Blink-sensing glasses: A flexible iontronic sensing wearable for continuous blink monitoring.

Blink reflex has long been considered closely related to physiological states, from which abundant information on ocular health and activities can be revealed. In this study, a smart glasses wearable has been developed, incorporating a flexible and sensitive pressure sensor, to monitor blink patterns by continuously detecting ocular muscular movements, referred to as blink-sensing glasses. By applying the emerging flexible iontronic sensing (FITS) sensor with the sensitivity of 340 pF/mmHg, the skin pressure variations induced by movements of the orbicularis oculi muscles can be monitored in real time. The blink-sensing glasses can successfully capture blink patterns with a high accuracy of 96.3% and have been used to differentiate the blink features from both dry-eye subjects and healthy controls. This device can be potentially used as a new clinical and research monitoring tool for continuous eye blink analysis, while providing patients with high comfortableness in long-term ambulatory and home settings.

Geographic Difference Shaped Human Ocular Surface Metagenome of Young Han Chinese From Beijing, Wenzhou, and Guangzhou Cities.

Purpose: Microbial ecosystems interact with the human body and affect human health. The microbial community on the ocular surface remains an underexplored territory despite its importance as the first line of defense barrier that protects the eye and ultimately sight. We investigated how age and sex affected human ocular surface microbiome, and in the present study wanted to understand how geographic difference shaped the microbiome in the ocular surface. Methods: We collected conjunctival specimens of 172 eyes from 86 healthy volunteers living in three Chinese cities, namely, Guangzhou, Wenzhou, and Beijing. Using the direct metagenomic shotgun sequencing approach, we characterized how geographic difference affected the human ocular microbiome. Results: We surveyed the taxonomic composition and metabolic function of the microbiota on human ocular surface. We showed that the ocular surface microbiota was composed of bacteria, viruses, and fungi. A geographical difference in both composition and function of the conjunctival microbiome suggests that the environment people lived in shapes their conjunctival microbiome, especially the dominate species. Conclusions: Our study provides a reference catalog of the healthy conjunctival metagenome and raises a concern for environmental influences on the ocular surface microbiome.

Recalcitrant Atopic Keratoconjunctivitis in Children: A Case Report and Literature Review.

Atopic keratoconjunctivitis (AKC) is the most severe type of allergic conjunctivitis and may eventually lead to blindness. Although AKC is reported to be more prevalent in adults, we report a child with AKC whose clinical characteristics were not inconsistent with those typically seen in adult patients with AKC, and who was refractory to traditional topical anti-inflammatory and immunosuppressant therapies. An 11-year-old boy presented with a 3-month history of ocular redness and itching and decreased vision for a week in both eyes. Slit-lamp examination revealed typical signs of vernal keratoconjunctivitis, including cobblestone papillae in both upper conjunctiva, superficial punctate keratopathy on the right cornea, and a sterile shield-shaped ulcer on the left cornea. Physical examination revealed eczematous lid changes and a generalized body rash, particularly on the face, neck, and flexor surfaces of the limbs. He was diagnosed to have AKC in both eyes and atopic dermatitis. The patient did not respond well to conventional topical antihistamine, mast cell stabilizers, corticosteroids, or tacrolimus, even in combination with amniotic membrane transplant. After using systemic immunosuppressants, the symptoms were relieved; the inflammation on the skin and ocular surface subsided, the cobblestone papillae disappeared, and the corneal ulcer healed gradually within 8 weeks. This case reveals that pediatric AKC should be differentiated from vernal keratoconjunctivitis because both disorders include upper cobblestone papillae, but the former is accompanied by atopic dermatitis. Pediatric AKC requires appropriate and aggressive treatment to prevent sight-threatening corneal complications. Systemic immunosuppressant should be considered when traditional topical anti-inflammatory therapies have failed.

Significant correlation between meibomian gland dysfunction and keratitis in young patients with Demodex brevis infestation.

AIMS: To report the clinical characteristics and correlation between meibomian gland dysfunction (MGD) and keratitis in young patients with ocular demodicosis. METHODS: Observational case series of 60 patients younger than 35 years with ocular demodicosis, of which the diagnosis was based on microscopic counting of Demodex folliculorum and D. brevis of epilated lashes. Severity of keratitis and MGD was graded by photography and meibography, respectively, in a masked fashion. RESULTS: MGD was detected in 54/60 (90%) patients with the loss of meibomian gland in the upper lid more than the lower lid (p<0.001). Blepharoconjunctivitis and a variety of corneal pathologies were noted in 47/60 (78.3%) and 39/60 (65%) patients, respectively. For a total of 120 eyes, normal cornea was noted in 53 (44.2%) eyes, superficial punctate keratitis or limbitis was noted in 17 (14.2%), while corneal stromal infiltration was found in 50 (41.7%) eyes. Both univariate and multivariate analyses showed that the severity of meibomian gland loss was significantly correlated with higher D. brevis count and more severe keratitis (all p<0.05). Rapid resolution of keratitis and blepharoconjunctivitis was accompanied by significant reduction of the Demodex count in 48 patients receiving lid scrub directed to kill mites. CONCLUSIONS: There is a significant correlation between MGD and keratitis in young patients with ocular demodicosis especially inflicted by D. brevis.

Genus Distribution of Bacteria and Fungi Associated with Keratitis in a Large Eye Center Located in Southern China.

PURPOSE: To investigate the genus distribution of bacteria and fungi associated with keratitis in a large eye center located in Southern China and to compare the results with existing data from other areas in China. METHODS: All results of corneal microbiological examinations from 2009 to 2013 of patients who had been clinically diagnosed with bacterial or fungal keratitis were obtained chronologically and anonymously from the microbiology database at Zhongshan Ophthalmic Center. Smear/culture data were reviewed and analyzed. Antibiotic resistance of the harvested bacteria was also evaluated. RESULTS: Of 2973 samples, the microbial detection rate was 46.05%; in which 759 eyes (25.5%) were positive for bacteria, 796 eyes (26.8%) were positive for fungi, and 186 eyes (6.3%) were co-infected with both fungi and bacteria. The most common type of bacteria isolated was Staphylococcus epidermidis (31.9%), followed by Pseudomonas aeruginosa (12.4%). The most common type of fungus was Fusarium species (29.3%), followed by Aspergillus species (24.1%). For the bacteria harvested, mean antibiotic resistance was chloromycetin (34.6%), cephalosporins (20.0%), fluoroquinolones (18.6%), and aminoglycosides (10.5%). CONCLUSION: The genus distribution of organisms detected in keratitis cases in the largest eye center located in Southern China differs from those in other areas in China. In Southern China during the time period studied, S. epidermidis and Fusarium sp. were the most common pathogens of infectious keratitis. Monitoring the changing trend of pathogens as well as antibiotic resistance are warranted.