Characteristics of tear meniscus using a spectral domain optical coherence tomography in medically controlled glaucoma.

Purpose: To compare the tear meniscus height (TMH) and tear meniscus depth (TMD) between medically controlled glaucoma subjects and age-matched controls. Methods: This prospective, cross-sectional, observational study included 50 patients with medically controlled glaucoma and 50 age-matched controls. Glaucoma subjects using topical medications for the duration of more than 1 year were included. The age-matched controls were participants with no history of glaucoma, dry eye, or any other diseases affecting the ocular surface. All the participants underwent TMH and TMD scan using spectral domain-optical coherence tomography (SD-OCT), which was followed by ocular surface disease index (OSDI) questionnaire administration. Results: The mean ages of glaucoma subjects and age-matched controls were 40 ± 22 and 39 ± 21 years, respectively (P > 0.05). Of them, 40% (n = 22) were on single drug therapy or monotherapy and 60% (n = 28) were on multidrug therapy. TMH and TMD of glaucoma subjects and age-matched controls were 101.27 ± 31.86 versus 230.63 ± 49.82 µm and 70.60 ± 27.41 versus 167.37 ± 57.06 µm, respectively. Subjects on multidrug therapy showed a statistically significant reduction in TMH and TMD when compared to age-matched controls. Conclusion: Preservative containing topical glaucoma medications affects the ocular surface, including the tear film. The prolonged duration and multiple combination of this drug usage serve as potential factors for causing reduction in the tear meniscus levels leading to drug-induced dryness.

Evaluation of ocular involvement in patients with Hansen's disease.

Hansen's disease (HD) belongs to the group of neglected diseases and can cause physical deformities and disabilities, in addition to leading to social discrimination. Ocular involvement in HD is estimated at 70-75% worldwide. About 10-50% suffer from severe ocular symptoms and loss of vision occurs in approximately 5% of cases. Ocular changes may persist or worsen even after patients are considered cured and it is necessary to better understand these conditions in order to determine the need for additional public policies. The objective of this study was to identify the prevalence of ocular involvement in patients with HD at two specialist referral centers for treatment of the disease. A cross-sectional study was conducted with ophthalmological evaluations of patients with HD from June 2017 to June 2018. Diagnostic ocular findings, corrected visual acuity, and refractive error were described. Findings were correlated with patients' clinical and epidemiological variables. A total of 86 patients were evaluated, with a mean age of 50.1 years, predominantly males (59.3%), and with multibacillary HD (92%). The prevalence of ophthalmologic changes was 100% and the most common were dysfunction of the Meibomian glands (89.5%) and dry eye syndrome (81.4%). Cataracts were observed in 22 patients (25.6%), but best corrected visual acuity was normal or near normal in 84 patients (97.7%) and there were no cases of bilateral blindness. Patients with some degree of physical disability had more ophthalmological alterations, involving both the ocular adnexa (p = 0.03) and the ocular globe (p = 0.04). Ocular involvement is common in patients with Hansen's disease, reinforcing the importance of ophthalmologic examination in the evaluation and follow-up of these patients.

Prevalence of ocular findings in a sample of Egyptian patients with psoriasis.

BACKGROUND: Psoriasis is a common disorder worldwide. The prevalence of psoriasis in Egypt, an African country with a Caucasian population, ranges 0.19-3%. Despite this relatively high prevalence of psoriasis, there are no epidemiologic data regarding the burden of associated eye affection. Determining the magnitude of the problem could help in offering better integrated health services. AIM: The purpose of this study was to evaluate eye involvement in a sample of Egyptian psoriatic patients. PATIENTS AND METHODS: This case-control study included 100 patients with psoriasis and 100 age and sex matched healthy controls. Psoriasis extent and severity was graded by psoriasis area and severity index (PASI). Complete ophthalmological examination and tests for dry eye were performed to all subjects. RESULTS: The mean age of the psoriasis group was 50.7 ± 14.3 years. Thirty eight percent of the cases were females. The mean duration of psoriasis was 10.1 ± 7.5 years. Psoriasis patients had more conjunctival injection (n = 40, P = 0.035), more pinguecula (n = 38, P = 0.048) than controls. Ocular surface disease index (OSDI), tear breakup time (TBUT), Schirmer I, and Rose Bengal staining showed statistically significant positive results in the psoriasis group. CONCLUSION: This is the first report on the prevalence of eye comorbidities in Egyptian psoriatic patients. Dry eyes were more common with psoriasis, particularly the erythrodermic type. Other ocular findings were not statistically significantly different except for conjunctival injection and pinguecula.

Comparative role of 20% cord blood serum and 20% autologous serum in dry eye associated with Hansen's disease: a tear proteomic study.

BACKGROUND: To compare the role of topically applied serum therapy with preservative-free artificial tear (AT) drops in patients with moderate to severe dry eye in Hansen's disease along with change in tear protein profile. METHODS: 144 consecutive patients were randomly divided into three groups. After a baseline examination of clinical parameters, each of the patients received designated modality of topical therapy six times a day for 6 weeks. Post-treatment documentation of clinical parameters was done at 6 weeks, and then at 12 weeks after discontinuation of topical therapy. Analysis of three tear proteins using gel electrophoresis (sodium dodecyl sulfate polyacrylamide gel electrophoresis) was done at baseline, at the first and second post-treatment visits. RESULTS: In the cord blood serum (CBS) group, except for McMonnies score and staining score, all other clinical parameters showed continued improvement in the first and second post-treatment analyses. In the autologous serum (ALS) group, all the clinical parameters except Schirmer's I showed significant improvement in the first post-treatment analysis .This was sustained at a significant level in the second analysis except for tear film break-up time (TBUT) and conjunctival impression cytology grading. In the AT group, all the parameters improved at a non-significant level except for TBUT in the first analysis. In the next analysis, apart from McMonnies score and TBUT, other clinical parameters did not improve. In the ALS and CBS groups, tear lysozyme, lactoferrin levels improved in both post-treatment measurements (statistically insignificant).Total tear protein continued to increase at statistically significant levels in the first and second post-treatment analyses in the CBS group and at a statistically insignificant level in the ALS group. In the AT group, the three tear proteins continued to decrease in both the analyses. CONCLUSIONS: In moderate to severe dry eye in Hansen's disease, serum therapy in comparison with AT drops, improves clinical parameters and causes betterment in tear protein profile. TRIAL REGISTRATION NUMBER: CTRI/2013/07/003802.

[Prevalence of dry eye in Hansen's disease patients from a colony hospital in Goiânia, Brazil]. / Prevalência de olho seco em portadores de hanseníase de um hospital-colônia em Goiânia.

PURPOSE: To determine the prevalence of dry eye in Hansen's disease patients from the "Hospital de Dermatologia Sanitária de Goiânia". METHODS: The sample of the present study included 70 patients with Hansen's disease, from the "Hospital de Dermatologia Sanitária de Goiânia", and 30 controls, from the "Fundação Banco de Olhos de Goiás", both located in Goiânia-GO, Brazil. Ophthalmologic examination and Schirmer I, break-up time (BUT) and rose Bengal staining tests were carried out for all patients in a single evaluation. For the diagnosis of dry eye the Schirmer I equal or less than 5 mm and rose Bengal grade II or III, in at least one eye were considered. RESULTS: Forty-four (63.0%) patients with Hansen's disease were male and 22 (73.3%) controls were female (p=0.001). The mean age of the patients with Hansen's disease was 61.1+/-12.5 years and in the control group, it was 55.7+/-9.6 years. Fifteen (21.4%) patients with Hansen's disease and four (13.3%) controls presented with dry eye diagnosis (p=0.429). The lepromatous type (74.2%) of Hansen's disease was the most prevalent and dry eye (66.7%) was more frequent in this clinical form of the disease. CONCLUSION: The dry eye disease was more prevalent in patients with Hansen's disease, although the difference was not statistically significant.

Prevalência de olho seco em portadores de hanseníase de um hospital-colônia em Goiânia / Prevalence of dry eye in Hansen's disease patients from a colony hospital in Goiânia, Brazil

OBJETIVO: Determinar a prevalência de olho seco em hansenianos do Hospital de Dermatologia Sanitária de Goiânia. MÉTODOS: A amostra do presente estudo incluiu 70 hansenianos, do Hospital de Dermatologia Sanitária de Goiânia, e 30 controles, da Fundação Banco de Olhos de Goiás, ambos localizados em Goiânia-GO. Foram realizados exame oftalmológico e testes de Schirmer I, "break-up time" (BUT) e rosa bengala em todos estes indivíduos em uma única avaliação. Para o diagnóstico de olho seco foi considerado o teste de Schirmer I menor ou igual a 5 mm e o rosa bengala grau II ou III, em pelo menos um olho. RESULTADOS: Quarenta e quatro (63,0 por cento) hansenianos eram do sexo masculino e 22 (73,3 por cento) controles, do sexo feminino (p=0,001). A idade média dos hansenianos foi de 61,1±12,5 anos e no grupo controle, 55,7±9,6 anos. Quinze (21,4 por cento) hansenianos e quatro (13,3 por cento) controles apresentaram diagnóstico de olho seco (p=0,429). A forma virchowiana (HV) (74,2 por cento) da hanseníase foi a mais prevalente e o olho seco (66,7 por cento) foi mais freqüente nesta forma clínica da doença. CONCLUSAO: A prevalência de olho seco foi maior no grupo de hansenianos, apesar de não ter havido diferença significativa.

Prevalencia de olho seco em portadores de hanseniase do Hospital de Dermatologia Sanitaria de Goiania / ?

Objetico: Determinar a prevalencia de olho seco em portadores de hanseniase do Hospital de Dermatologia Sanitaria de Goiania, comparando-se a um grupo controle. Desenho: Estudo de prevalencia. Material e metodos: A amostra do presente estudo inclui 70 portadores de hanseniase, do Hospital de Dermatologia Sanitaria de Goiania, e 30 individuos no grupo controle, da Fundacao Banco de Olhos de Goias, ambos localizados em Goiania-GO. Foram realizados exeme oftalmologico e testes de Schirmer I, break-up time (BUT) e rosa bengala em todos estes individuos em uma unica avaliacao. Resultados: Quarenta e quatro (63,0%) portadores de hanseniase eram do sexo masculino e 22 73,3%) individuos do grupo controle, do sexo feminino (p=0,001). A idade medica dos hansenianos foi de 61,1+-12,5 anos e no grupo controle, 55,7+-9,6 anos. Quinze (21,4%) hansenianos e quatro (13,3%) individuos deo grupo controle apresentaram diagnostico de olho seco (p=0,429) A forma virchowiana (74,2%) da hanseniase foi a mais prevalente e o olho seco (66,7%) foi mais frequente nesta forma clinica da doenca. Conclusao: A prevalencia de olho seco nos portadores de hanseniase foi semelhante a encontrada nos individuos do grupo controle

Pathogenesis of dry eye in leprosy and tear functions.

Seventy-five leprosy patients and an equal number of age- and sex-matched controls were examined for tear functions, using Schirmer's test and tear break up time (BUT). There was no statistically significant difference in the Schirmer's test, but the tear BUT showed a statistically significant lower value of < 10 seconds in multibacillary patients compared to paucibacillary patients. Leprosy patients with lagophthalmos and decreased corneal sensation showed a lower value of tear BUT which was also statistically significant. This study shows that even though the quantity of tears is not affected, proper and prolonged wetting of the cornea is deficient in many leprosy patients.

Assessment and treatment of the dry eye in leprosy.

During the period of existence of the Ophthalmologic Prevention Centre we have come across a large number of patients with corneal dehydration (dryness cornea, dry eye) due to various causes. We find that majority of the patients had a big improvement in their symptoms and the signs of the dry eye with just a simple prevention technique.

Avaliação e tratamento do olho seco na hanseníase / Assessment and treatment of the dry eye in Hansen's disease

O Reconhecimento do grande número de pacientes com ressecamento de córnea e a inexistência de publicações neste ramo, motivou os autores a elaborar o presente trabalho. Forma examinados um total de 150 pacientes de Fevereiro a Maio/86, sendo 66% da forma Virchoviana, 16,6% forma Borderline, 16,6% foram Tuberculóide. Em 62% dos pacientes examinados apresentam ressecamento de córnea, tendo como principais causas baixa produção da lágrima, triquíase, lagoftalmo I (inicial) e avançado ectrópio. O tratamento dos pacientes durante o período foi dividido conforme a gravidade do problema em duas categorias: lubrificação da córnea com lubrificante artificial simples e lubrificação completa e em casos de triquíase usou-se no tratamento a retirada dos cílios. Pelos resultados obtidos (100% de melhora do ressecamento de córnea) observou-se o êxito do trabalho.

Ocular leprosy / ?

The ocular complications of leprosy are the most serous lesions in the disease. Leprosy has been one of the great causes of blindness and partial loss of sight. With the advent of sulphone and cortisone therapy, most of this could be prevented if only patients suffering from this disease received the benefits of established treatment in the early stages. There are thousands and thousands of people in backward countries suffering from leprosy who receive no care