Comprehensive Ophthalmological Evaluation in Atopic Dermatitis.

INTRODUCTION: Atopic dermatitis (AD), a chronic type 2 inflammatory skin disease, is frequently associated with ocular surface diseases (OSD) which may appear or worsen under anti-type 2-targeted treatments. However, the exact prevalence of OSD and the ophthalmology referral criteria remain ill-defined in AD patients before initiating such biotherapies. We aimed to characterize the prevalence, the nature and the factors related to OSD development in AD that may justify an ophthalmological management. METHODS: A total of 98 consecutive AD inpatients without biological treatment were retrospectively included. These were systematically evaluated by an ophthalmologist during their dermatological care. Clinical and laboratory data were analysed to characterize OSD and their risk factors. RESULTS: OSD were found in 83/98 AD patients (85%); mainly dry eye syndrome (64%, 63/98), allergic conjunctivitis (42%, 41/98), posterior (33%, 32/98), and anterior blepharitis (27%, 26/98). In AD patients without ocular symptoms, OSDs were also frequently found (63%, 12/19) and were mostly mild. Risk factors for OSD were history of allergic rhinitis, allergic sensitization, head and neck AD, ocular symptoms (foreign body sensation in the eye, burning, itching, photophobia), and total IgE level >3,000 kU/L. CONCLUSION: The prevalence of OSD was high, even in asymptomatic patients. The risk factors identified may indicate the need for ophthalmological examination for therapeutic management, especially when biological agents targeting type 2 inflammation are considered.

Assessment of the prevalence and risk factors for dry eye symptoms among Romanian medical students using the ocular surface disease index - a cross-sectional study.

BACKGROUND: This study aims to assess how Romanian medical students suffer from dry eye disease symptoms, establish the prevalence and severity of dry eye (DE) symptoms and identify potential risk factors. METHODS: An analytical, cross-sectional study was conducted on students from "Carol Davila" University of Medicine, Romania, after the final examination period of July 2022. The OSDI score (Ocular Surface Disease Index©) was applied in an online survey. The study adopted the standards used by other authors, who defined symptomatic DED as an OSDI score greater than 12. The chi-square test was used to establish statistical significance at a cutoff value of p < 0.05. The predictive model was created using linear logistic regression analysis. The goodness of fit of the logistic regression model was assessed using the Hosmer-Lemeshow test. When the severity outcome had a nominal categorical form, multinomial regression analysis with normal subjects as a reference was performed. The distribution of the severe type of symptomatology across sex categories and years of study was analyzed using a nonparametric test (Independent-Samples Kruskal-Wallis Test). RESULTS: A total of 274 answers were received from 81.4% females and 18.6% males with a response rate of 35.58%. The mean age was 22.7 years ± 1.66 with an age range between 20 and 25 years old. Using the OSDI score, we established that the overall prevalence of DE symptoms was 83.6% (95%CI: 79.6%, 88%), with an 85.2% (95%CI: 80.5%, 89.8%) prevalence in females and 76.5% (95%CI: 65%,88%) in males. The severe form of DE was the most prevalent, regardless of the study year or sex. Increased screen time (p-value < 0.05) and non-smokers (p-value < 0.05) were proven risk factors. The predictive model which includes the explanatory variables (sex, contact lens wearers, smoking, oral contraceptives, screen time) proved an 84.7% predictability for symptomatic DE and was able to better predict the dependent variable than the intercept model only (p-value < 0.05). Smoking (p = 0.002) and screen time (p = 0.009) preserved their significance in the multinominal regression as well. CONCLUSIONS: This is the first study to report the epidemiology of DE symptoms among Romanian medical students. OSDI revealed a high prevalence of symptomatic DE in medical students. Screen time, although not the only factor, likely plays a role in exacerbating the disease. This information can be used to inform healthcare policies, establish occupational health guidelines, and implement preventive measures for individuals in similar high-stress academic or professional environments.

Association between sleep quality and dry eye disease: a literature review and meta-analysis.

OBJECTIVE: The purpose of this article is to systematically review the association between dry eye and sleep quality. METHODS: PubMed, EMBASE, Cochrane, Web of Science, and grey literature databases were searched for observational studies published before April 2023. Meta-analysis was performed using STAT15 software. RESULTS: A total of 21 studies with 419,218 participants were included. The results showed that the dry eye subjects had a worse sleep quality than the healthy population, with poorer subjective sleep quality, longer sleep latency, and a higher risk of unhealthy sleep duration such as insufficient sleep or excessive sleep. The Pittsburgh Sleep Quality Index (PSQI) scores of the dry eye subjects were significantly higher than those of the control subjects (WMD = 1.78, 95%CI: 1.06, 2.50, P < 0.001). The dry eye subjects scored higher than the control subjects in sleep quality, sleep latency, and sleep disturbance in PSQI; there was no difference between the dry eye individuals and control subjects in sleep duration, sleep efficiency, daytime dysfunction, and sleep medication scores. The risk of sleep disorders in the dry eye subjects was significantly higher than that in the non-dry eye subjects (RR = 2.20, 95%CI: 1.78, 2.72, P < 0.001); the risk of insufficient sleep in the dry eye subjects was higher than that in the control subjects (RR = 3.76, 95%CI: 3.15, 4.48, P < 0.001), and the prevalence of excessive sleepiness in dry eye subjects was higher than that in the control subjects (RR = 5.53, 95%CI: 3.83, 7.18, P < 0.001). The ESS scores of the dry eye subjects were significantly higher than those of the control subjects (WMD = 3.02, 95%CI: 2.43, 3.60, P < 0.01). CONCLUSION: Our meta-analysis suggests that individuals with dry eye have a worse sleep quality than the healthy population, with poorer subjective sleep quality, longer sleep latency, and higher risk of unhealthy sleep duration such as insufficient sleep or excessive sleepiness.

Prevalence of dry eye in people over 50 years old in Beichen district, Tianjin city: a cross-sectional population-based survey.

BACKGROUND: A cross-sectional population-based survey in the Beichen district of Tianjin was conducted to estimate the prevalence of dry eye disease (DED) among the population over 50 years old with Dry Eye Workshop (DEWS) II and Chinese expert consensus (CEC) criteria. METHODS: A total of 5791 subjects over 50 years old were enrolled. Ocular surface disease index (OSDI) questionnaire, lipid layer thickness (LLT), partial blink ratio (PBR), fluorescein tear film breakup time (FBUT), Schirmer I test (SIT), fluorescein staining, meibomian gland dropout, meibomian gland expression scores (MES) and quantity scores (MQS) was assessed. Additionally, basic information, weight, disease history, living habits, anxiety, and depression condition were collected. RESULTS: According to the CEC, the prevalence of DED was 39.0%, whereas 44.0% based on DEWS II. The prevalence of DED increased with age and was substantially greater among women (41.1%, 95% CI, 39.5-42.6%) than males (35.1%, 95% CI, 33.1 -37.2%) (p < 0.001). Furthermore, the severity of DED was more severe in women (p = 0.006). The associated risk factors were age, female, depression, smoking, insomnia, and glaucoma. On the other hand, 53.6% of these populations were diagnosed as asymptomatic DED, and the morbidity was higher in males (p = 0.007). CONCLUSIONS: The prevalence of DED in China was relatively high, which was associated with aging, female(sex), depression, smoking and sleep problems. Hence, it is crucial for clinicians and caregivers to be aware of the existence of asymptomatic DED within the susceptible population.

Dry eye symptoms and signs in United States Gulf War era veterans with myalgic encephalomyelitis/chronic fatigue syndrome.

BACKGROUND: To examine ocular symptoms and signs of veterans with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) diagnosis, ME/CFS symptoms, and controls. METHODS: This was a prospective, cross-sectional study of 124 South Florida veterans in active duty during the Gulf War era. Participants were recruited at an ophthalmology clinic at the Miami Veterans Affairs Hospital and evaluated for a diagnosis of ME/CFS, or symptoms of ME/CFS (intermediate fatigue, IF) using the Canadian Consensus criteria. Ocular symptoms were assessed via standardised questionnaires and signs via comprehensive slit lamp examination. Inflammatory blood markers were analysed and compared across groups. RESULTS: Mean age was 55.1 ± 4.7 years, 88.7% identified as male, 58.1% as White, and 39.5% as Hispanic. Ocular symptoms were more severe in the ME/CFS (n = 32) and IF (n = 48) groups compared to controls (n = 44) across dry eye (DE; Ocular Surface Disease Index [OSDI]: 48.9 ± 22.3 vs. 38.8 ± 23.3 vs. 19.1 ± 17.8, p < 0.001; 5 item Dry Eye Questionnaire [DEQ-5]: 10.8 ± 3.9 vs. 10.0 ± 4.6 vs. 6.6 ± 4.2, p < 0.001) and pain-specific questionnaires (Numerical Rating Scale 1-10 [NRS] right now: 2.4 ± 2.8 vs. 2.4 ± 2.9 vs 0.9 ± 1.5; p = 0.007; Neuropathic Pain Symptom Inventory modified for the Eye [NPSI-E]: 23.0 ± 18.6 vs. 19.8 ± 19.1 vs. 6.5 ± 9.0, p < 0.001). Ocular surface parameters and blood markers of inflammation were generally similar across groups. CONCLUSION: Individuals with ME/CFS report increased ocular pain but similar DE signs, suggesting that mechanisms beyond the ocular surface contribute to symptoms.

Vision Correction Habits After COVID-19 Onset in Spectacle and Contact Lens Wearers.

PURPOSE: To determine how vision correction habits changed after the 2019 coronavirus disease (COVID-19) pandemic onset. METHODS: Participants reported vision correction habits, refractive error, screen time, mask wearing time, and dry eye symptoms since the COVID-19 pandemic onset through email survey. RESULTS: A total of 133 participants completed the survey. Worsening dry eye symptoms were associated with increased screen time ( P =0.04). Hours per day of spectacle wear increased by approximately 1 hr ( P =0.001) and was associated with increased screen time ( P =0.002). Worsening dry eye symptoms were associated with increased days per week of spectacle wear ( P =0.02). Participants wore contact lenses about one day per week less than before the pandemic ( P =0.0001). Increased mask wearing time was associated with increased days per week of contact lens wear ( P =0.03). CONCLUSIONS: After pandemic onset, hours per day of spectacle wear increased, and days per week of contact lens wear decreased. Increases in hourly spectacle wear were associated with increased screen time, whereas increased daily contact lens wear was associated with increased mask wear time, suggesting that spectacles may be preferred for screen time activities and contact lenses for mask wear.

Prevalence of Dry Eye Disease in Laser-Assisted In Situ Keratomileusis Candidates.

OBJECTIVE: To evaluate the prevalence of dry eye disease (DED) in laser-assisted in situ keratomileusis (LASIK) candidates. METHODS: A chart review of consecutive LASIK candidates who underwent full ocular surface work-up was performed, including ocular surface disease index (OSDI), noninvasive tests (noninvasive tear breakup time [ni-TBUT], tear meniscus height, lipid layer thickness, and meibography), and invasive tests (Schirmer test I, fluorescein TBUT, corneal staining, and meibomian gland [MG] expressibility). The prevalence of DED was calculated according to the Dry Eye Workshop II (DEWS II), and Japanese and Asia Dry Eye Society (JDES/ADES) criteria. RESULTS: In total, 135 patients (270 eyes) were evaluated. The mean age was 32.6±8.3 years, and 62.9% were women (n=85); 19 patients (15.4%) wore contact lenses, and 31 patients (23.8%) used artificial tears. The mean OSDI was 18.2±16.9, which was abnormal in 54.1% (n=62). Inferior lid MG dropout was the sign with the highest percentage of abnormal results (61.5%; n=83). There were no differences between men and women in any test except for ni-TBUT (6.3±0.3 and 7.2±0.2, respectively; P=0.002). Dry eye disease prevalence was 25.9% and 53.3%, according to JDES/ADES and DEWS II criteria, respectively. The only significant risk factor for DED was artificial tear use for both DEWS II (odds ratio [OR]=3.5, confidence interval [CI] [1.35-9.39]) and JDES/ADES (OR=2.58, CI [1.03-6.48]). CONCLUSIONS: This study found a high prevalence of DED and abnormalities in LASIK candidates and highlights the importance of ocular surface evaluation before photorefractive surgery.

Prevalence of Computer Vision Syndrome and Its Risk Factors in a Spanish University Population.

OBJECTIVES: To determine the prevalence of digital eye strain or computer vision syndrome (CVS) and its risk factors in a university population (University of Valladolid, Spain). METHODS: An anonymous cross-sectional online survey was conducted in a university population [staff (lecturers and administrative employees) and students (undergraduate, master's, and PhD)], including two validated questionnaires (Ocular Surface Disease Index [OSDI] and the 17-item Computer-Vision Symptom Scale questionnaire [CVSS17]) and questions about sociodemographic data and visual display terminal use. The prevalence and risk factors for CVS (CVSS17≥29) (multivariate logistic regression model) were calculated. RESULTS: One thousand nine participants responded to the survey (35.2±15.2 years; 64.1% women). The mean OSDI and CVSS17 questionnaire scores were 18.9±15.6 and 31.5±6.4, respectively, and 35.4% of the respondents had dry eye symptoms (OSDI>22). The total prevalence of CVS was 65.4% (95% CI 62.1-68.3). Undergraduate students showed the highest CVS prevalence (72.6%; P <0.01), which was significant. In addition, women, participants younger than 36 years old, contact lens wearers, and subjects with dry eye symptoms reported a statistically higher CVSS17 score ( P ≤0.01). In the multivariate model, significant factors associated with the presence of CVS ( P ≤0.03) were female sex (OR=2.10; 95% CI 1.54-2.88), dry eye symptoms (OSDI>22) (OR=16.98; 95% CI 10.36-27.84), VTD use ≥6 hr daily (OR=1.96; 95% CI 1.09-3.52), and being an undergraduate student (OR=2.23; 95% CI 1.54-3.24). CONCLUSION: A high prevalence (65.4%) of CVS was found among the Spanish university population, with the undergraduate student group having the highest prevalence (72.6%). Female sex, more than 6 hr/day of visual display terminal use, being an undergraduate student, and dry eye symptoms significantly increased the risk of CVS in the university population.

Historical Profiling of Dry Eye Patients - Potential Trigger Factors and Comorbidities.

PURPOSE: Dry eye syndrome (DES) is one of the most common diseases of the ocular surface. Affected persons suffer from different subjective complaints, with sometimes severe impairment in the quality of life. The aetiology and pathogenesis are multifactorial, multifaceted, and not yet fully understood. The present study is intended to provide deeper insights into possible triggering factors and correlating comorbidities. MATERIALS AND METHODS: In German ophthalmological practices, 306 persons (174 women, 132 men, age: 18 - 87 years) were interviewed by questionnaire on concomitant diseases and possible further triggering factors. DES was diagnosed by an ophthalmologist in 170 cases. The statistical comparative analysis between persons with and without DES was carried out using the chi-squared test (SPSS statistical software). RESULTS: DES occurred with significantly (p < 0.05) increased frequency in women over 40 years of age, as well as in persons exposed to screen work, air conditioning, persons with chronic ocular inflammation, myomas (hysterectomy), dry skin, arterial hypertonicity in need of medication, cardiac arrhythmias, fatty liver, gastric ulcer, appendicitis, cholecystectomy, depression, hyperlipidaemia, hyperuricaemia, osteoporosis, and nephrolithiasis. CONCLUSION: Some of the known comorbidities and DES risk factors, e.g., computer work or depression, were confirmed. In contrast, the higher prevalence of hyperlipidaemia, hyperuricaemia, osteoporosis, nephrolithiasis, and fibroids among DES patients has not previously been reported. Additional studies should be performed on causal connections between DES and specific comorbidities.

Association between dry eye and periodontal disease in community-dwelling Japanese adults: data from the Uonoma cohort study.

BACKGROUND: While research has explored the risk of periodontal disease in various eye conditions, the link between dry eye and periodontal disease remains underexplored, especially in Japanese adults. This study aims to investigate the association between dry eye and periodontal disease in community-dwelling Japanese adults. METHODS: This study is a subset of the Uonuma cohort study, which includes Japanese adults aged 40 years and older residing in the Uonuma area of Niigata Prefecture, Japan. Participants completed a self-administered, paper-based questionnaire. Statistical analyses, including the chi-square test, independent t test, ANOVA test, and logistic regressions, were employed to assess the association of periodontal disease with independent variables. RESULTS: Among 36,488 participants (average age 63.3 years, 47.4% men), 39.3% had a history of periodontal disease, and gender differences were statistically significant (p < 0.001). Significant associations were found between periodontal disease and dry eye diagnosis or symptoms. Univariable logistic regression revealed links between periodontal disease and age, gender, living status, alcohol consumption, remaining teeth, bite molar availability, and history of dry eye disease or symptoms. Multiple-adjusted regression found that doctor-diagnosed dry eye was associated with a higher likelihood of periodontal disease (odds ratio, 1.12; 95% confidence interval, 1.03-1.22). Participants who never experienced dryness or foreign body sensation had lower ORs of periodontal disease than those who always experienced such symptoms across all models. CONCLUSION: A significant correlation was found between dry eye and periodontal disease in Japanese adults. Regular check-ups, early detection, and effective management of both conditions are strongly recommended.

Epidemiology and Risk Factors of Dry Eye Disease: Considerations for Clinical Management.

Dry eye disease is a multifactorial condition characterised by tear film instability, hyperosmolarity and ocular surface inflammation. Understanding the epidemiology of dry eye disease and recognising both modifiable and non-modifiable risk factors can assist eye care practitioners in assessing, treating, and managing patients with the condition. This review considers current knowledge surrounding its incidence and prevalence, as well as associated demographic, systemic, ocular, and iatrogenic, and lifestyle-related modifiable risk factors. Population-based prevalence estimates vary according to the diagnostic criteria used to define dry eye disease, as well as severity and demographic characteristics of the population. Considering recent data and variable population demographics, conservative prevalence estimates suggest that 10-20% of the population over 40 years of age report moderate to severe symptoms and/or seek treatment for dry eye disease. Individuals with specific non-modifiable demographic risk factors may be at increased risk of developing dry eye disease. Advanced age, female sex and East Asian ethnicity have been identified as key non-modifiable demographic features predisposing individuals to dry eye disease. Systemic conditions that have been associated with an increased risk of dry eye disease include migraine, Sjögren syndrome, connective tissue disorders, mental health disorders, diabetes mellitus and androgen deficiency. Medications that may contribute to this risk include antidepressants, antihistamines, and hormone replacement therapy. Ocular and iatrogenic risk factors of dry eye disease include blepharitis, Demodex infestation, ocular surgery, blink completeness, contact lens wear, and topical ophthalmic medications. A range of modifiable lifestyle factors that can increase the risk of dry eye disease have also been identified, including low humidity environments, digital screen use, quality of sleep, diet, and eye cosmetic wear. Dry eye is a common disease affecting millions globally. Increasing knowledge regarding its associated risk factors can better prepare the eye care practitioner to successfully manage patients with this ocular surface disease.

Dry eye and decreased tear film stability in primary acquired nasolacrimal duct obstruction patients.

PURPOSE: Exploring the prevalence of dry eye (DE) and the changes of tear film stability in patients with primary acquired obstruction of the nasolacrimal duct (PANDO). METHODS: In this cross-sectional, observational study, 370 eyes in 223 patients with PANDO were assessed. The ocular surface disease index (OSDI) was used to evaluate ocular surface symptoms, and the Keratograph 5M non-invasive ocular surface analyser was used to assess ocular surface parameters. According to the TFOS DEWS II criteria, patients with OSDI ≥ 13 and NIKBUT < 10 s were diagnosed with DE. RESULTS: Of the 223 PANDO patients, 65 (29.1%) met the diagnostic criteria for DE. Compared with patients without DE, PANDO patients with DE were significantly older (p < 0.001), had a longer duration of epiphora (p = 0.023), and more likely to have a positive regurgitation on pressure over the lacrimal sac (ROPLAS) sign (p = 0.003). Multifactorial analysis showed that older age, positive ROPLAS and hypertension were significant independent predictors of DE (p < 0.05). Among the 147 unilateral PANDO patients without DE, the TMH, NIKBUT-first, NIKBUT-average and bulbar erythema scores were significantly higher in the PANDO sides. CONCLUSIONS: This study illustrated the prevalence of DE in PANDO patients was 29.1% and DE is more likely to occur in those who are older, have hypertension and are positive for ROPLAS. In addition, in patients with unilateral nasolacrimal duct obstruction, a decrease in tear film stability was observed in the healthy eye.

Computer vision syndrome and dry eye symptoms among breastfeeding women.

INTRODUCTION: Breastfeeding women are susceptible to musculoskeletal symptoms and hormonal changes that can affect the ocular surface. As exposure to visual display units (VDU) that is known to cause symptoms of dry eye and computer vision syndrome (CVS) is increasing worldwide, including among breastfeeding women, it is unknown whether this group of VDU users would experience CVS more than non-breastfeeding women. Therefore, this study aimed to investigate the association between breastfeeding status and symptoms of CVS and dry eye. MATERIALS AND METHODS: In this cross-sectional study, selfreported CVS and dry eye symptoms were compared between 80 breastfeeding and 72 non-breastfeeding VDU users. Two questionnaires were administered online, which were the CVS-Questionnaire (CVS-Q) and the Ocular Surface Disease Index (OSDI) questionnaire, to evaluate symptoms of CVS and dry eye, respectively. Mann-Whitney test was used to compare CVS and OSDI scores between groups, while correlations between the scores were analyzed using Spearman's test. RESULT: Results showed that OSDI scores were significantly higher in the non-breastfeeding group (U = 2263, z-score = - 2.276, p = 0.023), indicating more dry eye symptoms experienced by respondents in this group, while no significant group difference was found in terms of CVS scores (U = 2772, z-score = -0.400, p = 0.689). Additionally, no significant association was observed between breastfeeding status and severity of dry eye symptoms as well as CVS symptoms. CONCLUSION: This study reported the possible benefit of breastfeeding in reducing dry eye symptoms. The CVS symptoms found in the breastfeeding group were possibly due to VDU usage rather than caused by breastfeeding. Public education on preventive measures to reduce the occurrence of CVS symptoms and ocular dryness among VDU users is essential to improve the quality of life.

Prevalence of dry eye disease among IT students in Pakistan.

BACKGROUND: Dry eye disease (DED) is a common tear film disorder caused by decreased tear production or increased tear evaporation. The increased use of computers in the workplace has brought about the development of ocular health concerns, including dry eye disease. Therefore, this study was designed to determine the prevalence of DED associated with computer work and recommend preventing or reducing its development. This study investigated the prevalence of DED among IT students in Dera Ghazi Khan. METHODS: A cross-sectional descriptive study was conducted among 327 undergraduate students of the IT department in the district of Dera Ghazi khan over 5 months from September 2021 to January 2022. DED was assessed subjectively with Ocular Surface Disease Index. Data were analysed using SPSS version 21. The quantitative analysis was presented as mean and standard deviation, and qualitative variables were introduced in frequency and percentages. The chi-square test (Fisher's exact test) was used to study the significance of associations between dependent and independent variables. RESULTS: The mean age of the participants was 20.25 ± 1.305 years (range 17-25). The prevalence of DED among computer programmers was 47.7%. This study showed that gender (p = 0.31), contact lens usage (p = 0.64), and duration of time spent on computer display units (p = 0.47) were not significant determinants of DED among computer programmers. CONCLUSION: DED is prevalent among IT students, along with different symptoms. However, further studies are required to adequately measure the prevalence of DED during longer exposure time to computer screens and explore environmental risk factors.

Ocular complications in adults with psoriasis: a cross-sectional study in a referral center in Brazil.

PURPOSE: There is limited literature on the ocular manifestations in patients with psoriasis. Therefore, this study aimed to identify the prevalence of and factors associated with ocular manifestations in adults with psoriasis. METHODS: This cross-sectional study included Brazilian adults with psoriasis. The dermatological evaluation included diagnosis, clinical form, Psoriasis Area and Severity Index (PASI) measurement, and location of the lesions. Patients underwent a full ophthalmological examination, including the Schirmer I test, Rose Bengala staining, and tear breakup time tests. The results were analyzed using chi-square and Pearson's linear correlation tests. RESULTS: Of the 130 patients assessed, 118 (90.8%) exhibited ocular abnormalities, with meibomian gland dysfunction (MGD) being the most prevalent (59.2%), followed by dry eye disease (DED) (56.2%). A significant correlation was observed between MGD and PASI (p = 0.05), and between MGD and certain treatment modalities. DED was significantly associated with PASI (p < 0.05). Concurrent use of acitretin was identified as an independent predictor of MGD (odds ratio [OR] = 3.5, p < 0.05), whereas PASI was a protective factor against DED (OR = 0.39, p < 0.01). CONCLUSION: Given the high prevalence of eye disease among individuals with psoriasis, routine ophthalmological assessments are recommended to prevent possible ocular complications.

The impact of prolonged face mask use on ocular surface health during COVID-19 pandemic: a clinical, and conjunctiva impression cytology study.

PURPOSE: To investigate the relationship between prolonged face mask use and ocular surface health utilizing conjunctival impression cytology, the Schirmer test, the tear break-up time (TBUT) test, and the ocular surface disease index (OSDI) questionnaire. METHODS: In this cross-sectional prospective study, individuals who used face masks for at least eight hours per day for at least six months were compared to healthy volunteers who used face masks for no more than one hour per day. Each participant completed an OSDI questionnaire. The Schirmer test (under anesthesia), the TBUT test, and conjunctiva impression cytology analysis according to the Nelson classification method were performed on each participant. RESULTS: This study included 102 (49 male, 53 female) face mask users with an average age of 33.29 ± 7.71 years and 110 (60 male, 50 female) healthy controls with an average age of 32.96 ± 7.10 years (p = 0.746). The total OSDI score was significantly higher in face mask users than the control group (25.18 ± 3.54 vs 9.46 ± 2.13, p < 0.001). The mean Schirmer test value and TBUT were significantly lower in the study group than the control group (p < 0.001, p < 0.001). There was a statistically significant difference between the two groups in total score and stage of the Nelson classification system (p < 0.001, and p = 0.024, respectively). All conjunctiva impression cytology assessments, including cellularity, cell-cell contact, nucleus/cytoplasma ratio, goblet cell amount, and metaplasia, revealed statistically significant deterioration in the study group compared to the control group (p < 0.001, p = 0.025, p < 0.001, p < 0.001, and p < 0.001, respectively). CONCLUSION: The prolonged use of face masks leads to dry eyes. The findings of conjunctiva impression cytology indicate the role of inflammation in the pathogenesis of mask associated dry eye.

Assessment of Symptomatic Dry Eye Disease among Postgraduate Medical Students of KIST Medical College and Teaching Hospital using an Ocular Surface Disease Index Questionnaire.

Background Symptomatic dry eye disease is a growing public health challenge especially among those who are visual display unit users and other long-time near activity workers. Increased screen time, prolonged use of face mask and shortage of sleep among resident doctors increases the risk of developing dry eye disease that can affect their learning and social abilities. Data is insufficient on the prevalence of dry eye disease among postgraduate medical students in Nepal. Objective To find out the prevalence of symptomatic dry eye disease using an ocular surface disease index questionnaire among postgraduate medical students of KIST Medical College and Teaching Hospital. Method A cross-sectional study was conducted among three batches postgraduate medical students until 2023 of KIST Medical College and Teaching Hospital, Imadol, Lalitpur. A single validated symptom-based questionnaire with 12 questions was used to assess symptomatic dry eye disease. Result Total of 110 post-graduate medical students with mean age of 30.4 years, 67 males and 43 females were enrolled. Among them, 68 (61.8%) had dry eye disease. Severe dry eye was the commonest followed by mild dry eye. There was statistically significant association between dry eye disease with the increased screen time and suboptimal durations of sleep. Conclusion About half of postgraduate students faced symptomatic dry eye disease. It is advisable for residents to have optimum sleep as possible, limit screen time and establish regular break time along their exposure.

Ocular surface microbiota dysbiosis contributes to the high prevalence of dry eye disease in diabetic patients.

People with diabetes mellitus (DM) are at an increased risk for developing dry eye disease (DED). However, the mechanisms underlying this phenomenon remain unclear. Recent studies have found that the ocular surface microbiota (OSM) differs significantly between patients with DED and healthy people, suggesting that OSM dysbiosis may contribute to the pathogenesis of DED. This hypothesis provides a new possible explanation for why diabetic patients have a higher prevalence of DED than healthy people. The high-glucose environment and the subsequent pathological changes on the ocular surface can cause OSM dysbiosis. The unbalanced microbiota then promotes ocular surface inflammation and alters tear composition, which disturbs the homeostasis of the ocular surface. This "high glucose-OSM dysbiosis" pathway in the pathogenesis of DED with DM (DM-DED) is discussed in this review.

Utilization of sodium-glucose cotransporter 2 inhibitors on dry eye disease severity in patients with type 2 diabetes mellitus.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have protective effects against various systemic diseases and neoplasms. This retrospective cohort study evaluated the severity of dry eye disease (DED) in patients with type 2 diabetes mellitus (T2DM) who were treated with SGLT2 inhibitors. Data were obtained from the National Health Insurance Research Database of Taiwan. Patients with T2DM who were treated with SGLT2 inhibitors were assigned to the SGLT2 group. Each patient in the SGLT2 group was matched to two individuals with T2DM who had not used SGLT2 inhibitors, constituting the control group. The primary outcomes were the development of DED and severe DED. A diagnosis of severe DED was indicated by the usage of cyclosporine. Cox proportional hazard regression was applied to yield adjusted hazard ratios (aHR) and 95% confidence intervals (CIs). In the SGLT2 group, 1864 new DED events and 147 severe DED events were recorded. Conversely, 4367 new DED events and 392 severe DED events were recorded in the control group. The incidence (aHR: 0.858, 95% CI: 0.811-0.908, p = 0.0010) and severity (aHR: 0.652, 95% CI: 0.481-0.777, p = 0.0006) of DED were significantly lower in the SGLT2 group than the control group after adjusting for multiple covariates. In subgroup analyses, the incidence and severity of DED were significantly lower in patients younger than 60 years old who were treated with SGLT2 inhibitors than in their older counterparts (p = 0.0008 and 0.0011, respectively). In conclusion, utilization of SGLT2 inhibitors in the T2DM population could reduce both the incidence and severity of DED.

An Online Questionnaire-Based Survey of 1076 Individuals in Poland to Identify the Prevalence of Ophthalmic Symptoms in Autumn 2022.

BACKGROUND Vision health affects functioning in society, and the ability to learn and work. Ophthalmic symptoms may be caused by eye diseases, but also by environmental or lifestyle factors. This online questionnaire-based survey aimed to identify the prevalence of ophthalmic symptoms in 1076 individuals in Poland, as well as to identify factors associated with the presence of ophthalmic symptoms. MATERIAL AND METHODS An online questionnaire-based survey was carried out in December 2022 on a representative sample of 1076 adult Poles. Non-probability quota sampling was used. Respondents were asked about the presence of 16 different eye symptoms and vision problems in the last 30 days. The presence of ophthalmic symptoms was self-declared. Data were analyzed with IBM SPSS package version 28. RESULTS More than half of the respondents (57.8%) had at least 1 ophthalmic symptom in the last 30 days. Burning and stinging eyes (21.6%) and dry eyes (18.9%) were the most common ophthalmic symptoms declared by the respondents. Moreover, 21.3% of respondents reported vision deterioration in the last 30 days. Out of 10 different factors analyzed in this study, female gender, living in rural areas or small cities (below 100 000 inhabitants), living with at least 1 other person, having low economic status, having chronic diseases, and wearing spectacles/contact lenses were significantly associated (P.