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Background: Late detection of ocular diseases negatively affects patients' quality of life (QoL), encompassing health status, psychological, financial, and social aspects. However, the early detection of eye conditions leads to rapid intervention and avoiding complications, thus preserving the QoL. This study assessed the impact of ocular diseases late detection on patients' QoL at multi-eye clinics based on questionnaire responses. Methods: We developed an original Arabic-English questionnaire to assess the QoL of patients with ocular diseases referred from primary and secondary healthcare centers to tertiary hospitals. It covered preliminary data, patient perspectives on having lately detected ocular disease and treatment costs, and the impact of late detection on finances, social life, psychology, health status, and awareness of current initiatives. Logistic regression analysis was used to explore the associations between patient perspectives on having ocular diseases detected at a late stage and its impact on different domains. Multivariate logistic regression was applied with impact types of health status, psychological, financial, and social (dependent variables) and age, income levels, and hospital type (independent variables). Results: Three hundred and eighty-eight responded, with 50% experiencing psychological effects, 27% health issues, 23% social impacts, and 23% financial burdens. Two hundred seventeen patients (56%) reported having ocular condition detected in late stage. Logistic regression analysis showed positive association with health status, social well-being, and financial effects (p < 0.05). Multivariate analysis revealed pronounced effects in patients ≤ 50 years, with income \< 5000 SAR, and those visiting private clinics (p < 0.05). The social impact was greater in patients visiting private hospitals. Ninety percent of all patients emphasized the importance of increasing awareness for better QoL. Conclusion: Significant associations were found between the late detection of eye diseases and their impact on QoL. Therefore, early detection and increasing patients' awareness of ocular diseases and treatment are essential.
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BACKGROUND: Solid organ rejection post-SARS-CoV-2 vaccination or COVID-19 infection is extremely rare but can occur. T-cell recognition of antigen is the primary and central event that leads to the cascade of events that result in rejection of a transplanted organ. OBJECTIVES: To describe the results of a systematic review for solid organ rejections following SARS-CoV-2 vaccination or COVID-19 infection. METHODS: For this systematic review and meta-analysis, we searched Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, Scopus and Nature through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines for studies on the incidence of solid organ rejection post-SARS-CoV-2 vaccination or COVID-19 infection, published from 1 December 2019 to 31 May 2022, with English language restriction. RESULTS: One hundred thirty-six cases from fifty-two articles were included in the qualitative synthesis of this systematic review (56 solid organs rejected post-SARS-CoV-2 vaccination and 40 solid organs rejected following COVID-19 infection). Cornea rejection (44 cases) was the most frequent organ observed post-SARS-CoV-2 vaccination and following COVID-19 infection, followed by kidney rejection (36 cases), liver rejection (12 cases), lung rejection (2 cases), heart rejection (1 case) and pancreas rejection (1 case). The median or mean patient age ranged from 23 to 94 years across the studies. The majority of the patients were male (n = 51, 53.1%) and were of White (Caucasian) (n = 51, 53.7%) and Hispanic (n = 15, 15.8%) ethnicity. A total of fifty-six solid organ rejections were reported post-SARS-CoV-2 vaccination [Pfizer-BioNTech (n = 31), Moderna (n = 14), Oxford Uni-AstraZeneca (n = 10) and Sinovac-CoronaVac (n = 1)]. The median time from SARS-CoV-2 vaccination to organ rejection was 13.5 h (IQR, 3.2-17.2), while the median time from COVID-19 infection to organ rejection was 14 h (IQR, 5-21). Most patients were easily treated without any serious complications, recovered and did not require long-term allograft rejection therapy [graft success (n = 70, 85.4%), graft failure (n = 12, 14.6%), survived (n = 90, 95.7%) and died (n = 4, 4.3%)]. CONCLUSION: The reported evidence of solid organ rejections post-SARS-CoV-2 vaccination or COIVD-19 infection should not discourage vaccination against this worldwide pandemic. The number of reported cases is relatively small in relation to the hundreds of millions of vaccinations that have occurred, and the protective benefits offered by SARS-CoV-2 vaccination far outweigh the risks.
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OBJECTIVE: To investigate dry eye disease in Saudi employees working in indoor and outdoor environments. METHODS: A single-center randomized controlled study was carried out in an optometry clinic, to assess the ocular dryness of 24 male employees (12 indoor and 12 outdoor employees, mean age 36.4±2.5 years). The Ocular Surface Disease Index questionnaire was used to assess ocular dryness. Tear film assessment was carried out using phenol red thread (PRT), tear film osmolarity test, and fluorescein tears breakup time (FTBUT) with slit-lamp biomicroscopy. RESULTS: Both indoor and outdoor employees showed mild-to-moderate ocular dryness. A significant difference (P=0.004) was found for the tear quality test (FTBUT) between the indoor (8.58±4.8) and outdoor (5.54±1.3) employees. However, no significant differences for the tear quantity tests (tear osmolarity and PRT) between the indoor and outdoor employees were observed. CONCLUSION: Dry eye cases were detected in both groups. This might be due to the hot dry environment in Riyadh and the use of air conditioners commonly used indoors. A significant difference was observed for the tear film stability, which might be due to the effect of environment and/or visual display unit use.
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OBJECTIVES: To investigate the repeatability and average tear osmolarity using the new lab-on-chip TearLab technology device in normal subjects living in Saudi Arabia, a hot climate country, and to compare the average readings with data from previous studies. METHODS: Thirty healthy young adults (13 males and 17 females) who ranged in age from 20 to 40 years (mean±SD: 28.57±5.58 years) with no symptoms of dry eyes or ocular disease, who did not wear contact lenses, and were not pregnant or breastfeeding were enrolled in the study. For inclusion criteria, all subjects were examined under a slit-lamp to verify the absence of ocular surface disorders. Moreover, phenol red thread, tear breakup time (TBUT) tests, and McMonnies questionnaire were used to exclude dry eyes. Three measurements of tear osmolarity were performed in 1 eye (at 5-min intervals) using the TearLab osmometer. RESULTS: The mean score on the McMonnies questionnaire was 6±2.9. The mean values obtained from the phenol red thread and TBUT tests were 22±7.7 mm (OD), 21.5±6.6 mm (OS) and 12±1.7 s (OD), 12.5±1.6 s (OS), respectively. There were no statistically significant differences between the osmolarity readings (Wilks' lambda; P=0.945). Tear osmolarity results confirmed that 50% of subjects had readings of 299 to 312 mOsm/L, 40% had readings of 288 to 299 mOsm/L, and 10% had readings of 277 to 288 mOsm/L. The overall mean osmolarity was 299.06±7.65 mOsm/L. There was a medium correlation between osmolarity and the McMonnies questionnaire and a strong negative correlation between osmolarity and TBUT values. CONCLUSIONS: We found that the average osmolarity for subjects living in Saudi Arabia was 299.06±7.65 mOsm/L, which falls within the reference range and is in agreement with published results (298.0-301.9±7.2-16.0 mOsm/L). Osmolarity was positively correlated with McMonnies questionnaire and negatively correlated with TBUT values. The TearLab osmolarity system test showed good precision in repeated measurements. This is the first report of use of the TearLab osmolarity system to assess tear film in normal Saudi adults.
