Tear film stability and tarsal gland morphological characteristics in myopic children / 眼科新进展

Objective To assess the tear film stability and morphological characteristics of the tarsal gland in myopic children.Methods In this prospective descriptive study,myopic children who performed refractive examinations in the Pediatric Ophthalmology & Refraction Clinic,Jinan Mingshui Eye Hospital from November 2021 to November 2022 were in-cluded.An Ocular Surface Disease Index(OSDI)questionnaire survey was carried out;tear meniscus height(TMH),non-invasive first breakup time(NIf-BUT)and images of the tarsal glands were obtained by OCULUS Keratograph 5M compre-hensive ocular surface analyzer.In addition,the atrophy and tortuosity of tarsal glands were scored to analyze the tear film stability and clinical characteristics of tarsal glands in myopic children.Results A total of 48 myopic children(91 eyes)aged from 7 to 16(10.25±2.23)years were recruited,including 27 males(56.25％)and 21 females(43.75％).The aver-age TMH was(0.19±0.04)mm(95％CI:0.18-0.19)and the average NIf-BUT was(5.40±2.62)s(95％CI:4.90-5.94);the TMH was positively correlated with NIf-BUT(r=0.223,P=0.034).The tarsal gland atrophy score was 1(0,1).The tortuosity score of the upper and lower tarsal gland was 0(0,1)and 0(0,0),respectively,with a statistically significant difference(Z=3.692,P＜0.001).In all subjects,49 eyes(53.85％)had tarsal gland atrophy,and 37 eyes(40.66％)had tarsal gland tortuosity.There were significant differences in TMH and NIf-BUT between children aged＜12 years and children aged ≥12 years(both P＜0.05).There was a significant difference in TMH between children with an OSDI score＜13 and children with an OSDI score ≥ 13(t=2.305,P=0.026).There was a significant difference in NIf-BUT between mild and moderate myopia children(t=2.300,P=0.024);the spherical equivalent was positively correlated with NIf-BUT(r=0.283,P=0.023).Conclusion Children with mild to moderate myopia show low tear film stability and a certain proportion of abnormal morphology in tarsal glands.In addition to the refractive status of children,attention should also be paid to ocular surface health in the refraction clinic.

Effect of diquafosol sodium combined with sodium hyaluronate on improving tear film stability after wearing orthokeratology lens / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the effect of diquafosol sodium(SD)eye drops combined with sodium hyaluronate eye drops on improving tear film stability after wearing orthokeratology lenses.METHODS:Prospective study. A total of 82 patients(82 right eyes)who were recruited from the outpatient department of Anhui Aier Eye Hospital from March to August 2022. Participants were assigned to three groups: sodium hyaluronate(SH)group(30 eyes), SD group(24 eyes), and sodium diquafosol combined with sodium hyaluronate(CG)group(28 eyes)according to random number table method. All groups wore the same brand of orthokeratology lens. Non-invasive tear breakup time(NIBUT), non-invasive tear meniscus height(NITMH)and lipid layer thickness were examined before treatment, and after wearing orthokeratology lens for 1 d, 1 wk, and 1 mo. Corneal spot staining was also recorded.RESULTS:The NITMH and NIBUT of CG group and the SD group at 1 mo after treatment were higher than those before wearing lenses(both P<0.05), and the NIBUT and NITMH of the CG group were 19.74±3.29 s and 0.30±0.05 mm, respectively, which were better than those of the SD group(NIBUT: 16.09±2.98 s, NITMH: 0.22±0.08 mm)and the SH group(NIBUT: 15.67±3.90 s, NITMH: 0.22±0.04 mm; all P<0.01). There were no significant differences in lipid layer thickness between the groups(all P>0.05). The incidence of corneal staining did not differ significantly among the groups(P>0.05).CONCLUSION:The combination of diquafosol sodium and sodium hyaluronate eye drops demonstrates a superior effect in improving NIBUT and NITMH after wearing orthokeratology lenses for 1 mo, effectively enhancing tear film stability in patients wearing orthokeratology lenses.

Correlation between ocular surface status and blood lipids in patients with meibomian gland dysfunction during pregnancy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the correlation between ocular surface status and serum lipids in patients with meibomian gland dysfunction(MGD)during pregnancy, and to provide new ideas for the management and treatment of MGD during pregnancy.METHODS: Totally 120 pregnant women(240 eyes)treated in our hospital from May 2021 to May 2022 were selected and they were divided into MGD group(60 cases, 120 eyes)and control group(60 cases, 120 eyes)according to the presence or absence of MGD. All subjects received the ocular surface disease index scores(OSDI)and underwent examinations of meibomian gland morphology and function, tear film and blood lipid.RESULTS: The scores of OSDI, the related indexes of meibomian gland, corneal fluorescein staining(FL)scores, total cholesterol(TC), triglyceride(TG)and low density lipoprotein-cholesterol(LDL-C)in the MGD group were significantly higher than those in the control group(P<0.05). The scores of fluorescein breakup time(FBUT), Schirmer Ⅰ test(SIt)and high-density lipoprotein cholesterol(HDL-C)in the MGD group were significantly lower than those in the control group(P<0.05). Correlation analysis showed that the scores of TG, TC, LDL-C were negatively correlated with the values of FBUT(rs =-0.702, -0.647, -0.710, all P<0.001).CONCLUSION: The level of blood lipids in pregnant patients with MGD is significantly increased, and the levels of TC, TG and LDL-C may be related to the stability of tear film.

Changes of binocular surface indexes after unilateral endoscopic dacryocystorhinostomy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the effect of unilateral endoscopic dacryocystorhinostomy on binocular surface indexes.METHODS: Totally 45 cases with monocular primary acquired nasolacrimal duct obstruction(PANDO)who successfully underwent endoscopic dacryocystorhinostomy between 1 December 2022 and 31 July 2023 were enrolled in the study. Ocular surface indexes, including the non-invasive tear break-up time(NIBUT), Sjögren's International Collaborative Clinical Alliance ocular staining score(SICCA OSS), Korb score of lid wiper and Schirmer test scores, were collected preoperatively and at 0.5, 1 and 3 mo post-operatively. Subsequently, various indexes were compared at each time point between the operated and healthy eyes pre- and post-operatively.RESULTS: There was no significant differences between operated and healthy eyes in NIBUT, SICCA OSS, Korb scores and Schirmer test(all P>0.05). Furthermore, the Korb scores of operated eye at 0.5, 1 and 3 mo post-operatively were significantly lower than the preoperative value(P=0.034, 0.044, 0.027). Moreover, the Schirmer test score of the operated eye at 1 mo post-operatively was significantly lower than the preoperative value(P=0.0461).CONCLUSION:After a successful endoscopic dacryocystorhinostomy, tear drainage is restored, however, ocular surface damage worsens. These changes typically peak at 1 mo post-operatively before gradually improving.

Application of optical coherence tomography in orthokeratology fitting / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To assess the gap between the peak of the base curve to the surface of the cornea, as well as examines the correlation between the thickness of the tear film and the fitting of the orthokeratology lens through optical coherence tomography(OCT), providing an intuitive and quantitative clinical evaluation method for the fitting of the orthokeratology lens.METHODS: Myopia patients who fitted orthokeratology at our hospital from January to December 2023 were included. Examinations, including naked vision, slit lamp, non-contact intraocular pressure, ocular fundus, eye position, corneal diameter, corneal topography, tear film rupture time, optometry, etc., were performed on all patients before fitting. The trial lens parameter was selected according to the examination results, and fluorescein staining was performed to evaluate lens fitting state after patients adapted to wearing glasses. According to the performance of fluorescein staining, the inspected eyes are divided into three groups: lens loose group, lens fitting group, and lens tight group. In addition, the tear film thickness of three groups of subjects was measured by OCT, and the differences between the three groups of data were evaluated.RESULTS: A total of 49 myopic patients(77 eyes)were included. The average sphere degree was -3.10±1.25 D, the average cylinder degree was -0.43(-0.75, 0)D, the average horizontal keratometry(HK)was 42.48±0.81 D, and vertical keratometry(VK)was 42.98(42.25, 43.50)D. There were 21 cases(34 eyes)in the lens fitting group, with 13 cases of bilateral eyes, 8 cases of one eye, 14 cases(22 eyes)in the lens loose group, with 8 cases of bilateral eyes, 6 cases of one eye, and 14 cases(21 eyes)in the lens tight group, with 7 cases of bilateral eyes, 7 cases of one eye. There was no statistical difference in the main basic data of the subjects in the three groups(all P>0.05). OCT showed that the tear film thickness of the lens fitting group, the lens loose group, and the lens tight group was 231.18(219.0, 243.0), 220.41(214.0, 224.3), and 249.00(241.5, 258.0)μm, respectively, and there was statistical significance in the thickness among the three groups(P<0.05).CONCLUSION: OCT can serve as a safe and reliable method for measuring the tear film thickness, which can help evaluate the suitability of orthokeratology and provide a non-invasive, more intuitive, and quantitative evaluation method for the fitting and evaluation of orthokeratology.

Instability of tear film and loss of meibomian glands in patients with acne vulgaris / Instabilidade do filme lacrimal e perda de glândulas meibomianas em pacientes com acne vulgaris

ABSTRACT Purpose: In this prospective study, we compared ocular clinical variables in patients with acne vulgaris with those of healthy controls. These variables included tear film break-up time, meibomian gland dropout rate, and anterior chamber parameters. Methods: Our sample comprised 73 eyes from 73 patients with acne vulgaris and 67 eyes from 67 healthy controls. All participants underwent a non-invasive first tear film break-up time test and the average tear film break-up time was evaluated. Meibography was used to identify any meibomian gland dropout. The parameters of the cornea and anterior chamber were measured using Scheimpflug topography imaging. Finally, the ocular surface disease index questionnaire was administered to score each participant on their subjective experience of ocular complaints. Results: The noninvasive first tear film break-up time values of the acne vulgaris Group and the control Group were 4.7 ± 2.8 and 6.4 ± 3.5 sec, respectively. There was a significant difference between the groups (p=0.016). The number of eyes with tear break-up at any time during the measurement period was also significantly higher in the acne Group (p=0.018). In the acne vulgaris Group, the mean meibomian gland dropout rates were 33.21 ± 15.5% in the upper lids and 45.4 ± 14.5% in the lower lids. In the control group, these rates were 15.7 ± 6.9% and 21 ± 9.7% respectively. Dropout was significantly higher in the acne group for both the upper and lower lids (p=0.000). Conclusion: We found impaired tear stability in patients with acne vulgaris and a high rate of meibomian gland dropout. These glands play a key role in tear stability and their dropout is likely to result in evaporative dry eye. Measurement of the variables in this study allows objective diagnosis of this condition using a non-invasive, dye-free methodology, with minimum contact.

RESUMO Objetivo: Neste estudo prospectivo, pacientes com acne vulgaris e indivíduos saudáveis do grupo controle foram comparados em relação ao tempo de ruptura do filme lacrimal, taxa de abandono de glândulas meibomianas e parâmetros da câmara anterior, usando o tempo de ruptura do filme lacrimal topográfico não invasivo, meibografia não invasiva e fotografia de Scheimpflug, respectivamente. Métodos: Setenta e três olhos de 73 pacientes com acne vulgaris e 67 olhos de 67 indivíduos saudáveis foram incluídos. Todos os participantes submetidos ao primeiro tempo de ruptura do filme lacrimal não-invasivo e ao tempo médio de ruptura do filme lacrimal não-invasivo foram avaliados pelo uso do tempo de ruptura do filme lacrimal; perda de glândulas meibomianas foram avaliadas por meibografia; os parâmetros da córnea e da câmara anterior foram medidos por fotografia de Scheimpflug; e, finalmente, as queixas oculares subjetivas foram pontuadas com o uso do questionário do Indice de doenças de superfície ocular. Resultados: Os valores do tempo de ruptura do primeiro filme lacrimal não-invasivo do Grupo com acne vulgaris e do Grupo controle foram 4,7 ± 2,8 e 6,4 ± 3,5 segundos, respectivamente, refererindo-se a uma diferença significativa entre os valores dos grupos (p=0,016). Qualitativamente, o número de olhos com ruptura lacrimal a qualquer momento durante o período de medição foi significativamente maior no grupo de pacientes. (p=0,018). No Grupo com acne vulgaris, a perda de glândulas meibomianas nas pálpebras superiores foi de 33,21 ± 15,5% e nas pálpebras inferiores foi de 45,4 ± 14,5%; por outro lado, no Grupo controle foi de 15,7 ± 6,9% e 21 ± 9,7% respectivamente; ambos os casos referem-se a uma diferença significativa entre os grupos (p=0,000). Conclusão: Encontramos estabilidade comprometida do filme lacrimal em pacientes com acne vulgaris. No entanto, o comprometimento foi de grau muito menor, em comparação com a taxa de perda das glândulas meibomianas que desempenham um papel fundamental na estabilidade do filme lacrimal. Esta condição pode ser documentada de forma objetiva - uma metodologia parcialmente sem contato, totalmente não-invasiva e livre de corantes.

Comparison of strip meniscometry and Schirmer tear test results and tear film breakup time between healthy dogs and dogs with dry eye disease / Comparação entre o teste de meniscometria em tira, o teste lacrimal de Schirmer e o tempo de ruptura do filme lacrimal em cães normais e com olho seco

ABSTRACT Purpose: To compare strip meniscometry and Schirmer tear test 1 results and tear film breakup time between dogs with normal eyes and dogs diagnosed with keratoconjunctivitis sicca. Methods: One-hundred fifty-six eyes of 78 dogs, 88 normal eyes, and 68 eyes diagnosed with keratoconjunctivitis sicca were included in the study. The tests were performed in the following sequence: Schirmer tear test 1 was used to allocate the dogs to the normal or keratoconjunctivitis sicca group, followed by the strip meniscometry test and tear film breakup time measurement. Results: The results (mean ± standard deviation) of the tests in the normal group were as follows: Schirmer tear test 1, 22.75 ± 3.88 mm/min; strip meniscometry test, 10.01 ± 2.35 mm/5 sec; and tear film breakup time, 25.82 ± 5.47 sec. In the keratoconjunctivitis sicca group, the results were as follows: Schirmer tear test 1, 6.10 ± 4.44 mm/min; strip meniscometry test, 3.03 ± 2.62 mm/5 sec; and tear film breakup time, 10.78 ± 4.23 sec. The Spearman correlation coefficient in the keratoconjunctivitis sicca group was very high, with a significant difference between the strip meniscometry test and Schirmer tear test 1 (r=0.848, p<0.001), and moderate and significant between the strip meniscometry test and tear film breakup time (r=0.773, p<0.001). The cutoff for the strip meniscometry test for keratoconjunctivitis sicca was 7.0 mm/5 sec. Keratoconjunctivitis sicca was suspected when the values were <10 mm/5 sec. Conclusions: This study provided strip meniscometry test values from dogs with normal eyes and eyes with keratoconjunctivitis sicca, with high sensitivity and specificity compared with those of the Schirmer tear test 1. In the future, the strip meniscometry test may be another important quantitative test and could complement the gold standard Schirmer tear test for the diagnosis of keratoconjunctivitis sicca in dogs, an excellent animal model for the study of the disease.

RESUMO Objetivo: Comparar o teste de meniscometria em tira com o teste lacrimal de Schirmer 1 e o tempo de ruptura do filme lacrimal, em cães com olhos normais e cães com diagnóstico de ceratoconjuntivite seca. Métodos: Cento e cinquenta e seis olhos de 78 cães, 88 olhos normais e 68 olhos com diagnóstico de ceratoconjuntivite seca. Os testes foram realizados na seguinte sequência: o teste lacrimal de Schirmer 1 foi utilizado para alocar os cães no grupo normal ou no grupo ceratoconjuntivite seca, seguido pelo teste de meniscometria em tira e tempo de ruptura do filme lacrimal. Resultados: As médias e desvios-padrão para os olhos normais foram: teste lacrimal de Schirmer 1 = 22,75 ± 3,88 mm / min; teste de meniscometria em tira = 10,01 ± 2,35 mm / 5 seg; tempo de ruptura do filme lacrimal = 25,82 ± 5,47 seg; e para os olhos do grupo ceratoconjuntivite seca foram: teste lacrimal de Schirmer 1 = 6,10 ± 4,44 mm / min; teste de meniscometria em tira = 3,03 ± 2,62 mm / 5 seg; tempo de ruptura do filme lacrimal = 10,78 ± 4,23 seg. O teste de correlação de Spearman no grupo ceratoconjuntivite seca foi muito alto, com diferença significativa entre teste de meniscometria em tira e teste lacrimal de Schirmer 1 (r=0,848, p<0,001), moderada e significativa entre teste de meniscometria em tira e tempo de ruptura do filme lacrimal (r=0,773, p<0,001). O cut-off para teste de meniscometria em tira para ceratoconjuntivite seca foi identificado em 7,0 mm / 5 seg, valores abaixo de 10 mm / 5 seg podem ser considerados suspeitos para KCS. Conclusões: Este estudo forneceu valores de teste de meniscometria em tira em olhos normais e com ceratoconjuntivite seca em cães, revelando alta sensibilidade e especificidade em comparação com o teste lacrimal de Schirmer 1. No futuro, o teste de meniscometria em tira pode ser outro teste quantitativo importante e pode complementar o teste lacrimal de Schirmer padrão ouro para o diagnóstico de ceratoconjuntivite seca em cães, um excelente modelo animal para o estudo de ceratoconjuntivite seca.

Impact of salivary stimulation on tear film function in dry eye subjects

Purpose: Dry eye is a common condition affecting people worldwide. It causes ocular discomfort by reducing the quality of vision and impacts daily activities. To overcome such ocular discomfort, artificial tears are used but it is difficult to use artificial tears every time to protect eyes from dryness. There is a need to explore other treatment options, which can be used during work hours. The aim was to study the effect of salivary stimulation on tear film functions among dry eye subjects. Methods: Thirty?three subjects were enrolled in this prospective experimental study. Tear film function tests such as tear break up time (TBUT), tear meniscus height (TMH), and Schirmer’s I and II tests were conducted. For dry eye subjects, salivation was induced by giving a tamarind candy (a soft slightly sour tamarind pulp mixed with sugar) for 5 min. Tear film function tests were carried out within a few seconds (2 to 3 s) after finishing the candy and then after 30 and 60 min of the induction of salivation. The pre? and post?tear film function measurements were recorded and analyzed. Results: TBUT, TMH, and Schirmer’s II tests showed statistically significant (P < 0.05) increase immediately and after 30 min of stimulation of salivation for all tests in both eyes. However, the difference was insignificant after 60 min of stimulation of salivation. Schirmer’s I showed statistically significant changes in the left eye, but not in the right eye immediately after stimulation of salivation (P = 0.025). Conclusion: The quantity as well as the quality of tear film improved after the stimulation of salivation among dry eye subjects.

Omega-3 fatty acids supplements for dry eye - Are they effective or ineffective?

Purpose: To evaluate effectiveness of omega?3 fatty acid supplements in relieving dry eye symptoms and signs in symptomatic visual display terminal users (VDT). Methods: A randomized controlled study was done; eyes of 470 VDT users were randomized to receive four capsules twice daily for 6 months (O3FAgroup), each containing 180 mg of eicosapentaenoic acid and 120 mg docosahexaenoic acid. The O3FA group was compared with another group (n = 480) who received four capsules of a placebo (olive oil) twice daily. Patients were evaluated at baseline, 1, 3, and 6 months, respectively. The primary outcome was improvement in omega?3 index (a measure of EPA and DHA ratio in RBC membrane). Secondary outcomes were improvement dry eye symptoms, Nelson grade on conjunctival impression cytology, Schirmer test values, tear film breakup time (TBUT), and tear film osmolarity. Means of groups (pre?treatment, 1, 3, and 6?months) were compared with repeated measure analysis of variance. Results: At baseline, 81% patients had low omega?3 index. In the O3FA group, a significant increase in omega?3 index, improvement in symptoms, reduction in tear film osmolarity, and increase in Schirmer, TBUT, and goblet cell density was observed. These changes were not significant in the placebo group. Improvement in test parameters was significantly (P < 0.001) better in patients with low omega3 index (<4%) subgroup. Conclusion: Dietary omega?3 fatty acids are effective for dry eye in VDT users; omega?3 index appears to be the predictor to identify potential dry eye patients who are likely to benefit from oral omega?3 dietary intervention

Comparing the efficacy of sodium hyaluronate eye drops and carboxymethylcellulose eye drops in treating mild to moderate dry eye disease

Purpose: Aim of this study was to compare the efficacy of sodium hyaluronate (SH) and carboxymethyl cellulose (CMC) eye drops in treating mild to moderate dry eye disease in terms of relief of symptoms, mean change in tear film breakup time, Schirmer’s test, and impression cytology of conjunctiva from baseline. Methods: An observational study was carried out during a 2?year period in our tertiary referral hospital. The study consisted of 60 patients randomly allotted to two groups to receive SH and CMC eye drops for an 8?week period. Ocular surface disease index, tear film breakup time, and Schirmer’s test were performed at baseline visit and 4 and 8 weeks of treatment, and impression cytology of conjunctiva was performed at baseline and 8 weeks. Results: Significant improvement in patient symptoms, tear film breakup time, and Schirmer’s test from baseline was seen in both SH and CMC groups at 8 weeks posttreatment, whereas impression cytology of conjunctiva in both groups did not show significant improvement at 8 weeks of treatment. Data analysis using unpaired t?test showed comparable results. Conclusion: Both CMC and SH demonstrated equal efficacy in treating mild to moderate dry eye disease.

Tear film microbiome in Sjogren’s and non-Sjogren’s aqueous deficiency dry eye

Purpose: To understand the bacterial microbiome changes associated with Sjogren’s syndrome (SS) and non?Sjogren’s syndrome (NSS) aqueous?deficient dry eyes compared to healthy eyes. Methods: Bacterial microbiome was generated from the deoxyribonucleic acid of tear film samples in healthy (n = 33), SS (n = 17), and NSS (n = 28) individuals. Sequencing of the V3?V4 region of the 16S rRNA gene was performed on the Illumina HiSeq2500 platform. Quantitative Insights Into Microbial Ecology (QIIME) pipeline was used to assign taxa to sequences. Statistical analysis was performed in R to assess the alpha diversity and beta diversity indices. Significant changes between the healthy, SS, and NSS cohorts were depicted by principal coordinate analysis (PCoA), differential abundance, and network analysis. Results: Tear microbiome was generated in healthy, SS, and NSS samples. Phyla Actinobacteria, Firmicutes, and Bacteroidetes showed significant changes in SS and NSS compared to healthy. Genera Lactobacillus and Bacillus were predominantly present in all samples. PCoA and heat map analysis showed distinct clusters for SS and NSS from the healthy cohort. Genera Prevotella, Coriobacteriaceae UCG?003, Enterococcus, Streptomyces, Rhodobacter, Ezakiella, and Microbacterium significantly increased in abundance in SS and NSS compared to a healthy cohort. Bacteria–bacteria interaction in SS, NSS, and healthy cohorts was predicted by CoNet network analysis. This analysis predicted a major hub of interaction for the pro?inflammatory bacterium Prevotella in the SS and NSS cohorts. Conclusion: The results of the study indicate significant changes in the phyla and genera in SS and NSS compared to healthy. Both discriminative analysis and network analysis indicated a possible association of predominant pro?inflammatory bacteria with SS and NSS.

Evaluation of the ocular surface in asymptomatic glaucoma patients on topical medications and following trabeculectomy - A cross-sectional study

Purpose: This present prospective, cross-sectional study aims to comprehensively evaluate the ocular surface in asymptomatic patients with diffuse blebs after trabeculectomy versus chronic anti?glaucoma medication use and compare it with the age?matched normal population. Methods: Objective clinical evaluation was done by tear film break?up time (TBUT) and Schirmer’s test (ST) in the three groups– trabeculectomy >6 months with a diffuse bleb (Wurzburg bleb classification score ?10), chronic anti?glaucoma medication (AGM >6 months) group, and normal population. In all groups, tear film osmolarity was checked with the TearLab® device (TearLab Corp., CA, USA), and subjective evaluation was performed by administering Ocular Surface Disease Index (OSDI) questionnaire. Patients already on chronic lubricants or any other drug for the treatment of dry eyes (viz. steroids, cyclosporin) or having symptoms suggestive of an abnormal ocular surface, who had undergone refractive or intraocular surgery, and contact lens users were excluded. Results: In total, 104 subjects/eyes were recruited over 6 weeks. Thirty?six eyes recruited in the trab group were compared with 33 eyes studied in the AGM group, and both these groups were compared to 35 normal eyes. When compared to normals, TBUT and ST were significantly lower (P = 0.003 and 0.014) and osmolarity and OSDI were statistically significantly higher (P = 0.007 and 0.003) in the AGM group, whereas only TBUT was statistically significantly different (P = 0.009) when the trab group was compared to normals. Also, when the trab group was compared to the AGM group, ST was found to be higher (P = 0.003) and osmolarity was lower (P = 0.034). Conclusion: To conclude, ocular surface is affected even in asymptomatic patients on AGM but near normalcy is possible following trabeculectomy when blebs are diffuse.

A simple technique of meibography for morphological and functional evaluation of meibomian glands in dry eye conditions

Purpose: Dry eye disease (DED) is because of a decrease in the tear film’s volume or a change in the composition of tears. Evaporative dry eye is the most common type, which is due to meibomian gland dysfunction (MGD). In this study, the morphology of meibomian glands was evaluated in all kinds of dry eyes to look for any loss of meibomian glands, assess the function of remaining glands, and investigate the relationship between anatomy, function, and severity of DED. Methods: A total of 300 patients were included in the study, with 150 eyes in the study group and 150 in the control group. Meibomian gland morphology was assessed by examining the tarsal plate after everting the eyelids. Tear film function was evaluated using tear film break?up time (TBUT) and Schirmer’s test (SCH I and II). Meibomian gland morphology was examined with a slit?lamp under magnification, a transilluminator using a small light emitting diode (LED) bulb, and non?contact meibography using an auto refracto?keratometer (ARK). Results: Females had a higher prevalence of dry eyes in our study. In all, 103 eyes (68.6%) in the study group had evaporative dry eye, making it the most prevalent type. Among the 150 controls, 104 controls with 69.3% had no dry eye symptoms, and in those with symptoms, the evaporative type was the most common, with a 28% prevalence. Conclusion: TBUT should be performed in all patients with detectable MG abnormality. Meibography has high specificity and sensitivity to diagnose MGD and in turn dry eyes and should be considered a routine screening modality.

Relación entre el ojo seco y la diabetes mellitus tipo 2

La diabetes mellitus es una patología metabòlica que altera los niveles de glucosa en el cuerpo, siendo más prevalente la tipo 2, la cual puede llegar a modular enfermedades sistémicas que causan diferentes desórdenes metabòlicos y cambios celulares. En cuanto a las alteraciones oftalmológicas, se pueden resaltar la retinopatía diabética y el ojo seco, siendo esta última una condición inflamatoria crónica que ocaciona daños en la superficie ocular. Por lo tanto, esta revisión brindará información de los factores asociados al desarrollo de ojo seco en la diabetes, resaltando cambios en la glicemia y el rol del metabolismo de glucosa sobre estructuras oculares tales como como la glándula lagrimal, glándulas de Meibomio, y en la microvasculatura, que pueden condicionar a trastornos neuropáticos que conducen a la sintomatologia ocular. De igual modo, se describen eventos biológicos como cambios en la expresión epigenética, estrés oxidativo e inflamación que presumiblemente juegan un papel importante en las diabetes y ojo seco, por lo cual la evaluación y análisis de la lágrima en esta población se hace necesaria, teniendo en cuenta los cambios en las estructuras oculares en la diabetes y las novedosas investigaciones sobre biomarcadores de diabetes a través de la película lagrimal.

Diabetes mellitus is a metabolic pathology that alters glucose levels in the body, being type 2 more prevalent, which can lead to modular systemic diseases that cause different metabolic disorders and cellular changes. Regarding ophthalmological alterations, diabetic retinopathy and dry eye can be highlighted, the latter being a chronic inflammatory condition causing damage to the ocular surface. Therefore, this review will provide information on the factors associated with the development of the dry eye in diabetes, highlighting changes in glycemia and the role of glucose metabolism on ocular structures such as the lacrimal gland, Meibomian glands, and the microvasculature, which can condition neuropathic disorders that lead to ocular symptoms, biological events such as changes in epigenetic expression, oxidative stress, and inflammation are prescribed, which presumably play an important role in diabetes and dry eye, for which the evaluation and analysis of tears in this population is done necessary, taking into account the changes in the ocular structures in diabetes and the new research on biomarkers of diabetes through the tear film.

Occurrence of dry eye in mobile phone users

Background: Most Indians today own one or more mobile phones. The average time of phone usage per person per day is 4.8 h and the excess usage of mobile phone is an emerging cause of dry eye. Although some studies have established this relation, not many studies focus on South India. Our study aims to highlight the South Indian population. Aim and Objective: To study the prevalence of dry eye among medical students of 18–25 years. Materials and Methods: This is a cross-sectional study, whose participants are undergraduate medical students, both males and females, between 18 and 25 years. Schirmer’s test was done for each candidate after answering an Ocular Surface Disease Index questionnaire. Results: The most frequent symptom reported by the participants at the time of answering the questionnaire was soreness and irritation of the eye (8%). The most common long-term symptom reported was burning and watering of eyes of tolerable severity (27%). Some participants experienced uncomfortable and bothersome eye fatigue. Conclusion: Dry eye in the form of symptoms of both dryness of eye and reflex epiphora is present in the population under study. About 76% of the study population use their phones for over 3 hours a day. The soreness and irritation of eyes, watering and burning of eyes are attributed to the mobile phone usage for more than 6 hours per day.

Effects of primary acquired nasolacrimal duct obstruction on tear film and ocular surface / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the effects of primary acquired nasolacrimal duct obstruction(PANDO)on the tear film and ocular surface using LipiView ocular surface interferometer and Keratograph 5M anterior segment analyzer.METHODS: A self-controlled clinical trials. A total of 40 patients diagnosed with unilateral PANDO for at least 6mo who were admitted to our department from September 2021 to March 2022 were enrolled in the study, and the healthy eyes of the patients were assessed as control group. The LipiView ocular surface interferometer and Keratograph 5M anterior segment analyzer were used to measure the changes in related parameters of the tear film and ocular surface in both eyes.RESULTS: The non-invasive tear meniscus height(NITMH), stimulated NITMH, loss rate of upper meibomian gland, nasal and temporal ciliary redness index, temporal conjunctival redness index of the affected eyes were higher than healthy eyes(P&#x003C;0.05), but there were no statistical differences in the non-invasive break-up time(NIBUT), loss rate of lower meibomian gland, nasal conjunctival redness index, dry eye grading, blink responses, partial blink rate and lipid layer thickness(LLT)between the both eyes(P&#x003E;0.05).CONCLUSION: PANDO may lead to the aggravation of ocular surface inflammation and the loss of upper meibomian gland, and damage the ocular surface of patients. Attention should be paid to the early treatment of PANDO.

Detrimental effects of soot from air pollution on tear film function in mice / 中华实验眼科杂志

Objective:To observe the detrimental effect of airborne black carbon suspension solution of different concentrations on the tear film function of mice.Methods:Twenty-eight SPF-grade male BALB/c mice, aged 6-8 weeks, were randomly divided into four groups, 0.5 mg/ml group, 1 mg/ml group, 5 mg/ml group, and control group, with 7 mice in each group.The right eyes of mice were dropped by 4 μl of 0.5 mg/ml, 1 mg/ml, 5 mg/ml black carbon suspension, or phosphate buffer solution, 3 times a day according to grouping.Tear volume, tear break-up time (TBUT), corneal fluorescein staining (CFS), and conjunctival congestion were assessed before treatment and 4, 7, 10, and 14 days after treatment.The use and care of experimental animals complied with the Regulations for Administration of Laboratory Animals in Peking Union Medical College Hospital (No.XHDW-2022-053).Results:At 14 days after treatment, the tear volumes of 0.5 mg/ml group, 1 mg/ml group, 5 mg/ml group and control group were (2.74±0.74), (2.73±0.76), (2.31±0.67), and (5.31±0.36)mm, respectively.TBUT of the four groups were (4.87±0.28), (4.00±0.76), (3.23±0.43), and (6.22±0.22)seconds, respectively.CFS of the four groups were 4(3, 4), 5(5, 6), 7(7, 8) and 0(0, 1) points, respectively.Conjunctival congestion grades of the four groups were 2(2, 3), 2(2, 3), 3(2, 3) and 0(0, 1), respectively.There were statistically significant differences in tear volume among the four groups at different time points ( Fgroup=83.325, P<0.001; Ftime=86.551, P<0.001; Finteraction=5.181, P<0.001). Before and at each time point after treatment, tear volumes were significantly lower in 0.5 mg/ml group, 1 mg/ml group, and 5 mg/ml group than in control group, and tear volumes in 0.5 mg/ml group, 1 mg/ml group, and 5 mg/ml group were significantly lower at 4, 7, 10, and 14 days after treatment than before treatment (all at P<0.05). There were statistically significant differences in TBUT among the four groups at different time points ( Fgroup=75.130, P<0.001; Ftime=56.265, P<0.001; Finteraction=6.103, P<0.001). Before and at each time point after treatment, TBUT was significantly shorter in 0.5 mg/ml group, 1 mg/ml group, and 5 mg/ml group than in control group, and the TBUT was significantly shorter in 0.5 mg/ml group, 1 mg/ml group, and 5 mg/ml group at 4, 7, 10, and 14 days after treatment than before treatment, shorter in 1 mg/ml group and 5 mg/ml group at 14 days after treatment than 4, 7 and 10 days after treatment (all at P<0.05). There were statistically significant differences in CFS score and conjunctival congestion grades among the four groups at different time points, but the interactions between concentration group and measurement time were not statistically significant (CFS: Hgroup=59.249, P<0.001; Htime=49.959, P<0.001; Hinteraction=15.980, P=0.192.conjunctival congestion grade: Hgroup=57.622, P<0.001; Htime=42.062, P<0.001; Hinteraction=12.565, P=0.401). Before and at each time point after treatment, the CFS scores and conjunctival congestion grades were significantly higher in 0.5 mg/ml group, 1 mg/ml group, and 5 mg/ml group than in control group, and CFS scores and conjunctival congestion grades were significantly higher in 0.5 mg/ml group, 1 mg/ml group, and 5 mg/ml group at 4, 7, 10, and 14 days after treatment than before treatment (all at P<0.05). Conclusions:The exposure of airborne black carbon on the ocular surface causes damage to tear film function and ocular surface inflammation in BALB/c mice.Within a certain concentration and time range, the tear secretion decreases, TBUT shortens, CFS and conjunctival congestion increase.

Research progress on the relationship between lid-wiper epitheliopathy and dry eye / 国际眼科杂志(Guoji Yanke Zazhi)

Lid-wiper epitheliopathy(LWE)refers to the corresponding pathological changes in the palpebral conjunctiva after the skin-mucosa junction area of the palpebral margin, and staining occurs after using dyes such as fluorescein sodium or lissamine green. Current studies suggest that LWE mainly results from the increase of friction between the lid wiper and the ocular surface. The specific mechanism of LWE is not clear, but the common causes include wearing contact lenses, abnormal tear film, blink abnormalities and inflammation. Clinical studies have found that LWE appears when the conventional dry eye index is negative, so the diagnosis of LWE plays an important role in the early diagnosis and treatment of dry eye. However, there are few studies on the correlation between LWE and dry eye in clinical practice. Based on the existing clinical studies, the etiology, pathogenesis, clinical manifestations and treatment of LWE are introduced, and the research progress of LWE and dry eye is reviewed, hoping to provide reference for further investigation and the clinical application of LWE.

Effects of phacoemulsification with steep meridian transparent corneal incision on visual function, corneal astigmatism and tear film changes / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the effect of phacoemulsification with steep meridian transparent corneal incision on visual function, corneal astigmatism and tear film changes.METHODS: A total of 106 cataract patients(106 eyes)who underwent phacoemulsification in our hospital from January 2019 to December 2020 were selected as research objects, and they were divided into observation group and control group according to the operation mode: with 51 patients in the observation group who were treated with steep meridian transparent corneal incision, and 55 patients in the control group who were treated with transnasal transparent corneal incision. The changes of visual function, corneal astigmatism and tear film between the two groups were compared before operation and at 1wk, 1 and 3mo after operation.RESULTS: There was no statistical difference between the operation of two groups(all P&#x0026;#x003E;0.05). The visual acuity was significantly improved at 1wk, 1 and 3mo after operation, and it was better in the observation group than that in the control group. Mean defect(MD)of visual field was significantly lower, and it was significantly lower in the control group(all P&#x0026;#x003C;0.05); The corneal astigmatism AKP(+0)of the two groups was significantly lower at 3mo after operation, and the observation group was significantly lower than the control group(P&#x0026;#x003C;0.05). There was no statistical difference in corneal astigmatism AKP(+45)(P&#x0026;#x003E;0.05); Schirmer Ⅰ test(SⅠt)value increased first and then decreased, and the valley value was at 1wk after operation; Tear film break-up time(BUT)decreased first and then increased, and the valley value was at 1wk after operation. SⅠt in the observation group was lower than that in the control group at each time point(all P&#x0026;#x003C;0.05), while BUT in the observation group was higher than that in the control group at each time point(all P&#x0026;#x003C;0.05).CONCLUSION: Steep meridian transparent corneal incision phacoemulsification surgery is beneficial to improve the postoperative visual function of patients, reduce postoperative corneal astigmatism, reduce the damage to the patient's tear film function, and promote its recovery.