A low NITBUT and Schirmer II test result correlated with no DED symptom improvement in both the groups (all p < 0.05). In conclusion, the application of 0.10% and 0.15% HA-containing artificial tears revealed similar effects to IPL therapy for DED. [ABSTRACT FROM AUTHOR]

Background: Dry eye disease (DED) includes neurosensory abnormalities as part of its multifactorial etiology. Nerve growth factor is important for maintaining corneal nerve integrity and wound healing. Cenegermin (recombinant human nerve growth factor) is a topical biologic that promotes corneal healing in patients with neurotrophic keratitis. The purpose of this study was to evaluate efficacy and safety of cenegermin in moderate-to-severe DED and identify an optimal dosing strategy. Methods: This was a phase II, multicenter, randomized, double-masked, vehicle-controlled, dose-ranging clinical trial in patients with moderate-to-severe DED, including Sjögren's DED (NCT03982368). Patients received 1 drop of cenegermin 3 times daily (t.i.d.; 20 mcg/mL), cenegermin 2 times daily (b.i.d.; 20 mcg/mL) and vehicle once daily, or vehicle t.i.d. for 4 weeks. Follow-up continued for 12 additional weeks. The primary endpoint was change in Schirmer I score from baseline to week 4. Other key endpoints included rate of responders (Schirmer I test > 10 mm/5 min) after treatment and change in Symptoms Assessment iN Dry Eye (SANDE) scores from baseline to end of follow-up. A 1-sided test (α = 0.025) was used to evaluate statistical significance. Results: At week 4, mean changes in Schirmer I scores were not statistically significantly different in either cenegermin group versus vehicle (cenegermin vs vehicle [treatment difference; 95% CI]: t.i.d., 2.60 mm and b.i.d., 3.99 mm vs 1.68 mm [t.i.d.: 0.93; −1.47 to 3.32, P = 0.078; b.i.d.: 2.31; −0.08 to 4.70, P = 0.066]). More patients responded to treatment with cenegermin t.i.d. and b.i.d. versus vehicle (t.i.d.: 25.9% [21/81, P = 0.028]; b.i.d.: 29.3% [24/82, P = 0.007] vs 11.9% [10/84]), with statistical significance (set at P < 0.025) observed in the b.i.d. group. Only cenegermin t.i.d. yielded statistically significant (P < 0.025) reductions in SANDE scores versus vehicle, which were sustained up to the end of follow-up (P value range, 0.002–0.008). Eye pain, primarily mild and transient, was the most frequently observed treatment-emergent adverse event with cenegermin. Similar results were observed in patients with Sjögren's DED. Conclusions: Cenegermin was well tolerated and although this study did not meet its primary endpoint, significant improvement in patient-reported symptoms of dry eye was observed through follow-up. Larger studies evaluating cenegermin in patients with DED are warranted. Trial registration: NCT03982368; registered May 23, 2019. [ABSTRACT FROM AUTHOR]

The study aims to characterize the robustness of distinct clinical assessments in identifying the underlying conditions of dry eye disease (DED), with a specific emphasis on the involvement of conjunctival goblet cells. Seven rabbits receiving surgical removal of the lacrimal and Harderian glands were divided into two groups, one with ablation of conjunctival goblet cells by topical soaking of trichloroacetic acid (TCA) to the bulbar conjunctiva (n = 3) and one without (n = 4), and the conditions of DED were assessed weekly using Schirmer test, tear breakup time (TBUT), tear osmolarity, and National Eye Institute (NEI) fluorescein staining grading. After 8 weeks, the rabbits were sacrificed, and the eyes were enucleated for histopathological examination. Histopathological analysis revealed corneal epithelial thinning in both groups. While TCA soaking significantly decreased the density of conjunctival goblet cells, DED rabbits without TCA also showed a partial reduction in goblet cell density, potentially attributable to dacryoadenectomy. Both groups showed significant decreases in Schirmer test and TBUT, as well as an increase in tear osmolarity. In DED rabbits with TCA soaking, tear osmolarity increased markedly, suggesting that tear osmolarity is highly sensitive to loss and/or dysfunction of conjunctival goblet cells. Fluorescein staining was gradually and similarly increased in both groups, suggesting that fluorescein staining may not reveal an early disruption of the tear film until the prolonged progression of DED. The Schirmer test, TBUT, tear osmolarity, and NEI fluorescein grading are distinct, yet complementary, clinical assessments for the evaluation of DED. By performing these assessments in definitive DED rabbit models, both with and without ablation of conjunctival goblet cells, the role of these cells in the homeostasis of tear osmolarity is highlighted. Characterizing the robustness of these assessments in identifying the underlying conditions of DED will guide a more appropriate management for patients with DED. [ABSTRACT FROM AUTHOR]

ObjectiveDry eye disease (DED) is a condition associated with a myriad of systemic disorders. According to recent preliminary data, axial spondylarthritis (axial-SpA) could represent a new entity associated with DED. Therefore, this study aimed to assess DED in patients with axial SpA by performing quantitative and qualitative specific tests to investigate the potential association between DED and ocular surface damage in patients with axial-SpA and to identify potential variables associated with DED.MethodsA total of 71 patients with axial-SpA who fulfilled the Assessment of SpondyloArthritis International Society (ASAS) classification criteria and 19 healthy controls were enrolled in this study. Both the patients and the controls underwent a complete ocular assessment aimed at evaluating the tear film and ocular surface, which included the Schirmer test, tear break-up time (TBUT), fluorescein staining, and lissamine green staining. The Ocular Surface Disease Index (OSDI) questionnaire was administered to all patients.ResultsDED symptoms were reported in 46 (64.8%) patients and three (15.8%) healthy controls (p = 0.0004). The odds ratio for receiving a diagnosis of axial-SpA based on the presence of dry-eye-related symptoms was 9.2 (95% C.I. 2.72–42.52, p = 0.001). The Schirmer test values of < 6 mm/5 min were observed in 31 (43.7%) patients with axial-SpA and two (10.5%) healthy controls (p = 0.013); a TBUT of

Treatment with aromatase inhibitors (AIs) in patients with breast cancer can lead to dry eye disease (DED). The purpose of the study is to determine the prevalence and risk factors of DED in patients treated with AIs for breast cancer. Participants in this cross-sectional study were patients with breast cancer treated with AIs. Demographic and clinical data, including age, sex, type of cancer, stage, grade, duration of treatment and adjuvant chemotherapy and/or radiotherapy were collected. All patients underwent a detailed ophthalmic examination, as well as Tear Break up Time (TBUT) and Schirmer test, while Ocular Surface Disease Index (OSDI) questionnaires were administered. Based on the clinical findings, a diagnosis of DED was made, and prevalence was calculated. Univariate analysis of the association of different variables with DED was performed. A logistic regression analysis was done to identify risk factors for DED among study population. A total of 102 participants were included in the study. The mean age of patients was 62.4 ± 10.8 years. A total of 77 out of 102 patients (75.5%) had ductal, 16 (15.7%) lobular and 9 (8.8%) other types of breast cancer. A total of 83 patients (81.4%) received chemotherapy and 70 patients (68.6%) received radiotherapy. The mean duration of treatment was 24.4 ± 18.9 months. The prevalence of DED in the study sample was 69.6%. Patients who received radiotherapy (OR = 3.31, 95%CI = 1.30–7.82, p = 0.01) or were under treatment with AIs for more than 24 months (OR = 3.53, 95%CI = 1.47–9.21, p = 0.002) were found to have an increased risk of DED. There was a high prevalence of DED among the study population. Radiotherapy and duration of treatment with AIs were independently associated with DED. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the association of prephotorefractive keratectomy Schirmer-1 test value with postphotorefractive keratectomy central corneal epithelial thickness, ocular surface disease index score, and uncorrected distance visual acuity. Methods: Patients were categorized according to preoperative Schirmer-1 value: the normal Schirmer Group (n=54; Schirmer-1 test value, >10 mm) and the low Schirmer Group (n=52; Schirmer-1 test value, between 6 and 10 mm). We analyzed ablation depth, visual acuity, result of Schirmer-1 test (with anesthesia), tear film break-up time, ocular surface disease index score, central corneal epithelial thickness, and spherical equivalent refraction. Results: We found significant differences between the groups in Schirmer-1 test value, tear film break-up time, and ocular surface disease index score, both preoperatively and postoperatively (p<0.001). The preoperative central corneal epithelial thicknesses of the two groups were similar (p>0.05). After photorefractive keratectomy, the Schirmer-1 test value and spherical equivalent refraction decreased in both groups (p<0.05), and ocular surface disease index scores and central corneal epithelial thickness values increased in the low Schirmer Group (p<0.001) but not in the normal Schirmer Group (p>0.05). The postoperative central corneal epithelial thicknesses of the low Schirmer Group were significantly higher than those of the normal Schirmer Group (p<0.001). Postoperative uncorrected distance visual acuity did not differ significantly between the two groups (p>0.05). Conclusions: In patients with low Schirmer-1 test values before photorefractive keratectomy, the corneal epithelium thickened and ocular surface complaints increased during the postoperative period. However, changes in the corneal epithelium did not affect the postoperative uncorrected distance visual acuity. To reduce postoperative problems on the ocular surface in these patients, we recommend that dry eye be treated before photorefractive keratectomy. [ABSTRACT FROM AUTHOR]

Masahiko Ayaki,1,2,&ast; Kazuno Negishi1,&ast; 1Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; 2Otake Eye Clinic, Kanagawa, Japan&ast;These authors contributed equally to this workCorrespondence: Masahiko Ayaki, Email mayaki@olive.ocn.ne.jpPurpose: We aimed to determine the seasonal variation in the tear meniscus level on strip meniscometry and its association with ocular parameters and symptoms. In Japan, there are four distinct seasons characterized by marked differences in temperature and humidity, which may contribute to an observed seasonality of ocular surface symptoms.Methods: We conducted a cross-sectional study in two Japanese clinics and recruited first-visit patients for 3 years. Tear strip meniscometry, tear break-up time (BUT), Schirmer test, and corneal staining were examined, and major ocular symptoms (dryness, irritation, pain, fatigue, blurred vision, and photophobia) were determined through interviews.Results: The 1196 participants had a mean age of 58.9± 15.2 years; 37.1% were of male sex. Strip meniscometry values and BUT revealed significant seasonality with one-way analysis of variance. The mean strip meniscometry value (mm) was 2.15± 2.59 in spring (p=0.025 vs winter), 2.37± 2.79 in summer (p< 0.001), 2.38± 2.80 in fall (p< 0.001), and 1.64± 2.29 in winter. Regression analysis indicated that strip meniscometry levels were correlated with BUT (p< 0.001), Schirmer test values (p< 0.001), corneal staining scores (p=0.022), and presence of dryness (p< 0.001).Conclusion: Strip meniscometry values exhibited distinct seasonality, being lowest in winter when the ambient condition is dry and cool, and were correlated with BUT, Schirmer test values, corneal staining scores, and the presence of subjective dryness.Keywords: dry eye, seasonality, strip meniscometry, Schirmer test, tear break-up time

Purpose: To compare dry eye findings in diabetes mellitus patients with and without diabetic foot. Methods: Diabetes mellitus patients with and without diabetic foot were included in this controlled cross-sectional study. Tear break-up time (BUT) and Schirmer test results of each participant were noted. Ocular Surface Disease Index (OSDI) questionnaire was administered to each participant. Results: There were 48 diabetic patients in the study; half of them had diabetic foot (n=24). The patients with and without diabetic foot were similar in age and sex distribution. The median levels of BUT (4.0 [3.0 – 6.0] seconds for the right eye, 4.5 [3.0 – 6.5] seconds for the left eye in patients with diabetic foot) (4.0 [3.8 – 6.2] seconds for the right eye, 5.0 [3.8 – 5.2] second for the left eye in patients without diabetic foot) and Schirmer’s test (7.0 [5.0 – 17.0] mm for the right eye, 11.0 [6.8 – 17.0] mm for the left eye in patients with diabetic foot) (11.0 [7.0 – 15.8] mm for the right eye, 14.5 [6.5 – 18.5] mm for the left eye in patients without diabetic foot) were similar in both groups of patients. The scores of OSDI were similar in patients with diabetic foot (22.7 [13.5 – 36.2]) and without diabetic foot (28.4 [13.6 – 41.5]) (p=0.749). Conclusion: The Schirmer test, BUT test, and OSDI score were lower in patients with diabetic foot, but they were not statistically significant. In future studies, peripheral neuropathy examination and corneal confocal microscopy may be beneficial when evaluating dry eye parameters in this group of patients.

Introduction: Pseudoexfoliation syndrome (PEX) is a systemic age-related disorder with the production and accumulation of abnormal fibrous material in visceral organs and in the eye. The presence of pseudoexfoliation in the conjunction and lacrimal glands can affect the tear film stability. Objective: The objective of this study was to study the tear film abnormalities in patients with PEX. Materials and Methods: In this case-control study, Group 1 consisted of 40 eyes with PEX, Group 2 consisted of 40 eyes with pseudoexfoliation glaucoma, and Group 3 consisted of 40 eyes without pseudoexfoliation (control group). Schirmer's two tests and tear film break-up time (TBUT) were performed to study the tear film abnormalities in all eyes. Results: The mean Schirmer's in Group 1, Group 2, and Group 3 was 12.43 ± 5.697, 13.10 ± 5.173, and 21.98 ± 5.399, respectively. The mean TBUT in Group 1, Group 2, and Group 3 was 6.0 ± 1.961, 5.13 ± 2.053, and 11.38 ± 1.644, respectively. Both Schirmer's 2 test and TBUT values between Groups 1 and Group 3, between Group 2 and 3 showed statistically significant differences (P < 0.05). Conclusion: This study reveals that tear film abnormalities are commonly seen in PEX syndrome and PEX glaucoma due to the involvement of conjunctiva in PEX. [ABSTRACT FROM AUTHOR]

Copyright of Sakarya Tıp Dergisi is the property of Sakarya Tip Dergisi 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.)

Purpose: To assess the repeatability of corneal pachymetry and epithelial thickness measurements with spectral-domain optical coherence tomography (SD-OCT) and identify correlations between epithelial thickness and ocular surface parameters. Methods: Adults who happened to have prolonged computer use were recruited, excluding those with conditions interfering with corneal measurements or tear production. All subjects filled in the ocular surface disease index (OSDI) questionnaire. Three consecutive measurements of central and peripheral corneal and epithelial thickness were performed with SD-OCT (RTVue XR). Schirmer test I and tear film break-up time (TBUT) were performed. Repeatability was evaluated with intraclass correlation coefficient (ICC), coefficient of variation and repeatability limit. Spearman correlation was used for non-parametric variables. Results: 113 eyes of 63 subjects were included in the study. ICC was ≥ 0.989 for all corneal and ≥ 0.944 for all epithelial pachymetry segments. The best repeatability was found centrally and the worst superiorly both for corneal and epithelial measurements. Central epithelial thickness was weakly correlated with Schirmer test I (rho = 0.21), TBUT (rho = 0.02), OSDI symptoms and OSDI score (rho <|0.32|). OSDI symptoms and OSDI score were weakly correlated with Schirmer test I (rho <|0.3|) and TBUT (rho <|0.34|). Conclusion: RTVue XR measurements of corneal and epithelial thickness are highly repeatable in all segments. The lack of correlation between epithelial thickness and ocular surface parameters could suggest the assessment of epithelial integrity with reliable methods such as SD-OCT. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to evaluate lacrimal punctum and tear meniscus using anterior segment-optical coherence tomography (AS-OCT), and compare the results among dry eye syndrome (DES) patients with aqueous-deficient dry eye (ADDE) and evaporative dry eye (EDE) subtypes, and healthy individuals. Methods: We included 62 eyes of 31 ADDE subtype DES patients (Group 1), 62 eyes of 31 EDE subtype DES patients (Group 2), and 62 eyes of 31 healthy individuals (Group 3). All participants underwent a thorough ophthalmic examination, including a non-anesthetic Schirmer test for DES confirmation and detailed assessment of the cornea, as well as the conjunctiva, globe, and tear film for increased reflex secretion. The lacrimal punctum and tear meniscus were then measured using a spectral domain OCT system with high-resolution scanning software. Results: Mean ages in Groups 1, 2, and 3 were 49.06±11.24, 46.74±11.68, and 45.48±9.17 years, respectively, (P=0.420). DES patients had significantly lower non-anesthetic Schirmer test (P<0.001), outer punctal diameter (P=0.012), punctal depth (PD) (P<0.001), tear well depth (P<0.001), and punctal reserve (P<0.001) than Group 3. Group 1 had significantly lower Schirmer test (P<0.001), PD (P=0.005), and tear well depth (P=0.003) than Group 2. Tear meniscus height (P=0.463), area (P=0.891), and angle (P=0.266) did not differ significantly among groups, nor did IOP (P>0.05). Conclusion: AS-OCT could potentially be a useful optical diagnostic technique for in vivo lacrimal punctum microstructural and tear meniscus quantitative evaluation. It could also enable DES classification, leading to a better understanding of the underlying pathology and the avoidance of unnecessary tear drops. [ABSTRACT FROM AUTHOR]

Copyright of Türkiye Klinikleri Journal of Ophthalmology is the property of Turkiye Klinikleri 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.)

Background: To evaluate the phenotype, tear secretion and refractive changes of patients diagnosed with peripheral hypertrophic subepithelial corneal opacification (PHSCO). Methods: This is a retrospective, interventional case series conducted at the Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz. Medical records of patients diagnosed with PHSCO were analysed. Sex, age, fluorescein tear film breakup time (FTBUT), Schirmer Test II, iris colour and hair colour were assessed. Objective refraction was evaluated at different time points and, in case of surgery, 1 month and 1 year postoperatively. Results: One hundred ninety‐five eyes of 112 patients (78.6% female, 21.4% male; mean age 56.2 ± 14.3) were included. The median FTBUT was 6 sec. (Q1: 4/Q3: 8.75; range 1–20 s) (measured in 70 eyes of 36 patients), the median Schirmer Test II was 8 mm (Q1: 5/ Q3:15; range 1–35 mm). In 83 patients (74.1%) both eyes were involved. In 86 eyes of 64 patients (55.3%) superficial keratectomy was performed. Sphere and cylinder changed significantly 1 month and 1 year postoperative compared to the pre‐operative objective refraction, while there was no significant change between 1 month and 1 year postoperatively. Conclusion: We found that PHSCO occurs mostly bilaterally in middle‐aged women and appears to be associated with decreased tear production and reduced tear film stability. [ABSTRACT FROM AUTHOR]

Highlights: 1. Females were the most gender who suffer from dry eye syndrome than males. 2. Undergone phacoemulsification patients had frequent dry eye syndrome. 3. Post-phacoemulsification patients were not statistically significant between the Ferning and the Schirmer test. Abstract: Dry eye syndrome is a multifactorial disease on the surface of the eyeball characterized by loss of tear film homeostasis, which is associated with eye symptoms, where there is tear instability and hyperosmolarity, inflammation, and damage to the surface of the eye, as well as neurosensory disorders that act as the cause of this syndrome. The aim of this study was to identify relationship between the Ferning pattern and the Schirmer test 1 in post-phacoemulsification patients. The design of this study was an analytical observational study with a cross-sectional data collection method where the Ferning and Schirmer test 1 were examined to determine the severity of dry eye syndrome in post-phacoemulsification patients. The Ferning test was assessed according to Rolando’s classification. In this study, it was found that the gender who suffer from dry eye syndrome are women. The most considerable age is age ≥ 60 years (56,7%). The results showed that the majority of patients experienced dry eyes measured with the Ferning test, and these results were following the previous Schirmer Test 1 examination. The Ferning and Schirmer tests were found to be abnormal in most of the subjects. It was found that there was a significant relationship between the Ferning pattern and the Schirmer test with the calculation of the t-value of 7.345 with a p-value of 0.001. There was a statistically significant difference between the results of Ferning and the Schirmer test in post-phacoemulsification patients.

Background: To examine firefighters (FFs) exposed to high levels of fire smoke and, as a result, to uncover risk factors for a dry eye disorder (DED) compared to age-and gender-matched healthy individuals. Methods: In this cross-sectional study, 51 FFs from the Afyonkarahisar Municipality Fire Department were chosen randomly (Group 1). A control group (Group 2) included 51 healthy relatives of patients who had routine ocular examinations. The Ocular Surface Disease Index (OSDI) questionnaire was administered after all participants thoroughly explained the study's objectives and procedures. Then, an ocular exam was performed on-site using a portable hand biomicroscope. DED was defined as a non-anesthetic Schirmer test result of <10 mm and a tear film break-up time (TBUT) of <5 seconds. Results: Groups 1 and 2 had mean ages of 44.82±7.29 and 44.73±7.41 years, respectively (p=0.946). The median work duration in Group 1 was 14 years (min-max: 1-27 years). The TBUT test revealed a significantly increased DED prevalence in Group 1 than in Group 2 (p=0.046). Despite the non-significant difference (p=0.276), the Schirmer test revealed that Group 1 had a higher DED prevalence than Group 2. The OSDI score showed that Group 1 had more mild, moderate, and severe DED than Group 2 (p=0.359). In addition, longer work duration was associated with a higher DED prevalence (p=0.179). Conclusions: Given the high prevalence of fire smoke-induced DED in FFs, preventive measures such as regular ocular exams, recommending personal protective equipment usage, and health education programs can assist in avoiding complications and reducing the burden of ocular diseases. [ABSTRACT FROM AUTHOR]

Alejandro Rodriguez-Garcia,1 Alejandro Babayan-Sosa,2 Arturo Ramirez-Miranda,3 Concepcion Santa Cruz-Valdes,3 Everardo Hernandez-Quintela,4 Julio C Hernandez-Camarena,1 Nallely Ramos-Betancourt,5 Regina Velasco-Ramos,2 Raul E Ruiz-Lozano1 1Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Cornea and External Disease Service, Monterrey, Mexico; 2Cornea and Refractive Surgery Service, Fundación Hospital Nuestra Señora de la Luz, I. A. P, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico; 3Cornea and Refractive Surgery Service, Instituto de Oftalmología Conde de Valenciana, I.A.P, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico; 4Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA; 5Asociación para Evitar la Ceguera en México, I.A.P, Mexico City, MexicoCorrespondence: Alejandro Rodriguez-Garcia, Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Cornea and External Disease Service, Hospital Zambrano Hellion, TecSalud, Av. Batallon de San Patricio #112, Col. Real de San Agustin, San Pedro Garza Garcia, N.L. CP. 66278, Mexico, Tel/Fax +52 81 88 88 05 51, Email immuneye@gmail.comAbstract: Dry eye disease (DED) has a higher prevalence than many important systemic disorders like cardiovascular disease and diabetes mellitus, representing a significant quality of life burden for the affected patients. It is a common reason for consultation in general eye clinics worldwide. Nowadays, the diagnostic and therapeutic approach at the high corneal and ocular surface specialty level should be reserved for cases of severe and chronic dry eye disease associated with systemic autoimmune diseases or complicated corneal and ocular surface pathologies. In such cases, the diagnostic and therapeutic approach is often complex, elaborate, time-consuming, and costly due to the use of extensive dry eye questionnaires, noninvasive electronic diagnostic equipment, and clinical laboratory and ancillary tests. However, other eye care specialists attend a fair amount of DED cases; therefore, its diagnosis, classification, and management should be simple, practical, achievable, and effective. Considering that many patients attending non-specialized dry eye clinics would benefit from better ophthalmological attention, we decided to elaborate a practical DED classification system based on disease severity to help clinicians discriminate cases needing referral to subspecialty clinics from those they could attend. Additionally, we propose a systematic management approach and general management considerations to improve patients’ therapeutic outcomes according to disease severity.Keywords: dry eye disease, fluorescein staining, tear breakup time, Schirmer test, tear osmolarity, dry eye questionnaire

Purpose: To investigate the potential effects of systemic fingolimod treatment on parameters of the anterior segment of the eye and tear film function tests in patients with multiple sclerosis (MS)., Methods: Forty-eight eyes of 24 individuals who were started on systemic fingolimod treatment for relapsing-remitting MS were prospectively enrolled in this study. Patients underwent examinations immediately before initiation of systemic fingolimod treatment, and at the first and sixth months of treatment. Anterior segment parameters were measured using Sirius Topography. The Schirmer-I test and tear break-up time (TBUT) were recorded during follow-up. Retinal thickness was also analyzed using spectral-domain optical coherence tomography (SD-OCT)., Results: There was no statistically significant difference in retinal thickness measurements between follow-up visits. The central corneal thickness, keratometric values, anterior chamber depth, aqueous humor depth, iridocorneal angle, horizontal anterior chamber tilt and anterior chamber volume values remained similar during follow-up. The Schirmer-I test value was 15.10 ± 2.65 mm at the zeroth month and 17.03 ± 3.61 mm at the sixth month ( p  = 0.044). The mean TBUT was significantly higher at the six-month visit compared to baseline and the one-month visit ( p 0-6 < 0.001, p 1-6 < 0.001), but there was no statistically significant difference between baseline and month 1 ( p 0-1 = 0.419)., Conclusion: Systemic use of fingolimod may increase Schirmer I test and TBUT values in MS patients without altering other anterior segment parameters within 6 months.

Background: Saliva, a complex fluid secreted by the salivary glands within the oral cavity, is the first to interact with smoke while smoking. Nicotine in smoke causes structural and functional changes in the saliva, leading to a significant reduction in salivary flow. Aim: The present study was done to compare the salivary flow between reverse smokers, regular smokers, and non-smokers with the help of the Modified Schirmer Test (MST) to assess unstimulated saliva. Materials and Methodology: Ninety subjects were randomly divided into three groups; Group A (30) subjects who had the habit of reverse smoking daily for >6 months, Group B (30) subjects who had the habit of smoking daily for >6 months, and Group C (30) healthy, non-tobacco users. MST was done in the morning hours; they were not asked to eat/drink for 2 h before the procedure. Later, they were asked to raise their tongue, and the rounded end of Schirmer's strip was placed on the floor of the mouth. Wetting of the strip was recorded every 1, 2, and 3-minute intervals. Results: Data was recorded, and statistical analysis was done by the paired t-test. The mean value of salivary flow rate in reverse smokers per 3 minutes (19.73 ± 4.16) was less when compared to conventional smokers (22.53 ± 2.75) and healthy individuals (31.53 ± 2.90), with a significant P value of P < 0.0001. Conclusion: There was a significantly reduced unstimulated salivary flow rate in reverse smokers compared to conventional smokers and healthy individuals.

Introduction/Objective. Dry eye is a multifactorial disease with incidence up to 50% in the general population. It is characterized by a loss of homeostasis of the tear film and accompanied by ocular symptoms. Ocular Surface Disease Index (OSDI) questionnaire is designed to provide a rapid assessment of the symptoms. The aim of this study was to evaluate the diagnostic capacity of OSDI. Methods. A prospective, randomized and observational study was conducted at the Clinic for Eye Disease, University Clinical Center of Serbia, between December 2018 and February 2019. The OSDI questionnaire was used to rate the severity of dry eye disease. Schirmer I test, tear break-up time test (TBUT), Rose Bengal test and lid-parallel conjunctival folds (LIPCOF) test were performed as a clinical proof of the symptoms. Results. A total of 27 patients, 15 male (55.4%) and 12 female (44.6%), with mean age of 60 ± 15 years were included in the study. The average value of OSDI score was 26.37 ± 23.98 (0–80). Schirmer I test and Rose Bengal test for the right and the left eye, as well as the TBUT test for the left eye were positively correlated with OSDI score (Spearman correlation coefficient). Conclusion. OSDI questionnaire is a fast, reliable, and inexpensive test. In our study we have found a correlation between the OSDI score and other clinical tests, except with LIPCOF test. At this moment, the questionnaire that could be the gold standard for dry eye disease diagnosis does not exist, therefore further studies concerning this topic are needed.

We aimed to evaluate the types and concentrations of trace elements in tears of individuals living in urban and rural environments using particle induced X-ray emission (PIXE) and the possible association with exposure to air pollution and suggest a novel method for tear-based biomonitoring studies. This cross-sectional pilot study comprised 42 healthy subjects, 28 living in a rural area and 14 in an industrial city. Tears were collected with Schirmer paper and characterized by PIXE. Trace element concentrations from both eyes were averaged together with environmental pollution data. Main outcome measures were between-group differences in types and concentrations of trace elements in tears and comparison to environmental data. The rural group included 12/28 men, mean age 45.2 ± 14.8 years. The urban group consisted of 11/14 men of mean age 27 ± 5.9 years. Six rural and all urban were active smokers. Air pollution data showed more toxic elements in the rural environment. On PIXE analysis, chlorine, sodium, and potassium were found in similar concentrations in all samples. Normalizing to chlorine yielded higher values of aluminum, iron, copper, and titanium in the rural group; aluminum was found only in the rural group. The higher levels of certain trace elements in the rural group may, in part, be a consequence of exposure to specific environmental conditions. No direct association was found with air pollution data. PIXE is useful to analyze trace elements in tears, which might serve as a marker for individual exposure to environmental pollutants in biomonitoring studies. [ABSTRACT FROM AUTHOR]

Dry eye syndrome is a multifactorial disease on the surface of the eyeball characterized by loss of tear film homeostasis, which is associated with eye symptoms, where there is tear instability and hyperosmolarity, inflammation, and damage to the surface of the eye, as well as neurosensory disorders that act as the cause of this syndrome. The aim of this study was to identify relationship between the Ferning pattern and the Schirmer test 1 in post-phacoemulsification patients. The design of this study was an analytical observational study with a cross-sectional data collection method where the Ferning and Schirmer test 1 were examined to determine the severity of dry eye syndrome in post-phacoemulsification patients. The Ferning test was assessed according to Rolando's classification. In this study, it was found that the gender who suffer from dry eye syndrome are women. The most considerable age is age = 60 years (56,7%). The results showed that the majority of patients experienced dry eyes measured with the Ferning test, and these results were following the previous Schirmer Test 1 examination. The Ferning and Schirmer tests were found to be abnormal in most of the subjects. It was found that there was a significant relationship between the Ferning pattern and the Schirmer test with the calculation of the t-value of 7.345 with a p-value of 0.001. There was a statistically significant difference between the results of Ferning and the Schirmer test in post-phacoemulsification patients. [ABSTRACT FROM AUTHOR]

Emine Sen,1 Ufuk Elgin,1 Osman Ozen,2 Fikriye Gozde Ozturk3 1University of Health Sciences, Ulucanlar Eye Education and Research Hospital, Glaucoma Department, Ankara, Turkey; 2University of Health Sciences, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey; 3Unye State Hospital, Ordu, TurkeyCorrespondence: Emine SenUniversity of Health Sciences, Ulucanlar Eye Education and Research Hospital, Kale Mahallesi, Ulucanlar Caddesi, No: 59, Altındağ, 06250, Ankara, TurkeyTel +90 505 2438124Fax +90 312 3124827Email eminesentr@yahoo.comObjective: To compare bleb morphology and tear tests of glaucoma patients who used trehalose and those who did not use after primary trabeculectomy with mitomycin C (MMC) during the early post-operative period.Methods: This retrospective study included two groups: Group 1 using Trehalose + hyaluronic acid (THA) after primary trabeculectomy with MMC (n = 19) and Group 2 undergoing primary trabeculectomy with MMC (n = 16). The preoperative and postoperative intraocular pressure (IOP), the results of Schirmer, and tear break-up time tests were analyzed. Postoperative bleb morphology was also evaluated at the 1st day, and 1st and 2nd weeks, and 1st and 2nd months.Results: There was no statistically significant difference in preoperative IOP, Schirmer test or tear break-up time between groups. The mean horizontal extent of the blebs was significantly wider in Group 1 at the first week (p= 0.02). Bleb vascularization was also found to be lower in Group 1 at the second week (p= 0.001). The mean bleb height and horizontal extent were significantly higher in Group 1 at the first month (p=0.02, p= 0.03, respectively). The mean bleb horizontal extent was significantly higher in Group 1 at the second month (p= 0.03).Conclusion: The use of trehalose improved surgical success of primary trabeculectomy with MMC in terms of IOP control, post-operative complications, and bleb morphology during the early postoperative period. Trehalose might contribute to wound healing which led to an ideal bleb.Keywords: bleb morphology, glaucoma, Schirmer test, trabeculectomy, trehalose

Objectives:To evaluate the frequency and findings of dry eye associated with ocular graft-versus-host disease (GVHD) in pediatric hematopoietic stem cell transplantation (HSCT) patients.Materials and Methods:Retrospectively the records of pediatric patients with ocular GVHD were evaluated and ophthalmologic examination findings as well as Schirmer test results, tear film break-up time, and corneal staining grades were recorded. In severe dry eye patients topical cyclosporine-A was prescribed and the results were evaluated.Results:GVHD was detected in 51 (23.4%) of 218 HSCT patients, 4 of whom died during follow-up. Thirty (63.8%) of the remaining 47 patients had chronic ocular GVHD and 4 patients with severe dry eye were treated with topical cyclosporine-A with a median follow-up of 12.1 months. Severe dry eye symptoms and findings significantly improved in 2 patients. However, 1 patient had to stop treatment due to side effects.Conclusion:In children, chronic ocular GVHD is a common finding of GVHD after HSCT. Therefore, these patients should be examined periodically for dry eye.

Femtosecond laser-assisted in situ keratomileusis (Femto-LASIK) represents a common treatment modality in refractive surgery and shows excellent results in terms of safety, efficacy, predictability, and long-term stability. However, patients may be affected by dry eye symptoms. The aim of this study was to identify a potential association between subjective dry eye symptoms, objective dry eye markers, and possible changes in the tear film, which could be a target for future therapy development. Therefore, clinical (dry eye) examinations (OSDI, Schirmer test, lissamine green and fluorescein staining, BUT, visual acuity) were carried out before LASIK as well as 5 and 90 days post-OP. The dry eye marker MMP-9, cytokines (IL-1β, IL-8), and pain markers (NGF, CGRP) were quantified in tear samples with immunoassays. In addition, correlation analyses were performed. Clinical examinations revealed an upregulated OSDI score 5 days post-OP and an increased lissamine green staining score 90 days post-OP. Downregulated CGRP levels were noted 5 days post-OP, while other protein markers were not significantly altered after Femto-LASIK. Hence, Femto-LASIK surgery induced subjective symptoms like that of dry eye which could objectively rather be classified as Femto-LASIK-related discomfort. In the future, this could possibly be better detected and treated using pain markers such as CGRP. [ABSTRACT FROM AUTHOR]

Smoking tobacco regularly or being exposed to tobacco smoke for a long time is a risk factor for the development of various problems on the ocular surface, including alterations in the tear and the ocular surface. The objective of this systematic review is to synthesize the available evidence on the various changes that the tear film may present due to exposure to tobacco smoke. For such purpose, clinical studies published between 2016 and 2021 are included, The search was carried out in three databases: PubMed, Web of Science and Science Direct, using the following keywords: "tear film" and "tobacco", as well as the Boolean operator "AND". We compared the values obtained by the TBUT, Schirmer and OSDI tests between smokers and non-smokers. Out of the nine articles included in this systematic review, four of the six that applied the TBUT report a significant difference in the TBUT between smokers and non-smokers. Also, four studies out of six that apply Schirmer I, report that there are no significant differences; The results suggest that exposure to tobacco smoke results in hyperosmolarity of the tear and deterioration of the lipid layer, and as well as change in the measurement of the Schirmer test, and TBUT as indicators of alterations in the quality of the tear film. [ABSTRACT FROM AUTHOR]

Objectives: Sjögren's syndrome (SS) is the most common autoimmune, multisystemic rheumatic disease. The wide spectrum of the signs and symptoms of SS often causes difficulties in diagnosis. Patients can apply with different complaints to general practitioners and many different specialists, apart from internists and ophthalmologists, who frequently encounter the disease. Our aim in this study was to evaluate the initial complaints of the patients who have been diagnosed with SS. Materials and Methods: Sixty-six patients who were diagnosed with primary SS according to 2012 or 2016 classification criteria were included in the study. The clinical and laboratory features were retrospectively evaluated. Results: The female/male ratio was 60/6. The initial complaint of most patients (n:34) was arthralgia or arthritis (51.51%). ANA was positive in 56 patients (84.84%), RF in 19 (28.78%), but not evaluated in 7 (10.6%), anti-SS-A in 29 (43.93%), and anti-SS-B in 16 (24.24%). Sixty-three patients had a positive Schirmer test. Minor salivary gland biopsy was obtained in 42 patients, and 28 had biopsy findings consistent with SS. Conclusion: SS is a common disease with a wide variety of clinical presentations. A detailed evaluation of patients is necessary to provide an accurate diagnosis and proper care. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical & Pharmaceutical Sciences is the property of Arab Journal of Sciences & Research Publishing (AJSRP) 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.)

Septal deviation causes the air entering the nose to encounter resistance and leads to turbulent flow formation by disrupting laminar air flow. In the literature, the Schirmer test has been recommended to evaluate the moistening of the nasal mucosa. The purpose of this study was to evaluate the degree of nasal humidification using the intranasal schirmer test in patients with septal deviation and to reveal changes in mucosal dryness and humidity in both nasal cavities following septoplasty surgery. Fifty-three patients with septal deviation detected at endoscopic rhinoscopic examination and scheduled for surgery were enrolled. Schirmer test was performed twice, at a one-month interval, pre- and postoperatively and test records were compared. The Schirmer test value for the deviated side of the septum was significantly lower than that for the contralateral side, for both nasal cavities. Schirmer test values increased significantly on the side of the septal deviation compared to the preoperative values. Septoplasty surgery performed for septal deviation significantly and reduces nasal mucosa dryness so increases Schirmer test results on the deviated side. We attribute this to septal deviation impairing air flow in the nasal cavity and causing nasal mucosa dryness. [ABSTRACT FROM AUTHOR]

Introduction and purpose. The main manifestation of eyelids, tear ducts, and orbits disorders is a dry eye disease considered as a serious disease that affects the quality of life. Nowadays, one in ten people worldwide faces this disease. Increased workload, development of multimedia technologies, hypodynamia, and environmental degradation are the main modern causes of the disease. Material and methods. In this work, we used an experimental model of dry eye in rats with the development of inflammation of the anterior surface of the eye. Alkali burns were used to develop inflammation. A fluorescein test performed immediately after alkaline erosion and on days 1, 5, and 10 after burns revealed a gradual increase in corneal epithelialization and vascularization. Results. One day after induction of inflammation, there was a dramatic and statistically significant increase in tear production in experimental rats. By the seventh day, tear production declined to the control level with a subsequent tendency to decrease tear production. Conclusions. In the group of rats with inflammation of the anterior surface of the eye that received polarized red-light therapy, there was no significant decrease in tear production on day 7, which may be indicative of a possible anti-inflammatory effect of light therapy under these conditions.

Purpose This study aimed to assess the efficacy of a platelet-rich plasma (PRP) injection into the lacrimal gland in severe dry eye and to compare it with preservative-free artificial tears. Patients and methods This study included a total of 74 eyes of 40 patients divided into two groups. The intervention group received three PRP injections transcutaneously in the region of the lacrimal gland. The control group was treated with preservative-free artificial tears. Results The intervention group showed improvement in all measured parameters, except the Meibomian gland score, with a statistically significant improvement in the Ocular Surface Disease Index (OSDI) score (P

Background/Aims: This study aimed to analyze the effects of perinatal history on tear film properties and lid geometry in adults born preterm. Methods: The Gutenberg Prematurity Eye Study (GPES) is a German prospective examination of adults born preterm and term aged 18 to 52 years with Keratograph® 5M and Schirmer test I. Main outcome measures were first non-invasive tear film break-up time (F-NITBUT), bulbar redness (BR), Schirmer test, and nasal palpebral angle measurement. The associations with gestational age (GA), birth weight (BW), and BW percentile, retinopathy of prematurity (ROP), ROP treatment, and other perinatal factors were evaluated using regression analyses. Results: 489 eyes of 255 preterm and 277 eyes of 139 full-term individuals (aged 28.6 +/− 8.8 years, 220 females) were included. Of these, 33 participants (56 eyes) had a history of spontaneously regressed ROP and 9 participants (16 eyes) had a history of ROP treatment. After adjustment for age and sex, lower F-NITBUT (<20 s) was associated with ROP treatment (OR = 4.42; p = 0.025). Lower GA correlated with increased bulbar redness (B = −0.02; p = 0.011) and increased length of wetting in the Schirmer test (B = −0.69; p = 0.003). Furthermore, low GA was associated with narrowing of the nasal palpebral angle (B = 0.22; p = 0.011) adjusted for age and sex, but not when considering ROP in the multivariable model. Conclusion: Our analyses indicate that perinatal history affects ocular surface properties, tear production and lid geometry in adults born term and preterm. This might indicate that affected persons have a predisposition to diseases of the corneal surface such as the dry eye disease. [ABSTRACT FROM AUTHOR]

Copyright of Balikesir Health Sciences Journal / Balıkesir Sağlık Bilimleri Dergisi is the property of Balikesir Health Sciences Journal (BAUN Health Sci J) 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.)

Modern corneal refractive surgery provides high efficiency, safety, predictability and stability of the different ametropia kinds correction’s clinically-functional results. However, in overwhelming percentage of cases, having spent some time after surgery patients complain about discomfort, eyes dryness, burning, feel gritty, redness, blurred and vision instability. Complaints mentioned above are caused by the appearance of transitory dry eye syndrome. Main etiology and pathogenesis factors of this disease are presented in this review. The results of dry eye syndrome classical diagnosis methods have been analyzed, as well as modern techniques, characterized by high specificity and sensitivity, which allow to increase the dry eye’s diagnostics accuracy. The study of the dry syndrome after corneal refractive surgery is devoted to a huge number of works of domestic and foreign authors. However, at present time there is no unique algorithm for assessing the damage of the ocular surface before and after corneal refractive surgery, which would include a set of high-precision and specific techniques for quickly and reliably evaluate the severity of dry eye syndrome, allowing to develop preventive measures and pathogenetically oriented treatment and, thereby, accelerate rehabilitation of patients after surgery. Research continuation is needed in this direction.

Introduction: Dry eye (keratoconjunctivitis sicca) is a common disorder of the tear film having multifactorial aetiology. Nowa-days, a large portion of population is affected with Dry Eye Disease (DED) because of substantial increase in usage of computers and digital devices. Aim: To evaluate the effect of varying durations of computer usage on parameters of DED. Materials and Methods: In this prospective study, total 120 participants were divided into two groups. Group I (n=58) included participants who used computer daily for less than six hours while group II (n=62) included those who used computer for more than six hours daily. Routine eye examination was done and dry eye parameters i.e., Ocular Surface Diseases Index (OSDI), Schirmer Test (ST) and Tear Film Break Up Time (TFBUT) were performed and analysed for any significant difference between groups I and II using unpaired t-test. SPSS 16.0 was used and p-value

Purpose: evaluation of the efficacy of the drug Tealose® in the therapy of cornea inflammatory diseases consequences such as dry eye syndrome.Patients and methods: 34 patients (34 eyes) with dry eye syndrome after inflammatory diseases of the cornea, aged 28–56 years old were included in the study. Two clinical groups were formed: observation group — 20 subjects (20 eye) and comparison group — 14 subjects (14 eyes). The dynamics of such indicators were estimated under therapy: visual acuity with maximal correction, corneal epithelium entity according fluoresceine dye test, tear production according Schirmer and Norn tests, the grade of dry eye syndrome severity according index of OSDI — Questionnarie. The patients in observation group in addition to the basic therapy, which included instillation antiseptics и 4 % taurine solution, were treated with 3 % solution of tregalose (Tealose®, “Laboratuar Thea”, France) by such mode: using of 4 times daily instillations during 1 month, 1 month break, than continuation of the same regimen instillations during 1 month was performed. The patients in comparison group in addition to the same basic therapy were treated with Visomitin® (“Mitotech”, Russia) by the mode, which was used for tregalose.Results. The improvement of cornea’s epithelization (p < 0,05), increasing of visual acuity with maximal correction (p < 0,05), improvement of tear production (p < 0,05), as well as the OSDI-index (p < 0,05) were revealed in the patients of the observation group. In the patients of the comparison group positive dynamics of these indicators was insignificant and unreliable.Conclusions. Using of 3 % tregalose solution in patients with consequences of inflammatory diseases of the cornea — keratitis leads to effective treatment of “dry eye” syndrome, reduces the severity of epithelization disorders and tendency to scarring in the corneal tissue.

Uncontrolled administration and prolonged use of antihypertensive drugs with preservatives often leads not only to subjectively poor tolerance of treatment, but also to a deterioration in the results of subsequent surgery, if required. The manifestations of dry eye syndrome and its aggravation as a result of such drops use can lead the patients to refuse therapy and worsening the prognosis. The manifestations of dry syndrome are often detected before any hypotensive therapy begins, since the functions of secretory cells change with age and there is always the influence of adverse environmental factors. It is necessary to examine the condition of the anterior surface of the eye to resolve the issue of the need to prescribe drugs without preservatives for all patients before the appointment of antihypertensive therapy. However, sometimes it is not possible due to lack of time or equipment. Therefore, it is important to study the condition of the anterior eye surface in patients with newly diagnosed glaucoma before and during treatment with nonpreservative forms of antihypertensive drugs in order to determine the necessity of the first prescription of non-preservative forms of antihypertensive drops to further interpolate its results into practical recommendations. This study revealed that drug treatment of patients with newly diagnosed glaucoma with the drug Timolol-POS® β-blocker on a non-preservative basis along with IOP compensation improves both subjective and objective indicators of the condition of the anterior surface of the eye with maximum effect after 3 months of treatment. This conclusion suggests the importance of the primary appointment for such patients with instillation drops on a preservative basis.

Purpose: A study of the association between vitamin D deficiency and dry eye syndrome (DES) in the Indian population.Methods: This was a cross-sectional, hospital-based observational study. Sixty patients diagnosed with vitamin D deficiency (<20 ng/dl) who met the inclusion criteria were sent to the Eye OPD from the Endocrinology OPD (case) were compared to 60 subjects with normal vitamin D levels (≥20 ng/dl) who attended the Eye OPD (controls). The examination of the tear film was done using Whatman filter paper in Schirmer test I and Schirmer test I (with anesthesia). The tear film break-up time (TFBUT) was determined by slit-lamp examination using the fluorescein stain, and scoring using the ocular surface disease index (OSDI) was done.Results: A significant difference in the mean values of Schirmer I and Schirmer I test (with anesthesia) (P < 0.001) was seen between the case and control groups. A significant difference in the mean values of TFBUT (P < 0.001) and OSDI scores (P < 0.01) was also seen between the two groups.Conclusion: A positive association was found between vitamin D deficiency and dry eye on comparing the above parameters. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate conjunctival impression cytology (CIC) findings and tear film parameters in patients with multiple sclerosis (MS) compared with controls. Methods: Thirty-three patients with MS (MS group) and 33 age- and sex-matched healthy subjects (control group) were included in this cross-sectional comparative study. CIC grades, tear break-up time (TBUT), Schirmer 1 test results, and Ocular Surface Disease Index (OSDI) scores were compared between the two groups, and correlations between CIC grade, TBUT, Schirmer 1 test result, OSDI score, Expanded Disability Status Scale score, and disease duration were analyzed. Results: Mean CIC grade was higher in the MS group than in the control group (1.48 ± 0.71 and 0.39 ± 0.56, respectively; p < 0.001). In the MS group, CIC of the 14 participants (42.4%) was grade 2–3. In the control group, CIC of the only one participant (3.3%) was grade 2, and none of them was grade 3. TBUT (8.12 ± 3.16, 13.06 ± 4.23 s in MS and control groups, respectively; p < 0.001) and Schirmer 1 test results (8.45 ± 5.75, 17.36 ± 10.89 mm in MS and control groups, respectively; p < 0.001) were lower, and OSDI score (36.36 ± 19.19, 13.70 ± 15.36 in MS and control groups, respectively; p < 0.001) was higher in the MS group compared to the control group. Conclusion: In patients with MS, objective findings of dry eye, subjective symptoms related to dry eye, and CIC abnormalities, including high grades of conjunctival squamous metaplasia and goblet cell loss, are more common. Patients with MS should be monitored for ocular surface alterations and dry eye disease. [ABSTRACT FROM AUTHOR]

Over the last two decades, a large number of non-communicable/chronic disorders reached an epidemic level on a global scale such as diabetes mellitus type 2, cardio-vascular disease, several types of malignancies, neurological and eye pathologies—all exerted system's enormous socio-economic burden to primary, secondary, and tertiary healthcare. The paradigm change from reactive to predictive, preventive, and personalized medicine (3PM/PPPM) has been declared as an essential transformation of the overall healthcare approach to benefit the patient and society at large. To this end, specific biomarker panels are instrumental for a cost-effective predictive approach of individualized prevention and treatments tailored to the person. The source of biomarkers is crucial for specificity and reliability of diagnostic tests and treatment targets. Furthermore, any diagnostic approach preferentially should be noninvasive to increase availability of the biomaterial, and to decrease risks of potential complications as well as concomitant costs. These requirements are clearly fulfilled by tear fluid, which represents a precious source of biomarker panels. The well-justified principle of a "sick eye in a sick body" makes comprehensive tear fluid biomarker profiling highly relevant not only for diagnostics of eye pathologies but also for prediction, prognosis, and treatment monitoring of systemic diseases. One prominent example is the Sicca syndrome linked to a cascade of severe complications that include dry eye, neurologic, and oncologic diseases. In this review, protein profiles in tear fluid are highlighted and corresponding biomarkers are exemplified for several relevant pathologies, including dry eye disease, diabetic retinopathy, cancers, and neurological disorders. Corresponding analytical approaches such as sample pre-processing, differential proteomics, electrophoretic techniques, high-performance liquid chromatography (HPLC), enzyme-linked immuno-sorbent assay (ELISA), microarrays, and mass spectrometry (MS) methodology are detailed. Consequently, we proposed the overall strategies based on the tear fluid biomarkers application for 3P medicine practice. In the context of 3P medicine, tear fluid analytical pathways are considered to predict disease development, to target preventive measures, and to create treatment algorithms tailored to individual patient profiles. [ABSTRACT FROM AUTHOR]

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