Effects of Recombinant Human Epidermal Growth Factor Eye Drops Combined with Phacoemulsification on Short- and Long-Term Visual Acuity Recovery and Related Dry Eye Complications in Patients with Senile Cataract.

Objective: To investigate the effects of recombinant human epidermal growth factor eye drops combined with phacoemulsification on short- and long-term visual acuity recovery and related dry eye complications in patients with senile cataract. Methods: Sixty patients with senile cataract cured from January 2019 to January 2021 were enrolled in our hospital. The patients in the control group were arbitrarily assigned into the control and the research group. The former group received phacoemulsification, and the latter group received recombinant human epidermal growth factor (RhEGF) eye drops combined with phacoemulsification. The curative effect, the incidence of xerophthalmia, short-term and long-term vision improvement, changes of corneal endothelial cells, serum factors, and life quality scores were compared. Results: The effective rate of the research group was 90.00%, and the effective rate of the control group was 66.67%; the curative effect of the research group was higher than that of the control group (P < 0.05). The incidence of dry eye in the research group was lower than that in the control group (P < 0.05). The short-term and long-term visual acuity improvement effect of the research group was better than that of the control group (P < 0.05). After treatment, the density of corneal endothelial cells in the research group was higher than that in the control group, while the proportion of hexagonal cells and the coefficient of variation of corneal endothelial cells in the research group were lower than those in the control group (P < 0.05). After treatment, IL-6 and TNF-α in the research group were lower than those in the control group (P < 0.05). Compared with the control group, the physical function, psychological function, social function, and healthy self-cognition scores of the research group were all lower (P < 0.05). Conclusion: Cataract is the leading cause of blindness in the world. With the continuous improvement of cataract phacoemulsification technology, the incidence of some serious complications has gradually lessened. Xerophthalmia is one of the most obvious and predictable complications after cataract surgery and may affect the recovery of postoperative visual acuity. Recombinant human epidermal growth factor eye drops can effectively enhance the visual acuity of patients, promote the curative effect, and strengthen the life quality.

Prospective evaluation of a new intense pulsed light, thermaeye plus, in the treatment of dry eye disease due to meibomian gland dysfunction

Purpose: This study aims to estimate the efficacy and safety of a new intense pulsed light (IPL) Thermaeye Plus for dry eye disease (DED) secondary to meibomian gland dysfunction (MGD).Patients and methods: This is a prospective, longitudinal study of patients with moderate to severe MGD. Treatment consisted of 4 consecutive IPL sessions, 12 flashes with the same energy 8J/cm2 on the periocular area at days 1, 14, 28, and 49. All patients were evaluated before each IPL sessions and 1 and 4 months after the last session. Measuring: Symptoms score and OSDI questionnaire, Non-invasive tear meniscus height (NITMH), Non-invasive break up (NITBUT), Tear osmolarity (TO), Corneal fluorescein staining (CFS) and Eyelid margin and Meibomian gland assessment. The adverse effects on the eye, periocular area, and systemic complications were evaluated. All types of skin pigmentation (Fitzpatrick scale I to VI) were included. Results: The study included 44 consecutive patients (88 eyes), 40 males and 48 females, with a mean age of 52.5±13.6 years, ranging from 22 to 78 years. Significant improvements were observed in single and total signs and symptoms. The most significant changes were observed in dryness, foreign body sensation (p<0.001), and pain (p<0.005). The OSDI questionnaire showed a significant decrease in total symptoms (p<0.003). The percentage of patients with a normal index <13, improved from 23.8% (10 patients) at baseline to 80.9% (34 patients) at last visit, after 23 weeks. Clinical sings also improved, more than 90%, stand out telangiectasia and blepharitis (p<0.002, and p<0.0005, respectively). No statistical differences between age (<40y, 40–60y, and >60y) and gender were observed. The clinical improvement began after the second and third week after the first IPL session, until the end of the IPL treatment (D49). After that, the results maintained stable until the last visit, after 11 weeks. ... (AU)

Common inflammatory and infectious conditions of the eyelid.

Patients with infection or inflammation of the eyelid will often first present to their primary care physicians with symptoms such as redness, swelling, tearing, itchiness, or a foreign body sensation. There are a variety of conditions that affect the eyelid which can cause such symptoms, and the exam and history can help a provider differentiate some of the more common conditions. This article will provide a comprehensive review of the background, diagnosis and management of dry eye disease, chalazion, hordeolum (stye), and preseptal cellulitis.

Influence of diabetes mellitus on anterior segment of the eye.

Diabetes mellitus (DM) has been emerging as one of the most serious health problems worldwide. Ocular complications of DM are currently one of the major causes of blindness in developed countries, among which diabetic retinopathy is relatively well studied and understood. However, although ocular surface complications of DM are common, diabetic complications of anterior segment of the eye, such as, cornea, conjunctiva, and lacrimal glands, are often overlooked. DM is associated with progressive damage to corneal nerves and epithelial cells, which increases the risk of anterior segment disorders including dry eye disease, corneal erosion, persistent epithelial defects, and even sight-threatening corneal ulcer. In this review, the authors will discuss the association of DM with disorders of anterior segment of the eye. Studies indicating the value of corneal nerve assessment as a sensitive, noninvasive, and repeatable biomarker for diabetic neuropathy will also be introduced. In addition, treatment modalities of anterior segment disorders associated with DM is discussed. The studies introduced in this review suggest that early and periodic screening of the anterior segment of the eye, as well as the retina, is important for the optimal treatment of DM.

Dry Eye Disease: Prevalence, Assessment, and Management.

Dry eye disease is a chronic condition of the corneal surface marked by persistent symptoms of irritation or burning that can cause inflammatory damage to the cornea and conjunctiva if untreated. Common risk factors for this syndrome include advancing age, female sex, low humidity environments, systemic medications, and autoimmune disorders. Treatments to relieve symptoms include tear replacement, humidification, improved nutrition, and anti-inflammatory ocular agents. Home healthcare nurses can identify signs and symptoms of dry eye syndrome and initiate strategies that range from warm compresses to physician referrals for more aggressive treatment. Consistent management of this condition improves quality of life and minimizes damage to the ocular surface.

Exposure keratopathy: Incidence, risk factors and impact of protocolised care on exposure keratopathy in critically ill adults.

PURPOSE: We aimed to determine the rate of exposure keratopathy (EK) in critically ill patients, identify risk factors for developing EK and ascertain the effectiveness of a protocol to prevent EK. MATERIALS AND METHODS: We undertook a two-phase prospective cohort study in a general adult ICU with first-phase being observational and an eye care protocol was introduced in the second-phase. Daily ophthalmic assessment was carried out along with recording of various risk factors. RESULTS: We studied 371 patients. In the first phase, the overall rate of EK was 21% but the rate in mechanically ventilated patients was 56%; χ2 (1, N=257)=80.8, p<0.001. Adjusted odds ratios (AOR) for development of EK was 28.6 (8.19-43.37), 13.0 (3.16-54.38) and 1.2 (1.03-1.33) with incomplete eye closure, mechanical ventilation, and higher sequential organ failure assessment score respectively. Following the introduction of the protocol, the overall rate of EK reduced to 2.6% (3 cases); χ2 (1, N=371)=18.6, p<0.001. CONCLUSIONS: EK is common in critically ill patients and a simple protocol substantially reduces the incidence of EK and is easily achieved in clinical practice.

[Comparison effects of acupuncture at distal acupoints and local acupoints on treatment of xerophthalmia].

OBJECTIVE: To compare the clinical efficacy differences between acupuncture at distal acupoints and local acupoints on treatment of xerophthalmia. METHODS: A total of 40 patients of xerophthalmia were randomly divided into a distal group and a local group, 20 cases in each one. One patient in local group lost contact, and finally 20 cases in the distal group and 19 cases in the local group finished treatment. The patients in the distal group were treated with acupuncture at Guangming (GB 37) and Diwuhui (GB 42), while those in the local group were treated with acupuncture at Cuanzhu (BL 2), Tongziliao (GB 1) and Taiyang (EX-HN 5). Patients in both groups were treated once a day, five times per week, and totally 2-week treatment were given. The subjective symptom based on visual analogue scale (VAS), tear secretion, ocular surface disease index (OSDI) and breakup time (BUT) were evaluated before treatment, after two-week treatment (end of treatment) and two weeks after end of treatment (follow-up visit) in the two groups. RESULTS: After treatment and follow-up visit, the VAS, tear secretion, OSDI and BUT were all improved (P<0.05, P<0.01), but the differences of VAS and OSDI between the two groups were not significant (both P>0.05). At follow-up visit, the differences of tear secretion and BUT between the two groups were significant (both P<0.05). CONCLUSION: The acupuncture at distal acupoints could relieve xerophthalmia symptoms, improve quality of life, increase tear secretion and prolong BUT, which is superior to local acupoints in long term.

Effects of chondrocyte-derived extracellular matrix in a dry eye mouse model.

PURPOSE: The occurrence of repetitive dry eye is accompanied by inflammation. This study investigated the anti-inflammatory effects of chondrocyte-derived extracellular matrix (CDECM) on the cornea and conjunctiva in a dry eye mouse model. METHODS: Dry eyes were experimentally induced in 12- to 16-week-old NOD.B10.H2(b) mice (Control) via subcutaneous injections of scopolamine (muscarinic receptor blocker) and exposure to an air draft for 10 days (desiccation stress [DS] 10D group). Tear volume and corneal smoothness were measured at 3, 5, 7, and 10 days after the instillation of PBS (PBS group) or CDECM (CDECM group). The corneas and conjunctivas were sectioned and stained with hematoxylin and eosin (H&E) and periodic acid Schiff (PAS). The expression of inflammatory markers (i.e., tumor necrosis factor-α [TNF-α], matrix metalloproteinase-2 [MMP-2], MMP-9, intercellular adhesion molecule-1 [ICAM-1], and vascular cell adhesion molecule-1 [VCAM-1]) was detected by quantitative real-time (qRT)-PCR and western blotting. All data were statistically processed using SPSS version 18.0. RESULTS: The instillation of CDECM after the removal of the DS increased tear production by up to 3.0-fold, and corneal smoothness improved to 80% compared to the PBS group (p<0.05). In the CDECM group, the detachment of the corneal epithelial cells was reduced by 73.3% compared to the PBS group, and the conjunctival goblet cell density was significantly recovered to the control levels (p<0.05). The expression of inflammatory factors was decreased in the cornea and conjunctiva of the CDECM group compared to the PBS group. CONCLUSIONS: These observations suggest that CDECM induced effective anti-inflammatory improvements in the cornea and conjunctiva in this experimental model of dry eye.

Xerophthalmia and vitamin A deficiency in an autistic child with a restricted diet.

We report the ocular and systemic manifestations of vitamin A deficiency in a child with a complicated medical history including autism and a restricted diet, living in a developed country. This child had significant vitamin A deficiency despite being under long-term medical care, yet the diagnosis was not considered until he had an ophthalmology review for visual deterioration.

[Professor ZHOU Yun-xian's experience of acupuncture combined with Chinese material medica for xerophthalmia].

Professor ZHOU Yun-xian's clinical experience of acupuncture combined with Chinese material medica for xerophthalmia is introduced. Her treatment for xerophthalmia is firstly focused on syndrome differentiation, indicating that different syndrome has different treatment of acupuncture and Chinese material medica. It is emphasized that by following the holistic concept of TCM, the local acupoints and whole-body acupoints cooperate closely, forming her special combination method of acupoints. In clinic, attention is focused on the application of many acupuncture techniques and extra points. With the combination of acupuncture and Chinese material medica, the treatment is flexible with superior clinical efficacy.

The 2012 PEMpix photograph competition award winner: making a case for pringles-flavored carrots.

This is a case report of a 14-year-old boy with autism who presented with photophobia. Physical examination was significant for bilateral corneal ulcers. Differential diagnosis of this chief complaint and the management of the suspected condition are discussed. This case was presented at the Section of Emergency Medicine Meeting at the National Conference and Exhibition of the American Academy of Pediatrics in 2012 and was awarded first place in the PEMpix photograph competition.

[Efficacy observation of xerophthalmia treated with acupuncture of warming-promotion needling technique].

OBJECTIVE: To observe the differences in the efficacy on xerophthalmia treated with the needling technique for warming-promotion at Fengchi (GB 20) as the main acupoint in comparison with the conventional needling technique. METHODS: Thirty cases were randomly divided into a warming-promotion needling group (n = 15) and a routine needling group (n = 15). In warming-promotion needling group, the needling technique for warming-promotion was applied to Fengchi (GB 20). Additionally, the local and distal acupoints [such as the point beneath Cuanzu (BL 2), Neiguan (PC 6), Guangming (GB 37), Taichong (LR 3), Fulio (KI 7) and Sanyinjiao (SP 6)], as well as the scalp acupuncture (bilateral supraoccipital lateral line and supraoccipital midline) were selected and stimulated with even-needling technique by rotating the needle. In routine needling group, the acupoints were same as warming-promotion needling group and were stimulated with even-needling technique by rotating the needle. After 2 sessions of treatment, the efficacy, tear secretion volume and the total score of symptoms were compared between two groups. RESULTS: The total effective rate was 86.7% (13/15) in warming-promotion needling group, which was superior to 66.7% (10/15) in routine needling group (P < 0.05). After treatment, the tear secretion volume and the total score of symptoms were all apparently improved in two groups (all P < 0.05), in which, the improvement in warming-promotion needling group was much obvious (all P < 0.05). CONCLUSION: The therapeutic effect of warming-promotion needling technique is apparently superior to that of conventional one.

[Efficacy assessment of acupuncture and moxibustion on tear secretion in xerophthalmia].

OBJECTIVE: To compare the efficacy differences between acupuncture-moxibustion and medication in xerophthalmia. METHODS: Eighty cases of xerophthalmia were randomly divided into an acupuncture-moxibustion group and a medication group, 40 cases in each group. In acupuncture-moxibustion group, acupuncture was applied to the local and distal points, such as Jingming (BL 1), Cuanzhu (BL 2), Taiyang (EX-HN 5) and Quchi (LI 11) etc., combined with non-smoking moxibustion. In medication group, Sodium Hyaluronate eye drops were administered, three times per day, 1 drop each time. Before and after treatment, tear secretion volume (Schirmer's test), break-up time (BUT), symptom score, visual function score and tear film grade were observed. RESULTS: The total effective rate was 73.1% (57/78) in acupuncture-moxibustion group, and was 37.2% (29/78) in medication group, indicating significant statistical difference in comparison (P < 0.05). There was a significant difference in statistics in tear secretion volume between two groups after treatment (P < 0.05), in which, the result in acupuncture-moxibustion group was superior to that in medication group. The significant statistical differences presented in tear secretion volume, BUT, symptom score, visual function score and tear film grade in comparison before and after treatment in acupuncture-moxibustion group (all P < 0.05). The significant statistical difference presented in symptom score and tear film grade before and after treatment in medication group (both P < 0.05). CONCLUSION: Acupuncture-moxibustion apparently relieves the symptoms of xerophthalmia, promotes tear secretion and improves the life quality of patients.

Clinical curative effect of acupuncture therapy on xerophthalmia.

This study observes changes in symptoms of xerophthalmia pre- and post-acupuncture therapy and compares the results of the acupuncture therapy (AT) group and the artificial tear control (ATC) group. Parallel comparative studies were carried out on 44 patients with xerophthalmia, who were divided into the AT group (n = 20) and the ATC group (n = 24). A 10-session acupuncture therapy program was performed for the AT group while Dextran 70 was used for the ATC group with each course of treatment lasting 21 day. Examinations were made on the day when a patient was chosen to join the study, 1 hour after completion of treatment, and 3 weeks after stopping treatment. There was no statistically significant difference in terms of the reduction of the symptoms and sign score (SSS) 1 hour after completion of treatment between the AT group and the ATC group. Three weeks after completion of treatment, the reduction of SSS for the AT group was larger than that of the ATC group, with the difference achieving statistical significance. Both acupuncture therapy and artificial tear therapy have an immediate positive effect on the symptoms of xerophthalmia, but acupuncture therapy has a longer continuous effect than that of artificial tears.

Ojo seco y calidad de vida / Dry eye and quality of life

Objetivos: Evaluar la relación entre la severidad deojo seco y la calidad de vida.Material y métodos: 19 pacientes diagnosticadosde ojo seco y 21 sin ojo seco fueron explorados conlámpara de hendidura y se les realizó el test deSchirmer, para evaluar el grado de severidad de ojoseco. La calidad de vida fue valorada con los cuestionariosOSDI (Ocular Surface Disease Index) andVFQ-25 (Visual Function Questionnaire-25).Resultados: La puntuación total del OSDI era significativamentemayor en los pacientes con ojoseco, mientras que el BUT y la puntuación total delVFQ-25 era significativamente menor que en lossanos. En los casos, se encontraron las siguientescorrelaciones estadísticamente significativas(p<0,05): Puntuación total del OSDI con la puntuacióntotal del VFQ-25 (r=-0,62), BUT con la tincióncorneal (r=-0,50) y con el Schirmer (r=0,66), BUTcon la puntuación total del OSDI, los síntomas y losdesencadenantes del OSDI (r=-0,56, -0,56, -0,60);tinción corneal con la puntuación total del OSDI ylos síntomas del OSDI (r=0,55, 0,54); BUT con lapuntuación total del VFQ-25, la ausencia de dolorocular, la función mental y la función laboral delVFQ-25 (r=0,56, 0,51, 0,63, 0,56); la tinción cornealcon la puntuación total del VFQ-25, la ausenciade dolor ocular y la visión cercana del VFQ-25 (r=-0,57, -0,49, -0,62).Conclusión: Los pacientes con ojo seco tienen unapeor de calidad de vida. Tanto el OSDI como elVFQ-25 son métodos adecuados de evaluación. ElBUT y la tinción corneal proporcionan una medidaindirecta de la calidad de vida (AU)

Purpose: To evaluate the relation between dry eyeseverity and quality of life.Methods: 40 participants (19 with dry eye and 21normal controls) underwent slit-lamp examinationand Schirmer test to evaluate dry eye severity. Qualityof life was evaluated with OSDI (Ocular SurfaceDisease Index) and VFQ-25 (Visual FunctionQuestionnaire-25).Results: The OSDI total score was significantlygreater in patients suffering dry eye. However, BUT(break-up time) and VFQ-25 total score were significantlylower than in control subjects.In dry eye patients several statistically significantcorrelations (p<0.05) were found:OSDI with VFQ-25 total score (r=-0.62), BUT withcorneal staining (r=-0.50) and Schirmer (0.66),BUT with OSDI total score, OSDI-symptoms andOSDI-triggers (r=-0.56, -0.56, -0.60); corneal stainingwith OSDI total score and OSDI-symptoms(r=0.55, 0.54), BUT with VFQ-25 total score,VFQ-25 ocular pain, mental function and role function.(r=0.56, 0.51, 0.63, 0.56); corneal stainingwith VFQ-25 total score, VFQ-25 ocular pain andnear vision (r=-0.57, -0.49, -0.62).Conclusion: Quality of life is decreased in patientswith dry eye. OSDI and VFQ-25 questionnaires arevalid instruments for measuring the impact of dryeye disease. BUT and corneal staining provide an tinción corneal.indirect measurement of quality of life (AU)