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Ocular Surface and Contact Lens

Works Count: 60512

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Description

This cluster of papers focuses on the diagnosis, classification, epidemiology, pathophysiology, and management of dry eye disease. It covers topics such as ocular surface, tear film, meibomian gland dysfunction, corneal nerves, inflammatory cytokines, and the impact of contact lens wear on dry eye. The papers also discuss various diagnostic methodologies and the prevalence of dry eye in different populations.

Keywords

Dry Eye Disease; Ocular Surface; Tear Film; Meibomian Gland Dysfunction; Corneal Nerves; Diagnostic Methodology; Epidemiology; Management and Therapy; Inflammatory Cytokines; Contact Lens

Report of the National Eye Institute/Industry workshop on Clinical Trials in Dry Eyes.

1995-10-01

Michael A. Lemp

Two multicenter, randomized studies of the efficacy and safety of cyclosporine ophthalmic emulsion in moderate to severe dry eye disease11Reprint requests to: Linda Lewis, 575 Anton Blvd, Suite 900, Costa Mesa, CA 92626.

2000-04-01

Kenneth Sall , Onex Dara Stevenson , Thomas K. Mundorf +1 more

Pro- and anti-inflammatory forms of interleukin-1 in the tear fluid and conjunctiva of patients with dry-eye disease.

2001-09-01

Abraham Solomon , Dilek Dursun , Z Liu +3 more

To compare the expression of the pro- and anti-inflammatory forms of interleukin (IL)-1 in the tear fluid and conjunctival epithelium of normal eyes and those with dry-eye disease.The concentrations of … To compare the expression of the pro- and anti-inflammatory forms of interleukin (IL)-1 in the tear fluid and conjunctival epithelium of normal eyes and those with dry-eye disease.The concentrations of IL-1 alpha, IL-1 beta (precursor and mature forms), and IL-1 receptor antagonist (IL-1Ra) were measured by ELISA in tear fluid samples obtained from normal individuals and patients with dry eye who had rosacea-associated meibomian gland disease (MGD) or Sjögren's syndrome (SS) aqueous tear deficiency (ATD). These cytokines were also measured in normal tear fluid before and after nasal stimulation to induce reflex tearing. The relative expression of these cytokines was evaluated in conjunctival impression cytology specimens and conjunctival biopsy tissue obtained from normal subjects and SS ATD-affected patients using immunofluorescent staining. Matrix metalloproteinase (MMP)-9 concentration and activity in the tear fluid were evaluated with gelatin zymography and with an MMP-9 activity assay kit, respectively.Compared with normal subjects, the concentration of IL-1 alpha and mature IL-1 beta in the tear fluid was increased, and the concentration of precursor IL-1 beta was decreased in patients with MGD (P < 0.05, P = 0.02, and P < 0.01, respectively) and SS ATD (P < 0.001, P = 0.02, and P < 0.001, respectively). There was no significant change in the concentration of IL-1 alpha, precursor IL-1 beta, and IL-1Ra in reflex tear fluid, indicating that the lacrimal glands may secrete these cytokines. The activity of MMP-9, a physiological activator of IL-1 beta, was significantly elevated in the tear fluid of both dry-eye groups compared with normal subjects. A strong positive correlation was observed between the intensity of corneal fluorescein staining and the tear fluid IL-1 alpha concentration (r(2) = 0.17, P < 0.02) and the mature-to-precursor IL-1 beta ratio (r(2) = 0.46, P < 0.001). Positive immunofluorescent staining for IL-1 alpha, mature IL-1 beta, and IL-1Ra was observed in a significantly greater percentage of conjunctival cytology specimens from eyes with SS ATD than in those from normal eyes (P < 0.01 for IL-1 alpha, P < 0.009 for mature IL-1 beta, and P < 0.05 for IL-1Ra).Dry-eye disease is accompanied by an increase in the proinflammatory forms of IL-1 (IL-1 alpha and mature IL-1 beta) and a decrease in the biologically inactive precursor IL-1 beta in tear fluid. Increased protease activity on the ocular surface may be one mechanism by which precursor IL-1 beta is cleaved to the mature, biologically active form. The conjunctival epithelium appears to be one source of the increased concentration of IL-1 in the tear fluid of patients with dry-eye disease. These results suggest that IL-1 may play a key role in the pathogenesis of keratoconjunctivitis sicca.

The epidemiology of dry eye in Melbourne, Australia, Historical image

1998-06-01

Catherine A. McCarty , Aashish K. Bansal , Patricia M. Livingston +2 more

The International Workshop on Meibomian Gland Dysfunction: Executive Summary

2011-03-30

Kelly K. Nichols , Gary N. Foulks , Anthony J. Bron +5 more

DOI:10.1167/iovs.10-6997a Investigative Ophthalmology & Visual Science, Special Issue 2011, Vol. 52, No. 4 Copyright 2011 The Association for Research in Vision and Ophthalmology, Inc. 1922 ドライアイ疾患の原因としては、マイボーム腺機能不全 (MGD)がおそらく最も多い。この疾患によって数百万人もの健康と幸福が損なわれているにもかかわらず、MGD の定義、分類、診断、治療について世界的なコンセンサスはない。 … DOI:10.1167/iovs.10-6997a Investigative Ophthalmology & Visual Science, Special Issue 2011, Vol. 52, No. 4 Copyright 2011 The Association for Research in Vision and Ophthalmology, Inc. 1922 ドライアイ疾患の原因としては、マイボーム腺機能不全 (MGD)がおそらく最も多い。この疾患によって数百万人もの健康と幸福が損なわれているにもかかわらず、MGD の定義、分類、診断、治療について世界的なコンセンサスはない。そうしたコンセンサスに達する目的で、非営利団体である Tear Film and Ocular Surface Society( TFOS; http://www. tearfilm.org)が International Workshop on Meibomian Gland Dysfunction(国際マイボーム腺機能不全ワークショップ、 www.tearfilm.org/mgdworkshop/index.html)を起ち上げた。このワークショップの目的は以下の通りである:

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Etiology, prevalence, and treatment of dry eye disease

2009-07-01

Johnny L. Gayton

This review article examines the prevalence, etiology, and current therapies of dry eye disease, with special focus on postmenopausal women.Method: A systematic literature search utilizing MEDLINE was conducted to identify … This review article examines the prevalence, etiology, and current therapies of dry eye disease, with special focus on postmenopausal women.Method: A systematic literature search utilizing MEDLINE was conducted to identify peerreviewed articles related to dry eye published prior to September 2008.The terms "dry eye" and "women" were searched in combination with one or more of the following words or phrases: prevalence, postmenopausal, etiology, risk factors, therapy, medications, surgery, tear film, and quality of life.Articles were selected based on their direct applicability to the subject matter.A manual search was also conducted based on citations in the published literature.Results: Epidemiologic studies identified prevalence rates ranging from 7% in the United States to 33% in Taiwan and Japan.Risk factors include advanced age, female sex, smoking, extreme heat or cold weather conditions, low relative humidity, use of video display terminals, refractive surgery, contact lens wear, and certain medications. Conclusion:The last decade has brought about a better understanding of the etiology of dry eye disease.New therapies that can alleviate the signs and symptoms of dry eye disease and, consequently, improve the quality of life of dry eye patients are available in the market.

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The International Workshop on Meibomian Gland Dysfunction: Report of the Diagnosis Subcommittee

2011-03-30

Alan Tomlinson , Anthony J. Bron , Donald R. Korb +7 more

Diagnostic tests of meibomian gland dysfunction (MGD) and of MGD-related disorders are based on the demonstration of abnormal anatomy and physiology of the glands and the detection of specific pathologic … Diagnostic tests of meibomian gland dysfunction (MGD) and of MGD-related disorders are based on the demonstration of abnormal anatomy and physiology of the glands and the detection of specific pathologic events. For this reason, this subcommittee report is divided into two sections. In part I, those aspects of meibomian anatomy and physiology that are relevant to currently available tests are described; a fuller account of the anatomy and physiology is provided in the report of the Anatomy Subcommittee of this workshop. In part II, each test and its performance is described in detail. In part III, the practical application of selected tests is summarized and recommendations for future approaches are made. Additional recommendations and a summary of pertinent literature and concepts are presented in Appendices 1 to 17.

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Soft contact lens polymers: an evolution

2001-12-01

Paul C. Nicolson , J. Vogt

Tear Film Osmolarity: Determination of a Referent for Dry Eye Diagnosis

2006-09-26

Alan Tomlinson , Santosh Khanal , Kanna Ramaesh +2 more

To determine new referents, or cutoff levels for tear film hyperosmolarity in the diagnosis of keratoconjunctivitis sicca (KCS) and to assess their effectiveness in independent patient groups.A meta-analysis was performed … To determine new referents, or cutoff levels for tear film hyperosmolarity in the diagnosis of keratoconjunctivitis sicca (KCS) and to assess their effectiveness in independent patient groups.A meta-analysis was performed on published data for tear osmolarity in samples of normal eyes and various subtypes of dry eye, and pooled estimates of the mean and standard deviations for normal and (all) dry eye subjects were determined. Diagnostic referents were derived from the intercept between the distributions of osmolarity in the two samples and from receiver operator characteristic (ROC) curves. This referent was tested for effectiveness of diagnosis in independent groups with normal and dry eyes.An osmolarity referent of 315.6 mOsmol/L was derived from the intercept of the distribution curves, and 316 mOsmol/L from the ROC curve. When applied to independent groups of normal and dry eye subjects a value of 316 mOsmol/L was found to yield sensitivity of 59%, specificity of 94%, and an overall predictive accuracy of 89% for the diagnosis of dry eye syndrome.Tear hyperosmolarity, defined by a referent of 316 mOsmol/L, was superior in overall accuracy to any other single test for dry eye diagnosis (Lactoplate, Schirmer test, and Rose Bengal staining), even when the other test measures were applied to a diagnosis within the sample groups from which they were derived. For overall accuracy in the diagnosis of dry eye, the osmolarity test was found to be comparable with the results of combined (in parallel or series) tests.

Altered cytokine balance in the tear fluid and conjunctiva of patients with Sjögren's syndrome keratoconjunctivitis sicca

1999-01-01

Stephen C. Pflugfelder , David Jones , Zhonghua Ji +2 more

PURPOSE. To compare epidermal growth factor (EGF) concentration in tear fluid and levels of inflammatory cytokines in the conjunctival epithelium of patients with Sjögren's syndrome keratoconjunctivitis sicca with those of … PURPOSE. To compare epidermal growth factor (EGF) concentration in tear fluid and levels of inflammatory cytokines in the conjunctival epithelium of patients with Sjögren's syndrome keratoconjunctivitis sicca with those of normal controls. METHODS. Schirmer 1 tear testing, corneal fluorescein staining and conjunctival impression cytology for quantitation of goblet cell density were performed in ten patients with Sjögren's syndrome-associated keratoconjunctivitis sicca and ten asymptomatic normal controls. ELISA was used to detect the concentration of EGF in tear fluid and interleukin 6 in lysates of conjunctival cytology specimens obtained from all subjects. The levels of RNA transcripts encoding inflammatory cytokines [interleukin 1a_(IL-1a), interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factor a_(TNF-a), and transforming growth factor ß1 (TGF-ß1)] as well as a housekeeping gene (G3PDH) were evaluated in conjunctival cytology specimens taken from all subjects by semiquantitative competitive reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS. Decreased tear fluid EGF concentration was noted in Sjögren's syndrome patients (mean 0.68 ± 0.59 ng/ml) compared to controls (mean 1.66 ± 0.45 ng/ml, P = 0.004). Significantly increased levels of IL-1a, IL-6, IL-8, TNF-a and TGF-ß1 RNA transcripts were found in the conjunctival epithelium of Sjögren's syndrome patients compared to controls (P < 0.05), while the level of G3PDH was similar in both groups. The concentration of IL-6 protein was significantly higher in Sjögren's syndrome conjunctiva samples (P = 0.012). Tear EGF concentration correlated with Schirmer 1 scores (rho 0.767, P < 0.001), corneal fluorescein staining scores (rho -0.562, P = 0.01), conjunctival goblet cell density (rho 0.661, P = 0.001) and the levels of IL-1a_and IL-8 RNA in the conjunctival epithelium (rho -0.677 and -0.747, respectively, P = 0.001). Both IL-1a_and IL-8 RNA in the conjunctival epithelium increased as Schirmer 1 scores decreased (P = 0.001). IL-8 RNA level correlated with corneal fluorescein staining (rho 0.690, P = 0.001) and conjunctival goblet cell density (rho -0.767, P < 0.001). A significant decrease in IL-8 RNA level, corresponding to improvement in irritation symptoms and ocular surface disease, was observed in six eyes after two weeks of topical corticosteroid therapy. CONCLUSIONS. The balance of cytokines in the tear fluid and conjunctival epithelium is altered in Sjögren's syndrome. The severity of keratoconjunctivitis sicca in this condition increases as tear fluid EGF concentration decreases and levels of inflammatory cytokines in the conjunctival epithelium increase. These findings provide new insight into the pathogenesis of keratoconjunctivitis and provide potential targets for therapy.

Prevalence of Ocular Surface Disease in Glaucoma Patients

2008-08-01

Eamon W. Leung , Felipe A. Medeiros , Robert N. Weinreb

To examine the prevalence of ocular surface disease (OSD) in glaucoma patients.This was a cross-sectional study. One hundred and one patients, 18 years of age or older, with open-angle glaucoma … To examine the prevalence of ocular surface disease (OSD) in glaucoma patients.This was a cross-sectional study. One hundred and one patients, 18 years of age or older, with open-angle glaucoma or ocular hypertension were consecutively recruited for the study. Patients with a history of use of cyclosporine, steroids, topical ocular nonsteroidal anti-inflammatory drugs, or punctal plugs within the last 3 months were excluded. Each patient completed an Ocular Surface Disease Index questionnaire and underwent evaluation by Schirmer test, corneal and conjunctival lissamine green staining, and tear break-up time.Using Ocular Surface Disease Index for measuring symptoms of dry eye, 60 (59%) patients reported symptoms in at least 1 eye. Severe symptoms were reported by 27 (27%) patients. Schirmer testing showed 62 (61%) patients with decrease in tear production in at least 1 eye. Severe tear deficiency was presented in 35 (35%) patients. Corneal and conjunctival lissamine green staining showed positive results in 22 (22%) patients. None had severe staining. Tear break-up time showed abnormal tear quality in 79 (78%) patients and severe decrease in tear quality was found in at least 1 eye in 66 (65%) patients. Multivariate logistic regression models were used to investigate the association between the number of benzalkonium chloride (BAK)-containing eyedrops and results on the clinical tests of OSD. After adjustment for age and sex, each additional BAK-containing eyedrop was associated with an approximately 2 times higher odds of showing abnormal results on the lissamine green staining test (odds ratio=2.03; 95% confidence interval: 1.06 to 3.89; P=0.034).A large proportion of patients with open-angle glaucoma or ocular hypertension had signs and/or symptoms of OSD in at least 1 eye. The coexistence of OSD and the use of BAK-containing medications may impact vision-related quality of life in this patient population.

The International Workshop on Meibomian Gland Dysfunction: Report of the Subcommittee on Management and Treatment of Meibomian Gland Dysfunction

2011-03-30

Gerd Geerling , Joseph Tauber , Christophe Baudouin +6 more

The goals of the subcommittee were to review the current practice and published evidence of medical and surgical treatment options for meibomian gland dysfunction (MGD) and to identify areas with … The goals of the subcommittee were to review the current practice and published evidence of medical and surgical treatment options for meibomian gland dysfunction (MGD) and to identify areas with conflicting, or lack of, evidence, observations, concepts, or even mechanisms where further research is required. To achieve these goals, a comprehensive review of clinical textbooks and the scientific literature was performed and the quality of published evidence graded according to an agreed on standard, using objective criteria for clinical and basic research studies adapted from the American Academy of Ophthalmology Practice Guidelines1 (Table 1). It should be noted that, in many of the clinical textbooks and previous reports, terminology is often interchanged and the management of anterior and posterior blepharitis and/or meibomitis is often considered concurrently. Thus, a broad scope of documents was reviewed in this process. Consistency in terminology and global adoption of the term “meibomian gland dysfunction” would significantly aid clinical research and clinical care in MGD going forward. Table 1. Grading Level of Evidence of Clinical and Basic Research Studies1

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The role of the lacrimal functional unit in the pathophysiology of dry eye

2003-11-20

Michael E. Stern , Jianping Gao , Karyn F. Siemasko +2 more

Tear Osmolarity in the Diagnosis and Management of Dry Eye Disease

2011-02-19

Michael A. Lemp , Anthony J. Bron , Christophe Baudouin +6 more

Prevalence of Dry Eye Among the Elderly

1997-12-01

Oliver D. Schein , Beatriz Muñoz , James M. Tielsch +2 more

To study the demographics and estimate the prevalence of dry eye among elderly Americans.A population-based prevalence study was performed in 2,520 residents of Salisbury, Maryland, aged 65 years and older … To study the demographics and estimate the prevalence of dry eye among elderly Americans.A population-based prevalence study was performed in 2,520 residents of Salisbury, Maryland, aged 65 years and older as of September 1993. The population was derived from the Health Care Financing Administration Medicare database. After completing a standardized questionnaire pertaining to dry eye symptoms, 2,420 subjects underwent Schirmer and rose bengal tests and anatomic assessment of the meibomian glands.In this population, 14.6% (363/2,482) were symptomatic, defined as reporting one or more dry eye symptoms often or all the time; 2.2% (53/2,448) were symptomatic and had a low Schirmer test result (< or = 5 mm), and 2% (48/2,432) were symptomatic and had a high rose bengal test score (> or = 5). Furthermore, 3.5% (84/2,425) were symptomatic and had either a low Schirmer score or a high rose bengal score, and 0.7% (17/2,420) were symptomatic and had both a low Schirmer score and a high rose bengal score. No association of symptoms or signs was seen with age, sex, or race. Although anatomic features of meibomianitis were associated with the presence of symptoms (P = .01), 76% (67/88) of the individuals with these anatomic features were asymptomatic; 10.5% (260/2,480) reported that they currently use artificial tears or lubricants.Symptoms and signs of dry eye are common among the elderly but were not associated with age, race, or sex in this population-based sample of elderly Americans. Extrapolating to the United States population aged 65 to 84 years, the study yields an estimate of 4.3 million who experience symptoms of ocular irritation often or all the time.

Noncontact Infrared Meibography to Document Age-Related Changes of the Meibomian Glands in a Normal Population

2008-04-30

Reiko Arita , Kouzo Itoh , Kenji Inoue +1 more

The Pathology of Dry Eye

1998-11-01

Michael E. Stern , Roger W. Beuerman , Robert I. Fox +3 more

Background Most dry-eye symptoms result from an abnormal, nonlubricative ocular surface that increases shear forces under the eyelids and diminishes the ability of the ocular surface to respond to environmental … Background Most dry-eye symptoms result from an abnormal, nonlubricative ocular surface that increases shear forces under the eyelids and diminishes the ability of the ocular surface to respond to environmental challenges. This ocular-surface dysfunction may result from immunocompromise due to systemic autoimmune disease or may occur locally from a decrease in systemic androgen support to the lacrimal gland as seen in aging, most frequently in the menopausal female. Hypothesis Components of the ocular surface (cornea, conjunctiva, accessory lacrimal glands, and meibomian glands), the main lacrimal gland, and interconnecting innervation act as a functional unit. When one portion is compromised, normal lacrimal support of the ocular surface is impaired. Resulting immune-based inflammation can lead to lacrimal gland and neural dysfunction. This progression yields the OS symptoms associated with dry eye. Therapy Restoration of lacrimal function involves resolution of lymphocytic activation and inflammation. This has been demonstrated in the MRL/lpr mouse using systemic androgens or cyclosporine and in the dry-eye dog using topical cyclosporine. The efficacy of cyclosporine may be due to its immunomodulatory and antiinflammatory (phosphatase inhibitory capability) functions on the ocular surface, resulting in a normalization of nerve traffic. Conclusion Although the etiologies of dry eye are varied, common to all ocular-surface disease is an underlying cytokine/receptor-mediated inflammatory process. By treating this process, it may be possible to normalize the ocular surface/lacrimal neural reflex and facilitate ocular surface healing.

Prevalence of dry eye syndrome among US women

2003-07-31

Debra A. Schaumberg , David A. Sullivan , Julie E. Buring +1 more

The International Workshop on Meibomian Gland Dysfunction: Report of the Subcommittee on the Epidemiology of, and Associated Risk Factors for, MGD

2011-03-30

Debra A. Schaumberg , Jason J. Nichols , Eric Papas +3 more

Scientists have been interested in studying the secretions of the meibomian glands for many years, 1– 8 and diseases associated with the meibomian glands (e.g., cancers, posterior blepharitis) have been … Scientists have been interested in studying the secretions of the meibomian glands for many years, 1– 8 and diseases associated with the meibomian glands (e.g., cancers, posterior blepharitis) have been noted in the medical literature since at least the early part of the 20th Century. 9 –13 However, the term “meibomian gland dysfunction” (MGD) was only introduced by Korb and Henriquez in 1980. 14 The terminology “meibomian gland disease” was later introduced by Bron et al. 15 as an umbrella term to indicate any disease affecting the meibomian glands (see Definition and Classification). Although the etiology of MGD may differ from that of aqueous-deficient dry eye disease (which is due to insufficient lacrimal gland production), the two conditions share many clinical features, including symptoms of ocular surface irritation and visual fluctuation, altered tear film stability, and potential ocular surface compromise. When MGD is of sufficient degree, it may give rise to the second major subtype of dry eye disease, evaporative dry eye. 16 These subtypes are not mutually exclusive, as has been acknowledged. 16

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Prevalence of dry eye among an elderly Chinese population in Taiwan

2003-06-01

Pei-Yu Lin , Su-Ying Tsai , Ching‐Yu Cheng +3 more

Tear physiology and dry eyes

1977-09-01

Frank J. Holly , Michael A. Lemp

Corneal nerves: structure, contents and function

2003-04-23

Linda Müller , Carl F. Marfurt , Friedrich E. Kruse +1 more

The Lack of Association Between Signs and Symptoms in Patients With Dry Eye Disease

2004-10-21

Kelly K. Nichols , Jason J. Nichols , MS MPH +1 more

The purpose of this report was to examine the relation between clinical tests and dry eye symptoms in patients with dry eye disease.Seventy-five patients with dry eye disease (ICD-9 code … The purpose of this report was to examine the relation between clinical tests and dry eye symptoms in patients with dry eye disease.Seventy-five patients with dry eye disease (ICD-9 code 375.15) were included in these analyses. There was no specific entry criterion for enrollment in addition to a previous dry eye diagnosis in this clinic-based sample. Patients represented varying types and severity of dry eye disease and were previously diagnosed by clinic attending doctors in this university clinic setting. The study examination included a symptom interview that assessed dryness, grittiness, soreness, redness, and ocular fatigue. The interview was followed by a clinical dry eye examination conducted in the following sequence: meibomian gland assessment, tear meniscus height, tear breakup time test, fluorescein staining, the phenol red thread test, Schirmer test, and rose bengal staining. Partial Spearman correlation coefficients, the Wilcoxon rank sum test, chi 2 test, and multivariate logistic regression were used to evaluate the relationship between dry eye tests and symptoms.Symptoms were generally not associated with clinical signs in patients with dry eye disease. There were no significant correlations between signs and symptoms after adjustment for age and artificial tear use. The rank of each clinical test result did not statistically differ when stratified by the presence of patient symptoms in Wilcoxon rank sum analyses. Likewise, the frequency of patient symptoms did not differ statistically when stratified by a positive clinical test result in chi 2 analyses. In multivariate logistic regression analyses, no clinical test significantly predicted frequently reported symptoms after adjustment for age and artificial tear use.These results suggest a poor relation between dry eye tests and symptoms, which represents a quandary in dry eye clinical research and practice.

Grading Of Corneal and Conjunctival Staining in the Context of Other Dry Eye Tests

2003-09-26

Anthony J. Bron , Vicki Evans , Janine A. Smith

Purpose To describe the Oxford Scheme for grading ocular surface staining in dry eye and to discuss optimization of stain detection using various dyes and filters. Also, to propose a … Purpose To describe the Oxford Scheme for grading ocular surface staining in dry eye and to discuss optimization of stain detection using various dyes and filters. Also, to propose a sequence of testing for dry eye diagnosis. Methods The grading of corneal and conjunctival staining is described, using the Oxford Scheme, including biomicroscopy, optical filters, illumination conditions, and the characteristics of and instillation techniques used for, selected clinical dyes. Results A series of panels, labeled A–E, in order of increasing severity, reproducing the staining patterns encountered in dry eye, are used as a guide to grade the degree of staining seen in the patient. The amount of staining seen in each panel, represented by punctate dots, increases by 0.5 of the log of the number of dots between panels B to E. The use of the vital dyes fluorescein, lissamine green, and rose Bengal is described; fluorescein and lissamine green, used in conjunction with appropriate absorption filters, are recommended for use in clinical trials. The placement of staining in relation to the sequence of other diagnostic tests is discussed. Conclusions The monitoring and assessment of corneal and conjunctival staining can be greatly enhanced by the use of a grading scale, controlled instillation of dyes, and standard evaluation techniques. This is of particular benefit in clinical trials, where ocular surface staining is commonly employed as an outcome measure

Highly stretchable and tough hydrogels

2012-09-01

Jeong‐Yun Sun , Xuanhe Zhao , Widusha R. K. Illeperuma +5 more

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Prestimulus Effects on Human Startle Reflex in Normals and Schizophrenics

1978-07-01

David Braff , C. Stone , Enoch Callaway +3 more

ABSTRACT Graham (1975) demonstrated that a weak prestimulus could effectively inhibit or facilitate the eyeblink component of the startle reflex in humans, depending on the temporal duration of the prestimulus. … ABSTRACT Graham (1975) demonstrated that a weak prestimulus could effectively inhibit or facilitate the eyeblink component of the startle reflex in humans, depending on the temporal duration of the prestimulus. This study had three goals: 1) to replicate the findings of Graham, 2) to establish the reliability of this phenomenon by a test‐retest comparison, and 3) to compare the eyeblink reflex response of normal subjects with schizophrenic subjects. Seven prestimulus durations of continuous tone (from 0 to 2000 msec) were presented to 20 normal subjects and the results confirmed that maximal inhibition of eyeblink amplitude occurred in the 120 msec prestimulus condition. Increased amplitude occurred nonsignificantly when the prestimulus lasted for 2000 msec. On retest, 14 normal subjects showed a significant degree of reliability. When 20 normal subjects were compared to 12 schizophrenic subjects, significant differences in eyeblink response were found for blink amplitude and latency in the 60 msec prestimulus condition. This change is consistent with information processing “overload” theories of sensory overstimulation in schizophrenia. The blink reflex is a rather stable phenomenon and is probably altered in schizophrenia and/or by antipsychotic medication.

A cascade of cytokines mediates mechanical inflammatory hypernociception in mice

2005-01-21

Thiago M. Cunha , Waldiceu A. Verri , João S. Silva +3 more

The hypernociceptive effects of cytokines [TNF-alpha, keratinocyte-derived chemokine (KC), and IL-1beta] and their participation in carrageenan (Cg)-induced inflammatory hypernociception in mice were investigated. Nociceptor sensitization (hypernociception) was quantified with an … The hypernociceptive effects of cytokines [TNF-alpha, keratinocyte-derived chemokine (KC), and IL-1beta] and their participation in carrageenan (Cg)-induced inflammatory hypernociception in mice were investigated. Nociceptor sensitization (hypernociception) was quantified with an electronic version of the von Frey filament test in WT and TNF receptor type 1 knockout mice (TNF-R1-/-). TNF-alpha-induced hypernociception was abolished in TNF-R1-/- mice, partially inhibited by pretreatment with IL-1 receptor antagonist (IL-1ra) or indomethacin and unaffected by Ab against KC (AbKC) or guanethidine. IL-1ra and indomethacin pretreatment strongly inhibited the hypernociception induced by IL-1beta, which was not altered by AbKC or guanethidine or by knocking out TNF-R1. KC-induced hypernociception was abolished by AbKC, inhibited by pretreatment with indomethacin plus guanethidine, and partially inhibited by IL-1ra, indomethacin, or guanethidine. In contrast, KC-induced hypernociception was not altered by knocking out TNF-R1. Cg-induced hypernociception was abolished by administration of indomethacin plus guanethidine, diminished in TNF-R1-/- mice, and partially inhibited in WT mice pretreated with AbKC, IL-1ra, indomethacin, or guanethidine. TNF-alpha, KC, and IL-1beta concentrations were elevated in the skin of Cg-injected paws. The TNF-alpha and KC concentrations rose concomitantly and peaked before that of IL-1beta. In mice, the cytokine cascade begins with the release of TNF-alpha (acting on TNF-R1 receptor) and KC, which stimulate the release of IL-1beta. As in rats, the final mediators of this cascade were prostaglandins released by IL-1beta and sympathetic amines released by KC. These results extend to mice the concept that the release of primary mediators responsible for hypernociception is preceded by a cascade of cytokines.

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Preservatives in eyedrops: The good, the bad and the ugly

2010-03-18

Christophe Baudouin , Antoine Labbé , Hong Liang +2 more

Impact of Dry Eye Syndrome on Vision-Related Quality of Life

2007-01-04

Biljana Miljanović , Reza Dana , David A. Sullivan +1 more

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Functional aspects of the tear film lipid layer

2003-11-24

Anthony J. Bron , John M. Tiffany , Scott M. Gouveia +2 more

Evaluation of Subjective Assessments and Objective Diagnostic Tests for Diagnosing Tear-Film Disorders Known to Cause Ocular Irritation

1998-01-01

Stephen C. Pflugfelder , Scheffer C.G. Tseng , Olga Sanabria +5 more

Purpose To determine which subjective assessments and objective tests have clinical utility as diagnostic tools in ocular irritation associated with Sjögren's syndrome—related aqueous tear deficiency (ATD), non-Sjögren ATD, inflammatory meibomian … Purpose To determine which subjective assessments and objective tests have clinical utility as diagnostic tools in ocular irritation associated with Sjögren's syndrome—related aqueous tear deficiency (ATD), non-Sjögren ATD, inflammatory meibomian gland disease (MGD) associated with rosacea, and atrophic MGD. Methods Forty adults with ocular irritation and 10 with normal ocular surfaces were enrolled in a nonrandomized, nonblinded clinical trial. Symptoms were evaluated. Tests included biomicroscopy; evaluation of tear-film integrity, production, and clearance; fluorescein and rose bengal staining; and serum autoantibody screening. Results Symptoms were similar among groups and most severe in the Sjögren's group. Fluorescein tear break-up time was significantly faster in the ATD and MGD groups than that in controls. Schirmer scores were significantly lower in the ATD group than those in MGD and control groups. Tear clearance was delayed in the ATD and atrophic MGD groups. Xeroscope grid distortion was noted only with ATD. The Sjögren's group had greater loss of nasolacrimal reflex, slower fluorescein clearance, and greater ocular-surface fluorescein and rose bengal staining than did the others. More MGD subjects had meibomian gland orifice metaplasia and acinar dropout than did those with Sjögren-related ATD and controls. Schirmer scores correlated inversely with rose bengal staining, corneal fluorescein staining, and grid distortion. Rose bengal staining correlated with grid distortion and loss of nasal—lacrimal reflex, but not with MGD. Conclusion Subjective assessments and objective diagnostic tests have clinical utility as diagnostic tools in tear-film disorders. ATD is correlated with ocular-surface disease. An algorithm summarizing the diagnostic utility of these tests is included.

The Incidence of Contact Lens–Related Microbial Keratitis in Australia

2008-06-06

Fiona Stapleton , Lisa Keay , Katie Edwards +4 more

Reliability and Validity of the Ocular Surface Disease Index

2000-05-01

Rhett M. Schiffman

<h3>Objective</h3> To evaluate the validity and reliability of the Ocular Surface Disease Index (OSDI) questionnaire. <h3>Methods</h3> Participants (109 patients with dry eye and 30 normal controls) completed the OSDI, the … <h3>Objective</h3> To evaluate the validity and reliability of the Ocular Surface Disease Index (OSDI) questionnaire. <h3>Methods</h3> Participants (109 patients with dry eye and 30 normal controls) completed the OSDI, the National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25), the McMonnies Dry Eye Questionnaire, the Short Form-12 (SF-12) Health Status Questionnaire, and an ophthalmic examination including Schirmer tests, tear breakup time, and fluorescein and lissamine green staining. <h3>Results</h3> Factor analysis identified 3 subscales of the OSDI: vision-related function, ocular symptoms, and environmental triggers. Reliability (measured by Cronbach α) ranged from good to excellent for the overall instrument and each subscale, and test-retest reliability was good to excellent. The OSDI was valid, effectively discriminating between normal, mild to moderate, and severe dry eye disease as defined by both physician's assessment and a composite disease severity score. The OSDI also correlated significantly with the McMonnies questionnaire, the National Eye Institute Visual Functioning Questionnaire, the physical component summary score of the Short Form-12, patient perception of symptoms, and artificial tear usage. <h3>Conclusions</h3> The OSDI is a valid and reliable instrument for measuring the severity of dry eye disease, and it possesses the necessary psychometric properties to be used as an end point in clinical trials.

Experimental Dry Eye Stimulates Production of Inflammatory Cytokines and MMP-9 and Activates MAPK Signaling Pathways on the Ocular Surface

2004-11-22

Lihui Luo , De‐Quan Li , Amish Doshi +3 more

To evaluate whether experimentally induced dry eye in mice activates mitogen-activated protein kinase (MAPK) signaling pathways, c-Jun N-terminal kinases (JNK), extracellular-regulated kinases (ERK), and p38 and stimulates ocular surface inflammation.129SvEv/CD-1 … To evaluate whether experimentally induced dry eye in mice activates mitogen-activated protein kinase (MAPK) signaling pathways, c-Jun N-terminal kinases (JNK), extracellular-regulated kinases (ERK), and p38 and stimulates ocular surface inflammation.129SvEv/CD-1 mixed mice aged 6 to 8 weeks were treated with systemic scopolamine and exposure to an air draft for different lengths of time, from 4 hours to 10 days. Untreated mice were used as the control. The concentrations of IL-1beta and TNF-alpha in tear fluid washings and in corneal and conjunctival epithelia were measured by ELISA. MMP-9 in tear washings was evaluated by zymography, and gelatinase activity in the cornea and conjunctiva was determined by in situ zymography. Corneal and conjunctival epithelia were lysed in RIPA buffer for Western blot with MAPK antibodies, or they were lysed in 4 M guanidium thiocyanate solution for extraction of total RNA, which was used to determine gene expression by semiquantitative RT-PCR, real-time PCR, and gene array.Compared with those in age-matched control subjects, the concentrations of IL-1beta and MMP-9 in tear fluid washings and the concentrations of IL-1beta and TNF-alpha and gelatinolytic activity in the corneal and conjunctival epithelia were significantly increased in mice receiving treatments to induce dry eye after 5 or 10 days. The expression of IL-1beta, TNF-alpha, and MMP-9 mRNA by the corneal and conjunctival epithelia was also stimulated in mice treated for 5 or 10 days. The levels of phosphorylated JNK1/2, ERK1/2, and p38 MAPKs in the corneal and conjunctival epithelia were markedly increased as early as 4 hours after treatment, and they remained elevated up to 5 days.Experimental dry eye stimulates expression and production of IL-1beta, TNF-alpha, and MMP-9 and activates MAPK signaling pathways on the ocular surface. MAPKs are known to stimulate the production of inflammatory cytokines and MMPs, and they could play an important role in the induction of these factors that have been implicated in the pathogenesis of dry eye disease.

Prevalence of and Risk Factors for Dry Eye Syndrome

2000-09-01

Scot E. Moss

<h3>Objective</h3> To examine risk factors for the prevalence of dry eye syndrome in a population-based cohort. <h3>Methods</h3> The prevalence of dry eye was determined by history at the second examination … <h3>Objective</h3> To examine risk factors for the prevalence of dry eye syndrome in a population-based cohort. <h3>Methods</h3> The prevalence of dry eye was determined by history at the second examination (1993-1995) of the Beaver Dam Eye Study cohort (N = 3722). <h3>Results</h3> The cohort was aged 48 to 91 years (mean ± SD, 65 ± 10 years) and 43% male. The overall prevalence of dry eye was 14.4%. Prevalence varied from 8.4% in subjects younger than 60 years to 19.0% in those older than 80 years (<i>P</i><.001 for test of trend). Age-adjusted prevalence in men was 11.4% compared with 16.7% in women (<i>P</i><.001). After controlling for age and sex, the following factors were independently and significantly associated with dry eye in a logistic model: history of arthritis (odds ratio [OR], 1.91; 95% confidence interval [CI], 1.56-2.33), smoking status (past, OR, 1.22; 95% CI, 0.97-1.52; current, OR, 1.82; 95% CI, 1.36-2.46), caffeine use (OR, 0.75; 95% CI, 0.61-0.91), history of thyroid disease (OR, 1.41; 95% CI, 1.09-1.84), history of gout (OR, 1.42; 95% CI, 1.02-1.96), total to high-density lipoprotein cholesterol ratio (OR, for 1 unit, 0.93; 95% CI, 0.88-0.99), diabetes (OR, 1.38; 95% CI, 1.03-1.86), and multivitamin use (past, OR, 1.35; 95% CI, 1.01-1.81; current, OR, 1.41; 95% CI, 1.09-1.82). Nonsignificant variables included body mass; blood pressure; white blood cell count; hematocrit; history of osteoporosis, stroke, or cardiovascular disease; history of allergies; use of antihistamines, parasympathetics, antidepressants, diuretics, antiemetics, or other drying drugs; alcohol consumption; time spent outdoors; maculopathy; central cataract; and lens surgery. <h3>Conclusion</h3> The results suggest several factors, such as smoking, caffeine use, and multivitamin use, could be studied for preventive or therapeutic efficacy.

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The International Workshop on Meibomian Gland Dysfunction: Report of the Subcommittee on Anatomy, Physiology, and Pathophysiology of the Meibomian Gland

2011-03-30

Erich Knop , Nadja Knop , T. J. Millar +2 more

T he tarsal glands of Meibom (glandulae tarsales) are large sebaceous glands located in the eyelids and, unlike those of the skin, are unassociated with hairs.According to Duke-Elder and Wyler, … T he tarsal glands of Meibom (glandulae tarsales) are large sebaceous glands located in the eyelids and, unlike those of the skin, are unassociated with hairs.According to Duke-Elder and Wyler, 1 they were first mentioned by Galenus in 200 AD and later, in 1666, they were described in more detail by the German physician and anatomist Heinrich Meibom, after whom they are named.Lipids produced by the meibomian glands are the main component of the superficial lipid layer of the tear film that protects it against evaporation of the aqueous phase and is believed also to stabilize the tear film by lowering surface tension. 2 Hence, meibomian lipids are essential for the maintenance of ocular surface health and integrity.Although they share certain principal characteristics with ordinary sebaceous glands, they have several distinct differences in anatomy, location, secretory regulation, composition of their secretory product, and function.Functional disorders of the meibomian glands, referred to today as meibomian gland dysfunction (MGD), 3 are increasingly recognized as a discrete disease entity. 4 -8 In patients with dry eye disease, alterations in the lipid phase that point to MGD are reportedly more frequent than isolated alterations in the aqueous phase.In a study by Heiligenhaus et al., 9 a lipid deficiency occurred in 76.7% of dry eye patients compared with only 11.1% of those with isolated alterations of the aqueous phase.This result is in line with the observations by Shimazaki et al. 10 of a prevalence of MGD in the absolute majority of eyes with ocular discomfort defined as dry eye symptoms.These observations noted that 64.6% of all such eyes and 74.5% of those excluding a deficiency of aqueous tear secretion were found to have obstructive MGD, or a loss of glandular tissue, or both. 10Horwath-Winter et al. 11 reported MGD in 78% of dry eye patients or, if only non-Sjo ¨gren patients are considered, in 87% compared with 13% with isolated aque-ous tear deficiency.It may thus be accepted that MGD is important, conceivably underestimated, and possibly the most frequent cause of dry eye disease due to increased evaporation of the aqueous tears. 5,9 -12 After some excellent reviews of MGD 4,7,8,13,14 in the past, many new findings have been reported in recent years, and other questions remain to be identified and resolved.A sound understanding of meibomian gland structure and function and its role in the functional anatomy of the ocular surface 15 is needed, to understand the contribution of the meibomian glands to dysfunction and disease.Herein, we seek to provide a comprehensive review of physiological and pathophysiological aspects of the meibomian glands. HEINRICH MEIBOMHeinrich Meibom the younger (1638 -1700; Fig. 1) 16 came from a scholarly family.He was the son of the physician Johann Heinrich Meibom and the grandson of the German historian and poet Heinrich Meibom the elder (1555-1625), 17 who was professor of history and poetry at the University of Helmstedt in Germany.Heinrich Meibom the younger was born on June 29, 1638, in Lu ¨beck, Germany, and later traveled around in Europe and received a cosmopolitan education.In a short article 18 that commemorated the 300th anniversary of his birth in 1938, the British Medical Journal characterized him as follows: "Like so many of his contemporaries, he was indeed a child of Apollo, god of culture, poetry, rhetoric, and healing.While still a medical student (he became MD at Angers in 1663) he was appointed to, and in 1664 took up, the professorship of medicine in the University of Helmstadt.Fourteen years later he accepted the additional chairs of history and of poetry.He further showed his versatility by straying into the pleasant fields of archaeology, philology, and philosophy, and all his life he was an insatiate traveller."Apparently a man of many talents, in 1666, shortly after receiving the chair of medicine, Heinrich Meibom published the first detailed description, including a drawing, of the oil glands inside the tarsus of the eyelid, that later were named the meibomian glands.His description appeared as a book with the title De Vasis Palpebrarum Novis Epistola. 19This early drawing showed basic characteristics of the glands, such as multiple single gland streaks along the extension of the tarsus with openings onto the lid margin, similar to but not as detailed as another much later and more well-known drawing (Fig. 2).

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The International Workshop on Meibomian Gland Dysfunction: Report of the Definition and Classification Subcommittee

2011-03-30

J. Daniel Nelson , Jun Shimazaki , Jose Benitez-del-Castillo +4 more

Recommended definition of MGD: Meibomian gland dysfunction (MGD) is a chronic, diffuse abnormality of the meibomian glands, commonly characterized by terminal duct obstruction and/or qualitative/quantitative changes in the glandular secretion. … Recommended definition of MGD: Meibomian gland dysfunction (MGD) is a chronic, diffuse abnormality of the meibomian glands, commonly characterized by terminal duct obstruction and/or qualitative/quantitative changes in the glandular secretion. This may result in alteration of the tear film, symptoms of eye irritation, clinically apparent inflammation, and ocular surface disease. Previous definitions and criteria of MGD: There is no firmly established definition of MGD published in the literature. Most researchers have used a criterion-based approach to describe the condition, with combinations of objective findings and measurements. Anatomic changes of the lid margin, expressibility of meibomian lipids, gland dropout by meibography, evaporimetry, and meibometry are most commonly used (Table 1). Table 1. Criteria of Meibomian Gland Dysfunction Used in Previous Works

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The Pathophysiology, Diagnosis, and Treatment of Dry Eye Disease

2015-01-30

Elisabeth M. Messmer

Dry eye disease (DED) is common; its prevalence around the world varies from 5% to 34%. Its putative pathogenetic mechanisms include hyperosmolarity of the tear film and inflammation of the … Dry eye disease (DED) is common; its prevalence around the world varies from 5% to 34%. Its putative pathogenetic mechanisms include hyperosmolarity of the tear film and inflammation of the ocular surface and lacrimal gland. Dry eye is clinically subdivided into two subtypes: one with decreased tear secretion (aqueous-deficient DED), and one with increased tear evaporation (hyperevaporative DED).This review is based on pertinent publications retrieved by a selective PubMed search and on the authors' own clinical and scientific experience.The diagnostic evaluation of dry eye disease should include a detailed patient history, thorough split-lamp examination, and additional tests as indicated. Few randomized controlled therapeutic trials for dry eye have been published to date. Artificial tears of various kinds are recommended if the symptoms are mild. Lid hygiene is helpful in the treatment of hyperevaporative dry eye, while collagen or silicon plugs can be used for partial occlusion of the efferent lacrimal ducts to treat severe hyposecretory dry eye. The benefit of long-term topical anti-inflammatory treatment of moderate or severe dry eye disease with corticosteroids or cyclosporine A eye drops has been documented in clinical trials on a high evidence level. Orally administered tetraycycline derivatives and omega-3 or omega-6 fatty acids are also used.The treatment of dry eye has evolved from tear substitution alone to a rationally based therapeutic algorithm. Current research focuses on pathophysiology, new diagnostic techniques, and novel therapies including secretagogues, topical androgens, and new anti- inflammatory drugs.

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The Epidemiology of Dry Eye Disease: Report of the Epidemiology Subcommittee of the International Dry Eye WorkShop (2007)

2007-04-01

The Definition and Classification of Dry Eye Disease: Report of the Definition and Classification Subcommittee of the International Dry Eye Workshop (2007)

2007-04-01

Methodologies to Diagnose and Monitor Dry Eye Disease: Report of the Diagnostic Methodology Subcommittee of the International Dry Eye WorkShop (2007)

2007-04-01

Management and Therapy of Dry Eye Disease: Report of the Management and Therapy Subcommittee of the International Dry Eye WorkShop (2007)

2007-04-01

TFOS DEWS II pathophysiology report

2017-07-01

Anthony J. Bron , Cintia S. de Paiva , Sunil K. Chauhan +7 more

TFOS DEWS II Tear Film Report

2017-07-01

Mark Willcox , Pablo Argüeso , Georgi Georgiev +7 more

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TFOS DEWS II Definition and Classification Report

2017-07-01

Jennifer P. Craig , Kelly K. Nichols , Esen K. Akpek +7 more

TFOS DEWS II Diagnostic Methodology report

2017-07-01

James S. Wolffsohn , Reiko Arita , Robin L. Chalmers +7 more

TFOS DEWS II Epidemiology Report

2017-07-01

Fiona Stapleton , Mônica Alves , Vatinee Y. Bunya +7 more

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TFOS DEWS II Management and Therapy Report

2017-07-01

Lyndon Jones , Laura E. Downie , Donald R. Korb +7 more

TFOS DEWS II Report Executive Summary

2017-08-08

Jennifer P. Craig , J. Daniel Nelson , Dimitri T. Azar +7 more

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Determination of tear volume and tear flow.

1966-06-01

S Mishima , Antonio R. Gasset , Stephen D. Klyce +1 more

The dynamics of tear flow ivere studied for human subjects using fluorescein as an indicator. A new fluorophotometer attachable to a slit lamp was designed to determine fluorescein concentration of … The dynamics of tear flow ivere studied for human subjects using fluorescein as an indicator. A new fluorophotometer attachable to a slit lamp was designed to determine fluorescein concentration of tears in situ. After the instillation of about 1 id of fluorescein solution (1.0 Gm. L.-) into the cul-de-sac, its concentration in the tears was found to decay in a single exponential pattern. In most cases, the turnover rate teas initially fast and became slower after about flve minutes. The initial faster turnover rate was interpreted as the result of stimulation of lacrimation due to the application of solution, and the subsequent slower decay interpreted as the physiologic turnover. The initial turnover showed individual variation and was lower in older than in younger persons. The physiologic turnover rate was fairly constant among normal subjects, the average being about 16 per cent minr The tear volume in the cul-de-sac ivas measured with two methods. The dilution method consisted of instilling 16.2 fil of fluorescein solution (0.10 Gm. hr) sampling after blinking and determining the dilution ratio. This method was found to be subject to large errors due to lacrimation. The second method involved the construction of a semilog plot of concentration decay after the application of a known amount (about 1 id) of fluorescein solution (1.0 Gm. L.-'), the extrapolation of the decay curve to zero time, and the computation of the tear volume from the zero time concentration. The latter method gave very consistent results. The average tear volume obtained was 7.0 2.0 fj-l, with no significant difference between age groups, sexes, and fellow eyes. This value agreed well with the probable tear volume calculated from anatomical considerations. The combination of the tear volume and turnover rate determinations gave an average tear flow of 1.2 id niinr with a range of 0.5 to 2.2 ixl minr. The tear volume was found to increase with increasing tear flow. Since the tear volume obtained with the zero time method corresponds to an initial faster tear flow, the normal tear volume with a normal tear flow was estimated from the volume-flow relationship; the average normal tear volume was 6.2 2.0 id.

Prevalence and Risk Factors of Dry Eye Syndrome Among Medical Students in the Northern Philippines: A Cross-Sectional Survey

2025-06-25

Mary Arsenia N Mondiguing , Karl Coycoyen , Monique Goygoyan +7 more | Cureus

Introduction Dry eye syndrome (DES) accounts for the majority of ophthalmological consultations and should be considered a high-priority health concern. DES can be progressive and has significant consequences for an … Introduction Dry eye syndrome (DES) accounts for the majority of ophthalmological consultations and should be considered a high-priority health concern. DES can be progressive and has significant consequences for an individual's vision and quality of life. This study aims to fill the information gap regarding the prevalence and risk factors of DES among medical students at Saint Louis University (SLU) in the northern part of the Philippines during the "New Normal" period. Methods A cross-sectional survey was conducted among 236 medical students. The dependent variable, the Ocular Surface Disease Index (OSDI), and independent variables were assessed using a questionnaire created with Google Forms (Google, Inc., Mountain View, CA). The Perceived Stress Scale-4 (PSS-4) was used to determine the level of stress of the students. Descriptive and analytical statistics were used to determine the risk factors associated with the OSDI scores of the participants. Results The prevalence of DES, as determined by the OSDI questionnaire, was 194 out of 236 (82.20%). The mean OSDI score of the cohort was 30.16 ± 6.99, with a 95% confidence level. This study revealed that the factors of sex, error of refraction (EOR), and psychological stress showed significant correlations with the OSDI score, as determined by Chi-square analysis with p-values of 0.013, 0.001, and 0.006, respectively. The female sex and those with errors of refraction (EOR) had a higher risk of developing DES. There is also a direct relationship between psychological stress and DES. The higher the perceived psychological stress, the higher the OSDI score. Psychological stress among the students was at 231/236 (97.87%). Conclusion Dry eye syndrome is increasingly recognized as a significant health issue among young individuals due to the increasingly demanding nature of their lifestyles. This study identified a high prevalence of dry eye syndrome among medical students with female sex, error of refraction, and a high level of perceived stress as the significant risk factors. A longitudinal study involving different medical schools in the country, including clinical tests for DES, is recommended to better elucidate the relationship among the various risk factors. The results of this study serve as a basis for crafting policies to increase awareness, modify risk factors, and implement appropriate preventive measures.

Immunological Impact of Sex Hormones at Ocular Surface: A Narrative Review

2025-06-24

Alessandro Ferraro , Mariateresa Laborante , Francesco Cutrupi +3 more | Seminars in Ophthalmology

Relationship between sex hormones and ocular surface immunity is controversial. Estrogens, androgens, and progesterone, play pivotal roles in modulating immune responses on the ocular surface. Estrogens exhibit dual roles, acting … Relationship between sex hormones and ocular surface immunity is controversial. Estrogens, androgens, and progesterone, play pivotal roles in modulating immune responses on the ocular surface. Estrogens exhibit dual roles, acting as both pro-inflammatory and anti-inflammatory agents depending on their concentration and receptor interaction, while androgens generally demonstrate immunosuppressive effects. Progesterone, though less studied, may have immunomodulatory properties. Despite numerous studies, the exact molecular pathways through which sex hormones regulate ocular immunity are not fully understood, and findings often appear inconsistent. To address these gaps, a comprehensive literature search was conducted across PubMed, Scopus, and Web of Science, focusing on keywords related to sex hormones, immunity, and ocular surface health. The aim is to summarize hormone receptor mechanisms, their influence on immune cell function and production of inflammatory mediators at the ocular surface. Overall, this review highlights the intricate interplay between sex hormones and ocular surface immunity, emphasizing that hormonal balance is essential for maintaining ocular health. A deeper understanding of these mechanisms could drive the development of novel, hormone-based therapeutic strategies for inflammatory ocular disorders, such dry eye disease, meeting an urgent clinical need.

Impact of a Focussed Workshop on Ocular Surface Disorders on the Knowledge and Practice of Attendees Over a Decade

2025-06-24

Jayesh Vazirani , Vikas Mittal | Seminars in Ophthalmology

The Ocular Surface Workshop (OSW) is a sub-specialty meeting focussed on the management of complex ocular surface disorders. This survey aimed to assess the impact of the workshop on the … The Ocular Surface Workshop (OSW) is a sub-specialty meeting focussed on the management of complex ocular surface disorders. This survey aimed to assess the impact of the workshop on the knowledge and practice of attendees over a decade. An online survey was circulated to attendees of past editions of the OSW in February 2025. Survey results were compiled and presented using descriptive statistics, charts and tables. Sixty-seven responses were received within the survey period. Respondents had a median age of 42 years, and included a significant proportion of trainees and young clinicians. Most respondents (64%) attended the workshop multiple times. Attendees improved their knowledge about various complex ocular surface conditions, which positively impacted their practice. Respondents also reported improvements in the availability of good quality care for ocular surface disorders in their practice location. Attendees of the OSW reported significant improvements in their knowledge and impact on their practice after attending the workshop. The workshop serves as a model than can be emulated by other sub-specialty meetings to enhance clinician knowledge and improve access to high quality care for patients.

FGF10 Protects the Corneal Epithelium From Dry Eye-Induced Oxidative and ER Stress Via Upregulation of SLC7A11

2025-06-24

Zhiwei Zha , Juan Li , Shuang Xie +6 more | Investigative Ophthalmology & Visual Science

To investigate the protective effect of fibroblast growth factor 10 (FGF10) on the corneal epithelium in dry eye disease (DED) and reveal the underlying mechanism. DED mouse model was induced … To investigate the protective effect of fibroblast growth factor 10 (FGF10) on the corneal epithelium in dry eye disease (DED) and reveal the underlying mechanism. DED mouse model was induced via scopolamine injections and low-humidity airflow to evaluate the therapeutic effects of FGF10. Mice received topical FGF10 (5, 25, or 125 µg/mL) or vehicle for seven days. Corneal fluorescein staining, oxidative stress (ROS levels), endoplasmic reticulum (ER) stress, and apoptosis were evaluated. To investigate protective mechanisms on corneal epithelium cells, hyperosmolar-stressed HCE-2 cells were treated with 100 ng/mL FGF10, and RNA sequencing was performed. Transcriptomic analysis identified SLC7A11, a key regulator of cellular antioxidant defense, as significantly upregulated by FGF10. SLC7A11's functional importance was validated through siRNA-mediated silencing in HCE-2 cells and AAV-mediated overexpression in mouse model. FGF10 treatment significantly improved corneal epithelial integrity in dry eye mice, reducing fluorescein staining, ROS level, and ER stress markers, while increasing Bcl-2 and decreasing BAX. RNA sequencing revealed that FGF10 stimulated antioxidant signaling pathways and upregulated SLC7A11 expression. FGF10 also increased SLC7A11 protein levels in HCE-2 cells and dry eye corneas. Silencing of SLC7A11 in vitro prevented FGF10-induced reductions in ROS, ER stress, and apoptosis. Furthermore, AAV-mediated overexpression of SLC7A11 in dry eye mice recapitulated the protective effects observed with FGF10 treatment. FGF10 protects mouse corneal epithelium and HCE-2 cells from oxidative stress, ER stress, and apoptosis, partially through SLC7A11 upregulation. The FGF10-SLC7A11 pathway represents a promising therapeutic target in dry eye.

Letter to the editor: efficacy and safety of minor salivary gland transplantation for the treatment of severe dry eye disease a single-arm meta-analysis

2025-06-24

Guandu Li , Xiaoyan Wang , Guangzhen Wu | International Journal of Surgery

Relationship between type 2 diabetes mellitus and changes of the lid margin, meibomian gland and tear film in dry eye patients: a cross-sectional study

2025-06-24

Yiran Hao , Binge Wu , Jun Feng +4 more | International Ophthalmology

To investigate the relationship between type 2 diabetes and changes of the lid margin, meibomian glands and tear film in dry eye patients, to explore the possible pathological mechanism of … To investigate the relationship between type 2 diabetes and changes of the lid margin, meibomian glands and tear film in dry eye patients, to explore the possible pathological mechanism of the effect of type 2 diabetes on the ocular surface of dry eye disease. This cross-sectional study included 302 eyes of 151 patients. Participants were divided into two groups: dry eye disease with type 2 diabetes group (DED-DM group, n = 108) and dry eye disease without diabetes group (DED group, n = 194). All patients underwent morphological and physiological functional evaluation of the ocular surface and a blood glucose level test. Compared with the DED group, the DED-DM group had higher upper lid margin irregularity(P = 0.035), lid margin vascularity(P < 0.0001), plugging of gland orifices grade(P < 0.0001), lid margin thickening grade(upper, P < 0.001; lower, P = 0.002), upper meibomian gland dropout(P = 0.003) and ciliary hyperemia(P = 0.013), and shorter first non-invasive tear breakup time(NIBUT) (P = 0.011). Blood glucose level had a significant correlation with NIBUT(first, P = 0.006; average, P = 0.003), lid margin thickening grade(upper, P = 0.006; lower, P = 0.001), and lower lid margin irregularity (P = 0.016). In patients with type 2 diabetes and dry eye, lid margin abnormalities, orifice plugging and tear film instability was more severe than patients with dry eye only.

Changes in the ocular surface and meibomian glands following administration of 0.01 and 0.02% atropine

2025-06-24

Xueyan Li , Yi Zhu , Huisheng Xie +4 more | Frontiers in Medicine

Purpose To investigate the changes in the ocular surface and meibomian glands following the administration of 0.01 and 0.02% atropine. Setting The Second Affiliated Hospital of Anhui Medical University, Anhui, … Purpose To investigate the changes in the ocular surface and meibomian glands following the administration of 0.01 and 0.02% atropine. Setting The Second Affiliated Hospital of Anhui Medical University, Anhui, China. Methods In this randomized controlled study, the 0.01% group (18 patients, 36 eyes) and the 0.02% group (15 patients, 30 eyes) underwent assessments using the Ocular Surface Disease Index (OSDI), Visual Analogue scale (VAS), tear meniscus height (TMH), first noninvasive tear film breakup time (fNIBUT), and average noninvasive tear film breakup time (avNIBUT) at baseline (before administration) and at 1, 3, 6, and 12 months post-treatment. The meibomian glands of both the upper (U) and lower (L) eyelids were evaluated using Meibomian Gland Bio-image Analyzer, measuring parameters such as average gland diameter (avGD), average gland length (avGL), average gland area (avGA), deformation coefficient (DC), and gland visibility score (VS). Results There were no statistically significant differences in any of the parameters within the 0.01% group (all p &gt; 0.05). In the within-group comparisons of the 0.02% group, OSDI was higher at 3 month ( p = 0.006) and was lower at 12 months ( p = 0.038). VAS was higher at 3 months and 6 months (all p &lt; 0.05). TMH was lower at 12 months (all p &lt; 0.05). U-VS was lower at 3 months ( p = 0.006) and higher at 6 and 12 months (all p &lt; 0.05). L-avGL was higher at 1 month ( p = 0.001) and lower at 6 months ( p = 0.013). L-VS was higher at 6 and 12 months (all p &lt; 0.05). In the 0.02% group, at 3 months, the change in U-VS and L-VS were positively correlated with the change in the VAS (r = 0.542, p = 0.037; r = 0.614, p = 0.015). At 6 months, the change in L-VS was positively correlated with the change in OSDI (r = 0.610, p = 0.016). At 12 months, the change in U-VS was positively correlated with the change in TMH (r = 0.521, p = 0.003). Conclusion 0.01% atropine had no significant impact. 0.02% atropine eye drops affected the lipid secretion of meibomian glands, tear meniscus height and subjective discomfort.

Tear Pharmacokinetics and Systemic Exposure of Dexamethasone Canalicular Inserts in Rabbits

2025-06-24

Mikyung Moon , Jihyun Won , Wonku Kang | Journal of Ocular Pharmacology and Therapeutics

Purpose: A dexamethasone canalicular insert, Dextenza®, has been used to treat anterior inflammation of the eye, including keratoconjunctivitis sicca. This study aimed to investigate the tear pharmacokinetics and systemic exposure … Purpose: A dexamethasone canalicular insert, Dextenza®, has been used to treat anterior inflammation of the eye, including keratoconjunctivitis sicca. This study aimed to investigate the tear pharmacokinetics and systemic exposure of dexamethasone in New Zealand White rabbits after inserting the preparation into the punctum and to correlate the data with the in vitro dissolution test. Methods: Dextenza was inserted into the punctum of rabbits. A paper strip serially collected tears, and dexamethasone concentrations in tears and plasma were measured using HPLC-MS/MS. The time courses of tear and plasma dexamethasone concentrations were characterized. Results: The release of dexamethasone from the insert to tears in rabbits was completed in ∼ 5 days, much faster than in humans and dogs (30 days). The time course of plasma dexamethasone concentration was fully characterized, in contrast to the fact that systemic exposure was merely observed in the other species. The present results might be attributed to the anatomical structure of the lacrimal sac beneath rabbits' canaliculi. The in vitro dissolution pattern represented an excellent correlation with the in vivo release in tears. Conclusions: We first examined the pharmacokinetic study of the canalicular insert in rabbits, which could be applied to the other insert studies in the species.

Comparison of Tobramycin-Dexamethasone Combination Eyedrop Versus Artificial Tear Eyedrop for the Management of Presumed Viral Epidemic Conjunctivitis: A Randomized Treatment Trial

2025-06-22

Chintan Shah , Courtney F. Goodman , Alok Sen +2 more | Current Eye Research

To compare the efficacy and safety of one-time povidone-iodine (PovI) administration followed by a course of tobramycin-dexamethasone eye drops versus artificial tears in acute viral conjunctivitis (AVC). This was a … To compare the efficacy and safety of one-time povidone-iodine (PovI) administration followed by a course of tobramycin-dexamethasone eye drops versus artificial tears in acute viral conjunctivitis (AVC). This was a single-centre, randomized controlled trial. Patients with AVC were instilled with PovI (5%) after proparacaine and then divided into two groups using a computer-generated random number table. Group A received combination drops of tobramycin(0.3%) and dexamethasone(0.5%), and group B received carboxymethylcellulose(0.5%) eyedrops. Both groups administered one drop four times daily for at least three days and until complete symptom resolution. A symptom score (SS) encompassing the five symptoms (redness, lid swelling, foreign body sensation, pain, watering; max score 15) was calculated at baseline, day 3, and day 7. The study included 230 eyes (120 in group A, 110 in group B). There was a significant reduction in mean total SS at day 3 (2.16 ± 2.42) and day 7 (0.56 ± 1.14) in all eyes compared to at presentation (8.33 ± 2.46). At day 3, there was a lower mean total SS in group A (1.97 ± 2.31) compared to group B (2.36 ± 2.54) which was marginally significant (p = 0.086). At day 7, the proportion of eyes that were symptom-free was similar between groups (70.9%, p = 0.881). A multivariate analysis found that group B (OR = 2.08, p = 0.036) and a higher pain score (OR = 1.50, p = 0.046) were associated with a lack of clinical resolution by day 3. A course of tobramycin-dexamethasone combination eyedrops after PovI may lead to early symptomatic relief, but recovery was similar to artificial tears by day 7. No significant/sight-threatening complications were observed in any groups.

Effects of Intense Pulsed Light Treatment on Dry Eye Disease After Keratorefractive Surgery: A Retrospective Cohort Study

2025-06-22

Chia‐Yi Lee , Shun‐Fa Yang , Yun-Chen Chen +1 more | Cureus

Dry eye after photorefractive keratectomy (PRK) and transepithelial photorefractive keratectomy (T-PRK): a comparative clinical study

2025-06-20

Siamak Zarei-Ghanavati , Javad Sadeghi , Samira Hassanzadeh +7 more | International Ophthalmology

A transient receptor potential vanilloid 1-dependent corneal-trigeminal neuroinflammatory circuit promotes corneal neuropathy

2025-06-20

Manuela Pizzano , Alexia Vereertbrugghen , Jazmín Martínez +7 more | Research Square (Research Square)

<title>Abstract</title> Corneal neurosensory abnormalities cause pain and discomfort in ocular surface disease, yet their pathophysiology is poorly understood. Here, we show that in a mouse dry eye model, ocular (over)activation … <title>Abstract</title> Corneal neurosensory abnormalities cause pain and discomfort in ocular surface disease, yet their pathophysiology is poorly understood. Here, we show that in a mouse dry eye model, ocular (over)activation of transient receptor potential vanilloid-1 (TRPV1) channels in response to tear deficiency and tissue damage promotes neuroinflammatory gene expression and macrophage reactivivity in the trigeminal ganglion, where the cornea-innervating sensory neurons are located. This is accompanied by ocular surface macrophage activation, impaired corneal sensitivity to mechanical and non-TRPV1-mediated chemical stimulation, reduced corneal nerve density, and sensitization of ocular TRPV1 channels, thus establishing a vicious neurosensory cycle. Isolated corneal TRPV1 activation without ocular desiccation recapitulates macrophage reactivity, corneal nerve degeneration and trigeminal neuroinflammation, whereas ocular substance P blockade reverts most of the TRPV1-driven corneal neurosensory changes. Our study identifies a corneal-trigeminal axis that facilitates corneal neurosensory dysfunction and suggests potential targets for the treatment of ocular surface disease-associated corneal neuropathy.

Topical lifitegrast therapy for dry eye disease

2025-06-20

Lama Assi , Salim C. Lutfallah , Tsz Wing Yim +3 more | Cochrane library

Smart Contact Lens with High Sensitivity and Biocompatibility for Continuous Non-Invasive Intraocular Pressure Monitoring

2025-06-20

Yunhao Tai , Qilong Cheng , Yuteng Liu +7 more | ACS Sensors

Intelligent intraocular pressure (IOP) sensors capable of continuous monitoring play a crucial role in the treatment of glaucoma. However, early diagnosis and treatment continue to face significant challenges due to … Intelligent intraocular pressure (IOP) sensors capable of continuous monitoring play a crucial role in the treatment of glaucoma. However, early diagnosis and treatment continue to face significant challenges due to the unique physiological environment of the eye. The primary scientific challenge lies in developing a method for continuous, high-sensitivity IOP monitoring that does not damage corneal tissue. To address this issue, a novel smart contact lens was developed, integrating hydrogel-based micronano architectures with diffraction-grating-embedded films. This device leverages 3D printing technology to achieve conformal adhesion to the ocular surface, enabling real-time IOP monitoring through optical-to-digital signal transduction. Additionally, ex vivo porcine eyeballs were used for in vitro testing and evaluation to quantitatively demonstrate the performance of the smart sensor. The results indicate that the smart contact lens developed in this study exhibits excellent biocompatibility and a high sensitivity of 2.5% mmHg-1 within the range of 0-50 mmHg, enabling precise IOP monitoring. These lenses hold significant potential for clinical IOP monitoring and demonstrate substantial promise for the next generation of ocular disease prevention.

Methodology of easy-to-use horizontally centrifuged platelet-rich fibrin as a topical treatment for equine ulcerative keratitis in 5 horses

2025-06-20

E. B. Collins , Erin K. Barr , Chongben Zhang +3 more | Journal of the American Veterinary Medical Association

Abstract Objective To describe the most efficient topical horizontally centrifuged platelet-rich fibrin (H-PRF) treatment protocol for equine ulcerative keratitis (EUK) that is easy to use, and to report the preliminary … Abstract Objective To describe the most efficient topical horizontally centrifuged platelet-rich fibrin (H-PRF) treatment protocol for equine ulcerative keratitis (EUK) that is easy to use, and to report the preliminary concentration of growth factors and cytokines in equine H-PRF. Animals 5 client-owned horses diagnosed with EUK were enrolled over an 11-month period. Clinical Presentation 3 horses were geldings, and 2 were mares. The mean (± SD) age was 5.95 ± 5.01 years. The owners’ main goal was to avoid surgery for EUK. Results H-PRF was used in 3 different protocols: solid H-PRF, sutured to the EUK area (n = 1); liquid H-PRF, used topically (n = 2); and combined solid H-PRF, placed in the ventral fornix plus liquid H-PRF (n = 2). Unused H-PRF was analyzed for concentration of growth factors and cytokines. Three of 5 eyes (60%) healed with corneal vascularization and granulation tissue (healing rate, 34 ± 16 days), either negative for culture growth (n = 2) or positive for Staphylococcus aureus (n = 1). Two of 5 eyes (40%), both positive for fungal growth, perforated and were enucleated. Solid H-PRF had the highest concentration of growth factors and cytokines, except for IL-6 and tumor necrosis factor-α, which was mildly higher in liquid H-PRF. Systemic flunixin meglumine seemed to lower growth factors and cytokines in H-PRF. Clinical Relevance The combined H-PRF protocol gave the highest concentration of growth factors and cytokines, which can lead to a healing response with corneal vascularization and granulation tissue. Future studies should evaluate fungal infection and the effect of systemic NSAIDs on H-PRF healing properties.

Long-Term Evolution of Chronic Neuropathic Ocular Pain and Dry Eye Following Corneal Refractive Surgery

2025-06-20

Cristina Valencia‐Sandonís , Amanda Vázquez , Laura Valencia‐Nieto +7 more | Journal of Clinical Medicine

Background/Objectives: Chronic neuropathic ocular pain (NOP) can manifest concurrently with dry eye (DE) symptoms following ocular surgical procedures. Due to its low prevalence, NOP remains an underrecognized and underdiagnosed postoperative … Background/Objectives: Chronic neuropathic ocular pain (NOP) can manifest concurrently with dry eye (DE) symptoms following ocular surgical procedures. Due to its low prevalence, NOP remains an underrecognized and underdiagnosed postoperative complication, leading to suboptimal management. This study evaluated the long-term evolution of symptoms, signs, and tear biomarkers in patients with NOP and DE after corneal refractive surgery (RS). Methods: Patients with chronic NOP and persistent DE-related symptoms after corneal RS were assessed in two visits (V1 and V2), at least two years apart. Symptoms (DE, pain, anxiety, and depression) were measured with specific questionnaires. Clinical examination included a slit-lamp ocular surface evaluation, corneal sensitivity measurement, and subbasal corneal nerve plexus evaluation. Basal tear samples were collected, and a 20-plex cytokine panel and Substance P (SP) were assayed. Results: Twenty-three patients (35.57 ± 8.43 years) were included, with a mean time between visits of 4.83 ± 1.10 years. DE symptoms, measured with the Ocular Surface Disease Index questionnaire, improved at V2 (p < 0.001), along with a reduction in anxiety and depression levels, measured with the Hospital Anxiety and Depression Scale (p = 0.027). Corneal staining also decreased (p < 0.001), while subbasal nerve plexus parameters and corneal sensitivity remained unchanged. Tear analysis revealed increased concentrations of fractalkine/CX3CL1 (p = 0.039), interleukin (IL)-1 receptor antagonist (Ra) (p = 0.025), IL-10 (p = 0.002), and SP (p < 0.001). Conclusions: Symptom improvement may result from better control of underlying pathologies or natural disease progression. However, the increased levels of SP and fractalkine/CX3CL1 suggest sustained neurogenic inflammation, while elevated IL-1Ra and IL-10 indicate a potential compensatory anti-inflammatory response.

Reply

2025-06-20

Johannes Menzel-Severing , Jennifer Prues-Hölscher , Lukas Jürgens +1 more | Cornea

The association between diabetes mellitus and meibomian gland dysfunction: A meta-analysis

2025-06-20

Beom Joon Kim , Hong Kyu Kim , Tae Keun Yoo | International Journal of Diabetes in Developing Countries

Microbiological spectrum and antibiotic susceptibility analysis of secretion from 308 cases of chronic dacryocystitis in north China

2025-06-20

Yue He , Yang Zhang , Sun Hua | International Journal of Ophthalmology

AIM: To determine the microbiological agents and antibiotic susceptibility of chronic dacryocystitis in recent years to guide effective treatment strategies. METHODS: A total of 308 adult patients with chronic dacryocystitis … AIM: To determine the microbiological agents and antibiotic susceptibility of chronic dacryocystitis in recent years to guide effective treatment strategies. METHODS: A total of 308 adult patients with chronic dacryocystitis were enrolled from January 2020 to September 2022 in Beijing Tongren Hospital. The 229 pus specimens were taken from the conjunctival sac, while 79 specimens were taken from the opened lacrimal sac during transnasal dacryocystorhinostomy (DCR) surgery. All the samples were sent for microbiological smear and culture and drug susceptibility tests. RESULTS: The 202 specimens showed microbial growth, with a positive rate of 65.6%. The 313 strains of bacteria were isolated, including 272 aerobic or facultative anaerobes, accounting for 86.9%, and 41 anaerobic bacteria, accounting for 13.1%. The most common strains were Staphylococcus epidermidis, Corynebacterium macginleyi, and Staphylococcus aureus. Six strains of fungi were isolated. The 14 strains (18.9%) of Staphylococcus were found to be multidrug resistant. It showed a wide variety of gram-negative bacteria, up to 23 species. Specimens obtained during DCR surgery had a positive rate of 70.9%, which was higher than those obtained from the conjunctival sac (63.8%), with a statistically significant difference. More microbiological species were found in intraoperative specimens, and consisted largely of pathogenic bacteria or conditional pathogens. All the 6 strains of fungi were obtained from intraoperative specimens. All bacteria were sensitive to vancomycin, while a large number of bacteria were resistant to erythromycin. The commonly used ocular antibiotics levofloxacin, moxifloxacin and tobramycin were generally sensitive to most of the bacteria. CONCLUSION: Gram-positive cocci, gram-positive bacilli, and gram-negative bacilli are the predominant pathogens for chronic dacryocystitis. Specimens taken during DCR surgery can obtain more accurate microbiological results.

Introduction to Special Issue: Update on Ocular Surface Disease

2025-06-20

Deborah S. Jacobs | Eye & Contact Lens Science & Clinical Practice

Tear Cytokine Changes up to One Year After Allogeneic Hematopoietic Stem Cell Transplant: Effect of Daily Topical Cyclosporine-A 0.1% Emulsion

2025-06-19

Louis Tong , Yu‐Chi Liu , Sharon Yeo +7 more | International Journal of Molecular Sciences

To profile tear cytokine changes in Allogeneic Hematopoietic Stem Cell Transplant (HSCT) patients after instillation of daily topical cyclosporine-A 0.1% cationic emulsion. Participants in a longitudinal study were given cyclosporine … To profile tear cytokine changes in Allogeneic Hematopoietic Stem Cell Transplant (HSCT) patients after instillation of daily topical cyclosporine-A 0.1% cationic emulsion. Participants in a longitudinal study were given cyclosporine eyedrops daily from 3 to 5 weeks before and 3 months, 6 months, and 12 months post-HSCT. The outcomes included tear cytokine concentration assayed by the Proximity Extension Assay O-linked target 96 platform. The patients were divided into two groups: Group 1 (n = 8 conjunctival CD4 cells responding to cyclosporine) and Group 2 (n = 5 conjunctival CD4 cells not suppressed after cyclosporine, where patients were non-compliant with cyclosporine). All participants had a standardized clinical examination, including meibomian gland evaluation and tear breakup times. The levels of 38 cytokines/chemokines showed significant changes (p < 0.05) over time, and in many, the elevation was marked at one year. These include gamma-interferon, CXCL9, CCL3, and CCL4 (all p < 0.0001). For gamma-interferon, there was significant interaction between group and time at 1 year (p = 0.022), where the cytokine was significantly suppressed in Group 1. Four other cytokines showed significant group and time interaction at 1 year: FGF23, FGF5, LIFR, and Enrage (all p < 0.05). All patients had either withdrawal or a reduction in systemic immunomodulation between 6 months and 1 year. We found several cytokines to be associated with changes in tear osmolarity or symptom scores. HSCT induces significant elevation of 38 tear cytokines/chemokines even without the occurrence of ocular graft-versus-host disease when systemic immunosuppression is reduced within the first year. Topical daily cyclosporine eyedrops can reduce some pro-inflammatory tear cytokines.

Ocular Pharmacokinetics and Biodistribution of Perfluorohexyloctane after Topical Administration to Rabbits

2025-06-19

Sonja Krösser , Ralf Grillenberger , Kirsten Eickhoff +3 more | Journal of Ocular Pharmacology and Therapeutics

Purpose: Perfluorohexyloctane ophthalmical solution (PFHO) forms an anti-evaporative layer at the air-tear interface and is indicated for treatment of the signs and symptoms of dry eye disease (DED). This study … Purpose: Perfluorohexyloctane ophthalmical solution (PFHO) forms an anti-evaporative layer at the air-tear interface and is indicated for treatment of the signs and symptoms of dry eye disease (DED). This study evaluated the ocular pharmacokinetics and biodistribution of PFHO in rabbits. Methods: Radiolabeled PFHO was administered to female Dutch Belted rabbits as single (35 µL to each eye) or multiple (twice daily for 5 days) topical ocular doses. Animals were euthanized at designated timepoints. Tears (antemortem), ocular tissues, and blood were collected for pharmacokinetic analysis; heads and carcasses were collected for autoradiographic analysis. Concentrations were measured using liquid scintillation counting. Results: After multiple doses, maximum concentration (Cmax) and area under the concentration-time curve were highest in tears (2330 µg/g, 3720 µg•h/g) and Meibomian glands (222 µg/g, 1440 µg•h/g), followed by other anterior tissues (cornea, 27.6 µg/g, 463 µg•h/g; palpebral conjunctiva, 14.0 µg/g, 136 µg•h/g). PFHO was measurable in tears for 8 h and in Meibomian glands for ≥24 h. Distribution to the posterior ocular segment was minimal, and plasma concentrations were low (single-dose Cmax, 0.97 µg/g; multiple-dose Cmax, 3.2 µg/g). In non-ocular tissues, PFHO was confined primarily to nasal tissues and gastrointestinal tract contents; exposure to other systemic tissues was negligible. Conclusions: Exposure of PFHO was highest in tears, consistent with its anti-evaporative mode of action, followed by the Meibomian glands. PFHO exposure was very low in posterior ocular tissues and negligible in systemic circulation, consistent with the clinical safety profile.

All eyes on semifluorinated alkanes: a comprehensive review of the influence of semifluorinated alkane eyedrops on tear film stabilization and drug delivery in dry eye disease

2025-06-19

Priyanka Agarwal , Alice Epitropoulos , Ian Benjamin Gaddie +3 more | Expert Opinion on Drug Delivery

Dry eye disease (DED) is a prevalent and multifactorial ocular disorder characterized by tear film instability, ocular surface inflammation, and patient discomfort, negatively impacting the quality of life. Conventional therapies … Dry eye disease (DED) is a prevalent and multifactorial ocular disorder characterized by tear film instability, ocular surface inflammation, and patient discomfort, negatively impacting the quality of life. Conventional therapies have limitations due to poor drug bioavailability and patient tolerability. This review summarizes the application of semifluorinated alkanes (SFAs) as advanced ocular drug delivery systems, with a focus on perfluorobutylpentane (PFBP)-based Cyclosporine A (CsA) eyedrops. Preclinical and clinical evidence highlighting the influence of SFAs on tear film dynamics, ocular bioavailability, and patient-reported outcomes has been discussed. The review compiles findings from preclinical and clinical studies reported in peer-reviewed journals, databases, including PubMed, USPTO, and conference abstracts through 2024. SFAs represent a paradigm shift in ocular drug delivery. The unique physicochemical properties of PFBP-based eyedrops, such as their water-free nature, excellent spreadability, and ability to stabilize tear film lipid layer, address several challenges associated with conventional DED therapies. Clinical evidence demonstrates that PFBP-based CsA eyedrops (VEVYE®) have an earlier onset of action than aqueous CsA eyedrops and show a significant improvement in the clinical signs and symptoms of DED with high patient tolerability. Ongoing clinical trials are exploring the use of SFA-based vehicles to treat other conditions, aiming to overcome drug delivery limitations.

Comparison of Postoperative Outcomes in 71 Patients Undergoing Cataract Surgery at a Single Center with and Without Preoperative Keratostill Moisturizing Eye Drops

2025-06-18

Piotr Miklaszewski , Anna Maria Gadamer , Dominika Janiszewska-Bil +5 more | Journal of Clinical Medicine

Background/Objectives: Dry eye disease (DED) is a common condition that can significantly impact cataract surgery outcomes. Preoperative management strategies, including the use of moisturizing eye drops, may improve ocular surface … Background/Objectives: Dry eye disease (DED) is a common condition that can significantly impact cataract surgery outcomes. Preoperative management strategies, including the use of moisturizing eye drops, may improve ocular surface health and postoperative recovery. This study aimed to compare postoperative outcomes in 71 patients undergoing cataract surgery between June 2022 and May 2023 at a single center with and without preoperative keratostill moisturizing eye drops (sterile aqueous 0.3% hydroxypropyl methylcellulose solution) determined using the ocular surface disease index (OSDI), tear break-up time (TBUT), and optical coherence tomography (OCT) at diagnosis, on the day of surgery, and at two weeks postoperatively. Methods: A prospective observational study was conducted on 71 patients undergoing cataract surgery at Saint Barbara Hospital Trauma Center, Sosnowiec, Poland, from June 2022 to May 2023. Patients were randomly assigned to a test group (moisturizing eye drops) or a control group (no preoperative eye drops). The OSDI, TBUT, and OCT were evaluated at the baseline, preoperatively, and postoperatively. Results: The test group showed a significant improvement in OSDI scores (preoperative: 6.34 vs. baseline: 11.81; p < 0.001), which further decreased postoperatively (3.30; p < 0.001). TBUT also significantly increased from baseline to the preoperative visit (6.20 s to 7.97 s; p = 0.002) and remained stable after surgery (7.78 s). In contrast, the control group demonstrated only a minimal postoperative change in OSDI (3.92 to 3.70; p > 0.05) and a significant postoperative decrease in TBUT (5.96 s to 5.69 s; p = 0.864). Only the control group showed a significant postoperative decrease in epithelial thickness in operated eyes (p = 0.021), whereas no significant changes were observed in the test group. Conclusions: The preoperative use of moisturizing eye drops significantly improves the tear film stability, ocular comfort, and epithelial integrity, leading to better postoperative outcomes in cataract surgery patients.

Fabrication of an alginate-poloxamer 407 thermosensitive carboxymethyl chitosan stabilized nanosuspension hydrogel for enhanced ocular delivery of clobetasol propionate in uveitis management

2025-06-18

Bin Li , Judith Casmir Shemkai , Qian Zhang +5 more | International Journal of Biological Macromolecules

In-depth analysis of the tear fluid glycoproteome reveals diverse lacritin glycosylation and spliceoforms

2025-06-18

Vincent Chang , Keira E. Mahoney , Isaac Lian +5 more | bioRxiv (Cold Spring Harbor Laboratory)

Abstract Tear fluid comprises a diverse group of extracellular glycoproteins which are critical for ocular homeostasis. Within the tear fluid glycoproteome, lacritin is highly expressed and plays a key role … Abstract Tear fluid comprises a diverse group of extracellular glycoproteins which are critical for ocular homeostasis. Within the tear fluid glycoproteome, lacritin is highly expressed and plays a key role in immune response, tear secretion, and antimicrobial activity. Importantly, glycosylation constitutes over 50% of lactritin’s molecular weight. However, despite this fact, nothing is known about the specific glycan structures on lacritin and how they influence its protein folding, function, or downstream biological processes. Similarly, it remains completely unknown whether alterations to lacritin glycans are correlated with ocular pathologies. To address this gap in knowledge, we harnessed mass spectrometry (MS) to conduct the first O-glycoproteomic study of tear fluid. Here, we report unprecedented coverage of lacritin glycosylation, detailing 19 O-glycosites bearing a myriad of glycan structures. Further, we leveraged Alphafold 3.0 and GlycoShape to visualize the impact of these glycans on its structure, demonstrating that O-glycosylation renders the protein backbone rigid and extended. Surprisingly, we also detected protein-level evidence of two lacritin spliceoforms, representing the first observation of these isoforms by MS. Simultaneously, we describe the most comprehensive characterization of the tear fluid glycoproteome to date, elucidating the glycosylation profile of Immunoglobulin A (IgA), lactoferrin, and other glycoproteins with demonstrated clinical relevance as diagnostic biomarkers. Overall, this study lays critical groundwork for future biochemical investigation of tear fluid glycoproteins and their application as diagnostic or therapeutic tools for ocular diseases.

TOXIC CONJUNCTIVIT (CLINICAL CASES)

2025-06-17

M.E. Efendiyeva | Azerbaijan Journal of Ophthalmology

Purpose – to investigate the causes of toxic conjunctivitis. The analysis of 2 clinical cases is given as an illustration. In most cases, patients used some kind of drug and … Purpose – to investigate the causes of toxic conjunctivitis. The analysis of 2 clinical cases is given as an illustration. In most cases, patients used some kind of drug and their combination. The recommended approach to manage this situation involves discontinuing conservative treatment, switching to preservative-free antiglaucoma medications and steroid drops, and prioritizing early surgical intervention. Conclusion Conservative therapy is the core of glaucoma treatment. However, long-term, years-long use of drops leads to the appearance of the surface diseases of the eye listed above and toxic conjunctivitis due to their cumulative effect. It is important and necessary to consider them, because the patient's quality of life is directly related to the treatment received and the side effects of conservative therapy. Key words: glaucoma, toxic conjunctivit, brimonidin

Effect of blue‐filtering lens spectacles on signs and symptoms of dry eye during exposure to a digital screen

2025-06-16

Akarapon Watcharapalakorn , Teera Poyomtip , Noppadol Srisurattanamethakul +3 more | Ophthalmic and Physiological Optics

Abstract Purpose Digital device tasks emit blue light, which may cause damage to the ocular surface, resulting in dry eyes. This study compared lenses with blue‐blocking filters, anti‐reflective‐coated CR39 lenses … Abstract Purpose Digital device tasks emit blue light, which may cause damage to the ocular surface, resulting in dry eyes. This study compared lenses with blue‐blocking filters, anti‐reflective‐coated CR39 lenses and uncoated CR39 lenses with regard to their effect on dry eye signs and symptoms during a 120‐min reading task from a digital device. Methods This randomised crossover study included adults from an optometry clinic in Thailand. Twenty‐six healthy participants (age, 21.7 ± 2.6 years) performed three reading tasks from a tablet for 3 days. The effects of the spectacles were explored by determining the differences in the mean values between pre‐ and post‐task measurements. Results No significant changes in dry eye symptoms were observed in the 5‐Item Dry Eye Questionnaire or Ocular Surface Disease Index compared with the three lenses ( p = 0.97 and 0.45, respectively). For dry eye signs, no significant differences in the mean values of tear meniscus height, non‐invasive tear breakup time (keratometry mires) or fluorescence tear breakup time were found using the Friedman test (right eye: p = 0.53, 0.93 and 0.44, respectively; left eye: p = 0.53, 0.44 and 0.85, respectively). Conclusions Lenses with blue‐blocking filters did not alleviate dry eye signs and symptoms during a 120‐min digital activity.

Calcium-Dependent Regulation of Desmosomal Proteins in Human Meibomian Gland Epithelial Cells

2025-06-16

Fabian Garreis , Susanne Adelung , Martin Schicht +2 more | Investigative Ophthalmology & Visual Science

Meibomian gland dysfunction (MGD) is the leading cause of dry eye disease and is characterized by altered function of the meibomian glands. These glands produce lipids that form the outer … Meibomian gland dysfunction (MGD) is the leading cause of dry eye disease and is characterized by altered function of the meibomian glands. These glands produce lipids that form the outer layer of the tear film, which is critical for reducing evaporation from the ocular surface. Desmosomes-adhesive intercellular junctions-have been implicated in the differentiation processes of meibocytes, but their precise role remains to be further elucidated. This study aimed to get further insights into the function of desmosomal components in meibocyte differentiation and to improve our understanding of the pathogenesis of MGD. Immunohistochemical and immunofluorescence analyses of C57BL/6 mouse eyelid sections were performed to observe distribution patterns of desmosomal proteins in meibomian glands. Stimulation experiments using an immortalized human meibomian gland epithelial cell (HMGEC) line subjected to high calcium and fetal calf serum conditions, followed by real-time RT-PCR and Western blot analysis were performed to assess gene and protein expression of desmosomal components. Immunofluorescence was used to determine the intracellular localization within HMGEC. Our results indicate that a high calcium concentration promotes cell membrane localization and significantly increases the expression of desmocollin 3, desmoglein 2, and desmoplakin 1/2 in serum-free cultured HMGEC. Immunohistochemistry in C57BL/6 mice shows that desmosomal proteins are present at all stages of differentiation. Desmocollin and desmoglein are prevalent in basal and differentiating cells, whereas desmoplakin is distributed evenly, except in hypermature cells. Our study demonstrates the impact of calcium concentration on the expression and localization of desmosomal proteins and their role in meibocyte differentiation in both human and mouse models. To further understand the physiological mechanisms of desmosomes in the meibomian gland and the pathophysiology of MGD, further research into desmosomal functionality is required, which may pave the way for novel therapeutic strategies for evaporative dry eye disease.

Safety and efficacy of a novel intense pulsed light system in patients with meibomian gland dysfunction: a randomized, double-masked, intra-individual controlled study

2025-06-16

Andreas Schlatter , Stefan Palkovits , Sahand Amir-Asgari +5 more | International Ophthalmology

International corneal and ocular surface disease dataset for electronic health records

2025-06-15

Darren Shu Jeng Ting , Stephen B. Kaye , Saaeha Rauz | British Journal of Ophthalmology

Background/Aims To provide a comprehensive and internationally standardised Cornea and Ocular Surface Disease (C&OSD) dataset for use in electronic health records (EHRs). Methods This was an international consensus study conducted … Background/Aims To provide a comprehensive and internationally standardised Cornea and Ocular Surface Disease (C&OSD) dataset for use in electronic health records (EHRs). Methods This was an international consensus study conducted through roundtable discussions involving 35 international experts specialising in the field of C&OSD. The Royal College of Ophthalmologists dataset guidelines were used to articulate initial C&OSD data elements template by curating data elements from validated published datasets obtained through scientific literature searches and accessing existing international patient clinical and reported outcome recording instruments and registries. These included data elements recommended by the Dry Eye Workshop II, International Meibomian Gland Dysfunction Workshop, Ocular Surface Disease Activity and Damage Indices, the Cicatrising Conjunctivitis Assessment Tool, Limbal Stem Cell Deficiency Clinical and Confocal Grading, Chronic Ocular Manifestations in Patients with Stevens–Johnson Syndrome, and the UK Transplant Registry. Data elements pooled into an independent operational data model. Results A comprehensive generic dataset (common to all ophthalmology datasets) and C&OSD-specific dataset were developed. Within the C&OSD dataset, several gateway disease datasets, such as atopic or allergic eye diseases, meibomian gland dysfunction, cicatrising conjunctivitis, chemical injury, dry eye, limbal stem cell deficiency, microbial or infectious keratitis, corneal erosion syndrome, and keratoconus, were established to streamline data entry for clinical audit and research purposes. Conclusion A comprehensive C&OSD dataset is provided which can be used by both generalist and specialist ophthalmologists. Adoption of the full dataset by EHR providers will lead to better interoperability and patient care and facilitate international research collaboration.

Conceptual Study of Haritaki and Shunthi Churna Bidalaka in Vernal Keratoconjunctivitis

2025-06-15

Sneha Moholkar , Sarita S. Mulik , Manjula Matekar +2 more | Journal of Neonatal Surgery

Vernal keratoconjunctivitis (VKC) is a chronic, bilateral corneal and conjunctival problem which typically presents in young individuals. VKC is characterized by itching, photophobia, white mucous discharge, lacrimation, foreign body sensation, … Vernal keratoconjunctivitis (VKC) is a chronic, bilateral corneal and conjunctival problem which typically presents in young individuals. VKC is characterized by itching, photophobia, white mucous discharge, lacrimation, foreign body sensation, and pain due to corneal involvement of shield ulcers. Vernal keratoconjunctivitis is categorized within ocular diseases. The diagnosis is clinical, as no sure biomarkers pathognomonic of the disease have yet been identified. The VKC therapy relies on different types of drugs, from antihistamines and topical steroids to cyclosporine or tacrolimus eye drops. In extremely rare cases, there is also the need for surgical treatment for the debridement of ulcers, as well as for advanced glaucoma and cataracts, caused by excessive prolonged use of steroid eye drops.This condition can be correlated with Kaphaja Abhishyanda in Ayurvedic texts. Owing to the symptoms and signs, the case was diagnosed as Kaphaja Abhishyanda/VKC. Hence this patient was treated with Kriyakalpa (ocular therapeutic procedures) Haritaki and Sunthi Churna Bidalaka which gave significant results and found useful in the management of Vernal keratoconjunctivitis. According to Ayurvedic principles, the spring season is when Kapha prakopa (Kapha vitiation) occurs, which is indicated by the name of the ailment, spring catarrh. The Kapha dominant stage of life is childhood, and the disease's clinical signs resemble those of Kaphaja Abhishyanda. Kaphaja Abhishyanda and VKC share a striking clinical similarity. Thus, there is an increasing need to understand the disease in view of Ayurveda and to establish the management through Ayurvedic system of medicine

Wound healing in glaucoma surgery. Part 3. Methods of preoperative prevention

2025-06-14

S. Yu. Petrov , E. V. Yani , O. M. Filippova +1 more | Russian Ophthalmological Journal

Study of factors preventing excessive scarring in antiglaucoma surgery creates a foundation for developing methods of influencing these processes in the postoperative period in order to increase the effectiveness of … Study of factors preventing excessive scarring in antiglaucoma surgery creates a foundation for developing methods of influencing these processes in the postoperative period in order to increase the effectiveness of the intervention. Analysis of the literature showed that a systematic approach to preparing for successful surgical treatment of glaucoma should include a rational choice of previous hypotensive therapy with preservative-free drugs, prevention of damage to the ocular surface using tear substitute and immunosuppressive therapy, as well as preoperative anti-inflammatory prophylaxis with steroid and non-steroid agents with proven ophthalmic hypertension safety.

Comparative characteristics of eye drops used for the treatment of glaucoma in an experimental model of dry eye

2025-06-14

Е.В. Блинова , Е. А. Литвин , Д. С. Блинов +7 more | Russian Ophthalmological Journal

Purpose of the work is a comparative study of the effect of different concentrations of the excipient carbomer on the local bioavailability and local irritant effect of brinzolamide and timolol … Purpose of the work is a comparative study of the effect of different concentrations of the excipient carbomer on the local bioavailability and local irritant effect of brinzolamide and timolol in an experimental model of dry eye syndrome (DES). Material and methods . The study was performed on 35 sexually mature male rabbits of the Soviet Chinchilla breed. The effect of Brinarga eye drops (INN brinzolamide + timolol) containing carbomer 4.2 mg as an excipient (Sentiss Pharma Pvt. Ltd., India) and the comparison drugs — Preparation 1 (original) and Preparation 2 (generic, European manufacturer), containing INN brinzolamide + timolol and carbomer 4.0 mg, when instilled into the conjunctival sac every 12 hours for 14 days was studied. The local irritant effect of eye drops on the cornea of the eye and the bioavailability of the active substances included in all the studied drops were assessed on an experimental model of dry eye syndrome, which was reproduced by daily instillation of 1 drop of 1 % atropine sulfate into experimental animals 3 times a day for 5 days. Results . It was found that Brinarga eye drops containing 4.2 mg/ml carbomer 974P do not aggravate the course of DES and do not have a local irritant effect. On the contrary, their use is accompanied by a partial correction of the pathological condition (although it does not lead to complete restoration of corneal moisture to the values of the intact eye), unlike the existing analogs — Preparation 1 and Preparation 2, containing carbomer 974P at a concentration of 4.0 mg/ml. At the same time, Preparation 2 (generic, European manufacturer) caused a pronounced local irritant effect (total score 7.2 ± 1.2), which led to its early exclusion from the experiment. At 60 min, the maximum measured concentration of brinzolamide and timolol (Brinarga) in the aqueous humor of the anterior chamber during DES significantly exceeded that of Preparation 1 and Preparation 2. Conclusion . Increasing the concentration of carbomer to 4.2 mg/ml facilitates the passage of brinzolamide/timolol (Brinarga) through the tissue barrier of the eye and prevents presystemic elimination due to imparting optimal viscometric characteristics to the dosage form.

Autologous Serum Tears in the Management of Ocular Surface Diseases: A Comprehensive Review of Published Evidence

2025-06-14

Konstantina Bachtalia , Athina Plakitsi , Sotiria Palioura | Seminars in Ophthalmology

This comprehensive review evaluates the efficacy and safety of autologous serum (AS) tears in managing dry eye disease (DED) by analyzing published prospective randomized controlled trials (RCTs). A comprehensive literature … This comprehensive review evaluates the efficacy and safety of autologous serum (AS) tears in managing dry eye disease (DED) by analyzing published prospective randomized controlled trials (RCTs). A comprehensive literature search was conducted in PubMed, Scopus, and the Cochrane Library up to February 28, 2025. The primary outcome measures included symptom improvement, Schirmer's test, tear break-up time, ocular surface staining, and visual performance. The Cochrane Risk of Bias Version 2 tool was used to assess study quality. Six RCTs (102 participants, 169 eyes) were included. Significant symptom improvement was recorded with AS tears 20%. The most consistent improvement in clinical signs was observed with AS tears 50%. The risk of bias assessment identified only one study as high risk due to lack of blinding. AS tears show promise for moderate-to-severe DED, but variability in study design and small sample sizes necessitate standardized protocols and larger RCTs.

Effectiveness of Femtosecond Laser Combined with Recombinant Human Epidermal Growth Factor in Postoperative Dry Eye in Cataract Patients and Effect on Ocular Surface Function

2025-06-12

Rui Ding , Lijun Yang | International Journal of Biology and Life Sciences

Sixty patients with dry eye after cataract surgery admitted to Lanzhou Purui Optometry Hospital from January 2023 to February 2024 were selected as the study subjects, and were divided into … Sixty patients with dry eye after cataract surgery admitted to Lanzhou Purui Optometry Hospital from January 2023 to February 2024 were selected as the study subjects, and were divided into observation group (30 cases) and control group (30 cases) according to the envelope method, with femtosecond laser treatment for the patients in the control group, and combined treatment with recombinant human epidermal growth factor for the patients in the observation group. The Ocular Surface Disease Index OSDI questionnaire (assessing ocular surface function), Dry Eye Symptom Assessment Questionnaire, Fluorescein Staining Score, FL Score, Tear Secretion Test (SIT), Tear Film Stability Test (BUT) and safety were compared between the two groups. The OSDI questionnaire score, dry eye symptom assessment questionnaire and fluorescein staining score of the observation group were lower than those of the control group after the intervention, and the difference was statistically significant (P < 0.05); the FL score of the observation group was lower than those of the control group, and the difference was statistically significant (P < 0.05); the SIT and BUT of the observation group were higher than those of the control group, and the difference was statistically significant (P < 0.05); the adverse reaction rate of the patients in both groups was compared. The incidence of adverse reactions in the two groups was not statistically significant (P>0.05). Conclusion: Femtosecond laser combined with recombinant human epidermal growth factor in patients with dry eye after cataract surgery can help to improve the patients' ocular surface function, can reduce fluorescein staining, SIT and BUT levels, and has high therapeutic safety, which is worthy of popularization and application.

Novel 5-[2,7-Diazaspiro[3.5]nonan-7-yl]-5-[4-phenoxyphenyl]hexahydropyrimidine-2,4,6-trione Derivatives as MMP9 Inhibitors for Treating Ocular Surface Diseases, in Particular Dry Eye Disease

2025-06-11

Ram W. Sabnis | ACS Medicinal Chemistry Letters

The Effects of Topical Cyclosporine 0.05% on Dry Eye Symptoms of Postcataract Surgery

2025-06-11

Yu‐Min Chang , Ke‐Hung Chien | Journal of Medical Sciences

Purpose: This study aimed to evaluate the effect of topical cyclosporine 0.05% on postcataract surgery-related dry eye symptoms. Materials and Methods: Sixty eyes of 60 patients who had undergone cataract … Purpose: This study aimed to evaluate the effect of topical cyclosporine 0.05% on postcataract surgery-related dry eye symptoms. Materials and Methods: Sixty eyes of 60 patients who had undergone cataract surgery in the past 3 months were enrolled. All patients received standard postoperative treatment with econopred and cravit eye drops for 1 week. After this, 20 eyes received artificial tears and topical fluorometholone 0.1% four times a day for 6 weeks (artificial tear + fluorometholone 0.1% group). Nineteen eyes received topical cyclosporine 0.05% twice daily for 2 weeks before cataract surgery and continued for 6 weeks postoperatively (cyclosporine group). The remaining 21 eyes did not receive any additional treatment (control group). The ocular surface disease index (OSDI) questionnaire, tear meniscus height (TMH), noninvasive keratograph tear breakup time (NIKBUT), and red scores (RS) were assessed preoperatively and postoperatively at 1 week and 1 month. Results: Topical cyclosporine 0.05% was more effective in improving certain dry eye parameters compared to artificial tears + fluorometholone 0.1% or no treatment. The cyclosporine group showed significant improvements in OSDI and TMH over time, with better outcomes at 1 month postoperatively compared to the artificial tears + fluorometholone 0.1% and control groups. Although all groups experienced a decline in NIKBUT and RS postoperatively, the artificial tears + fluorometholone 0.1% and control groups exhibited a more pronounced decrease. The cyclosporine group showed no improvement in the NIKBUT or RS postoperatively. Conclusion: Topical cyclosporine 0.05% eye drops and artificial tears + fluorometholone 0.1% are beneficial for postcataract surgery dry eye disease control. However, the significant effects of cyclosporine require further large-scale investigation.