WorldWideScience

Sample records for dry eye syndromes

  1. Dry eye syndrome

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000426.htm Dry eye syndrome To use the sharing features on this page, ... second-hand smoke exposure Cold or allergy medicines Dry eye can also be caused by: Heat or ... Symptoms may include: Blurred vision Burning, itching, ...

  2. Scleral lens use in dry eye syndrome.

    Science.gov (United States)

    Bavinger, J Clay; DeLoss, Karen; Mian, Shahzad I

    2015-07-01

    Dry eye syndrome can be difficult to manage in severe or refractory cases. In patients in whom traditional treatments have limited efficacy, alternative treatments may be considered for dry eye syndrome, including scleral lenses. The present review summarizes the evidence regarding scleral lens use in dry eye syndrome. Scleral lenses have become a viable option for severe dry eye syndrome, and have been shown to be efficacious and well tolerated, with most reports citing improved visual acuity and relief of symptoms. Currently, there are 18 manufacturers of scleral lenses, although published reports on scleral lenses primarily focus on the BostonSight PROSE and the Jupiter Lens. Scleral lenses are efficacious and well tolerated for use in severe dry eye syndrome. Further research is needed to compare different sizes and types of lenses, and to standardize outcome measures.

  3. [Psychosomatic aspects of dry eye syndrome].

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    Nepp, J

    2016-02-01

    Patients with dry eye syndrome are known to suffer from anxiety and depression. Analysis of psychological disorders in therapy-resistant dry eye syndrome. A retrospective analysis of the training for interactive psychiatric screening (TRIPS) questionnaire from 110 patients with therapy-resistant dry eye syndrome was carried out. The results of the questionnaire allow the diagnosis of psychological disorders and vegetative disorders. Patients were divided into groups with anxiety, depression, mixed diagnoses, vegetative disorders and no diagnosis. A sicca score was used for assessment of dryness comprising the Schirmer test, measurement of tear meniscus, break up time, lipid layer thickness, the use of fluorescein and rose bengal staining tests and the subjective visual analogue scale. The diagnosis of dry eye syndrome was compared with the psychological disorders of anxiety and depression. Of the patients 52.7 % had psychological disorders with anxiety in 21.8 %, depression in 15.3 %, mixed diagnoses in 14.5 %, dystonia in 25.4 % and in 22.7 % no psychological disorders were diagnosed. General anxiety was frequent and panic disorders were often associated with other kinds of anxiety. Severe depression, such as bipolar disorder was rare. Dry eye scores were highest in the mixed group (0.59), and lowest in the group with mild anxiety (0.38). No single sicca phase disorder could be correlated with any of the psychological diagnoses. Patients with therapy-resistant dry eye syndrome often suffer from anxiety and depression. The psychological stress acts on the nervous system to suppress lacrimal gland function. Further investigation of the correlation between the lacrimal tear film phase and psychological disorders is recommended. Knowledge of personality disorders may allow psychological support that would improve the treatment options for dry eye syndrome.

  4. Prevalence of dry eye syndrome in an adult population.

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    Hashemi, Hassan; Khabazkhoob, Mehdi; Kheirkhah, Ahmad; Emamian, Mohammad Hassan; Mehravaran, Shiva; Shariati, Mohammad; Fotouhi, Akbar

    2014-04-01

    To determine the prevalence of dry eye syndrome in the general 40- to 64-year-old population of Shahroud, Iran. Population-based cross-sectional study. Through cluster sampling, 6311 people were selected and 5190 participated. Assessment of dry eye was done in a random subsample of 1008 people. Subjective assessment for dry eye syndrome was performed using Ocular Surface Disease Index questionnaire. In addition, the following objective tests of dry eye syndrome were employed: Schirmer test, tear break-up time, and fluorescein and Rose Bengal staining using the Oxford grading scheme. Those with an Ocular Surface Disease Index score ≥23 were considered symptomatic, and dry eye syndrome was defined as having symptoms and at least one positive objective sign. The prevalence of dry eye syndrome was 8.7% (95% confidence interval 6.9-10.6). Assessment of signs showed an abnormal Schirmer score in 17.8% (95% confidence interval 15.5-20.0), tear break-up time in 34.2% (95% confidence interval 29.5-38.8), corneal fluorescein staining (≥1) in 11.3% (95% confidence interval 8.5-14.1) and Rose Bengal staining (≥3 for cornea and/or conjunctiva) in 4.9% (95% confidence interval 3.4-6.5). According to the Ocular Surface Disease Index scores, 18.3% (95% confidence interval 15.9-20.6) had dry eye syndrome symptoms. The prevalence of dry eye syndrome was significantly higher in women (P = 0.010) and not significantly associated with age (P = 0.291). The objective dry eye syndrome signs significantly increased with age. Based on the findings, the prevalence of dry eye syndrome in the studied population is in the mid-range. The prevalence is higher in women. Also, objective tests tend to turn abnormal at higher age. Pterygium is associated with dry eye syndrome and increased its symptoms. © 2013 Royal Australian and New Zealand College of Ophthalmologists.

  5. Prevalence of dry eye syndrome and Sjogren's syndrome in patients with rheumatoid arthritis.

    Science.gov (United States)

    Kosrirukvongs, Panida; Ngowyutagon, Panotsom; Pusuwan, Pawana; Koolvisoot, Ajchara; Nilganuwong, Surasak

    2012-04-01

    Rheumatoid arthritis has manifestations in various organs including ophthalmic involvement. The present study evaluates prevalence of dry eye and secondary Sjogren's syndrome using salivary scintigraphy which has not been used in previous reports. To evaluate the prevalence of secondary Sjogren's syndrome in patients with rheumatoid arthritis, including clinical characteristics and dry eye, compared with non-Sjogren's syndrome. Descriptive cross sectional study Sixty-one patients with rheumatoid arthritis were recruited at Siriraj Hospital during March 2009-September 2010 and filled in the questionnaires about dry eye for Ocular Surface Disease Index (OSDI) with a history taking of associated diseases, medications, duration of symptoms of dry eyes and dry mouth. The Schirmer I test without anesthesia, tear break-up time, rose bengal staining score, severity of keratitis and salivary scintigraphy were measured and analyzed. Prevalence of secondary Sjogren's syndrome and dry eye were 22.2% (95% CI 15.4 to 30.9) and 46.7% (95% CI 38.0 to 55.6), respectively. Dry eye interpreted from OSDI, Schirmer 1 test, tear break-up time and rose bengal staining was 16.4%, 46.7%, 82% and 3.3% respectively. Fifty-two percent of patients had a history of dry eye and dry mouth with mean duration 27.4 and 29.8 months, respectively. Superficial punctate keratitis and abnormal salivary scintigraphy were found in 58.2% and 77.8%. Duration of rheumatoid arthritis, erythrocyte sedimentation rate were not correlated with secondary Sjogren's syndrome. Dry eye from OSDI with secondary Sjogren's syndrome (33.3%) compared with non-Sjogren's syndrome (9.5%) was significant difference (p = 0.008). Adjusted odds ratio for secondary Sjogren's syndrome in OSDIL score > 25 was 13.8 (95% CI 2.6 to 73.8, p = 0.002) compared to OSDI score dry eye syndrome and secondary Sjogren's syndrome in rheumatoid arthritis was crucial for evaluation of their severity and proper management.

  6. Severe dry-eye syndrome following external beam irradiation

    International Nuclear Information System (INIS)

    Parsons, J.T.; Bova, F.J.; Million, R.R.

    1994-01-01

    There are limited data in the literature on the probability of dry-eye complications according to radiotherapy dose. This study investigates the risk of radiation-induced severe dry-eye syndrome in patients in whom an entire orbit was exposed to fractionated external beam irradiation. Between October 1964 and May 1989, 33 patients with extracranial head and neck tumors received irradiation of an entire orbit. Most patients were treated with 60 Co. The dose to the lacrimal apparatus was calculated at a depth of 1 cm from the anterior skin surface, the approximate depth of the major lacrimal gland. The end point of the study was severe dry-eye syndrome sufficient to produce visual loss secondary to corneal opacification, ulceration, or vascularization. Twenty patients developed severe dry-eye syndrome. All 17 patients who received dose ≥57Gy developed severe dry-eye syndrome. Three (19%) of 16 patients who received doses ≥45 Gy developed severe dry-eye syndrome; injuries in the latter group were much more slower to develop (4 to 11 years) than in the higher dose group, in whom corneal vascularization and opacification were usually pronounced within 9-10 months. There were no data for the range of doses between 45.01 and 56.99 Gy. The data did not suggest an increased risk of severe dry-eye syndrome with increasing age. Data from the current series and the literature are combined to construct a sigmoid dose response curve. The incidence of injury increases from 0% reported after doses ≥30 Gy to 100% after doses ≥57 Gy. 13 refs., 3 figs., 5 tabs

  7. Dry eye syndrome. Etiological and therapeutic aspects.

    Science.gov (United States)

    Apostol, Silvia; Filip, M; Dragne, Carmen; Filip, A

    2003-01-01

    "Dry eye syndrome" is a common disorder of the tear film that results from inadequate tear production, excessive tear evaporation or abnormality in mucin or lipid components of the tear film. A number of 53 patients suffering from dry eye syndrome were followed up for a period of 18 months. The study group was heterogeneous, including a lot of conditions accompanied by dry eye syndrome: Syogren's syndrome, lupus erythematous, ocular rosacea, patients with systemic treatments with antidepressants, betablockers, diuretics, oral contraceptives, glaucomatous patients with topical beta-blockers, postmenopausal women, aging people, computer users and long-term contact lens wearers. The therapeutical options were dictated by the severity of the syndrome: substitution therapy, treatment of the underlying eyelid diseases, modifying of the environmental conditions and treatment of the complications in the most severe cases. The new pathological approach is innovative and it may provide a real therapeutical measure for this condition: topical A Cyclosporine and androgen drops.

  8. Dry eye syndrome among computer users

    Science.gov (United States)

    Gajta, Aurora; Turkoanje, Daniela; Malaescu, Iosif; Marin, Catalin-Nicolae; Koos, Marie-Jeanne; Jelicic, Biljana; Milutinovic, Vuk

    2015-12-01

    Dry eye syndrome is characterized by eye irritation due to changes of the tear film. Symptoms include itching, foreign body sensations, mucous discharge and transitory vision blurring. Less occurring symptoms include photophobia and eye tiredness. Aim of the work was to determine the quality of the tear film and ocular dryness potential risk in persons who spend more than 8 hours using computers and possible correlations between severity of symptoms (dry eyes symptoms anamnesis) and clinical signs assessed by: Schirmer test I, TBUT (Tears break-up time), TFT (Tear ferning test). The results show that subjects using computer have significantly shorter TBUT (less than 5 s for 56 % of subjects and less than 10 s for 37 % of subjects), TFT type II/III in 50 % of subjects and type III 31% of subjects was found when compared to computer non users (TFT type I and II was present in 85,71% of subjects). Visual display terminal use, more than 8 hours daily, has been identified as a significant risk factor for dry eye. It's been advised to all persons who spend substantial time using computers to use artificial tears drops in order to minimize the symptoms of dry eyes syndrome and prevents serious complications.

  9. Burning Eye Syndrome: Do Neuropathic Pain Mechanisms Underlie Chronic Dry Eye?

    Science.gov (United States)

    Kalangara, Jerry P; Galor, Anat; Levitt, Roy C; Felix, Elizabeth R; Alegret, Ramon; Sarantopoulos, Constantine D

    2016-04-01

    Dry eye is a multi-factorial disorder that manifests with painful ocular symptoms and visual disturbances, which can only be partly attributed to tear dysfunction. This disorder may also involve neuroplasticity in response to neuronal injury. This review will emphasize the key characteristics of dry eye pain and its pathologic mechanisms, making the argument that a subset of dry eye represents a neuropathic pain disorder of the eye, more appropriately called "burning eye syndrome." A literature review was conducted using a PubMed search focusing on dry eye, corneal nociception, and neuropathic pain. Articles were reviewed and those discussing clinical course, pathophysiology, and neuronal regulation of chronic ocular pain as related to dry eye were summarized. We found that there is a discordance between ocular pain and dryness on the ocular surface. Although tear dysfunction may be one of the initial insults, its persistence may be associated with repeated ocular sensory nerve injury leading to an acute-to-chronic pain transition associated with neuropathologic changes (peripheral and central sensitization), neuronal dysfunction, and spontaneous ocular pain. Dry eye is becoming a major health concern due to its increasing incidence, significant morbidity, and economic burden. Recent evidence suggests that a subset of dry eye may be better represented as a chronic neuropathic pain disorder due to its features of dysesthesia, spontaneous pain, allodynia, and hyperalgesia. Future therapies targeted at the underlying neuroplasticity may yield improved efficacy for patients with this subset of dry eye, which we term "burning eye syndrome." © 2015 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. [Pathogenetic relationship between pterygium and dry eye syndrome (clinical and cytological study)].

    Science.gov (United States)

    Petraevskiĭ, A V; Trishkin, K S

    2014-01-01

    To study the prevalence of dry eye syndrome in patients with initial primary pterygium for determination of a possible pathogenetic role of dry eye syndrome in the development of pterygium. 30 patients with initial primary pterygium; besides conventional ophthalmic assessment, cytological examination of bulbar conjunctiva was performed in all cases. Signs of dry eye syndrome, of similar severity in both eyes, were found in 100% of patients. Dry eye can be one of the precipitating factors of primary pterygium.

  11. Analysis of tear cytokines and clinical correlations in Sjögren syndrome dry eye patients and non-Sjögren syndrome dry eye patients.

    Science.gov (United States)

    Lee, Sang Yeop; Han, Soo Jung; Nam, Sang Min; Yoon, Sang Chul; Ahn, Ji Min; Kim, Tae-Im; Kim, Eung Kweon; Seo, Kyoung Yul

    2013-08-01

    To compare concentrations of tear cytokines in 3 groups composed of Sjögren syndrome (SS) dry eye, non-Sjögren syndrome (non-SS) dry eye, and normal subjects. Correlations between ocular surface parameters and tear cytokines were also investigated. Prospective cross-sectional study. SS dry eye patients (n = 24; 40 eyes) were diagnosed with primary SS according to the criteria set by the American-European Consensus Group. Non-SS dry eye patients (n = 25; 40 eyes) and normal subjects (n = 21; 35 eyes) were also enrolled. Tear concentrations of interleukin (IL)-17, IL-6, IL-10, IL-4, IL-2, interferon γ (IFN-γ), and tumor necrosis factor α (TNF-α) were measured by a multiplex immunobead assay. Ocular Surface Disease Index (OSDI), tear film breakup time (TBUT), Schirmer I test, and fluorescein staining scores were obtained from dry eye patients. All cytokine levels except for IL-2 were highest in the SS group, followed by non-SS dry eye group and control subjects. Concentrations of IL-17, TNF-α, and IL-6 were significantly different among the 3 groups (IL-17: SS > control P control P = .042, SS > non-SS P control P = .006, non-SS > control P = .034, SS > non-SS P = .029; IL-6: SS > control P = .002, non-SS > control P = .032, SS > non-SS P = .002). IL-17 was significantly correlated with TBUT (R = -0.22, P = .012) and Schirmer I test (R = -0.36, P = .027) scores in the SS group. IL-6 was significantly correlated only with TBUT (R = -0.38, P = .02) in the non-SS group. Differences in tear cytokine levels and correlation patterns between SS dry eye and non-SS dry eye patients suggest the involvement of different inflammatory processes as causes of dry eye syndrome. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. The potential role of neuropathic mechanisms in dry eye syndromes.

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    Mcmonnies, Charles W

    Dry eye syndromes can involve both nociceptive and neuropathic symptoms. Nociceptive symptoms are the normal physiological responses to noxious stimuli. Neuropathic symptoms are caused by a lesion or disease of the somatosensory nervous system and can be the result of hypersensitisation of peripheral or central corneal and conjunctival somatosensory nerves. For example, inflammation could induce neuroplastic peripheral sensitisation of the ocular surface or lid wiper and exacerbate nociceptive symptoms. Neuropathic symptoms may explain the incommensurate relation between signs and symptoms in some dry eye syndromes although absence of signs of a dry eye syndrome may also be a consequence of inappropriate methods used when examining for them. Involvement of neuropathic mechanisms may also help explain dry eye symptoms which occur in association with reduced corneal sensitivity. This review includes a discussion of the potential for ocular symptoms involving neuropathic mechanisms to contribute to psychosocial problems such as depression, stress, anxiety and sleep disorders as well as for these types of psychosocial problems to contribute to neuropathic mechanisms and dry eye syndromes. Failure to consider the possibility that neuropathic mechanisms can contribute to dry eye syndromes may reduce accuracy of diagnosis and the suitability of treatment provided. Dry eye symptoms in the absence of commensurate evidence of tear dysfunction, and unsatisfactory response to tear dysfunction therapies should prompt consideration of neuropathic mechanisms being involved. Symptoms which persist after local anaesthetic instillation are more likely to be neuropathic in origin. Reducing inflammation may help limit any associated neuroplastic hypersensitivity. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  13. [Guiding-qi acupuncture for dry eye syndrome].

    Science.gov (United States)

    Xie, Wenzhang; Zeng, Liang; Tao, Ying; Zhou, Yingfan; Zhao, Ran; Huang, Xinyun; Hou, Wenguang; Zhang, Ren; Zong, Lei

    2018-02-12

    To observe the clinical efficacy differences between different needling methods for dry eye syndrome. Sixty patients of dry eye syndrome were randomly divided into an observation group and a control group, 30 cases (60 eyes) in each group. Shangjingming (Extra), Xiajingming (Extra), Tongziliao (GB 1), Cuanzhu (BL 2), Fengchi (GB 20), Hegu (LI 4), Sanyinjiao (SP 6), Taixi (KI 3) and Taichong (LR 3) were selected in the two groups. The control group was treated with conventional acupuncture, while the observation group was treated with guiding- qi acupuncture. Electroacupuncture (EA) was used at bilateral Tongziliao (GB1) and Cuanzhu (BL 2), 30 min per treatment. The treatment was given three times per week. Totally 1-month treatment (12 treatments) was given. The eye symptom score, breakup time of tear film (BUT), Schirmer Ⅰ test (SⅠT) and visual analogue scale (VAS) score were compared before and after treatment in the two groups. The clinical efficacy was compared between the two groups. Compared before treatment, the eye symptom score, BUT, SⅠT and VAS score were improved after treatment in the two groups (all P eye symptom score and SⅠT in the observation group were superior to those in the control group (both P 0.05). The total effective rate was 86.7% (52/60) in the observation group, which was superior to 73.3% (44/60) in the control group ( P dry eye syndrome, and the efficacy of guiding- qi acupuncture combined with EA is superior to that of conventional EA.

  14. Prevalence of dry eye syndrome in residents of surgical specialties.

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    Castellanos-González, José Alberto; Torres-Martínez, Verónica; Martínez-Ruiz, Adriana; Fuentes-Orozco, Clotilde; Rendón-Félix, Jorge; Irusteta-Jiménez, Leire; Márquez-Valdez, Aída Rebeca; Cortés-Lares, José Antonio; González-Ojeda, Alejandro

    2016-07-16

    The aim of this study was to determine the prevalence and severity of dry eye syndrome in a group of Mexican residents of different surgical specialties. A cross-sectional descriptive study where the residents were studied using the Ocular Surface Disease Index, together with diagnostic tests for dry eye syndrome, such as tear breakup time, Oxford Schema, Schirmer's test I, and meibomian gland dysfunction testing. Statistical analyses were performed by Pearson's chi-squared test for categorical variables and student's t-test for quantitative variables. Any P value eyes); 90 (73 %) were male and 33 (27 %) were female. The mean age was 27.8 ± 2.1 years. A higher number of residents with dry eye syndrome was found in the cardiothoracic surgery (75 %) and otorhinolaryngology (71 %) specialties; 70 % of them reported ocular symptoms, with teardrop quality involvement in >50 % of them. We found a prevalence of 56 % for mild-to-moderate/severe stages of the condition. Their presence in the operating room predisposes surgical residents to dry eye syndrome because of environmental conditions.

  15. Therapeutic inhibitors for the treatment of dry eye syndrome.

    Science.gov (United States)

    Rodríguez-Pomar, Candela; Pintor, Jesus; Colligris, Basilio; Carracedo, Gonzalo

    2017-12-01

    Dry eye disease (DED), defined as a multifactorial disease of tears and ocular surface, results in symptoms of discomfort, ocular irritation, visual disturbance and tear film instability. This syndrome is accompanied of ocular surface inflammation and it is produced by a deficient activity of the lacrimal functional unit. In addition, it is associated with systemic autoimmune diseases such as Sjögren´s Syndrome, rheumatoid arthritis, systemic lupus erythematosus and some drug administration. The treatment of dry eye disease is based on the typical signs and symptoms of dry eye, which are associated with hyperosmolarity, ocular surface inflammation, discomfort, visual disturbance, and tear film instability. Areas covered: This review is focused on synthetic drugs currently used in clinical practice, from phase III development onwards to treat the ocular surface signs and symptoms of dry eye disease. Expert opinion: The multifactorial disease and the lack of correlation between signs and symptoms imply that not all the pharmacological approaches will be successful for dry eye. The correct design of the clinical trials, with appropriate endpoints, and the type of dry eye under study are complicated but mandatory. The anti-inflammatory and secretagogues drugs are both the main compounds to currently treat the dry eye disease.

  16. Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Afkhami-Ardekani Mohammad

    2008-06-01

    Full Text Available Abstract Background This study was performed to assess the prevalence of dry eye syndrome and diabetic retinopathy (DR in type 2 diabetic patients and their contributing factors. Methods 199 type 2 diabetic patients referred to Yazd Diabetes Research Center were consecutively selected. All Subjects were assessed by questionnaire about other diseases and drugs. Dry eye syndrome was assessed with Tear break up time tests and Schirmer. All the subjects underwent indirect ophthalmoscopy and retinal color photography. DR was graded according to early Treatment Diabetic Retinopathy (ETDRS criteria. Results Of 199 subjects, 108 patients (54.3% suffer from dry eye syndrome. Although dry eye syndrome was more common in older and female patients, this association was not significant. But there was significantly association between dry eye syndrome and duration of diabetes (P = 0.01. Dry eye syndrome was more frequent in diabetic patients with DR (P = 0.02. DR was found in 140 patients (70.35%, which included 34 patients (17.1% with mild non proliferative DR (NPDR, 34 patients (17.1% with moderate NPDR, 22 patients (11.1% with severe NPDR and 25 patients (25.1% with proliferative DR (PDR. There were significant relation between age, sex and duration of diabetes and DR. Conclusion In this study the prevalence of dry eye syndrome was 54.3%. Diabetes and dry eyes appear to have a common association. Further studies need to be undertaken to establish an etiologic relationship. However, examination for dry eye should be an integral part of the assessment of diabetic eye disease.

  17. Clinical correlations of dry eye syndrome and allergic conjunctivitis in Korean children.

    Science.gov (United States)

    Kim, Tae Hyung; Moon, Nam Ju

    2013-01-01

    Clinical patterns in pediatric patients with dry eye syndrome and allergic conjunctivitis were investigated. Children aged 6 to 15 years with dry eye symptoms were included. Slit-lamp examinations including tear film break-up time, Schirmer's test, and fluorescent staining were performed, and subjective symptoms were investigated. Patients with allergic conjunctivitis were subjected to skin prick tests. Tear film break-up time was shorter and the number of symptoms related to dry eyes was higher in pediatric patients with allergic conjunctivitis than in those without allergic conjunctivitis. Patients with allergic conjunctivitis who had higher numbers of positive allergens on the skin prick test also had shorter tear film break-up time. Because pediatric patients with dry eye syndrome tend to complain less about their symptoms than adult patients, dry eye syndrome is commonly overlooked. This study showed that dry eyes tended to be more severe with the presence of allergic conjunctivitis; the more allergens present, the more severe the dry eyes. More attention should be paid to the treatment of pediatric patients with dry eyes accompanied by allergies. Copyright 2013, SLACK Incorporated.

  18. Prevalence of dry eye syndrome at patients with diabetus melitus TIP 2

    Directory of Open Access Journals (Sweden)

    Nora Burda

    2013-01-01

    Conclusions: In our study the Dry Eye Syndrome showed to have a high correlation with Diabetes Mellitus Tip II ( about 52.9%. Prevalence of Dry Eye was significantly higher at patients with longer duration of diabetes. Dry Eye seems to be an important contributing factor related to corneal abnormalities. Age and sex not seem to play any important role in this condition. Good glycemic control is important for prevention and control of Dry Eye Syndrome.

  19. Dry eye syndrome in thyroid-associated ophthalmopathy

    Directory of Open Access Journals (Sweden)

    A. F. Brovkina

    2015-01-01

    Full Text Available Purpose: The pathogenesis of keratoconjunctivitis sicca in patients with thyroid eye disease is presented. The influence of therapy by a HYLO-PARIN® on a condition of a tear film in patients with various forms of thyroid eye disease is assessed. Methods: 34 eyes (17 patients with thyroid eye disease were investigated. Dry eye evaluations included Shirmer and Jhones testing, tear film break-up time, corneal fluorescein staining. Patients were treated with HYLOPARIN ® (Ursapharm, Germany.Results: Study showed that HYLO-PARIN® resulted in marked improvement as assessed by subjective complaints, Schirmer’s test, tear film break-up test.Conclusion: HYLO-PARIN® provided relief from the signsand symptoms of dry eye syndrome at patients with various forms of thyroid eye disease.

  20. Dry eye syndrome in thyroid-associated ophthalmopathy

    Directory of Open Access Journals (Sweden)

    A. F. Brovkina

    2014-01-01

    Full Text Available Purpose: The pathogenesis of keratoconjunctivitis sicca in patients with thyroid eye disease is presented. The influence of therapy by a HYLO-PARIN® on a condition of a tear film in patients with various forms of thyroid eye disease is assessed. Methods: 34 eyes (17 patients with thyroid eye disease were investigated. Dry eye evaluations included Shirmer and Jhones testing, tear film break-up time, corneal fluorescein staining. Patients were treated with HYLOPARIN ® (Ursapharm, Germany.Results: Study showed that HYLO-PARIN® resulted in marked improvement as assessed by subjective complaints, Schirmer’s test, tear film break-up test.Conclusion: HYLO-PARIN® provided relief from the signsand symptoms of dry eye syndrome at patients with various forms of thyroid eye disease.

  1. Tear osmolarity measurements in dry eye related to primary Sjögren's syndrome.

    Science.gov (United States)

    Utine, Canan Asli; Bıçakçıgil, Müge; Yavuz, Sule; Çiftçi, Ferda

    2011-08-01

    To evaluate the tear osmolarity in patients with dry eye syndrome related to primary Sjögren's Syndrome (SS). Twenty eyes of 10 patients with dry eye and primary SS (Group 1) and 20 eyes of 20 subjects who do not have dry eye syndrome (Group 2) were included in this cross-sectional study. In all eyes, ophthalmic examination was performed in the same order: International Ocular Surface Disease Index survey, visual acuity assessment, conjunctival hyperemia scoring, tear osmolarity measurement with TearLab(™) Osmolarity System, tear film break-up time assessment, corneal fluorescein staining scoring, ocular surface Lissamine Green staining scoring, anesthetized Schirmer test. Dry eye severity was graded according to Dry Eye Workshop (DEWS) classification system. Four eyes with grade 1, four eyes with grade 2, seven eyes with grade 3, and five eyes with grade 4 dryness, according to DEWS system, were included. The mean tear osmolarity value was 301.9 ± 11.40 mOsm/L (range: 290-328) in Group 1, and 294.85 ± 8.33 mOsm/L (range: 283-311) in Group 2 (p = 0.03). In Group 1, tear osmolarity values were positively correlated with OSDI scores (r(18) = 0.55, r(2) = 0.31, p = 0.01), DEWS classification grades (r(18) = 0.73, r(2) = 0.54, p dry eye syndrome related to primary SS compared to control subjects, and positively correlated with the severity of dry eye.

  2. The Correlation between Daily Lens Wear Duration and Dry Eye Syndrome.

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    Lubis, Rodiah Rahmawaty; Gultom, Monica Tumiar Hanna

    2018-05-20

    To analyze the correlation between the daily lens wear duration and dry eye syndrome. This study was an analytic cross sectional study using consecutive sampling conducted among the students in Economy and Bussiness Faculty and Faculty of Humanities in University of Sumatera Utara aged between 17 to 23 that wore contact lens continously for at least a year and 5 days a week. The symptoms were assessed using Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) and interview about their contact lens comfort; eye drops usage, contact lens washing habit, daily circumstances, places to buy contact lens and personal experince in wearing contact lens. The questionnaire was completed by 53 students. All of them were female and wore softlens wearers. The mean duration of daily wear was 8.19 ± 2.20 hours. The most common symptom experienced was dry eye and the least symptom experienced was removing lens. The most frequent symptom experienced was closing eyes and the least frequent symptom experienced was removing lenses. This study used Exact Test as analysis statistic method. The result was p > 0.05 which means there is no correlation between daily lens wear duration and dry eye syndrome. This study showed that dry eye syndrome was not correlated with daily lens wear duration, but affected by many factors such as contact lens, lens care solution, eye drops usage and environment.

  3. [Observation on therapeutic effect of dry eye syndrome treated with acupuncture on the acupoints around the eyes].

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    Gao, Wei-Ping; Liu, Min; Zhang, Yi-Biao

    2010-06-01

    To observed the clinical efficacy on dry eye syndrome treated with acupuncture on the acupoints around the eyes. Fifty-six cases of dry eye syndrome were divided into two groups, acupuncture group and western medicine group, 28 cases in each one. In acupuncture group, acupuncture was applied to Jingming (BL 1), Cuanzhu (BL 2), Sizhukong (TE 23), Tongziliao (GB 1), etc. In western medicine group, the topical artificial tear eye drops were administered. The corneal fluorescein staining, breaking-up time (BUT), tear volume and the symptom score were observed before and after treatment in two groups. In comparison before and after treatment in acupuncture group, the statistical significant difference presented in BUT, tear volume and the symptom score (all P eyes achieves a quite good efficacy on dry eye syndrome.

  4. [Effect of anti-inflammatory therapy on the treatment of dry eye syndrome].

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    Mrukwa-Kominek, Ewa; Rogowska-Godela, Anna; Gierek-Ciaciura, Stanisława

    2007-01-01

    Dry eye syndrome is a common chronic disease; agents and strategies for its effective management are still lacking. The syndrome tends to be accompanied by ocular surface inflammation; therefore, the use of anti-inflammatory agents might prove beneficial. The authors present up-to-date guidelines, strategies, and efficacy of dry eye syndrome management, including anti-inflammatory treatment. As no diagnostic tests are now available to assess ocular surface inflammation severity, the right timing to launch an anti-inflammatory agent is difficult to determine. Patients with mild intermittent bouts of symptoms which can be alleviated with ophthalmic lubricants do not typically require anti-inflammatory therapy. The latter should be considered in those who do not respond to lubricating drops, obtain poor results on clinical tests, and show symptoms of ocular surface irritation (eg. conjunctivae redness). Anti-inflammatory treatment of dry eye syndrome may include short-term corticosteroids, cyclosporine A emulsion, oral tetracycline therapy, oral omega-3 fatty acid supplements, and autologous serum eye drops. Anti-inflammatory treatment should be safe and effective; potential benefits should be evaluated for each individual patient. The authors have reviewed the advantages of anti-inflammatory treatment in dry eye syndrome, presented in literature.

  5. Manifestation of meibomian gland dysfunction in patients with Sjögren's syndrome, non-Sjögren's dry eye, and non-dry eye controls.

    Science.gov (United States)

    Kang, Yeon Soo; Lee, Hyo Seok; Li, Ying; Choi, Won; Yoon, Kyung Chul

    2018-06-01

    To evaluate the manifestation of meibomian gland dysfunction in patients with Sjögren's syndrome (SS), non-Sjögren's syndrome dry eye (non-SS) patients, and non-dry eye controls. We recruited 31 participants with SS dry eye, 30 participants with non-SS dry eye, and 35 healthy controls without dry eye symptoms. Noninvasive tear breakup time (NITBUT) and meibomian gland dropout score (meiboscore) were measured using the Oculus Keratograph 5 M. Meibomian gland expressibility and secretion quality were evaluated via slit lamp biomicroscopy. The correlation between measurements was analyzed. NITBUT was lower, and the meiboscore, meibomian gland expressibility, and secretion quality scores were significantly higher in the SS and non-SS groups than in the control group (p dry eye controls. SS patients had more severe meibomian gland dysfunction with poorer mean meiboscore and meibomian gland expressibility than non-SS patients.

  6. Allergic conjunctivitis and dry eye syndrome.

    Science.gov (United States)

    Hom, Milton M; Nguyen, Andrew L; Bielory, Leonard

    2012-03-01

    Allergic conjunctivitis (AC) and dry eye syndrome (DES) are 2 of the most common anterior inflammatory disorders of the ocular surface and one does not preclude the coexistence of the other. To examine the potential overlap between AC and DES as comorbidities. Using the validated questionnaire known as Subjective Evaluation of Symptom of Dryness, we studied self-reported itchiness, dryness, and redness. In an outpatient optometric setting, 689 patients treated from January 1, 2007, to January 1, 2011, were surveyed for their ocular history and categorized according to their reported level of discomfort of itchiness, dryness, and redness. Patients ranged in age from 5 to 90 years (median age, 25 years; 39.5% male; 60.5% female). In the studied 689 patients, clinically significant itchiness was found in 194 (28.2%), dry eyes in 247 (35.8%), and redness in 194 (28.2%). Symptom overlap was demonstrated in many of the patients. Of the 194 patients with itchiness, 112 (57.7%) had clinically significant dryness. In the 247 patients with dry eyes, 112 (45.3%) had clinically significant itch. Redness was apparent in 120 of the 194 patients with itch (61.9%) and 122 of the 247 patients with dryness (49.4%). Statistical analysis demonstrated that self-reported itchiness, dryness, and redness were not independent of each other (Peyes" also experiencing dry eyes were 2.11 times and the odds of these patients also experiencing redness were 7.34 times that of patients with nonitchy eyes. Most patients with "itchy eyes" consistent with AC also have dry eyes and redness. These results suggest that some symptomatic patients concomitantly have features of AC and DES. Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  7. A Comprehensive Review of Sex Disparities in Symptoms, Pathophysiology, and Epidemiology of Dry Eye Syndrome.

    Science.gov (United States)

    Rapoport, Yuna; Singer, Jason M; Ling, Jeanie D; Gregory, Anthony; Kohanim, Sahar

    2016-01-01

    The etiology, frequency, manifestation, and treatment of dry eye syndrome are commonly influenced by sex and gender. This study aims to review the differences in epidemiology, pathophysiology, and associated diseases between the sexes. The terms men and male and women and female are used interchangeably throughout the review to refer to biological sex. There are numerous objective and subjective markers of dry eye syndrome but not one diagnostic criterion. There are numerous associated conditions with dry eye syndrome varying from autoimmune to allergic. Large epidemiologic studies reviewed suggest that there does indeed exist a difference between dry eye symptoms between men and women, with women having dry eye signs and reporting dry eye symptoms more often than men. The increased prevalence in women could be correlated to an increased association with certain systemic diseases, specifically autoimmune diseases, and to hormonal variations. Several studies found equivocal data about prevalence of dry eye symptoms between men and women. Interpreting studies that investigate epidemiology, pathogenesis, and treatment of dry-eye conditions is complicated by the lack of universally adapted diagnostic criteria and standardized, specific diagnostic tests, and inter-study variability in the definition of dry eye syndrome.

  8. Advancements in anti-inflammatory therapy for dry eye syndrome.

    Science.gov (United States)

    McCabe, Erin; Narayanan, Srihari

    2009-10-01

    The goal of this literature review is to discuss recent discoveries in the pathophysiology of dry eye and the subsequent evolution of diagnostic and management techniques. The mechanisms of various anti-inflammatory treatments are reviewed, and the efficacy of common pharmacologic agents is assessed. Anti-inflammatory therapy is evaluated in terms of its primary indications, target population, and utility within a clinical setting. The Medline PubMed database and the World Wide Web were searched for current information regarding dry eye prevalence, pathogenesis, diagnosis, and management. After an analysis of the literature, major concepts were integrated to generate an updated portrayal of the status of dry eye syndrome. Inflammation appears to play a key role in perpetuating and sustaining dry eye. Discoveries of inflammatory markers found within the corneal and conjunctival epithelium of dry eye patients have triggered recent advancements in therapy. Pharmacologic anti-inflammatory therapy for dry eye includes 2 major categories: corticosteroids and immunomodulatory agents. Fatty acid and androgen supplementation and oral antibiotics have also shown promise in dry eye therapy because of their anti-inflammatory effects. Anti-inflammatory pharmacologic agents have shown great success in patients with moderate to severe dry eye when compared with alternative treatment modalities. A deeper understanding of the link between inflammation and dry eye validates the utilization of anti-inflammatory therapy in everyday optometric practice.

  9. Additive Effect of preservative-free sodium hyaluronate 0.1% in treatment of dry eye syndrome with diquafosol 3% eye drops.

    Science.gov (United States)

    Hwang, Ho Sik; Sung, Yoon-Mi; Lee, Weon Sun; Kim, Eun Chul

    2014-09-01

    The aim of this study was to evaluate the treatment effect of diquafosol 3% with preservative-free sodium hyaluronate 0.1% eye drops in dry eye syndrome. In total, 150 patients with dry eye syndrome were divided randomly into 3 groups. Group 1 (50 patients) was treated 4 times daily with preserved sodium hyaluronate 0.1%, group 2 (50 patients) was treated 4 times daily with diquafosol 3%, and group 3 (50 patients) was treated 4 times daily with diquafosol 3% and preservative-free sodium hyaluronate 0.1% eye drops for 3 months. Ocular surface disease index (OSDI) score, tear film break-up time, Schirmer I test, corneal fluorescein staining, and impression cytology were evaluated. There were significant improvements in the OSDI score, tear film break-up time, Schirmer I score, fluorescein and Rose Bengal staining, goblet cell density, and impression cytological findings in groups 2 and 3 compared with those for group 1 in patients with dry eye syndrome at 1, 2, and 3 months (P dry eye syndrome. Preservative-free sodium hyaluronate 0.1% eye drops can increase the effect of diquafosol 3% in dry eye syndrome.

  10. Dry Eyes and Mouth? You May Have Sjögren's Syndrome

    Science.gov (United States)

    ... Special Issues Subscribe March 2012 Print this issue Dry Eyes and Mouth? You May Have Sjögren’s Syndrome Send us your comments If your eyes and mouth feel as dry as a desert, there are many possible causes, ...

  11. Use of krypton laser stimulation in the treatment of dry eye syndrome

    Science.gov (United States)

    Kecik, Tadeusz; Switka-Wieclawska, Iwona; Ciszewska, Joanna; Portacha, Lidia

    1991-08-01

    We''d like to present the use of krypton laser stimulation in the treatment of dry eye syndrom. 10 patients with dry eye syndrom were treated with irradiation of the lacrimal gland. Schirmer test and break up time were performed before and after therapy. After 10 days of treatment we observed higher value of secreted tear amount.

  12. Antioxidant and inflammatory cytokine in tears of patients with dry eye syndrome treated with preservative-free versus preserved eye drops.

    Science.gov (United States)

    Jee, Donghyun; Park, Sang Hee; Kim, Man Soo; Kim, Eun Chul

    2014-07-03

    To compare the antioxidant and inflammatory cytokine activities in tears of patients with dry eye syndrome treated with preservative-free versus preserved eye drops. A total of 100 patients with moderate to severe dry eye syndrome were randomly divided into two groups. Fifty patients (group 1) were treated four times with preservative-free 0.1% sodium hyaluronate and 0.1% fluorometholone eye drops in the first month and with preservative-free 0.1% sodium hyaluronate and 0.05% cyclosporine eye drops in the second and third months. Another 50 patients (group 2) were treated with preserved eye drops on the same schedule. Ocular Surface Disease Index, corneal fluorescein staining, Schirmer I test, tear film breakup time, impression cytology, and antioxidant and inflammatory cytokine activities in tears were evaluated. Treatment with preservative-free eye drops led to significant improvements in symptoms, tear film breakup time, Schirmer I score, and impression cytologic findings compared to treatment with preserved eye drops (P dry eye syndrome. There was a statistically significant decrease in the IL-1β, IL-6, IL-12, and TNF-α concentrations and a statistically significant increase in the catalase, peroxiredoxin 2, superoxide dismutase 2 (SOD 2), and thioredoxin mean fluorescence intensity (MFI) of tears in the preservative-free group at 1, 2, and 3 months compared to initial values, respectively (P eye drops is effective against the dry eye syndrome. Preservative-free eye drops seem to be more effective than preserved eye drops in decreasing ocular inflammation and in increasing antioxidant contents in tears of patients with dry eye syndrome. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  13. Dry eye syndrome in aromatase inhibitor users.

    Science.gov (United States)

    Turaka, Kiran; Nottage, Jennifer M; Hammersmith, Kristin M; Nagra, Parveen K; Rapuano, Christopher J

    2013-04-01

    Aromatase inhibitors are frequently used as an adjuvant therapy in the treatment of breast cancer. We observed that several patients taking aromatase inhibitors presented with severe dry eye symptoms, and we investigated whether there is a relationship between aromatase inhibitors and dry eyes in these patients. Retrospective chart review. Forty-one women. A computerized search of health records was performed to identify patients using anastrazole, letrozole and exemestane seen by the Cornea Service from August 2008 to March 2011. The results were compared with age-matched controls. Ocular surface changes among aromatase inhibitors users. Of the 41 women, 39 were Caucasians. Thirty-nine patients had breast cancer (95%), one patient had ovarian cancer (2.5%) and one had an unknown primary cancer. Mean age was 68 ± 11.3 years (range 47-95). Most common presenting symptoms were blurred vision in 28 (68%) patients, irritation/foreign body sensation in 12 (29%) patients, redness in 9 (22%) patients, tearing in 6 (22%) patients and photosensitivity in 2 (5%) patients. Mean Schirmer's test measurement was 11 ± 5.8 mm (range 0.5-20 mm). Blepharitis was noted in 68 of 82 eyes (73%), decreased or poor tear function in 24 eyes (29%), conjunctival injection in 18 eyes (22%) and superficial punctate keratitis in 12 eyes (29%). Among an age-matched population (45-95 years), dry eye syndrome was found in only 9.5% of patients. Because the prevalence of ocular surface disease signs and symptoms appears to be higher in study group than control patients, aromatase inhibitors might be a contributing factor to the dry eye symptoms. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

  14. [Dry eye syndrome in patients with primary open-angle glaucoma].

    Science.gov (United States)

    Boyko, E V; Simakova, I L; Yakushev, D Yu; Ignat'ev, S A; Alekseev, I B; Mel'nikova, N V; Alyab'ev, M V; Mal'tsev, D S

    2015-01-01

    to determine the frequency and severity of dry eye syndrome (DES) in primary open-angle glaucoma (POAG) patients that are newly diagnosed or already receiving beta blocker instillation therapy. A total of 127 patients (190 eyes) with POAG were divided into two groups. Group 1 included 55 newly diagnosed patients (88 eyes), group 2-72 POAG patients (102 eyes) instilling timolol 0.5% twice daily into the affected eye. The control group included 20 patients (40 eyes) aged 60-88 years (73.6 ± 9.2 years on average) with early age-related cataract. DES was found in 69 POAG patients (79%) who was just starting their topical hypotensive therapy and 85 of those (84%) under treatment (p = 0.39). One should take into account when prescribing ocular hypotensive therapy that newly diagnosed POAG patients usually already suffer from a dry eye. The use of topical beta blockers that contain preservatives exacerbates dry eye signs and symptoms in these patients.

  15. Dry eye syndrome: A rising occupational hazard in tropical countries

    Directory of Open Access Journals (Sweden)

    Kavita R Bhatnagar

    2014-01-01

    Full Text Available Aim : The aim of this study was to find out the prevalence of dry eye and evaluate personal and environmental risk factors attributable to dry eye in a hospital-based population. Materials and Methods : In this cross-sectional study, 1890 patients above 15 years of age were screened randomly for dry eye. McMonnies Dry Eye Questionnaire, Schirmer′s test, tear film breakup time (TBUT, presence of conjunctival injection, punctate epithelial erosions (PEE, and meibomian gland dysfunction (MGD were used to diagnose dry eye. Patient demographics including age, sex, smoking, and occupation and working environment were also recorded. Correlation of dry eye signs with symptoms and TFBUT and Schirmer′s tests was also assessed. Results : The prevalence of dry eye was 10.58%. The prevalence was higher in outdoor workers (17.77%. The male: female ratio was 2.33:1. The number of males was highest in the 56-60 (13% and 60-65 (14% years age groups while that of females was highest in the 46-50 (16.67% years age group. A total of 10% of the patients were smokers, while 8% were tobacco chewers. A 2.15-fold increase was found in the odds for dry eye in those exposed to excessive wind, 1.91-fold to sunlight exposure, and 2.04 for air pollution. Abnormally low TBUT and Schirmer′s tests were significantly associated with dry eye signs (P=0.009 and 0.014, respectively. Conclusion : Dry eye is a leading cause of ocular discomfort in OPD patients. Excessive exposure to wind, sunlight, high temperature, and air pollution was significantly related to dry eyes. There was a significant correlation between patient′s history, symptoms, dry eye signs and objective tests for tear film. The rural people and those with outdoor occupation are more exposed to extraneous influences of environmental factors in tropical climate. These factors affect the tear film and ocular surface causing the dry eye syndrome.

  16. Clinical Characteristics of Dry Eye Patients With Chronic Pain Syndromes

    NARCIS (Netherlands)

    Vehof, Jelle; Smitt-Kamminga, Nicole Sillevis; Kozareva, Diana; Nibourg, Simone A.; Hammond, Christopher J.

    PURPOSE: To investigate clinical characteristics of dry eye disease (DED) patients with a chronic pain syndrome. DESIGN: Cross-sectional. study. METHODS: Four hundred twenty-five patients of a tertiary care DED patient cohort in the Netherlands were included. Chronic pain syndromes irritable bowel

  17. Effect of Oral Pilocarpine in Treating Severe Dry Eye in Patients With Sjögren Syndrome.

    Science.gov (United States)

    Kawakita, Tetsuya; Shimmura, Shigeto; Tsubota, Kazuo

    2015-01-01

    The aim of this study is to evaluate the efficacy and safety of oral pilocarpine in treating severe dry eye unresponsive to conventional conservative treatment in patients with Sjögren syndrome. A prospective study. Oral doses of pilocarpine were administered for at least 3 months to patients with Sjögren syndrome complicated by established dry eye of great severity unresponsive to conventional conservative treatment. Subjective eye symptoms (dry eye sensation and eye pain), fluorescein staining scores, rose Bengal staining scores, and tear film breakup time measurements improved significantly after 1 month and 3 months of oral treatment with pilocarpine, whereas no significant improvement was noted in Schirmer I testing. Oral administration of pilocarpine was useful in treating severe dry eye unresponsive to conventional conservative treatment in patients with Sjögren syndrome from the standpoint of efficacy and safety. Thus, we conclude that oral pilocarpine is effective as a new option in treating severe dry eye.

  18. Severity of dry eye syndrome is related to anti-dsDNA autoantibody in systemic lupus erythematosus patients without secondary Sjogren syndrome: A cross-sectional analysis.

    Science.gov (United States)

    Chen, Alexander; Chen, Hung-Ta; Hwang, Yih-Hsiou; Chen, Yi-Tsun; Hsiao, Ching-Hsi; Chen, Hung-Chi

    2016-07-01

    There are as many as one-third of the systemic lupus erythematosus (SLE) patients who suffer from dry eye syndrome. To this date, dry eye syndrome in SLE patients is believed to be caused by secondary Sjogren syndrome (sSS). However, there is increasing evidence for possible independency of dry eye syndrome and sSS in patients suffering from autoimmune diseases. The purpose of this retrospective observational case series was to identify SLE patients without sSS who had dry eye syndrome, examine the correlation of different autoantibodies and dry eye severity, and determine the cause of dry eye in these patients.We included 49 consecutive SLE patients with dry eye who visited our dry eye clinic. In order to rule out sSS, these patients were all negative for anti-Sjogren's-syndrome-related antigen A and B (anti-SSA/SSB) and had no oral symptoms. Each patient's lupus activity was determined by serological tests including antidouble-stranded DNA antibody (anti-dsDNA), complement levels (C3, C4), erythrocyte sedimentation rate (ESR), and antinuclear antibody (ANA). Severity of dry eye syndrome was determined by corneal sensation (KSen), superficial punctuate keratopathy (SPK), Schirmer-I test (Schirmer), and tear film break-up time (TBUT). The autoantibodies and the dry eye parameters in each group were tested using the χ test or the Mann-Whitney U test for normally distributed or skewed data, respectively.The anti-dsDNA showed significant correlations with KSen (P dry eye parameters were observed between C4, ESR, and ANA.The major finding of this study was that the severity of dry eye syndrome in SLE patients without sSS was strongly correlated with anti-dsDNA and C3 but not with C4, ESR, and ANA.

  19. Factors associated with severe dry eye in primary Sjögren's syndrome diagnosed patients.

    Science.gov (United States)

    Fernandez Castro, Mónica; Sánchez-Piedra, Carlos; Andreu, Jose Luis; Martínez Taboada, Víctor; Olivé, Alejandro; Rosas, Jose

    2018-06-01

    Primary Sjögren's syndrome (pSS) is an autoimmune disease, characterized by lymphocytic infiltration of exocrine glands and other organs, resulting in dry eye, dry mouth and extraglandular systemic findings. To explore the association of severe or very severe dry eye with extraocular involvement in patients diagnosed with primary Sjögren's syndrome. SJOGRENSER registry is a multicenter cross-sectional study of pSS patients. For the construction of our main variable, severe/very severe dry eye, we used those variables that represented a degree 3-4 of severity according to the 2007 Dry Eye Workshop classification. First, bivariate logistic regression models were used to identify the effect of each independent variable on severe/very severe dry eye. Secondly, multivariate analysis using regression model was used to establish the independent effect of patient characteristics. Four hundred and thirty-seven patients were included in SJOGRENSER registry; 94% of the patients complained of dry eye and 16% developed corneal ulcer. Schirmer's test was pathological in 92% of the patients; 378 patients presented severe/very severe dry eye. Inflammatory articular involvement was significantly more frequent in patients with severe/very severe dry eye than in those without severe/very severe dry eye (82.5 vs 69.5%, p = 0,028). Inflammatory joint involvement was associated with severe/very severe dry eye in the multivariate analysis, OR 2.079 (95% CI 1.096-3.941). Severe or very severe dry eye is associated with the presence of inflammatory joint involvement in patients with pSS. These results suggest that a directed anamnesis including systemic comorbidities, such as the presence of inflammatory joint involvement or dry mouth in patients with dry eye, would be useful to suspect a pSS.

  20. Dry Eyes and Glaucoma: Double Trouble

    Science.gov (United States)

    ... Involved News About Us Donate In This Section Dry Eyes and Glaucoma: Double Trouble email Send this article ... eye disease bothers the patient more. What Causes Dry Eye Syndrome? Dry eye can be caused by many ...

  1. Systemic Comorbidities of Dry Eye Syndrome: The Korean National Health and Nutrition Examination Survey V, 2010 to 2012.

    Science.gov (United States)

    Roh, Hyun Cheol; Lee, Jimmy K; Kim, Martha; Oh, Jong-Hyun; Chang, Min-Wook; Chuck, Roy S; Park, Choul Yong

    2016-02-01

    To identify systemic comorbidities in patients with dry eye syndrome in South Korea. From 2010 to 2012, 17,364 participants aged 20 or older were randomly included in the nationwide Korean National Health and Nutrition Examination Survey V. The prevalence of dry eye syndrome and demographics of these patients were investigated. We performed conditional logistic regression analyses based on age, sex, residential area, education level, occupation type, and household income level to obtain the odds ratio for each systemic comorbidity among subjects with and without dry eye syndrome. The prevalence of dry eye syndrome in this study was 10.4%. Age [adjusted odds ratio (AOR): 1.02], female gender (AOR: 3.01), and indoor occupation (AOR: 1.30) were associated with a higher prevalence of dry eye syndrome and found to be less prevalent in those residing in rural areas (AOR: 0.73) and with lower education levels (AOR: 0.66-0.99). With regard to systemic comorbidities, dyslipidemia (AOR: 1.63), degenerative arthritis (AOR: 1.56), rheumatoid arthritis (AOR: 1.44), thyroid disease (AOR: 1.79), and renal failure (AOR: 2.56) were associated with a significantly higher prevalence of dry eye syndrome. We found that patients with dry eye syndrome have a higher prevalence of several systemic comorbidities. A more comprehensive therapeutic approach considering the effect of systemic medication may be necessary in these patients.

  2. Effectiveness of hormone therapy for treating dry eye syndrome in postmenopausal women: a randomized trial.

    Science.gov (United States)

    Piwkumsribonruang, Narongchai; Somboonporn, Woraruk; Luanratanakorn, Patanaree; Kaewrudee, Srinaree; Tharnprisan, Piangjit; Soontrapa, Sugree

    2010-06-01

    The efficacy of hormone therapy (HT) on dry eye syndrome remains debatable. To study the efficacy of HT on dry eye syndrome. A randomized controlled, double blind, parallel group, community-based study in 42 post-menopausal patients was conducted. The patients had dry eye syndrome and were not taking any medications. They were assigned to one of two groups. Group A comprised 21 patients given transdermal 17 beta-estradiol (50 mg/day) and medroxy progesterone acetate (2.5 mg/day) continuously for three months and group B comprised 21 patients given both transdermal and oral placebo. Participants in the study were included for final analysis. The improvement of dry eye symptoms were measured by visual analog scale, tear secretion, intraocular pressure, corneal thickness, and tear breakup time determined before treatment and at 6 and 12 weeks of treatment. At 12 weeks, the number of patients who reported improvement of dry eye symptoms was greater in the HT group than that in the placebo group. However, the difference was not statistically significant (RR 0.25, 95% CI 0.04-2.80 and 0.60, 95% CI 0.33-2.03 in right and left eye, respectively). For other parameters, there was no significant difference between the two groups. According to the present study, there is no strong evidence to support the use of HT for treating dry eye syndrome. The limited number of participants included in the present study may have contributed to the insignificant effects.

  3. Tear clearance measurement in patients with dry eye syndrome using quantitative lacrimal scintigraphy

    International Nuclear Information System (INIS)

    Gencoglu, E.A.; Dursun, D.; Akova, Y.A.; Cengiz, F.; Yalcin, H.; Koyuncu, A.

    2005-01-01

    The aim of this study was to evaluate the tear clearance in patients with dry eye syndrome using quantitative lacrimal scintigraphy. We investigated 21 patients (42 eyes; 18 women, 3 men; mean age, 63.19±13.33 years) with dry eye syndrome. Additionally, for the sake of comparison, 12 normal subjects of the same age group (24 eyes; 10 women, 2 men; mean age, 68.25±2.63 years) were included. Lacrimal scintigraphy, Schirmer-1 test, break-up time (BUT), and rose bengal ocular surface vital staining were performed in these cases. According to the results of lacrimal scintigraphy, the mean value of T1/2 was 4.16±1.22 minutes and the mean value of radioisotope (RI) was 14.15%±2.30% in normal subjects. However, in patients with dry eye syndrome, these values were 20.59±1.97 minutes and 55.64%±6.90%, respectively. Consistent with the results of ophthalmologic tests, the mean Schirmer-1 value was 12.46±2.10 mm, the mean value of BUT was 14.36±3.40 seconds, and the mean staining value of the rose bengal was 1.98±0.80 in normal subjects, whereas these values were 1.36±0.49 mm, 5.46±1.33 seconds, 6.62±0.86, respectively, in patients with dry eye syndrome. When we compared the results of lacrimal scintigraphy and the results of ophthalmologic tests, an inverse correlation was noted between both the T1/2 and RI values and both the Schirmer-1 and BUT values in all subjects (p<0.001). However, there was a greater positive correlation between the rose bengal ocular surface staining value and both the T1/2 and RI values in all cases (p<0.001). In the current study, it was concluded that although the lacrimal drainage system was normal, tear clearance was significantly delayed in dry eye patients. With this study, we have shown that quantitative lacrimal scintigraphy, which is an objective, practical, and noninvasive method, appears to be useful for the assessment of the tear clearance in patients with dry eye syndrome. (author)

  4. Elevation of autophagy markers in Sjögren syndrome dry eye.

    Science.gov (United States)

    Byun, Yong-Soo; Lee, Hyun Jung; Shin, Soojung; Chung, So-Hyang

    2017-12-08

    Autophagy is known to be implicated in the pathogenesis of Sjögren syndrome (SS), but evidences are limited. We aimed to examine the levels of autophagy markers in tear film and conjunctival epithelial cells from SS dry eye patients, and analyze their correlations with clinical features. Patients with SS dry eye exhibited lower Schirmer values, lower tear breakup time, and higher ocular staining scores. In tears, ATG5 and LC3B-II/I levels were significantly higher in SS dry eye. ATG5 and LC3B-II mRNA in the conjunctiva were also elevated in SS dry eye compared with non-SS dry eye. The immunostaining of conjunctival epithelium showed a punctate pattern of ATG5 and LC3B-II in SS dry eye. These staining patterns were also observed in the lacrimal gland of SS animal models. ATG5 levels in tears and the conjunctival epithelium strongly correlated with ocular staining scores, and one month of topical corticosteroid treatment reduced both ATG5 and LC3B-II/I levels in tear film and the conjunctival epithelium of patients with SS dry eye. Our results suggest that autophagy is enhanced or dysregulated in SS and autophagy markers may be serve as both diagnostic and therapeutic biomarkers in SS dry eye.

  5. Prevalence of dry eye syndrome after allogeneic hematopoietic stem cell transplantation.

    Science.gov (United States)

    Ivanir, Yair; Shimoni, Avichai; Ezra-Nimni, Orit; Barequet, Irina S

    2013-05-01

    To evaluate the prevalence, severity, and effect of dry eye in patients after allogeneic hematopoietic stem cell transplantation (aHSCT) and to correlate the findings to the duration after transplantation. A total of 222 eyes of 111 patients after aHSCT at the Department of Bone Marrow Transplantation, Sheba Medical Center, Israel in a consecutive 3-year period. All patients underwent a full ophthalmic examination and filled the ocular surface disease index (OSDI) questionnaire to assess ocular involvement in the form of dry eye syndrome or any other ocular manifestation. The main outcome measures were best-corrected visual acuity, tear break-up time, corneal fluorescein staining, Schirmer test, and OSDI questionnaire. A total of 111 patients were recruited. In 37%, a diagnosis of ocular graft versus host disease was previously made and 46% had no previous ocular examination. Schirmer test was less than 5 mm in 50% of all patients, and in 30% of patients with undiagnosed ocular involvement. The mean OSDI score was 13, and in 28% it was above 20. Correlation was found between visual acuity decrease and high OSDI score to the diagnosis of ocular graft versus host disease and signs of dry eye syndrome. A trend of worsening dry eye was observed up to the second half of the second year posttransplantation. Although many patients are either asymptomatic or do not seek ophthalmic examination, severe dry eye is a common finding after aHSCT. Mandatory follow-up, patient education, and early treatment may improve the quality of life.

  6. Efficacy of combined pranoprofen eye drops and artificial tears on the treatment of mild to moderate dry eye syndrome after trabbeculectomy

    Directory of Open Access Journals (Sweden)

    Guang-Ming Zhao

    2015-02-01

    Full Text Available AIM:To evaluate the efficacy of combined pranoprofen eye drops and artificial tears on the treatment of mild to moderate dry eye syndrome after trabbeculectomy. METHODS: This prospective case control study included 63 cases(63 eyesof patients with mild to moderate dry eye syndrome after trabbeculectomy in our hospital from November 2013 to June 2013. All subjects were randomly divided into two groups. Observation group was treated with combined pranoprofen eye drops and artificial tears and control group received simple artificial tears marking the eyes at 1, 2, 4wk. The patient's symptoms, signs, BUT, SⅠt, and FL were observed before treatment and 1, 2, 4wk after treatment. RESULTS:After 2wk, the symptoms of observation group were improved, there was statistically significant difference(PPPPCONCLUSION: Artificial tears joint pranoprofen eye drops has good curative effect in the treatment of mild to moderate dry eye syndrome after trabbeculectomy.

  7. Essential fatty acids in the treatment of dry eye syndrome: A myth or reality?

    OpenAIRE

    Al Mahmood, Ammar M.; Al-Swailem, Samar A.

    2014-01-01

    Dry eye is a common condition that can severely impair the quality of life. Systemic and topical omega-3 fatty acids and omega-6 fatty acids have been used as treatment for patients with dry eye disease and showed promising results. Further multicenter randomized controlled trials are required in order to establish a standardized protocol for the treatment of dry eye syndrome with those essential fatty acids.

  8. Survey of Ophthalmologists Regarding Practice Patterns for Dry Eye and Sjogren Syndrome.

    Science.gov (United States)

    Bunya, Vatinee Y; Fernandez, Karen B; Ying, Gui-Shuang; Massaro-Giordano, Mina; Macchi, Ilaria; Sulewski, Michael E; Hammersmith, Kristin M; Nagra, Parveen K; Rapuano, Christopher J; Orlin, Stephen E

    2018-01-15

    To survey ophthalmologists about current practice patterns regarding the evaluation of dry eye patients and referrals for a Sjogren syndrome (SS) workup. An online survey was sent to ophthalmologists affiliated with the Scheie Eye Institute or Wills Eye Hospital using REDCap in August 2015. Descriptive statistics were used to summarize the data. Four hundred seventy-four survey invitations were sent out and 101 (21%) ophthalmologists completed the survey. The common traditional dry eye test performed was corneal fluorescein staining (62%) and the most common newer dry eye test performed was tear osmolarity (18%). Half of respondents (51%) refer fewer than 5% of their dry eye patients for SS workups, with 18% reporting that they never refer any patients. The most common reasons for referrals included positive review of systems (60%), severe dry eye symptoms (51%) or ocular signs (47%), or dry eye that is refractory to treatment (42%). The majority (83%) felt that there is a need for an evidence-based standardized screening tool for dry eye patients to decide who should be referred for evaluation for SS. Ophthalmologists continue to prefer the use of traditional dry eye tests in practice, with the most common test being corneal fluorescein staining. There is an underreferral of dry eye patients for SS workups, which is contributing to the continued underdiagnosis of the disease. Most respondents felt that there was a need for an evidence-based standardized screening tool to decide which dry eye patients should be referred for SS evaluations.

  9. Dry eyes: etiology and management.

    Science.gov (United States)

    Latkany, Robert

    2008-07-01

    Until recently, the cause of dry eye syndrome was uncertain and the treatment was palliative. Since discovering that dry eyes are caused by inflammation, there has been an abundance of research focusing on anti-inflammatory therapies, other contributing causes, and better diagnostic testing. This review summarizes some of the interesting published research on ocular surface disease over the past year. The definition of dry eye now highlights the omnipresent symptom of blurry vision. The re-evaluation of ocular surface staining, tear meniscus height, and visual change will allow for a better diagnosis and understanding of dry eyes. Punctal plugs, and oral and topical anti-inflammatory use will strengthen our arsenal against ocular surface disease. Major progress has occurred in the past few years in gaining a better understanding of the etiology of dry eye syndrome, which will inevitably lead to more effective therapeutic options.

  10. Analysis of novel Sjogren's syndrome autoantibodies in patients with dry eyes.

    Science.gov (United States)

    Everett, Sandra; Vishwanath, Sahana; Cavero, Vanessa; Shen, Long; Suresh, Lakshmanan; Malyavantham, Kishore; Lincoff-Cohen, Norah; Ambrus, Julian L

    2017-03-07

    Dry eye is a common problem in Ophthalmology and may occur for many reasons including Sjogren's syndrome (SS). Recent studies have identified autoantibodies, anti-salivary gland protein 1 (SP1), anti-carbonic anhydrase 6 (CA6) and anti-parotid secretory protein (PSP), which occur early in the course of SS. The current studies were designed to evaluate how many patients with idiopathic dry eye and no evidence of systemic diseases from a dry eye practice have these autoantibodies. Patients from a dry eye clinic and normal controls were assessed by Schirmer's test for tear flow. Sera were assessed for autoantibodies using ELISA assays. Statistics was performed with Prism 7 software and student's unpaired t test. In this study 60% of the dry eye patients expressed one of these autoantibodies. Only 30% expressed one of the autoantibodies associated with long-standing SS, which are included in the diagnostic criteria for SS, anti-Ro and anti-La. Patients with disease for less than 2 years and mild dry eyes did not express anti-Ro or anti-La, while 25% expressed anti-SP1. Similar observations, with smaller numbers, were made when patients had not only dry eye but also dry mouth. Antibodies to SP1, CA6 and PSP occur in some patients with idiopathic dry eyes. Further studies will be needed to determine how many of these patients go on to develop systemic manifestations of SS. Testing for these autoantibodies may allow early recognition of patients with SS. This will lead to improved management of the patients and the development of new strategies to maintain normal lacrimal and salivary gland function in patients with SS.

  11. The Prevalence of Dry Eye and Sjögren Syndrome in Patients with Migraine.

    Science.gov (United States)

    Sarac, Ozge; Kosekahya, Pinar; Yildiz Tasci, Yelda; Keklikoglu, Hava D; Deniz, Orhan; Erten, Şükran; Çağıl, Nurullah

    2017-06-01

    To evaluate the presence of dry eye and primary Sjögren syndrome (SS) in patients with migraine. In total, 46 eyes of 46 patients with migraine (group 1) and 50 eyes of 50 healthy subjects (group 2) were included in this study. Detailed ophthalmologic, neurologic and rheumatologic examination were performed on all participants. Ocular surface disease index questionnaire, tear function tests, visual analog scale for pain, serologic analysis were also performed. Dry eye symptoms and findings were significantly higher and more severe in group 1 when compared with group 2. Primary SS was not found in any of the participants. The migraine lifetime duration was negatively correlated with the tear function tests while it was positively correlated with the ocular surface disease index scores. Dry eye symptoms and findings are higher in migraine patients when compared with the healthy subjects without the presence of Sjögren syndrome.

  12. Systematic review of randomized controlled trials in the treatment of dry eye disease in Sjogren syndrome.

    Science.gov (United States)

    Shih, Kendrick Co; Lun, Christie Nicole; Jhanji, Vishal; Thong, Bernard Yu-Hor; Tong, Louis

    2017-01-01

    Primary Sjögren's syndrome is an autoimmune disease characterized by dry eye and dry mouth. We systematically reviewed all the randomized controlled clinical trials published in the last 15 years that included ocular outcomes. We found 22 trials involving 9 topical, 10 oral, 2 intravenous and 1 subcutaneous modalities of treatment. Fluoromethalone eye drops over 8 weeks were more effective than topical cyclosporine in the treatment of dry eye symptoms and signs; similarly, indomethacin eye drops over 1 month were more efficacious than diclofenac eye drops. Oral pilocarpine 5 mg twice daily over 3 months was superior to use of lubricants or punctal plugs for treating dry eye, but 5% of participants had gastrointestinal adverse effects from pilocarpine, though none discontinued treatment. In contrast, etanercept, a TNF-alpha blocking antibody, administered as subcutaneous injections twice weekly, did not improve dry eye significantly compared to placebo injections. In conclusion, topical corticosteroids have been shown to be effective in dry eye associated with Sjögren's syndrome. As some topical non-steroidal anti-inflammatory drugs may be more effective than others, these should be further evaluated. Systemic secretagogues like pilocarpine have a role in Sjögren's syndrome but the adverse effects may limit their clinical use. It is disappointing that systemic cytokine therapy did not produce encouraging ocular outcomes but participants should have assessment of cytokine levels in such trials, as those with higher baseline cytokine levels may respond better. (229 words).

  13. Association of IL-21 cytokine with severity of primary Sjögren syndrome dry eye.

    Science.gov (United States)

    Lim, Sung A; Nam, Doo Hyun; Lee, Jee Hye; Kwok, Seung-Ki; Park, Sung-Hwan; Chung, So-Hyang

    2015-03-01

    IL-21 plays an important role in primary Sjögren syndrome (SS) pathogenesis. The purpose of this study was to evaluate IL-21 expression in tears and the conjunctiva and to analyze the impact of IL-21 on primary SS dry eyes. Eighty subjects were enrolled in this study: 30 patients with primary SS dry eye (30 eyes); 30 patients with non-SS dry eye (30 eyes), and 20 normal controls. Tear IL-21 levels were measured by flow cytometry, and IL-21 gene expression in the conjunctiva from impression cytology was evaluated by quantitative polymerase chain reaction. Ocular Surface Disease Index, tear film breakup time, Schirmer I test, and ocular surface staining scores were obtained for all patients. Primary SS dry eyes had significantly higher tear IL-21 levels than non-SS dry eyes and normal controls (P dry eyes than in non-SS dry eyes and normal controls (P dry eyes and controls. The tear IL-21 level was significantly correlated with ocular surface stain scores (r = 0.54, P dry eyes. Our findings suggest that severity of primary SS dry eye is associated with IL-21.

  14. Prevalence of dry eye syndrome at patients with diabetus melitus tip 2, one year retrospective study May 2011-June 2012

    Directory of Open Access Journals (Sweden)

    Nora Burda

    2012-01-01

    Conclusions: In our study the Dry Eye Syndrome showed to have a high correlation with Diabetes Mellitus Tip II (about 52.9%. Prevalence of Dry Eye was significantly higher at patients with longer duration of diabetes. Dry Eye seems to be an important contributing factor related to corneal abnormalities. Age and sex not seem to play any important role in this condition. Good glycemic control is important for prevention and control of Dry Eye Syndrome.

  15. Systematic review of randomized controlled trials in the treatment of dry eye disease in Sjogren syndrome

    Directory of Open Access Journals (Sweden)

    Kendrick Co Shih

    2017-11-01

    Full Text Available Abstract Primary Sjögren’s syndrome is an autoimmune disease characterized by dry eye and dry mouth. We systematically reviewed all the randomized controlled clinical trials published in the last 15 years that included ocular outcomes. We found 22 trials involving 9 topical, 10 oral, 2 intravenous and 1 subcutaneous modalities of treatment. Fluoromethalone eye drops over 8 weeks were more effective than topical cyclosporine in the treatment of dry eye symptoms and signs; similarly, indomethacin eye drops over 1 month were more efficacious than diclofenac eye drops. Oral pilocarpine 5 mg twice daily over 3 months was superior to use of lubricants or punctal plugs for treating dry eye, but 5% of participants had gastrointestinal adverse effects from pilocarpine, though none discontinued treatment. In contrast, etanercept, a TNF-alpha blocking antibody, administered as subcutaneous injections twice weekly, did not improve dry eye significantly compared to placebo injections. In conclusion, topical corticosteroids have been shown to be effective in dry eye associated with Sjögren’s syndrome. As some topical non-steroidal anti-inflammatory drugs may be more effective than others, these should be further evaluated. Systemic secretagogues like pilocarpine have a role in Sjögren’s syndrome but the adverse effects may limit their clinical use. It is disappointing that systemic cytokine therapy did not produce encouraging ocular outcomes but participants should have assessment of cytokine levels in such trials, as those with higher baseline cytokine levels may respond better. (229 words

  16. Holmium laser use in the treatment of selected dry eye syndrome complications

    Science.gov (United States)

    Kecik, Dariusz; Kecik, Tadeusz; Kasprzak, Jan; Kecik, Mariusz

    1996-03-01

    The authors present initial results of treatment selected complications of dry eye syndrome with holmium laser. The lacrimal puncta obliteration and coagulation of the corneal ulcer surface were done.

  17. Analysis of Th17-associated cytokines in tears of patients with dry eye syndrome.

    Science.gov (United States)

    Tan, X; Sun, S; Liu, Y; Zhu, T; Wang, K; Ren, T; Wu, Z; Xu, H; Zhu, L

    2014-05-01

    To determine the levels of Th17-associated cytokines, particularly interleukin (IL)-17 and IL-22 in tears of patients with dry eye syndrome. Tear samples were collected from 20 healthy volunteers, 20 dry eye (DE) patients with non-Sjögren's syndrome (NSSDE) and 20 DE patients with Sjögren's syndrome (SSDE). Symptom questionnaire was self-administered and multiple dry eye disease (DED)-related clinical tests were performed. The levels of IL-17 and IL-22 in tears were measured by enzyme-linked immunosorbent assay. The levels of IL-17 and IL-22 were significantly increased in tears of DE patients compared with those of controls and also higher in SSDE patients compared with those of NSSDE patients (Ptear film break-up time and Schirmer I test in both NSSDE and SSDE patients (Ptears were significantly increased in DE patients, which were associated with the disease severity. Therefore, Th17 cell-associated cytokines, particularly IL-17 and IL-22, may have important roles in the immunopathogenesis of the DED.

  18. Efficacy and Safety of Carbomer-Based Lipid-Containing Artificial Tear Formulations in Patients With Dry Eye Syndrome.

    Science.gov (United States)

    Chung, So-Hyang; Lim, Sung A; Tchach, Hungwon

    2016-02-01

    To evaluate the efficacy and safety profile of carbomer-based lipid-containing artificial tear formulations (CBLAT) in patients with dry eye syndrome. A multicenter parallel-group study was conducted in 412 patients with dry eye syndrome. Of these patients, 221 switched from using artificial tears to CBLAT (switching group) and 191 added CBLAT to their current treatment (add-on group). Ocular symptom scores, ocular staining grades, tear film breakup time (tBUT), Schirmer I test value, and Korean dry eye level (as defined by the Korean Corneal Disease Study Group guidelines) were evaluated at baseline and after 4 weeks of treatment. After 4 weeks of treatment, ocular surface staining grade, tBUT, Schirmer I value, ocular irritation symptom scores, and the positive rate of visual symptom improved significantly in both groups. Mean reductions in ocular surface staining grades (-0.8 ± 0.9) and ocular irritation symptom scores (-0.8 ± 0.8) in the add-on group were significantly higher than those (-0.5 ± 0.8 and -0.6 ± 0.8) in the switching group (P dry eye level was 30.1% in the switching group and 51.6% in the add-on group. More patients in the add-on group had decreased dry eye levels than those in the switching group (P dry eye syndrome.

  19. [Autologous serum tears: Long-term treatment in dry eye syndrome].

    Science.gov (United States)

    Beylerian, M; Lazaro, M; Magalon, J; Veran, J; Darque, A; Grimaud, F; Stolowy, N; Beylerian, H; Sabatier, F; Hoffart, L

    2018-03-01

    Dry eye disease is a multifactorial pathology of the ocular surface. The high incidence of this pathology, as well as its significant impact on quality of life and vision and its financial cost, makes it a real public health problem. While the treatment of mild cases is generally simple and effective, treatment of severe forms is often disappointing. The use of autologous serum tears (AST) represents a therapeutic alternative for the most severe cases. The purpose of our study is to evaluate the efficacy of long-term AST treatment in patients with severe dry eye disease refractory to conventional treatment or secondary to systemic diseases such as Sjögren's syndrome or Graft versus Host disease (GVH), or ocular pathologies such as neurotrophic keratitis, chemical burns and ocular cicatricial pemphigoid. This is a monocentric retrospective observational study conducted on 47 patients, with 83 eyes treated with autologous serum eye drops for isolated or secondary dry eye disease at the Marseille Public Hospitals between April 2014 and April 2017. The patients' subjective symptoms (ocular surface disease index [OSDI] score), their degree of satisfaction and the side effects were collected using questionnaires. Tear Break Up Time (BUT) and Schirmer scores were noted. A clinical evaluation based on fluorescein staining (Oxford score) was carried out prior to treatment with AST at P0 followed by 5 periods: P1 (between 1 and 3 months), P2 (3 to 9 months), P3 (9 to 15 months), P4 (15 months to 24 months), and P5 (>24 months). Out of the 83 eyes treated, the mean age was 54.39±21.56. There were 20 males (42.55 %) and 27 females (57.44 %); treatment indications consisted mainly of 25.53 % GVH, 21.27 % severe dry eye disease and 19.14 % Sjögren syndrome. The mean duration of follow-up was 9.82 months±15.50. The OSDI score decreased by 19.32 points±29.37 (Pdry eye symptoms over time with AST, significantly at P1 (Peyes treated with ASD, clinical

  20. Punctal occlusion for dry eye syndrome.

    Science.gov (United States)

    Ervin, Ann-Margret; Law, Andrew; Pucker, Andrew D

    2017-06-26

    Dry eye syndrome is a disorder of the tear film that is associated with symptoms of ocular discomfort. Punctal occlusion is a mechanical treatment that blocks the tear drainage system in order to aid in the preservation of natural tears on the ocular surface. To assess the effects of punctal plugs versus no punctal plugs, different types of punctal plugs, and other interventions for managing dry eye. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 11), MEDLINE Ovid (1946 to 8 December 2016), Embase.com (1947 to 8 December 2016), PubMed (1948 to 8 December 2016), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to 8 December 2016), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com; last searched 18 November 2012 - this resource is now archived), ClinicalTrials.gov (www.clinicaltrials.gov; searched 8 December 2016), and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en; searched 8 December 2016). We did not use any date or language restrictions in the electronic searches for trials. We also searched the Science Citation Index-Expanded database and reference lists of included studies. The evidence was last updated on 8 December 2016 SELECTION CRITERIA: We included randomized and quasi-randomized controlled trials of collagen or silicone punctal plugs in symptomatic participants diagnosed with aqueous tear deficiency or dry eye syndrome. Two review authors independently assessed trial quality and extracted data. We contacted study investigators for additional information when needed. We included 18 trials (711 participants, 1249 eyes) from Austria, Canada, China, Greece, Japan, Mexico, Netherlands, Turkey, the UK, and the USA in this review. We also identified one ongoing trial. Overall we judged these trials to be at unclear risk of bias because they were poorly reported. We

  1. STUDY OF PREVALENCE OF DRY EYE IN DIABETES

    Directory of Open Access Journals (Sweden)

    Vivek Mahadev Sahasrabudhe

    2017-06-01

    Full Text Available BACKGROUND Diabetes causes blindness in 20-74 year old persons. Blindness in diabetic patients may due to cataract or retinopathy. Dry eye is one of the ocular surface problem increasingly observed in diabetic patients. This study was performed to assess the prevalence of dry eye syndrome in type 2 diabetic patients and their contributing factors. MATERIALS AND METHODS A cross-sectional study was done between April 2016 to September 2016. 70 patients of type 2 diabetes diagnosed at Dr. Shankarrao Chavan Government Hospital, Nanded, were included in this study. Patients were assessed by questionnaire about other diseases and drugs. Dry eye syndrome was assessed with Tear Breakup Time (TBUT, Schirmer's test, lissamine green staining apart from routine ophthalmic examination. RESULTS Out of 60 patients, 32 (53% suffer from dry eye syndrome. CONCLUSION Diabetes and dry eyes appear to have a common association. Further studies need to be undertaken to establish an aetiologic relationship. As routine dilated fundus examination is an integral part of evaluation of diabetic patients in ophthalmic clinics, examination for dry eye should also be an integral part of the assessment of diabetic eye disease.

  2. Effects of phytoestrogen supplementation in postmenopausal women with dry eye syndrome: a randomized clinical trial.

    Science.gov (United States)

    Scuderi, Gianluca; Contestabile, Maria Teresa; Gagliano, Caterina; Iacovello, Daniela; Scuderi, Luca; Avitabile, Teresio

    2012-12-01

    To evaluate the correlation between tear osmolarity and blood levels of 17-β estradiol, estrone, and testosterone in postmenopausal women with dry eye syndrome, and to assess the efficacy and safety of oral supplementation with phytoestrogens, lipoic acid, and eicosapentaenoic acid in this population. Cross-sectional study including 66 postmenopausal women with dry eye syndrome. Sixty-six postmenopausal women with dry eye syndrome were enrolled in a randomized, double-blind, placebo-controlled, crossover study. Patients were divided into 2 groups (groups A and B) and treated, respectively, with phytoestrogen (Bioos, Montegiorgio, Italy) tablets or placebo tablets for 30 days. The 2 treatment periods were separated by a 30-day washout. Patients were examined on days 0 and 30 of each period. Assessments included blood levels of sex hormones, the Schirmer test for tear production, and measurement of tear osmolarity and tear film break-up time. At baseline, all patients had low sex hormone levels, which were correlated with high tear film osmolarity values (r = -0.59,-0.61,-0.58, respectively). After 30 days of therapy, the group treated with Lacrisek® (Bioos) had significantly decreased tear osmolarity (Pdry eye syndrome in postmenopausal women. Copyright © 2012 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  3. Síndrome de ojo seco Dry eye syndrome

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    Rafael Balbona Brito

    2005-06-01

    Full Text Available Se realizó una revisión bibliográfica sobre el síndrome de ojo seco, que abarcó su clasificación, diagnóstico y tratamiento. Se tuvo en cuenta que constituye una entidad frecuente en la Oftalmología; se presenta con la finalidad de mostrar el síndrome de manera actualizada y con el objetivo de facilitar su manejoA bibliographic review of the dry eye syndrome that included its classification, diagnosis and treatment is made. Taking into account that it is a frequent entity in Ophthalmology, it is presented in order to provide an updating of the syndrome and to facilitate its management

  4. Stability of epitheliotrophic factors in autologous serum eye drops from chronic Stevens-Johnson syndrome dry eye compared to non-autoimmune dry eye.

    Science.gov (United States)

    Phasukkijwatana, Nopasak; Lertrit, Patcharee; Liammongkolkul, Sompong; Prabhasawat, Pinnita

    2011-09-01

    To compare the concentrations of epitheliotrophic factors in autologous serum eye drops (ASE) prepared from sera of chronic Stevens-Johnson syndrome (SJS) patients with dry eyes to those prepared from non-autoimmune dry eye controls and to study the stability of the epitheliotrophic factors in different storage conditions. Twenty-percent ASE were prepared from 10 chronic SJS patients with dry eyes and 10 age-matched non-autoimmune dry eye controls. The concentrations of major epitheliotrophic factors comprising epidermal growth factor (EGF), transforming growth factor-beta1 (TGF-β1), transforming growth factor-beta2 (TGF-β2), and fibronectin in those ASE preparations were determined by enzyme-linked immunosorbent assay (ELISA) at baseline and after different storage conditions: at 4 °C for 1 week and 1 month; and at -20 °C for 1, 3 and 6 months. There were no significant differences in the concentrations of EGF, TGF-β1, TGF-β2 and fibronectin in 20% ASE between the SJS and control groups (EGF: 176.9 ± 40.9 vs. 185.5 ± 36.9 pg/mL, TGF-β1: 9.5 ± 2.1 vs. 9.5 ± 1.9 ng/mL, TGF-β2: 55.3 ± 30.0 vs. 63.91 ± 45.6 pg/mL and fibronectin: 70.5 ± 20.2 vs. 62.2 ± 21.3 µg/mL, respectively). These factors were stable at 4 °C for up to 1 month. Storage at -20 °C for up to 6 months resulted in a slight decrease in TGF-β1 (SJS: from 9.5-8.4 ng/mL, p dry eye patients, and that ASE should be sufficiently stable for up to 6 months, if stored properly at -20 °C.

  5. Systematic review of randomized controlled trials in the treatment of dry eye disease in Sjogren syndrome

    OpenAIRE

    Shih, Kendrick Co; Lun, Christie Nicole; Jhanji, Vishal; Thong, Bernard Yu-Hor; Tong, Louis

    2017-01-01

    Abstract Primary Sjögren’s syndrome is an autoimmune disease characterized by dry eye and dry mouth. We systematically reviewed all the randomized controlled clinical trials published in the last 15 years that included ocular outcomes. We found 22 trials involving 9 topical, 10 oral, 2 intravenous and 1 subcutaneous modalities of treatment. Fluoromethalone eye drops over 8 weeks were more effective than topical cyclosporine in the treatment of dry eye symptoms and signs; similarly, indomethac...

  6. Managing Sjögren’s Syndrome and non-Sjögren Syndrome dry eye with anti-inflammatory therapy

    Directory of Open Access Journals (Sweden)

    Coursey TG

    2014-08-01

    Full Text Available Terry G Coursey, Cintia S de PaivaCullen Eye Institute, Baylor College of Medicine, Houston, TX, USAAbstract: Dry eye from Sjögren’s syndrome is a multifactorial disease that results in dysfunction of the lacrimal functional unit. Studies have shown changes in tear composition, including inflammatory cytokines, chemokines, and metalloproteinase. T-lymphocytes have been shown to increase in the conjunctiva and lacrimal glands in patient and animal models. This inflammation is in part responsible for the pathogenesis of the disease, which results in symptoms of eye irritation, ocular surface epithelial disease, and loss of corneal barrier function. There are a number of anti-inflammatory approaches for treating this disease. The current study reviews details of immune response and anti–inflammatory therapies used to control this disease.Keywords: keratoconjunctivitis sicca, SS, cyclosporin A, steroids, dry eye, Sjögren’s Syndrome

  7. Comparison of the NEI-VFQ and OSDI questionnaires in patients with Sjögren's syndrome-related dry eye

    Directory of Open Access Journals (Sweden)

    Smith Janine A

    2004-09-01

    Full Text Available Abstract Background To examine the associations between vision-targeted health-related quality of life (VT-HRQ and ocular surface parameters in patients with Sjögren's syndrome, a systemic autoimmune disease characterized by dry eye and dry mouth. Methods Forty-two patients fulfilling European / American diagnostic criteria for Sjögren's syndrome underwent Schirmer testing without anesthesia, ocular surface vital dye staining; and measurement of tear film breakup time (TBUT. Subjects were administered the Ocular Surface Disease Index (OSDI and the 25-item National Eye Institute Vision Functioning Questionnaire (NEI-VFQ. Main outcome measures included ocular surface parameters, OSDI subscales describing ocular discomfort (OSDI-symptoms, vision-related function (OSDI-function, and environmental triggers, and NEI-VFQ subscales. Results Participants (aged 31–81 y; 95% female all had moderate to severe dry eye. Associations of OSDI subscales with the ocular parameters were modest (Spearman r (ρ Conclusions Associations between conventional objective measures of dry eye and VT-HRQ were modest. The generic NEI-VFQ was similar to the disease-specific OSDI in its ability to measure the impact of Sjögren's syndrome-related dry eye on VT-HRQ.

  8. Efficacy of topical cyclosporine 0.05% eye drops in the treatment of dry eyes

    OpenAIRE

    Haitham Y Al-Nashar

    2015-01-01

    Purpose The aim of the present study was to evaluate the effectiveness of cyclosporine 0.05% in the treatment of dry-eye disease. Patients and methods A total of 35 eyes of 20 patients with dry-eye disease were included in the present study. Ten patients (20 eyes) had dry eyes associated with systemic rheumatologic disease (Sjögren′s syndrome), five patients (10 eyes) had dry eyes after undergoing laser in-situ keratomileusis, and five patients (five eyes) had dry eyes after cataract...

  9. Treatment of Sjögren's syndrome-associated dry eye an evidence-based review.

    Science.gov (United States)

    Akpek, Esen Karamursel; Lindsley, Kristina B; Adyanthaya, Rohit S; Swamy, Ramya; Baer, Alan N; McDonnell, Peter J

    2011-07-01

    Outcomes-based review of reported treatment options for patients with dry eye secondary to Sjögren's syndrome (SS). Dry eye affects many individuals worldwide. Significant proportion of patients with dry eye has underlying SS, a progressive autoimmune condition. The few suggested guidelines for the treatment of dry eye are mostly based on severity of symptoms and/or clinical findings rather than on outcomes analysis, and do not differentiate SS from other causes of dry eye. METHODS AND LITERATURE REVIEW: A search strategy was developed to identify prospective, interventional studies of treatments for SS-associated dry eye from electronic databases. Eligible references were restricted to English-language articles published after 1975. These sources were augmented by hand searches of reference lists from accessed articles. Study selection, data extraction, and grading of evidence were completed independently by ≥4 review authors. The searches identified 3559 references as of August 10, 2010. After duplicate review of the titles and abstracts, 245 full-text papers were assessed, 62 of which were relevant for inclusion in the review. In the current literature on SS-associated dry eye, there is a paucity of rigorous clinical trials to support therapy recommendations. Nonetheless, the recommended treatments include topical lubricants, topical anti-inflammatory therapy, and tear-conserving strategies. The efficacy of oral secretagogues seems greater in the treatment of oral dryness than ocular dryness. Although oral hydroxychloroquine is commonly prescribed to patients with SS to alleviate fatigue and arthralgias, the literature lacks strong evidence for the efficacy of this treatment for dry eye. Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  10. Use of preservative-free hyaluronic acid (Hylabak® for a range of patients with dry eye syndrome: experience in Russia

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    Brzhesky VV

    2014-06-01

    Full Text Available Vladimir Vsevolodovich Brjesky,1 Yury Fedorovich Maychuk,2 Alexey Vladimirovich Petrayevsky,3 Peter Gerrievich Nagorsky41Department of Ophthalmology, Pediatric State Medical Academy, Saint Petersburg, 2Moscow Research Institute of Eye Diseases, Moscow, 3Department of Ophthalmology, Volgograd State Medical University, Volgograd, 4Novosibirsk Branch of the Federal State Institute MNTK Eye Microsurgery, Novosibirsk, Russian Federation, RussiaAbstract: Artificial tear preparations are important in the management of dry eye syndrome. We present the findings from four recently published studies conducted in Russia assessing Hylabak® (marketed as Hyabak® in Europe, a preservative-free hyaluronic acid preparation, for the treatment of dry eye syndrome. All studies had an open, noncomparative design, but one compared the findings with those from 25 patients treated with Tear Naturale® in previous studies. A total of 134 children and adults were enrolled, and the etiologies of dry eye syndrome included contact lens use, intensive office work, adenovirus eye infection, postmenopausal status, persistent meibomian blepharitis, Sjögren's syndrome, phacoemulsification with intraocular lens implantation, and refractive surgery. The patients were treated with Hylabak for 2 weeks to 2 months. All studies showed that Hylabak resulted in marked improvement as assessed by subjective sensations/complaints, Schirmer's test, Norn’s test, impression cytology and biomicroscopy, staining, and tear osmolarity. Greater benefits were also reported compared with Tear Naturale, including a faster onset of action. Hylabak was well tolerated. In conclusion, Hylabak provided rapid and safe relief from the signs and symptoms of dry eye syndrome, as well as improvement in objective measures, in a wide range of patients.Keywords: dry eye, eye drops, artificial tears, hyaluronic acid, Hylabak®, preservative-free

  11. Treatment of Sjögren's syndrome dry eye using 0.03% tacrolimus eye drop: Prospective double-blind randomized study.

    Science.gov (United States)

    Moscovici, Bernardo Kaplan; Holzchuh, Ricardo; Sakassegawa-Naves, Fernando Eiji; Hoshino-Ruiz, Diego Ricardo; Albers, Marcos Bottene Villa; Santo, Ruth Miyuki; Hida, Richard Yudi

    2015-10-01

    To describe the clinical efficacy of the treatment of Sjögren's syndrome dry eye using 0.03% tacrolimus eye drop. Prospective double-blind randomized study. Institutional outpatient clinic. Forty-eight eyes of twenty-four patients with dry eye related to Sjögren syndrome were enrolled in this study. The patients were randomized in 2 groups: tacrolimus (n=14) and vehicle (n=10) group. The tacrolimus group received a vial containing tacrolimus 0.03% (almond oil as vehicle) and the other group received the almond oil vehicle. All patients were instructed to use the eye drops every 12h in the lower conjunctival sac. Schirmer I test, break-up-time (BUT), corneal fluorescein and Rose Bengal staining scores were evaluated in all patients one day before the treatment (baseline), 7, 14, 28 and 90 days after treatment with the eye drops. The average fluorescein and Rose Bengal scores improved statistically after 7 days of treatment and even more after 90 days. The average Schirmer I and BUT values were unchanged after 7, 14 and 21 days but did show an improvement relative to baseline after 28 days of treatment. Schirmer I, BUT, fluorescein and Rose Bengal did not show any statistical significance in the vehicle group. Topical 0.03% tacrolimus eye drop improved tear stability and ocular surface status in cases of inflammatory or SS-related dry eye. ClinicalTrials.gov Identifier: NCT01850979. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  12. Over the counter (OTC) artificial tear drops for dry eye syndrome.

    Science.gov (United States)

    Pucker, Andrew D; Ng, Sueko M; Nichols, Jason J

    2016-02-23

    Over the counter (OTC) artificial tears historically have been the first line of treatment for dry eye syndrome and dry eye-related conditions like contact lens discomfort, yet currently we know little regarding the overall efficacy of individual, commercially available artificial tears. This review provides a much needed meta-analytical look at all randomized and quasi-randomized clinical trials that have analyzed head-to-head comparisons of OTC artificial tears. To evaluate the effectiveness and toxicity of OTC artificial tear applications in the treatment of dry eye syndrome compared with another class of OTC artificial tears, no treatment, or placebo. We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2015, Issue 12), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to December 2015), EMBASE (January 1980 to December 2015), Latin American and Caribbean Health Sciences (LILACS) (January 1982 to December 2015), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en) and the US Food and Drugs Administration (FDA) website (www.fda.gov). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 4 December 2015. We searched reference lists of included trials for any additional trials not identified by the electronic searches. This review includes randomized controlled trials with adult participants who were diagnosed with dry eye, regardless of race and gender. We included trials in which the age of participants was not reported, and clinical trials comparing OTC artificial tears with another class of OTC artificial tears, placebo, or no treatment. This review did not consider head-to-head comparisons of artificial tears with

  13. Dry eye after laser in-situ keratomileusis.

    Science.gov (United States)

    Raoof, Duna; Pineda, Roberto

    2014-01-01

    Laser-assisted in-situ keratomileusis (LASIK) is one of the most commonly performed refractive procedures with excellent visual outcomes. Dry eye syndrome is one of the most frequently seen complications after LASIK, with most patients developing at least some mild dry eye symptoms postoperatively. To achieve improved visual outcomes and greater patient satisfaction, it is essential to identify patients prone to dry eyes preoperatively, and initiate treatment early in the course. Enhanced understanding of the pathophysiology of post-LASIK dry eye will help advance our approach to its management.

  14. Tear proteomic analysis of patients with type 2 diabetes and dry eye syndrome by two-dimensional nano-liquid chromatography coupled with tandem mass spectrometry.

    Science.gov (United States)

    Li, Bing; Sheng, Minjie; Xie, Liqi; Liu, Feng; Yan, Guoquan; Wang, Weifang; Lin, Anjuan; Zhao, Fei; Chen, Yihui

    2014-01-09

    Diabetes mellitus has been shown to be associated with and complicated by dry eye syndrome. We sought to examine and compare the tear film proteome of type 2 diabetic patients with or without dry eye syndrome and normal subjects using two-dimensional nano-liquid chromatography coupled with tandem mass spectrometry (MS)-based proteomics. Tears were collected from eight type 2 diabetes patients with dry eye syndrome, eight type 2 diabetes patients without dry eye syndrome, and eight normal subjects. Tear breakup time (BUT) was determined, and tear proteins were prepared and analyzed using two-dimensional strong cation-exchange/reversed-phase nano-scale liquid chromatography MS. All MS/MS spectra were identified by using SEQUEST against the human International Protein Index (IPI) database and the relative abundance of individual proteins was assessed by spectral counting. Tear BUT was significantly lower in patients with diabetes and dry eye syndrome than in patients with diabetes only and normal subjects. Analysis of spectral counts of tear proteins showed that, compared to healthy controls, patients with diabetes and dry eye syndrome had increased expression of apoptosis-related proteins, like annexin A1, and immunity- and inflammation-related proteins, including neutrophil elastase 2 and clusterin, and glycometabolism-related proteins, like apolipoprotein A-II. Dry eye syndrome in diabetic patients is associated with aberrant expression of tear proteins, and the findings could lead to identification of novel pathways for therapeutic targeting and new diagnostic markers.

  15. Effectiveness of Autologous Serum Eye Drops Combined With Punctal Plugs for the Treatment of Sjögren Syndrome-Related Dry Eye.

    Science.gov (United States)

    Liu, Ying; Hirayama, Masatoshi; Cui, Xin; Connell, Samuel; Kawakita, Tetsuya; Tsubota, Kazuo

    2015-10-01

    To evaluate the efficacy and safety of autologous serum (AS) eye drops combined with punctal plugs (PPs) in patients with Sjögren syndrome (SS)-related dry eye. A retrospective clinical study was performed in patients with dry eye caused by SS. We evaluated the Schirmer test value, tear breakup time (tBUT), and fluorescein and Rose Bengal (RB) staining scores at baseline, 3 months, 6 months, 1 year, and >1 year after treatment. The dry eye indexes were also evaluated in 2 subgroups, which determined by the using of PPs, including the AS + PP group and AS only group. A total of 56 eyes of 28 patients were investigated with a mean follow-up of 42.3 ± 26.1 months. After the application of AS eye drops, the Schirmer test showed no significant changes. The tBUT (2.7 ± 1.9 seconds) was significantly improved at each time point (3.9 ± 3.1, 4.5 ± 3.1, 3.7 ± 2.5, and 5.1 ± 4.0; P eye drops was found to be an effective and apparently safe treatment for SS dry eye. Furthermore, PPs in combination with AS eye drops were considered to have an additive effect on SS dry eye.

  16. Comparison of two methods for composite score generation in dry eye syndrome.

    Science.gov (United States)

    See, Craig; Bilonick, Richard A; Feuer, William; Galor, Anat

    2013-09-19

    To compare two methods of composite score generation in dry eye syndrome (DES). Male patients seen in the Miami Veterans Affairs eye clinic with normal eyelid, corneal, and conjunctival anatomy were recruited to participate in the study. Patients filled out the Dry Eye Questionnaire 5 (DEQ5) and underwent measurement of tear film parameters. DES severity scores were generated by independent component analysis (ICA) and latent class analysis (LCA). A total of 247 men were included in the study. Mean age was 69 years (SD 9). Using ICA analysis, osmolarity was found to carry the largest weight, followed by eyelid vascularity and meibomian orifice plugging. Conjunctival injection and tear breakup time (TBUT) carried the lowest weights. Using LCA analysis, TBUT was found to be best at discriminating healthy from diseased eyes, followed closely by Schirmer's test. DEQ5, eyelid vascularity, and conjunctival injection were the poorest at discrimination. The adjusted correlation coefficient between the two generated composite scores was 0.63, indicating that the shared variance was less than 40%. Both ICA and LCA produced composite scores for dry eye severity, with weak to moderate agreement; however, agreement for the relative importance of single diagnostic tests was poor between the two methods.

  17. Extended release of hyaluronic acid from hydrogel contact lenses for dry eye syndrome.

    Science.gov (United States)

    Maulvi, Furqan A; Soni, Tejal G; Shah, Dinesh O

    2015-01-01

    Current dry eye treatment includes delivering comfort enhancing agents to the eye via eye drops, but low residence time of eye drops leads to low bioavailability. Frequent administration leads to incompliance in patients, so there is a great need for medical device such as contact lenses to treat dry eye. Studies in the past have demonstrated the efficacy of hyaluronic acid (HA) in the treatment of dry eyes using eye drops. In this paper, we present two methods to load HA in hydrogel contact lenses, soaking method and direct entrapment. The contact lenses were characterized by studying their optical and physical properties to determine their suitability as extended wear contact lenses. HA-laden hydrogel contact lenses prepared by soaking method showed release up to 48 h with acceptable physical and optical properties. Hydrogel contact lenses prepared by direct entrapment method showed significant sustained release in comparison to soaking method. HA entrapped in hydrogels resulted in reduction in % transmittance, sodium ion permeability and surface contact angle, while increase in % swelling. The impact on each of these properties was proportional to HA loading. The batch with 200-μg HA loading showed all acceptable values (parameters) for contact lens use. Results of cytotoxicity study indicated the safety of hydrogel contact lenses. In vivo pharmacokinetics studies in rabbit tear fluid showed dramatic increase in HA mean residence time and area under the curve with lenses in comparison to eye drop treatment. The study demonstrates the promising potential of delivering HA through contact lenses for the treatment of dry eye syndrome.

  18. Over the counter (OTC) artificial tear drops for dry eye syndrome

    Science.gov (United States)

    Pucker, Andrew D; Ng, Sueko M; Nichols, Jason J

    2016-01-01

    Background Over the counter (OTC) artificial tears historically have been the first line of treatment for dry eye syndrome and dry eye-related conditions like contact lens discomfort, yet currently we know little regarding the overall efficacy of individual, commercially available artificial tears. This review provides a much needed meta-analytical look at all randomized and quasi-randomized clinical trials that have analyzed head-to-head comparisons of OTC artificial tears. Objectives To evaluate the effectiveness and toxicity of OTC artificial tear applications in the treatment of dry eye syndrome compared with another class of OTC artificial tears, no treatment, or placebo. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2015, Issue 12), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to December 2015), EMBASE (January 1980 to December 2015), Latin American and Caribbean Health Sciences (LILACS) (January 1982 to December 2015), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en) and the US Food and Drugs Administration (FDA) website (www.fda.gov). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 4 December 2015. We searched reference lists of included trials for any additional trials not identified by the electronic searches. Selection criteria This review includes randomized controlled trials with adult participants who were diagnosed with dry eye, regardless of race and gender. We included trials in which the age of participants was not reported, and clinical trials comparing OTC artificial tears with another class of OTC artificial tears, placebo, or no treatment. This review did not

  19. Utility of Novel Autoantibodies in the Diagnosis of Sjögren's Syndrome Among Patients With Dry Eye.

    Science.gov (United States)

    Karakus, Sezen; Baer, Alan N; Agrawal, Devika; Gurakar, Merve; Massof, Robert W; Akpek, Esen K

    2018-04-01

    To investigate the value of 3 novel autoantibodies [salivary protein 1 (SP1), carbonic anhydrase 6 (CA6), and parotid secretory protein (PSP)] in differentiating Sjögren's syndrome (SS)-related dry eye from non-SS dry eye. Forty-six dry eye patients with SS (SS dry eye), 14 dry eye patients without SS (non-SS dry eye), and 25 controls were included. The 2012 American College of Rheumatology classification criteria were used for the diagnosis of SS. After a detailed review of systems, the Ocular Surface Disease Index questionnaire, Schirmer test without anesthesia, tear film breakup time, and ocular surface staining were performed to assess dry eye. All participants underwent serological testing using a commercially available finger prick kit. Thirty-seven patients with SS (80.4%) had a positive traditional autoantibody and 28 (60.9%) had a positive novel autoantibody. Traditional autoantibodies were absent in all non-SS dry eye patients and controls. Novel autoantibodies were present in 7/14 (50%) non-SS dry eye patients and 4/25 (16%) controls. Among 3 novel autoantibodies, anti-CA6 was significantly more prevalent in the SS and non-SS dry eye groups than in controls (52.2% vs. 42.9% vs. 8.0%, P = 0.001). Dry eye patients with positive anti-CA6 alone were significantly younger than patients with only traditional autoantibodies. Anti-CA6 was associated with worse dry eye signs and symptoms. Anti-CA6 was the most prevalent novel autoantibody in patients with dry eye, and was associated with younger age and more severe disease. Longitudinal studies are needed to determine whether anti-CA6 is a marker for early SS or perhaps another form of an autoimmune dry eye disease.

  20. Aging: A Predisposition to Dry Eyes

    Directory of Open Access Journals (Sweden)

    Anushree Sharma

    2014-01-01

    Full Text Available Dry eye syndrome is a disease of the ocular surface and tear film that is prevalent in older adults. Even though the degree of visual acuity loss in dry eye patients is commonly mild-to-moderate, in the aging population, this minimal change in visual status can lead to a significant decrease in visual function and quality of life. A healthy ocular surface is maintained by appropriate tear production and tear drainage, and deficiencies in this delicate balance can lead to dryness. In the aging eye, risk factors such as polypharmacy, androgen deficiency, decreased blink rates, and oxidative stress can predispose the patient to developing dry eye that is frequently more severe, has higher economic costs, and leads to worse consequences to the well-being of the patient. Understanding why elderly patients are at higher risk for developing dry eyes can provide insights into the diagnosis and management of the growing number of older adults struggling with dry eye and minimize the burden of disease on our aging population.

  1. [Prospective, monocentric, uncontrolled study of efficacy, tolerance and adherence of cyclosporin 0.1 % for severe dry eye syndrome].

    Science.gov (United States)

    Boujnah, Y; Mouchel, R; El-Chehab, H; Dot, C; Burillon, C; Kocaba, V

    2018-02-01

    To evaluate the efficacy, tolerability and treatment adherence of Ikervis ® (Santen, SAS) (ciclosporine 0.1 %) for first line therapy or following treatment with Restasis ® (Allergan, Inc.) (ciclosporine 0.05 %) for severe dry eye syndrome. A prospective, monocentric, uncontrolled study was conducted between January 2012 and March 2015 on 110 eyes of 55 patients with severe dry eye on first line therapy or previously treated with Restasis ® who required the introduction of Ikervis ® . Patients' quality of life was assessed before and after treatment was started using a standardized questionnaire (Ocular Surface Disease Index © [OSDI]), clinical efficacy was quantified at the slit lamp, by measurement of the Break Up time Test (BUT) and the Oxford classification. Tolerability and adherence to treatment were measured using a simple questionnaire. A total of 72 eyes of 37 patients were included. Etiologies of dry eye syndrome were dominated by Sjögren syndrome (32 %) and severe ocular surface conditions (48 %). The mean age was 57.7 years (±17.45) and mean follow-up was 458 days (±292). The mean BUT increased by 2.043seconds [1.522-2.563] (Pdry eye. Its indications tend to evolve towards less severe dry eye. However, the tolerability profile remains poor, and an improvement in this would be desirable. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  2. Dry Eye

    Science.gov (United States)

    ... Eye » Facts About Dry Eye Listen Facts About Dry Eye Fact Sheet Blurb The National Eye Institute (NEI) ... and their families search for general information about dry eye. An eye care professional who has examined the ...

  3. Rationale for anti-inflammatory therapy in dry eye syndrome.

    Science.gov (United States)

    de Paiva, C S; Pflugfelder, S C

    2008-01-01

    Dry eye is a multifactorial condition that results in a dysfunctional lacrimal functional unit. Evidence suggests that inflammation is involved in the pathogenesis of the disease. Changes in tear composition including increased cytokines, chemokines, metalloproteinases and the number of T cells in the conjunctiva are found in dry eye patients and in animal models. This inflammation is responsible in part for the irritation symptoms, ocular surface epithelial disease, and altered corneal epithelial barrier function in dry eye. There are several anti-inflammatory therapies for dry eye that target one or more of the inflammatory mediators/pathways that have been identified and are discussed in detail.

  4. Critical Involvement of Macrophage Infiltration in the Development of Sjogren's Syndrome-Associated Dry Eye

    NARCIS (Netherlands)

    Zhou, D.; Chen, Y.T.; Chen, F.L.; Gallup, M.; Vijmasi, T.; Bahrami, A.F.; Noble, L.B.; van Rooijen, N.; McNamara, N.A.

    2012-01-01

    Lymphocytic infiltration of the lacrimal gland and ocular surface in autoimmune diseases such as Sjögren's syndrome (SS) causes an aqueous-deficient dry eye that is associated with significant morbidity. Previous studies from our laboratory and others have established autoimmune regulator

  5. Diagnosing dry eye with dynamic-area high-speed videokeratoscopy

    Science.gov (United States)

    Alonso-Caneiro, David; Turuwhenua, Jason; Iskander, D. Robert; Collins, Michael J.

    2011-07-01

    Dry eye syndrome is one of the most commonly reported eye health conditions. Dynamic-area high-speed videokeratoscopy (DA-HSV) represents a promising alternative to the most invasive clinical methods for the assessment of the tear film surface quality (TFSQ), particularly as Placido-disk videokeratoscopy is both relatively inexpensive and widely used for corneal topography assessment. Hence, improving this technique to diagnose dry eye is of clinical significance and the aim of this work. First, a novel ray-tracing model is proposed that simulates the formation of a Placido image. This model shows the relationship between tear film topography changes and the obtained Placido image and serves as a benchmark for the assessment of indicators of the ring's regularity. Further, a novel block-feature TFSQ indicator is proposed for detecting dry eye from a series of DA-HSV measurements. The results of the new indicator evaluated on data from a retrospective clinical study, which contains 22 normal and 12 dry eyes, have shown a substantial improvement of the proposed technique to discriminate dry eye from normal tear film subjects. The best discrimination was obtained under suppressed blinking conditions. In conclusion, this work highlights the potential of the DA-HSV as a clinical tool to diagnose dry eye syndrome.

  6. Treatment of Dry Eye Disease.

    Science.gov (United States)

    Marshall, Leisa L; Roach, J Michael

    2016-02-01

    Review of the etiology, clinical manifestations, and treatment of dry eye disease (DED). Articles indexed in PubMed (National Library of Medicine), Iowa Drug Information Service (IDIS), and the Cochrane Reviews and Trials in the last 10 years using the key words "dry eye disease," "dry eye syndrome," "dry eye and treatment." Primary sources were used to locate additional resources. Sixty-eight publications were reviewed, and criteria supporting the primary objective were used to identify useful resources. The literature included practice guidelines, book chapters, review articles, original research articles, and product prescribing information for the etiology, clinical manifestations, diagnosis, and treatment of DED. DED is one of the most common ophthalmic disorders. Signs and symptoms of DED vary by patient, but may include ocular irritation, redness, itching, photosensitivity, visual blurring, mucous discharge, and decreased tear meniscus or break-up time. Symptoms improve with treatment, but the condition is not completely curable. Treatment includes reducing environmental causes, discontinuing medications that cause or worsen dry eye, and managing contributing ocular or systemic conditions. Most patients use nonprescription tear substitutes, and if these are not sufficient, other treatment is prescribed. These treatments include the ophthalmic anti-inflammatory agent cyclosporine, punctal occlusion, eye side shields, systemic cholinergic agents, and autologous serum tears. This article reviews the etiology, symptoms, and current therapy for DED.

  7. Successful Treatment of Dry Mouth and Dry Eye Symptoms in Sjögren's Syndrome Patients With Oral Pilocarpine: A Randomized, Placebo-Controlled, Dose-Adjustment Study.

    Science.gov (United States)

    Papas, Athena S; Sherrer, Yvonne S; Charney, Michael; Golden, Harvey E; Medsger, Thomas A; Walsh, Bridget T; Trivedi, Madhu; Goldlust, Barry; Gallagher, Susan C

    2004-08-01

    : Sjögren's syndrome is characterized by the presence of xerostomia and/or xerophthalmia. Pilocarpine, a muscarinic cholinergic agonist, has been proven to be efficacious in treating radiation-induced xerostomia (up to 30 mg/day) and symptoms of dry mouth in Sjögren's patients (up to 20 mg/day). : To compare the safety and efficacy of oral pilocarpine (dose-adjusted) versus placebo in the treatment of dry eye and dry mouth symptoms in Sjögren's syndrome at 6 and 12 weeks. : In this 11-center, 256-patient placebo-controlled study, the safety and efficacy of oral pilocarpine (20 mg to 30 mg daily) for relief of Sjögren's-related dry mouth and dry eye symptoms was assessed. Changes in symptoms and salivary flow were measured over 12 weeks. : Compared with placebo, salivary flow was significantly increased in the pilocarpine group (Pdry mouth (Poral symptoms (Pdry eyes (Pdry mouth symptoms was noted at 20 mg/day, and significant relief in ocular symptoms, including lower artificial tear requirement, was noted after the dose was increased to 30 mg/day.

  8. A HOSPITAL-BASED STUDY ON THE PREVALENCE OF DRY EYES IN A TERTIARY CARE HOSPITAL

    OpenAIRE

    Prashant V. Solanke; Preeti Pawde; A. Vinolin Maria Sebastina

    2017-01-01

    BACKGROUND Dry eye syndrome is a common eye disease. Dry Eye Syndrome (DES), also known as Keratoconjunctivitis Sicca (KCS), is the condition of having dry eyes. Other associated symptoms include irritation, redness, discharge and easily fatigued eyes. Blurred vision may also occur. The symptoms can range from mild and occasional to severe and continuous. Scarring of the cornea may occur in some cases without treatment. Dry eye occurs when either the eye does not produce enough...

  9. Acidic mammalian chitinase in dry eye conditions.

    Science.gov (United States)

    Musumeci, Maria; Aragona, Pasquale; Bellin, Milena; Maugeri, Francesco; Rania, Laura; Bucolo, Claudio; Musumeci, Salvatore

    2009-07-01

    An acidic mammalian chitinase (AMCase) seems to be implicated in allergic asthma and allergic ocular pathologies. The aim of this work was to investigate the role of AMCase during Sjögren's Syndrome (SS) and Meibomian Gland Dysfunction (MGD) dry eye diseases. Six patients with MGD dry eye (20-58 years, median 40) and six patients with dry eye associated to SS (32-60 years, median 47) were enrolled in this study. AMCase activity was measured in tears and AMCase mRNA expression was evaluated by real-time polymerase chain reaction from RNA extracted from epithelial cells of the conjunctiva. Six healthy adult subjects of the same age (34-44 years, median 39) were also studied as the control group. AMCase activity was significantly increased in patients affected by MGD dry eye (18.54 +/- 1.5 nmol/ml/h) and SS dry eye (8.94 +/- 1.0 nmol/ml/h) respectively, compared to healthy controls (1.6 +/- 0.2 nmol/ml/h). AMCase activity was higher in the tears of subjects with MGD dry eye (P < 0.001). AMCase mRNA was detected in conjunctival epithelial cells and the expression was significantly higher in MGD dry eye than SS dry eye. A significant correlation between AMCase activity in the tears and mRNA in conjunctival epithelial cells was found. AMCase may be an important marker in the pathogenesis of dry eye, suggesting the potential role of AMCase as a therapeutic target in these frequent pathologies.

  10. Qualitative changes of ocular surface in the patients with dry eye syndrome after Systein Ultra systemic using

    Directory of Open Access Journals (Sweden)

    T. I. Poltanova

    2014-07-01

    Full Text Available Purpose: To evaluate clinical efficiency of systemic usage of artificial tears drops Systein Ultra in the patients with different forms of dry eye syndrome.Methods: 42 patients (84 eyes at the age of 21‑84 with different pathogenic forms of ocular xerosis and degrees of it’s severity were investigated. Systein Ultra eye drops in instillations were prescribed to all patients 3 times a day. Complex examination of being investigated was performed before the drug administration, in 7 days and then in 2 weeks.Results: Positive dynamics after the treatment was reavealed on average in 4‑7 days. There was decrease or absolute reduction of subjective and objective signs in the majority of cases. In the severest cases of the disease all investigated parameters were not changed.Conclusion: The positive clinical result after artificial tears drops Systein Ultra using, accompanied by eye comfort without significant side effects, allows us to recommend Systein Ultra to the wide application in therapy of different pathogenic forms dry eye syndrome.

  11. [Ocular graft-versus-host disease: An often misdiagnosed etiology of dry eye syndrome].

    Science.gov (United States)

    Moyal, L; Adam, R; Akesbi, J; Rodallec, F T; Nordmann, J-P

    2017-02-01

    To report a case of severe ocular graft-versus-host disease (GVHD) after cataract surgery. Observational case report. We describe the case of a 59-year-old man with postoperative corneal ulcer on his only functional eye. His past history reported allogenic bone marrow transplant. His visual acuity (VA) was limited to hand motions. Slit lamp examination revealed diffuse conjunctival hyperemia, severe blepharitis, Meibomian dysfunction, total corneal opacification with epithelial and stromal keratitis and neovascular invasion. Because of the severe dry eye symptoms and history of allogenic hematological stem cell transplantation, ocular GVHD was diagnosed. Functional and anatomical improvement occurred rapidly with topical cyclosporine 2%, with improved VA after treatment. With any severe dry eye syndrome in the context of allogenic bone marrow transplant, ocular GVHD must be considered. For planned ocular surgery, we recommend adding cyclosporine 0.1% treatment before and after surgery to prevent severe ocular GVHD. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. Oral omega-3 fatty acids treatment in computer vision syndrome related dry eye.

    Science.gov (United States)

    Bhargava, Rahul; Kumar, Prachi; Phogat, Hemant; Kaur, Avinash; Kumar, Manjushri

    2015-06-01

    To assess the efficacy of dietary consumption of omega-3 fatty acids (O3FAs) on dry eye symptoms, Schirmer test, tear film break up time (TBUT) and conjunctival impression cytology (CIC) in patients with computer vision syndrome. Interventional, randomized, double blind, multi-centric study. Four hundred and seventy eight symptomatic patients using computers for more than 3h per day for minimum 1 year were randomized into two groups: 220 patients received two capsules of omega-3 fatty acids each containing 180mg eicosapentaenoic acid (EPA) and 120mg docosahexaenoic acid (DHA) daily (O3FA group) and 236 patients received two capsules of a placebo containing olive oil daily for 3 months (placebo group). The primary outcome measure was improvement in dry eye symptoms and secondary outcome measures were improvement in Nelson grade and an increase in Schirmer and TBUT scores at 3 months. In the placebo group, before dietary intervention, the mean symptom score, Schirmer, TBUT and CIC scores were 7.5±2, 19.9±4.7mm, 11.5±2s and 1±0.9 respectively, and 3 months later were 6.8±2.2, 20.5±4.7mm, 12±2.2s and 0.9±0.9 respectively. In the O3FA group, these values were 8.0±2.6, 20.1±4.2mm, 11.7±1.6s and 1.2±0.8 before dietary intervention and 3.9±2.2, 21.4±4mm, 15±1.7s, 0.5±0.6 after 3 months of intervention, respectively. This study demonstrates the beneficial effect of orally administered O3FAs in alleviating dry eye symptoms, decreasing tear evaporation rate and improving Nelson grade in patients suffering from computer vision syndrome related dry eye. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  13. Dry eyes among information technology professionals in India

    Directory of Open Access Journals (Sweden)

    Amaravathy Karuppaiah Brindha

    2015-08-01

    Full Text Available AIM: To perform the determination ofthe burden of dry eye syndrome among information technology(ITprofessionals and examine association of dry eye syndrome between various daily activities. METHODS: This was a pilot cross-sectional study conducted for a period of 3mo from October-December, 2013 in Chennai, South India. The study population was enrolled from three IT companies in a city in Chennai. The inclusion criteria consisted of individuals working in the IT industry at least for a period of 6mo, aged 18y or above and giving voluntary, written informed consent. Variable information was gathered by using series of questionnaires and ophthalmic assessment. Information about sociodemographic characteristics was also gathered. Schirmer's test was performed for ophthalmic assessment. All of the analysis was performed by using SPSS vs.16. RESULTS: About one fifth(n=36, 18%of the participants were suspected to have dry eyes, with mean age of 29y(SD=7, and majority of them being males, graduates/ postgraduates, single, living in extended families in urban areas. Windy environment significantly showed to aggravate redness(P=0.04and burning sensation of the eyes(P=0.000. Similarly, watching television significantly showed to aggravate gritty sensation(P=0.01and led to excess mucous in the eyes(P=0.02. CONCLUSION:Based on the results of our study, it can be concluded that the exposure to various daily activities such as watching television, using computer, reading, and use of air conditioning and windy environments(dry environmentswere associated with signs and symptoms of dry eyes. Also, watching television and windy environment were significantly positively correlated with some of the signs of dry eye. This study emphasizes the urgent need of multi-factorial approach including policy measures for addressing the burden of dry eye in population.

  14. Aging: A Predisposition to Dry Eyes

    OpenAIRE

    Anushree Sharma; Holly B. Hindman

    2014-01-01

    Dry eye syndrome is a disease of the ocular surface and tear film that is prevalent in older adults. Even though the degree of visual acuity loss in dry eye patients is commonly mild-to-moderate, in the aging population, this minimal change in visual status can lead to a significant decrease in visual function and quality of life. A healthy ocular surface is maintained by appropriate tear production and tear drainage, and deficiencies in this delicate balance can lead to dryness. In the aging...

  15. What Is Dry Eye?

    Medline Plus

    Full Text Available ... Español Eye Health / Eye Health A-Z Dry Eye Sections What Is Dry Eye? Dry Eye Symptoms ... Dry Eye Dry Eye Treatment What Is Dry Eye? Leer en Español: ¿Qué es el ojo seco? ...

  16. What Is Dry Eye?

    Medline Plus

    Full Text Available ... Stories Español Eye Health / Eye Health A-Z Dry Eye Sections What Is Dry Eye? Dry Eye Symptoms ... of Dry Eye Dry Eye Treatment What Is Dry Eye? Leer en Español: ¿Qué es el ojo seco? ...

  17. Androgen deficiency and dry eye syndrome in the aging male.

    Science.gov (United States)

    Azcarate, Patrick M; Venincasa, Vincent D; Feuer, William; Stanczyk, Frank; Schally, Andrew V; Galor, Anat

    2014-07-03

    To evaluate the relationship between androgen levels and subjective and objective measures of dry eye syndrome (DES). A total of 263 male patients from the Miami Veterans Affairs Medical Center eye clinic aged ≥50 were recruited for this prospective cross-sectional study. Patients completed Dry Eye Questionnaire 5, underwent tear film evaluation, and had serum androgen levels measured. The correlations between androgen levels, DES composite scores, DES symptoms, and global, lipid, and aqueous tear film parameters were evaluated. Two hundred sixty-three patients with a mean age of 69 (50-95) were examined. There was no linear association between composite DES scores (generated using latent class analysis) and androgen levels. However, eyes with high DES scores (0.95-1.0) had higher levels of sex hormone-binding globulin (P = 0.03) and lower levels of dehydroepiandrosterone sulfate (DHEAS) (P = 0.02), androstenedione (A) (P = 0.02), and androstane-3α,17β-diol glucuronide (P = 0.03) compared to eyes with intermediate (0.05-0.95) or low (0-0.05) scores. There were no strong correlations between tear film measures and androgen levels. Regarding global parameters, a weak inverse correlation was found between corneal staining and A (r = -0.17, P = 0.009). For lipid parameters, a weak correlation existed between tear breakup time (TBUT) and A (r = 0.15, P = 0.02). When considering aqueous and lipid deficiency independently, the association between TBUT and A existed only with aqueous tear deficiency (r = 0.66, P = 0.002). Regarding aqueous parameters, a weak correlation existed between Schirmer test and DHEAS (r = 0.13, P = 0.047) and A (r = 0.21, P = 0.001). There was a weak correlation between higher levels of androstenedione and healthier global, lipid, and aqueous tear film parameters. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  18. Establishing the tolerability and performance of tamarind seed polysaccharide (TSP in treating dry eye syndrome: results of a clinical study

    Directory of Open Access Journals (Sweden)

    Valente Cristiana

    2007-03-01

    Full Text Available Abstract Background One of the problems arising from available preparations for dry eye syndrome is the limited residence time of products on the ocular surface. In this paper, we look at an innovative new treatment for dry eye, tamarind seed polysaccharide (TSP. TSP possesses mucomimetic, mucoadhesive and pseudoplastic properties. The 'mucin-like' molecular structure of TSP is similar to corneal and conjunctival mucin 1 (MUC1, a transmembrane glycoprotein thought to play an essential role in protecting and wetting the corneal surface and may explain its increased retention on the eye surface. Methods The activity of TSP and hyaluronic acid (HA in the treatment of dry eye syndrome was compared in an open-label, randomised, single-centre clinical study. Thirty patients were randomised to receive three or more applications per day of either TSP 0.5%, TSP 1% or HA 0.2% (Hyalistil™ over a period of 90 days. The primary objective of tolerability was assessed by visual analogue scale (VAS, scoring of specific symptoms and the incidence of adverse events. Secondary objectives included improvement in stability of the precorneal tear film, subjective symptoms and corneal and conjunctival staining. Results TSP 0.5% and 1% were comparable to HA 0.2% with regard to both primary and secondary objective parameters. TSP 1% showed benefits over HA 0.2% for the subjective symptoms; trouble blinking, ocular burning and foreign body sensation. Conclusion This study suggests that TSP 0.5% and 1% offer at least equivalent relief to HA 0.2% for dry eye syndrome. All treatments demonstrated optimal tolerability and are suitable for frequent use in the therapy of dry eye. TSP 1% produced promising results in terms of improvements in certain patient symptoms and suggests benefits of the TSP formulation. This study paves the way for a larger study to further establish the performance and safety of TSP compared with HA and highlights the need to expand this therapeutic

  19. Making the diagnosis of Sjögren's syndrome in patients with dry eye.

    Science.gov (United States)

    Beckman, Kenneth A; Luchs, Jodi; Milner, Mark S

    2016-01-01

    Sjögren's syndrome (SS) is a chronic and progressive systemic autoimmune disease that often presents initially with symptoms of dry eye and dry mouth. Symptoms are often nonspecific and develop gradually, making diagnosis difficult. Patients with dry eye complaints warrant a step-wise evaluation for possible SS. Initial evaluation requires establishment of a dry eye diagnosis using a combination of patient questionnaires and objective ocular tests, including inflammatory biomarker testing. Additional work-up using the Schirmer test and tear film break-up time can differentiate between aqueous-deficient dry eye (ADDE) and evaporative dry eye. The presence of ADDE should trigger further work-up to differentiate between SS-ADDE and non-SS-ADDE. There are numerous non-ocular manifestations of SS, and monitoring for SS-related comorbid findings can aid in diagnosis, ideally in collaboration with a rheumatologist. The clinical work-up of SS can involve a variety of tests, including tear function tests, serological tests for autoantibody biomarkers, minor salivary gland and lacrimal gland biopsies. Examination of classic SS biomarkers (SS-A/Ro, SS-B/La, antinuclear antibody, and rheumatoid factor) is a convenient and non-invasive way of evaluating patients for the presence of SS, even years prior to confirmed diagnosis, although not all SS patients will test positive, particularly those with early disease. Recently, newer biomarkers have been identified, including autoantibodies to salivary gland protein-1, parotid secretory protein, and carbonic anhydrase VI, and may allow for earlier diagnosis of SS. A diagnostic test kit is commercially available (Sjö(®)), incorporating these new biomarkers along with the classic autoantibodies. This advanced test has been shown to identify SS patients who previously tested negative against traditional biomarkers only. All patients with clinically significant ADDE should be considered for serological assessment for SS, given the

  20. Pathogenesis of the dry eye syndrome observed by optical coherence tomography in vitro

    Science.gov (United States)

    Kray, Oya; Lenz, Markus; Spöler, Felix; Kray, Stefan; Kurz, Heinrich

    2011-06-01

    Three dimensional optical coherence tomography (OCT) is introduced as a valuable tool to analyze the pathogenesis of corneal diseases. Here, OCT in combination with a novel in vitro model for the dry eye syndrome enables an improved understanding of the underlying damaging process of the ocular surface. En-face OCT projections indicate a deep structural damage of the epithelium and anterior stroma by osmotic forces.

  1. What Is Dry Eye?

    Science.gov (United States)

    ... Eye? Dry Eye Symptoms Causes of Dry Eye Dry Eye Treatment What Is Dry Eye? Leer en Español: ¿Qué ... Inside of Your Eyelid Nov 29, 2017 New Dry Eye Treatment is a Tear-Jerker Jul 21, 2017 Three ...

  2. What Is Dry Eye?

    Medline Plus

    Full Text Available ... Eye? Dry Eye Symptoms Causes of Dry Eye Dry Eye Treatment What Is Dry Eye? Leer en Español: ¿Qué ... Inside of Your Eyelid Nov 29, 2017 New Dry Eye Treatment is a Tear-Jerker Jul 21, 2017 Three ...

  3. How Are Ocular Signs and Symptoms of Dry Eye Associated With Depression in Women With and Without Sjögren Syndrome?

    Science.gov (United States)

    Gonzales, John A; Chou, Annie; Rose-Nussbaumer, Jennifer R; Bunya, Vatinee Y; Criswell, Lindsey A; Shiboski, Caroline H; Lietman, Thomas M

    2018-07-01

    To determine whether ocular phenotypic features of keratoconjunctivitis sicca (KCS) and/or participant-reported symptoms of dry eye disease are associated with depression in women participants enrolled in the Sjögren's International Collaborative Clinical Alliance (SICCA). Cross-sectional study. Women enrolled in the SICCA registry from 9 international research sites. Participants met at least 1 of 5 inclusion criteria for registry enrollment (including complaints of dry eyes or dry mouth, a previous diagnosis of Sjögren syndrome (SS), abnormal serology (positive anti-Sjögren syndrome antigen A and/or B [anti-SSA and/or anti-SSB]), or elevated antinuclear antibody and rheumatoid factor), bilateral parotid gland enlargement, or multiple dental caries). At baseline, participants had oral, ocular, and rheumatologic examination; blood and saliva collection; and a labial salivary gland biopsy (LSGB). They also completed an interview and questionnaires including assessment of depression with the Patient Health Questionnaire 9 (PHQ-9). Univariate logistic regression was used to assess the association between depression and demographic characteristics, participant-reported health, phenotypic features of Sjögren syndrome, and participant-reported symptoms. Mixed-effects modeling was performed to determine if phenotypic features of KCS and/or participant-reported symptoms of dry eye disease were associated with depression, controlling for health, age, country or residence, and sex and allowing for nonindependence within geographic site. Dry eye complaints produced a 1.82-fold (95% confidence interval [CI] 1.38-2.40) higher odds of having depression compared to being symptom-free (P dry eyes and/or dry mouth rather than SS itself resulted in higher odds of depression. One particular ocular phenotypic feature of SS, a positive ocular staining score, was inversely correlated with depression. Participant-reported eye symptoms, particularly specific ocular sensations such as

  4. Dry eye in vitamin D deficiency: more than an incidental association.

    Science.gov (United States)

    Yildirim, Pelin; Garip, Yeşim; Karci, Ayse Aslihan; Guler, Tuba

    2016-01-01

    The aim of this article is two-fold: (i) to demonstrate the relation between vitamin D deficiency and dry eye and impaired tear function; and (ii) to investigate the possible associations among clinical parameters of hypovitaminosis D with dry eye parameters. Fifty premenopausal women with vitamin D deficiency (serum vitamin D levels dry eye parameters (P > 0.05). Vitamin D level was negatively correlated with OSDI (r = -0.49; P Dry eye and impaired tear function in patients with vitamin D deficiency may indicate a protective role of vitamin D in the development of dry eye, probably by enhancing tear film parameters and reducing ocular surface inflammation. Patients with vitamin D deficiency should be evaluated for dry eye syndromes. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  5. Managing Sjögren's Syndrome and non-Sjögren Syndrome dry eye with anti-inflammatory therapy.

    Science.gov (United States)

    Coursey, Terry G; de Paiva, Cintia S

    2014-01-01

    Dry eye from Sjögren's syndrome is a multifactorial disease that results in dysfunction of the lacrimal functional unit. Studies have shown changes in tear composition, including inflammatory cytokines, chemokines, and metalloproteinase. T-lymphocytes have been shown to increase in the conjunctiva and lacrimal glands in patient and animal models. This inflammation is in part responsible for the pathogenesis of the disease, which results in symptoms of eye irritation, ocular surface epithelial disease, and loss of corneal barrier function. There are a number of anti-inflammatory approaches for treating this disease. The current study reviews details of immune response and anti-inflammatory therapies used to control this disease.

  6. Salivary flow and its relationship to oral signs and symptoms in patients with dry eyes.

    Science.gov (United States)

    Koseki, M; Maki, Y; Matsukubo, T; Ohashi, Y; Tsubota, K

    2004-03-01

    The aim of this study was to investigate oral symptoms and clinical parameters in dry eye patients. Subjective reports of the sensation of a dry mouth, salivary flow rates, and clinical parameters of oral disease related to three different types of dry eye patients were examined. There were 224 individuals, including dry eye patients and control subjects. The dry eye patients were classified into three types: patients with Sjögren's syndrome (SS-DE), patients without SS-DE (non-SS-DE), and patients with Stevens-Johnson syndrome (SJS-DE). Salivary flow rates were measured using two kinds of sialometry. Subjective and objective oral symptoms and signs were also examined. Over half of the dry eye patients complained of a dry mouth. The flow rates of their stimulated whole saliva and parotid saliva were significantly lower than those of the control groups (P Candida frequently occurred in dry eye patients.

  7. Making the diagnosis of Sjögren’s syndrome in patients with dry eye

    Science.gov (United States)

    Beckman, Kenneth A; Luchs, Jodi; Milner, Mark S

    2016-01-01

    Sjögren’s syndrome (SS) is a chronic and progressive systemic autoimmune disease that often presents initially with symptoms of dry eye and dry mouth. Symptoms are often nonspecific and develop gradually, making diagnosis difficult. Patients with dry eye complaints warrant a step-wise evaluation for possible SS. Initial evaluation requires establishment of a dry eye diagnosis using a combination of patient questionnaires and objective ocular tests, including inflammatory biomarker testing. Additional work-up using the Schirmer test and tear film break-up time can differentiate between aqueous-deficient dry eye (ADDE) and evaporative dry eye. The presence of ADDE should trigger further work-up to differentiate between SS-ADDE and non-SS-ADDE. There are numerous non-ocular manifestations of SS, and monitoring for SS-related comorbid findings can aid in diagnosis, ideally in collaboration with a rheumatologist. The clinical work-up of SS can involve a variety of tests, including tear function tests, serological tests for autoantibody biomarkers, minor salivary gland and lacrimal gland biopsies. Examination of classic SS biomarkers (SS-A/Ro, SS-B/La, antinuclear antibody, and rheumatoid factor) is a convenient and non-invasive way of evaluating patients for the presence of SS, even years prior to confirmed diagnosis, although not all SS patients will test positive, particularly those with early disease. Recently, newer biomarkers have been identified, including autoantibodies to salivary gland protein-1, parotid secretory protein, and carbonic anhydrase VI, and may allow for earlier diagnosis of SS. A diagnostic test kit is commercially available (Sjö®), incorporating these new biomarkers along with the classic autoantibodies. This advanced test has been shown to identify SS patients who previously tested negative against traditional biomarkers only. All patients with clinically significant ADDE should be considered for serological assessment for SS, given the

  8. What Is Dry Eye?

    Medline Plus

    Full Text Available ... Eye Symptoms Causes of Dry Eye Dry Eye Treatment What Is Dry Eye? Leer en Español: ¿Qué ... Your Eyelid Nov 29, 2017 New Dry Eye Treatment is a Tear-Jerker Jul 21, 2017 Three ...

  9. Rationale for anti-inflammatory therapy in dry eye syndrome

    OpenAIRE

    De Paiva,CS; Pflugfelder,SC

    2008-01-01

    Dry eye is a multifactorial condition that results in a dysfunctional lacrimal functional unit. Evidence suggests that inflammation is involved in the pathogenesis of the disease. Changes in tear composition including increased cytokines, chemokines, metalloproteinases and the number of T cells in the conjunctiva are found in dry eye patients and in animal models. This inflammation is responsible in part for the irritation symptoms, ocular surface epithelial disease, and altered corneal epith...

  10. What Is Dry Eye?

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    Full Text Available ... Eye Health A-Z Symptoms Glasses & Contacts Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye ... Eye Symptoms Causes of Dry Eye Dry Eye Treatment What Is Dry Eye? Leer en Español: ¿Qué ...

  11. Effect of Autologous Serum Eye Drops in Patients with Sjögren Syndrome-related Dry Eye: Clinical and In Vivo Confocal Microscopy Evaluation of the Ocular Surface.

    Science.gov (United States)

    Semeraro, Francesco; Forbice, Eliana; Nascimbeni, Giuseppe; Taglietti, Marco; Romano, Vito; Guerra, Germano; Costagliola, Ciro

    To evaluate in vivo changes after therapy using autologous serum (AS) eye drops in Sjögren's syndrome (SS)-related dry eyes by confocal microscopy. In this study, 24 patients with SS-related dry eyes [12 in AS eye drop therapy and 12 in artificial tear (AT) therapy] and 24 healthy volunteers were recruited. Ocular Surface Disease Index (OSDI), central corneal thickness, tear film, break-up time, corneal and conjunctival staining, Schirmer's test and corneal confocal microscopy were investigated. Tear production, tear stability, corneal staining, inflammation, and central corneal thickness, Langherans cells, activated keratocytes, intermediate epithelial cell density, nerve tortuosity, number of sub-basal nerve branches, and number of bead-like formations differed between patients and controls (peye drops improve symptoms and confocal microscopy findings in SS-related dry eyes. Copyright © 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  12. Serum components and clinical efficacies of autologous serum eye drops in dry eye patients with active and inactive Sjogren syndrome.

    Science.gov (United States)

    Ma, I-Hsin; Chen, Lily Wei; Tu, Wen-Hui; Lu, Chia-Ju; Huang, Chien-Jung; Chen, Wei-Li

    2017-01-01

    Autologous serum eye drops are considered safe and efficient for the treatment of various ocular surface disorders, including dry eye diseases (DED) caused by the primary and secondary Sjogren syndrome (SS). However, the serum components in patients of SS may be different from those of normal patients and can thus lead to unpredictable therapeutic effects. This study divided the SS patients into active and inactive types based on the erythrocyte sedimentation rate and the presence or absence of active rheumatoid arthritis. We compared the serum components of these two groups with standard and multiplex enzyme linked immunosorbent assay arrays and predicted the therapeutic effects of topical autologous serum for the treatment of DED with ocular surface disease index (OSDI) and Oxford Schema scale (OSS). Hyaluronic acid and transforming growth factor b1 levels were significantly higher in the active SS group compared to the inactive SS group ( P Sjogren dry eye patients into active and inactive groups may appear as a reasonable method to predict the quality of autologous serum eye drops, but there seems to be no significant predictability to the therapeutic effects.

  13. Change in quality of life of patients undergoing silicone stent intubation for nasolacrimal duct stenosis combined with dry eye syndrome.

    Science.gov (United States)

    Oh, Jong Rok; Chang, Jee Ho; Yoon, Jin Sook; Jang, Sun Young

    2015-11-01

    To investigate the effect of silicone stent intubation (SI) on the quality of life of patients diagnosed with nasolacrimal duct stenosis and dry eye syndrome. This study is a prospective, interventional case series. Consecutive 30 patients diagnosed with nasolacrimal duct stenosis and reflex tearing due to dry eye syndrome were included. Eligible subjects underwent SI and were asked to complete the Glasgow Benefit Inventory (GBI) questionnaire. Surgical outcomes and GBI scores were investigated 6 months postoperatively. The surgical success rate determined by the patients' subjective symptoms was 76.7% (23/30). Mean total GBI score was +17.19 (95% CI 8.34 to 26.03). The general subscale score was +20.36 (95% CI 10.19 to 30.54), the social support scale score was +21.54 (95% CI 11.37 to 31.71) and the physical health score was -0.56 (95% CI -8.92 to 7.80). SI could be an effective treatment option for reflex tearing in patients diagnosed with dry eye syndrome and nasolacrimal duct stenosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  14. Effect of pulsed laser light in patients with dry eye syndrome.

    Science.gov (United States)

    Guilloto Caballero, S; García Madrona, J L; Colmenero Reina, E

    2017-11-01

    The objective of this study was to determine the clinical benefits of pulsed light therapy for the treatment of Dry Eye Syndrome (DES) due to the decrease in aqueous tear production (aqueous deficient DES) and/or excessive tear evaporation (evaporative DES) due to Meibomian Gland Dysfunction (MGD). A study was conducted on 72 eyes corresponding to 36 patients with DES. Out of these 72 eyes, 60 underwent refractive surgery (48 with femtosecond laser, 6 were operated with a mechanical microkeratome, and 6 with refractive photo-keratectomy[RPK], 6 treated with phacoemulsification, and 6 with no previous surgical treatment. Pulsed laser light (Intense Pulsed Light Regulated [IRPL ® ]) was use to stimulate the secretion of the Meibomian glands during 4 sessions, one every 15 days. Patients with aqueous deficient DES did not show any improvement. Eyes with no previous surgery and those treated with phacoemulsification and PRK had a favourable outcome. On the other hand, less conclusive results were observed in the eyes treated with excimer laser. This treatment could be very helpful to treat evaporative DES produced by MGD. On the other hand, it is not helpful for those cases related to an isolated damage in the aqueous phase, or the mucin phase. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Review: The Lacrimal Gland and Its Role in Dry Eye

    Directory of Open Access Journals (Sweden)

    Christopher D. Conrady

    2016-01-01

    Full Text Available The human tear film is a 3-layered coating of the surface of the eye and a loss, or reduction, in any layer of this film may result in a syndrome of blurry vision and burning pain of the eyes known as dry eye. The lacrimal gland and accessory glands provide multiple components to the tear film, most notably the aqueous. Dysfunction of these glands results in the loss of aqueous and other products required in ocular surface maintenance and health resulting in dry eye and the potential for significant surface pathology. In this paper, we have reviewed products of the lacrimal gland, diseases known to affect the gland, and historical and emerging dry eye therapies targeting lacrimal gland dysfunction.

  16. Impact of Dry Eye Syndrome on Vision-Related Quality of Life in a Non-Clinic-Based General Population

    Directory of Open Access Journals (Sweden)

    Le Qihua

    2012-07-01

    Full Text Available Abstract Background Dry eye syndrome (DES is a common ocular disorder occurring in general population. The purpose of this study is to evaluate the impact of DES on vision-related quality of life (QoL in a non-clinic-based general population. Methods This population-based cross-sectional study enrolled subjects older than 40 years, who took part in an epidemiological study on dry eye in Sanle Community, Shanghai. Apart from the collection of sociodemographics, dry eye symptoms, and other clinical data, a Chinese version of the 25-item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25 was administered to all subjects. Comparisons of the NEI VFQ-25 subscale item scores and composite score were made among subgroups divided according to the presence of dry eye symptoms or signs. Multivariate regression analysis was performed to investigate the relationship between the clinical variables and the VFQ-25 composite score. Results A total of 229 participants were enrolled in the study, with an average age of (60.7 ±10.1 years old. Majority of these participants were female (59.8 %, 137/229. The total DES symptom scores (TDSS in subjects either with definite DES or only with dry eye symptoms were significantly higher (F = 60.331, P  Conclusions The symptoms of dry eye are associated with an adverse impact on vision-related QoL in non-clinic-based general population, which is mainly represented as more ocular pain and discomfort, and impaired mental health as well. Apart from clinical examination, it is also important to refer to subjective symptoms and QoL scores when assessing the severity of DES.

  17. Efficacy of laser stimulation of the lacrimal gland and collagen punctual occlusion in the treatment of dry-eye syndrome

    Science.gov (United States)

    Switka-Wieclawska, Iwona; Kecik, Tadeusz; Ciszewska, Joanna

    1997-10-01

    In this study we would like to monitor the tear secretion during a 7 day period of temporary intracanalicular occlusion and laser stimulation of lacrimal gland in a small group of female suffering of dry eye syndrome.

  18. What Is Dry Eye?

    Medline Plus

    Full Text Available ... Ophthalmology/Strabismus Ocular Pathology/Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis Focus On ... Dry Eye Sections What Is Dry Eye? Dry Eye Symptoms Causes of ...

  19. Managing Sjögren’s Syndrome and non-Sjögren Syndrome dry eye with anti-inflammatory therapy

    Science.gov (United States)

    Coursey, Terry G; de Paiva, Cintia S

    2014-01-01

    Dry eye from Sjögren’s syndrome is a multifactorial disease that results in dysfunction of the lacrimal functional unit. Studies have shown changes in tear composition, including inflammatory cytokines, chemokines, and metalloproteinase. T-lymphocytes have been shown to increase in the conjunctiva and lacrimal glands in patient and animal models. This inflammation is in part responsible for the pathogenesis of the disease, which results in symptoms of eye irritation, ocular surface epithelial disease, and loss of corneal barrier function. There are a number of anti-inflammatory approaches for treating this disease. The current study reviews details of immune response and anti–inflammatory therapies used to control this disease. PMID:25120351

  20. Characterization of the serological biomarkers associated with Sjögren’s syndrome in patients with recalcitrant dry eye disease

    Directory of Open Access Journals (Sweden)

    Matossian C

    2016-07-01

    Full Text Available Cynthia Matossian,1,2 Joan Micucci1 1Matossian Eye Associates, Doylestown, PA, USA; 2Department of Ophthalmology, Temple University School of Medicine, Philadelphia, PA, USA Purpose: The purpose was to characterize the biomarkers associated with Sjögren’s syndrome (SS identified in the serological samples of patients with recalcitrant dry eye disease; additionally, the modalities utilized in the treatment of dry eye disease were evaluated for subsets of patients with and without SS. Patients and methods: Data for this retrospective, single-center, pilot study were based on a chart review of 48 sequential patients with recalcitrant dry eye who were evaluated for SS via serological analysis. Data presented include the presence of the autoantibodies identified through the serological biomarker analysis and identification of the concurrent dry eye treatment modalities. Results: Eleven out of 48 patients (23% tested positive for biomarkers associated with SS. Autoantibodies for salivary protein-1, parotid secretory protein 1, and carbonic anhydrase VI, markers associated with the early development of SS, were detected in 91% (ten out of eleven of the patients who tested positive for SS, whereas 27% (three out of eleven of patients tested positive for the traditional SS markers, SS-A and/or SS-B. Common treatment modalities utilized in SS patients included omega-3 supplements (82%, topical cyclosporine (74%, and artificial tear solutions (64%, as compared to omega-3 supplements (80%, hot-mask therapy (77%, and artificial tear solutions (77%, in SS-negative patients. Conclusion: Evaluation for salivary protein-1, parotid secretory protein 1, and carbonic anhydrase VI biomarkers allows for identification of a subset of patients with biomarkers associated with SS that may not be identified through the traditional assessments (SS-A/SS-B. Earlier recognition of SS biomarkers allows for a confirmatory diagnosis and appropriate management of this

  1. Development and validation of the Chinese version of dry eye related quality of life scale.

    Science.gov (United States)

    Zheng, Bang; Liu, Xiao-Jing; Sun, Yue-Qian Fiona; Su, Jia-Zeng; Zhao, Yang; Xie, Zheng; Yu, Guang-Yan

    2017-07-17

    To develop the Chinese version of quality of life scale for dry eye patients based on the Impact of Dry Eye on Everyday Life (IDEEL) questionnaire and to assess the reliability and validity of the developed scale. The original IDEEL was adapted cross-culturally to Chinese language and further developed following standard procedures. A total of 100 Chinese patients diagnosed with dry eye syndrome were included to investigate the psychometric properties of the Chinese version of scale. Psychometric tests included internal consistency (Cronbach's ɑ coefficients), construct validity (exploratory factor analysis), and known-groups validity (the analysis of variance). The Chinese version of Dry Eye Related Quality of Life (CDERQOL) Scale contains 45 items classified into 5 domains. Good to excellent internal consistency reliability was demonstrated for all 5 domains (Cronbach's ɑ coefficients range from 0.716 to 0.913). Construct validity assessment indicated a consistent factorial structure of the CDERQOL scale with hypothesized construct, with the exception of "Dry Eye Symptom-Bother" domain. All domain scores were detected with significant difference across three severity groups of dry eye patients (P dry eye syndrome among Chinese population, and could be used as a supplementary diagnostic and treatment-effectiveness measure.

  2. A HOSPITAL-BASED STUDY ON THE PREVALENCE OF DRY EYES IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Prashant V. Solanke

    2017-06-01

    Full Text Available BACKGROUND Dry eye syndrome is a common eye disease. Dry Eye Syndrome (DES, also known as Keratoconjunctivitis Sicca (KCS, is the condition of having dry eyes. Other associated symptoms include irritation, redness, discharge and easily fatigued eyes. Blurred vision may also occur. The symptoms can range from mild and occasional to severe and continuous. Scarring of the cornea may occur in some cases without treatment. Dry eye occurs when either the eye does not produce enough tears or when the tears evaporate too quickly. Tobacco smoke exposure or infection may also lead to the condition. Diagnosis is mostly based on the symptoms, though a number of other tests may be used. Prevalence of dry eyes are commoner in females than males. There is a positive relationship between glaucoma and ocular dryness as well as diabetic retinopathy and ocular dryness. Dry eye is a multifactorial disease of the tears and ocular surface. Ocular symptoms such as pain, irritation and poor vision can result from dry eye. The aim of the study is to study the prevalence, symptomatology and distribution of dry eyes. MATERIALS AND METHODS A cross-sectional study was conducted during July 2016 to March 2017. Study place was Outpatient Department of Ophthalmology at Sree Mookambika Institute of Medical Sciences, Kulasekharam. Sample size was calculated by 4PQ/d², which was 132. Systemic random sampling was used for the study. RESULTS Prevalence of dry eyes - 17.8%. Dry eyes in males - 16.8% and in females - 24.6%. Dry eyes in age 40 yrs. - 21.8%. Prevalence of dry eyes in contact lens wearers - 36.5%. Prevalence of dry eyes in glaucoma cases - 38.2%. Prevalence of dry eyes in farmers - 27.3%, in smokers - 36.7%. Dry eyes in emmetropes - 12.8% in myopes - 17.2% in hypermetropes - 28.6%. CONCLUSION Dry eyes prevalence obtained was 17.8%. Dry eyes were seen more in females. As age increases, prevalence of dry eyes increases. Ocular surface dryness was observed more in contact

  3. Intense pulsed light treatment for dry eye disease due to meibomian gland dysfunction; a 3-year retrospective study.

    Science.gov (United States)

    Toyos, Rolando; McGill, William; Briscoe, Dustin

    2015-01-01

    The purpose of this study was to determine the clinical benefits of intense-pulsed-light therapy for the treatment of dry-eye disease caused by meibomian gland dysfunction (MGD). MGD is the leading cause of evaporative dry eye disease. It is currently treated with a range of methods that have been shown to be only somewhat effective, leading to the need for advanced treatment options. A retrospective noncomparative interventional case series was conducted with 91 patients presenting with severe dry eye syndrome. Treatment included intense-pulsed-light therapy and gland expression at a single outpatient clinic over a 30-month study. Pre/post tear breakup time data were available for a subset of 78 patients. For all patients, a specially developed technique for the treatment of dry eye syndrome was applied as a series of monthly treatments until there was adequate improvement in dry eye syndrome symptoms by physician judgment, or until patient discontinuation. Primary outcomes included change in tear breakup time, self-reported patient satisfaction, and adverse events. Physician-judged improvement in dry eye tear breakup time was found for 68 of 78 patients (87%) with seven treatment visits and four maintenance visits on average (medians), and 93% of patients reported post-treatment satisfaction with degree of dry eye syndrome symptoms. Adverse events, most typically redness or swelling, were found for 13% of patients. No serious adverse events were found. Although preliminary, study results of intense-pulsed-light therapy treatment for dry eye syndrome caused by meibomian gland dysfunction are promising. A multisite clinical trial with a larger sample, treatment comparison groups, and randomized controlled trials is currently underway.

  4. Social-economic analysis of patients with Sjogren's syndrome dry eye in East China: a cross-sectional study.

    Science.gov (United States)

    Yao, Wang; Le, Qihua

    2018-02-02

    Sjogren's syndrome is the leading cause for aqueous tear-deficiency dry eye. Little is known regarding the relationship between Sjogren's syndrome dry eye (SSDE) and patients' medical expenditure, clinical severity and psychological status changes. Thirty-four SSDE patients and thirty non-Sjogren's syndrome dry eye (non-SSDE) subjects were enrolled. They were required to complete three self-report questionnaires: Ocular Surface Disease Index, Zung Self Rating Anxiety Scales, and a questionnaire designed by the researchers to study the patients' treatment, medical expenditure and income. The correlations between expenditures and these parameters were analyzed. The annual total expenditure on the treatment of SSDE was Chinese Yuan 7637.2 (approximately US$1173.8) on average, and the expense paid by SSDE patients themselves was Chinese Yuan 2627.8 (approximately US$403.9), which were 5.5 and 4.5 times higher than non-SSDE patients (both P < 0.001). The annual total expense on Chinese medicine and western medicine were 35.6 times and 78.4% higher in SSDE group than in non-SSDE group (both P < 0.001). Moreover, indirect costs associated with the treatment were 70.0% higher in SSDE group. In SSDE group, the score of Zung Self Rating Anxiety Scales had significantly positive correlation with total medical expenditure and the expense on Chinese medicine (ρ = 0.399 and ρ = 0.400,both P = 0.019). Nevertheless, total medical expenditure paid by the patients in non-SSDE group positively correlated with the score of Ocular Surface Disease Index (ρ = 0.386, P = 0.035). Medication expenditures and associated costs is an unignorable economic burden to the patients with SSDE. The medical expense had a significantly correlation with clinical severity of SSDE and the patients' psychological status.

  5. Impact of dry eye syndrome on vision-related quality of life.

    Science.gov (United States)

    Miljanović, Biljana; Dana, Reza; Sullivan, David A; Schaumberg, Debra A

    2007-03-01

    To evaluate the impact of dry eye syndrome (DES) on vision-associated quality of life. Cross-sectional study. We identified 450 participants in the Women's Health Study (WHS) and 240 participants in the Physicians' Health Study (PHS) and sent a supplementary questionnaire asking how much their everyday activities were limited by symptoms of dry eye and to what degree problems with their eyes limited them in reading, driving, working at the computer, their professional activity, and watching television. By design, one-third of study subjects had clinically diagnosed DES or severe symptoms and two-thirds did not. We used logistic regression to examine relationships of DES with reported problems with everyday activities in each cohort and pooled estimates using meta-analysis methods. Of the participants invited, 85% completed the supplementary questionnaire, including 135 WHS and 55 PHS participants with DES, and 250 WHS and 149 PHS participants without DES. Controlling for age, diabetes, hypertension, and other factors, those with DES were more likely to report problems with reading ([odds ratio] OR = 3.64, 95% [confidence interval] CI 2.45 to 5.40, P computer (OR = 3.37, 95% CI 2.11 to 5.38, P < .0001); watching television (OR = 2.84, 95% CI 1.05 to 7.74, P = .04); driving during the day (OR = 2.80, 95% CI 1.58 to 4.96, P < .0001); and driving at night (OR = 2.20, 95% CI 1.48 to 3.28, P < .0001). DES is associated with a measurable adverse impact on several common and important tasks of daily living, further implicating this condition as an important public health problem deserving increased attention and resources.

  6. What Is Dry Eye?

    Medline Plus

    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Dry Eye ... Eye Treatment What Is Dry Eye? Leer en Español: ¿Qué es el ojo seco? Written By: Kierstan ...

  7. Changes in Tear Volume after 3% Diquafosol Treatment in Patients with Dry Eye Syndrome: An Anterior Segment Spectral-domain Optical Coherence Tomography Study.

    Science.gov (United States)

    Lee, Kwan Bok; Koh, Kyung Min; Kwon, Young A; Song, Sang Wroul; Kim, Byoung Yeop; Chung, Jae Lim

    2017-08-01

    To evaluate changes in the tear meniscus area and tear meniscus height over time in patients with dry eye syndrome, using anterior segment spectral-domain optical coherence tomography after the instillation of 3% diquafosol ophthalmic solution. Sixty eyes from 30 patients with mild to moderate dry eye syndrome were included. Tear meniscus images acquired by anterior segment spectral-domain optical coherence tomography were analyzed using National Institutes of Health's image-analysis software (ImageJ 1.44p). Tear meniscus area and tear meniscus height were measured at baseline, 5 minutes, 10 minutes, and 30 minutes after instillation of a drop of diquafosol in one eye and normal saline in the other eye. Changes in ocular surface disease index score, tear film break-up time, corneal staining score by Oxford schema, and meibomian expressibility were also evaluated at baseline, and after 1 week and 1 month of a diquafosol daily regimen. Sixty eyes from 30 subjects (mean age, 29.3 years; 8 men and 22 women) were included. In eyes receiving diquafosol, tear volume was increased at 5 and 10 minutes compared with baseline. It was also higher than saline instilled eyes at 5, 10, and 30 minutes. Changes in tear volume with respect to baseline were not statistically different after the use of diquafosol for 1 month. Ocular surface disease index score, tear film break-up time, and Oxford cornea stain score were significantly improved after 1 week and 1 month of daily diquafosol instillation, but meibomian expressibility did not change. Topical diquafosol ophthalmic solution effectively increased tear volume for up to 30 minutes, compared to normal saline in patients with dry eye syndrome. © 2017 The Korean Ophthalmological Society

  8. Efficacy and safety of diquafosol ophthalmic solution in patients with dry eye syndrome: a Japanese phase 2 clinical trial.

    Science.gov (United States)

    Matsumoto, Yukihiro; Ohashi, Yuichi; Watanabe, Hitoshi; Tsubota, Kazuo

    2012-10-01

    To investigate the dose-dependent efficacy and safety of diquafosol ophthalmic solution for the treatment of dry eye syndrome. Randomized, double-masked, multicenter, parallel-group, placebo-controlled trial. A total of 286 Japanese patients with dry eye who were prescribed topical diquafosol (1%, n = 96; 3%, n = 96) or placebo ophthalmic solution (n = 94). After a washout period of 2 weeks, qualified subjects were randomized to receive a single drop of 1% or 3% diquafosol or placebo ophthalmic solutions 6 times per day for 6 weeks. The primary outcome measure was fluorescein corneal staining score assessment. The secondary outcome measures were Rose Bengal corneal and conjunctival staining scores, tear break-up time (BUT), and subjective symptom assessment. Safety measures were clinical blood and urine examination and recording of adverse events. Fluorescein corneal staining scores significantly improved with both 1% and 3% topical diquafosol compared with placebo at 4 weeks, respectively (P = 0.037, P = 0.002). There was a dose-dependent effect among the groups. Rose Bengal corneal and conjunctival staining scores also improved significantly with both 1% and 3% diquafosol compared with placebo (P = 0.007 and P = 0.004, respectively). Subjective dry eye symptom scores significantly improved with both diquafosol ophthalmic solutions (P ≤ 0.033), although there were no significant differences in BUT compared with placebo. No significant differences between the treatment groups were observed in relation to the occurrence of adverse events. Both 1% and 3% diquafosol ophthalmic solutions are considered effective and safe for the treatment of dry eye syndrome. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  9. Value-based medicine, comparative effectiveness, and cost-effectiveness analysis of topical cyclosporine for the treatment of dry eye syndrome.

    Science.gov (United States)

    Brown, Melissa M; Brown, Gary C; Brown, Heidi C; Peet, Jonathan; Roth, Zachary

    2009-02-01

    To assess the comparative effectiveness and cost-effectiveness (cost-utility) of a 0.05% emulsion of topical cyclosporine (Restasis; Allergan Inc, Irvine, California) for the treatment of moderate to severe dry eye syndrome that is unresponsive to conventional therapy. Data from 2 multicenter, randomized, clinical trials and Food and Drug Administration files for topical cyclosporine, 0.05%, emulsion were used in Center for Value-Based Medicine analyses. Analyses included value-based medicine as a comparative effectiveness analysis and average cost-utility analysis using societal and third-party insurer cost perspectives. Outcome measures of comparative effectiveness were quality-adjusted life-year (QALY) gain and percentage of improvement in quality of life, and for cost-effectiveness were cost-utility ratio (CUR) using dollars per QALY. Topical cyclosporine, 0.05%, confers a value gain (comparative effectiveness) of 0.0319 QALY per year compared with topical lubricant therapy, a 4.3% improvement in quality of life for the average patient with moderate to severe dry eye syndrome that is unresponsive to conventional lubricant therapy. The societal perspective incremental CUR for cyclosporine over vehicle therapy is $34,953 per QALY and the societal perspective average CUR is $11,199 per QALY. The third-party-insurer incremental CUR is $37,179 per QALY, while the third-party-insurer perspective average CUR is $34,343 per QALY. Topical cyclosporine emulsion, 0.05%, confers considerable patient value and is a cost-effective therapy for moderate to severe dry eye syndrome that is unresponsive to conventional therapy.

  10. Correlation between corneal innervation and inflammation evaluated with confocal microscopy and symptomatology in patients with dry eye syndromes: a preliminary study.

    Science.gov (United States)

    Tepelus, Tudor C; Chiu, Gloria B; Huang, Jianyan; Huang, Ping; Sadda, SriniVas R; Irvine, John; Lee, Olivia L

    2017-09-01

    To evaluate corneal innervation and inflammatory cell infiltration using in vivo confocal microscopy (IVCM) and to correlate these findings with subjective symptoms of dry eye, as measured by the Ocular Surface Disease Index (OSDI) in patients with non-Sjögren's (NSDE) and Sjögren's syndrome dry eyes (SSDE). Central corneal images were prospectively captured from 10 age-matched healthy control eyes, 24 eyes with clinically diagnosed NSDE and 44 eyes with clinically diagnosed SSDE, using IVCM (HRT III RCM). Density, tortuosity and reflectivity of corneal nerves, presence of inflammatory dendritic cells (DCs) and OSDI scores were evaluated. Images obtained by IVCM from 78 eyes were analyzed. The density of nerve fibers was 1562 ± 996 μm/frame in the SSDE group, 2150 ± 1015 μm/frame in the NSDE group and 2725 ± 687 μm/frame in the control group (P eyes affected with NSDE and SSDE are characterized by alterations in corneal innervation and infiltration of inflammatory DCs. Corneal nerve density and reflectivity are correlated with severity of subjective dry eye symptoms, as measured by OSDI score.

  11. Dry eyes and AIs: If you don't ask you won't find out.

    Science.gov (United States)

    Inglis, Holly; Boyle, Frances M; Friedlander, Michael L; Watson, Stephanie L

    2015-12-01

    Our objective was to investigate the hypothesis that women on adjuvant aromatase inhibitors (AIs) for treatment of breast cancer have a higher prevalence of dry eye syndrome (DES) compared with controls. Exposure and control groups were recruited. A cross sectional questionnaire-based study was performed. Demographic data and medical histories were collected. The presence of dry eye syndrome was determined by the ocular surface disease index (OSDI). The Functional Assessment of Cancer Treatment - Endocrine Subscale (FACT-ES) was performed to investigate correlations with other side effects of AIs. 93 exposure group and 100 control group questionnaires were included. The groups were similar in all demographic variables. The prevalence of dry eye syndrome was 35% (exposure) and 18% (control) (p dry eyes. The OSDI score was negatively correlated with the total FACT-ES score and positively correlated with duration of treatment. Our study is the first to use a validated questionnaire to assess for DES in this population. DES is significantly more prevalent in women on AIs compared with controls. This is a newly emerging, and easily treated side effect of AIs. Self-reporting of dry eye symptoms underestimates the prevalence of DES with AIs. We recommend routine screening of patients on AIs with the OSDI with the aim of improving patient quality of life and possibly adherence. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Post-LASIK dry eye

    Science.gov (United States)

    Shtein, Roni M

    2011-01-01

    Laser-assisted in situ keratomileusis (LASIK) is a frequently performed corneal refractive surgery with excellent refractive outcomes. The most common complication of LASIK is dry eyes, with virtually all patients developing some degree of dryness in the immediate postoperative period. Identifying preoperative dry eyes, and conscientious attention and treatment in the perioperative time period, can lead to enhanced patient satisfaction and more accurate visual outcomes. Improved understanding of the development of dry eyes after LASIK will advance our understanding of the complex pathophysiology of dry eye disease. PMID:22174730

  13. [Assessment of lipid layer thickness of tear film in the diagnosis of dry-eye syndrome in children after the hematopoietic stem cell transplantation].

    Science.gov (United States)

    Kurpińska, Małgorzata; Gorczyńska, Ewa; Owoc-Lempach, Joanna; Bernacka, Aleksandra; Misiuk-Hojło, Marta; Chybicka, Alicja

    2011-01-01

    Dry eye syndrome (DES), also known as keratoconjunctivitis sicca (KCS) is recognized as the most frequent ocular complication after allogeneic stem cell transplantation (allo-SCT). KCS can appear either due to insufficient tear production or excessive tear evaporation, both resulting in tears hyperosmolarity that leads to ocular damage. The evaporation rate and better film stability is determined primarily by the status of the lipid layer. Observation and classification of tear film lipid layer interference patterns in normal and dry eyes in patients after allogeneic stem cell transplantation with a follow-up time of 6 months-5 years (median 26.54 months). Investigation of the relation between the lipid layer interference patterns in normal and dry eyes and the results of other dry eye examinations and complaints. Relation between DES and conditioning regimes, including total body irradiation and high-dose chemotherapy, immunosuppressive drugs, the time after allogeneic stem cell transplantation and chronic graft-versus-host disease. Precorneal tears lipid layer interference patterns, were examined in 114 eyes in treatment group with the Tearscope-plus. Patient with dry eye were identified on the basis of Schirmer test scores and/or tear breakup time, and positive lissamine and/or fluorescein staining. 42 of 114 eyes (36.8%) developed DES after allo-SCT A significant correlation between thickness of lipid layer and BUT, Schirmer test, lissamine green and fluorescein staining was found in the treatment group. A significant association was found between present chronic GVHD and DES in children. DES was not associated with TBI, corticosteroids, immunosuppressive drugs and the time in the present study. Tears lipid layer interference patterns are highly correlated with the diagnosis of DES. Tears lipid layer interference patterns ( noninvasive method), can be used to diagnose early DES in children after allo-SCT. Chronic GVHD play a major role in development of DES

  14. Inflammation in dry eye.

    Science.gov (United States)

    Stern, Michael E; Pflugfelder, Stephen C

    2004-04-01

    Dry eye is a condition of altered tear composition that results from a diseased or dysfunctional lacrimal functional unit. Evidence suggests that inflammation causes structural alterations and/or functional paralysis of the tear-secreting glands. Changes in tear composition resulting from lacrimal dysfunction, increased evaporation and/or poor clearance have pro-inflammatory effects on the ocular surface. This inflammation is responsible in part for the irritation symptoms, ocular surface epithelial disease, and altered corneal epithelial barrier function in dry eye. Anti-inflammatory therapies for dry eye target one or more of the inflammatory mediators/pathways that have been identified in dry eye.

  15. Three percent diquafosol ophthalmic solution as an additional therapy to existing artificial tears with steroids for dry-eye patients with Sjögren's syndrome.

    Science.gov (United States)

    Yokoi, N; Sonomura, Y; Kato, H; Komuro, A; Kinoshita, S

    2015-09-01

    To investigate the long-term results of 3% diquafosol ophthalmic solution as an alternative therapy to existing ophthalmic solutions, including topical immunosuppression, for the treatment of dry eye in patients with Sjögren's syndrome. This study involved 14 female dry-eye patients (mean age: 62.4 years) with Sjögren's syndrome who insufficiently responded to their current therapy. In all patients, 3% diquafosol ophthalmic solution was administered six times daily for 12 months in substitution for artificial tears and sodium hyaluronate ophthalmic solution. Their use of corticosteroid eye drops remained unchanged from that prior to the treatment with diquafosol sodium. The subjective symptoms assessed, and ocular signs including tear meniscus radius and the tear film breakup time, and ocular-surface epithelial damage score were examined at 1, 2, 3, 4, 5, 6, 9, and 12 months after initiating treatment. Among the subjective symptoms, significant improvement was obtained in dryness at 2 months post treatment, in eye fatigue at 1, 2, 3, 4, and 12 months post treatment, and in pain at 1, 2, 6, and 12 months post treatment. Difficulty in opening the eye, foreign body sensation, and redness were also significantly ameliorated at various time-points. The tear meniscus radius and the tear film breakup time were significantly improved throughout the observation period, and the corneal epithelial staining scores were significantly decreased at 3 months post treatment. In dry-eye patients with Sjögren's syndrome, treatment with 3% diquafosol ophthalmic solution improved both symptoms and signs, and that effectiveness was maintained for 12 months.

  16. What Is Dry Eye?

    Medline Plus

    Full Text Available ... Dry Eye Symptoms Related Ask an Ophthalmologist Answers Can a six-month dissolvable punctal plug be removed ... my eyes dry after LASIK? Jun 19, 2016 Can I be tested whether I close my eyes ...

  17. Effect of human milk as a treatment for dry eye syndrome in a mouse model.

    Science.gov (United States)

    Diego, Jose L; Bidikov, Luke; Pedler, Michelle G; Kennedy, Jeffrey B; Quiroz-Mercado, Hugo; Gregory, Darren G; Petrash, J Mark; McCourt, Emily A

    Dry eye syndrome (DES) affects millions of people worldwide. Homeopathic remedies to treat a wide variety of ocular diseases have previously been documented in the literature, but little systematic work has been performed to validate the remedies' efficacy using accepted laboratory models of disease. The purpose of this study was to evaluate the efficacy of human milk and nopal cactus (prickly pear), two widely used homeopathic remedies, as agents to reduce pathological markers of DES. The previously described benzalkonium chloride (BAK) dry eye mouse model was used to study the efficacy of human milk and nopal cactus (prickly pear). BAK (0.2%) was applied to the mouse ocular surface twice daily to induce dry eye pathology. Fluorescein staining was used to verify that the animals had characteristic signs of DES. After induction of DES, the animals were treated with human milk (whole and fat-reduced), nopal, nopal extract derivatives, or cyclosporine four times daily for 7 days. Punctate staining and preservation of corneal epithelial thickness, measured histologically at the end of treatment, were used as indices of therapeutic efficacy. Treatment with BAK reduced the mean corneal epithelial thickness from 36.77±0.64 μm in the control mice to 21.29±3.2 μm. Reduction in corneal epithelial thickness was largely prevented by administration of whole milk (33.2±2.5 μm) or fat-reduced milk (36.1±1.58 μm), outcomes that were similar to treatment with cyclosporine (38.52±2.47 μm), a standard in current dry eye therapy. In contrast, crude or filtered nopal extracts were ineffective at preventing BAK-induced loss of corneal epithelial thickness (24.76±1.78 μm and 27.99±2.75 μm, respectively), as were solvents used in the extraction of nopal materials (26.53±1.46 μm for ethyl acetate, 21.59±5.87 μm for methanol). Epithelial damage, as reflected in the punctate scores, decreased over 4 days of treatment with whole and fat-reduced milk but continued to

  18. Reflections on Dry Eye Syndrome Treatment: Therapeutic Role of Blood Products

    Directory of Open Access Journals (Sweden)

    Victor J. Drew

    2018-02-01

    Full Text Available Dry eye syndrome (DES is a multifactorial, frequent, pathology characterized by deficient tear production or increased evaporation of tears and associated with ocular surface alteration and inflammation. It mostly affects, but not exclusively, older individuals and leads to varying degrees of discomfort and decreased quality of life. Although the typical treatments of DES rely on using artificial tears, polyunsaturated fatty acids, integrin antagonists, anti-inflammatory agents, or on performing punctal occlusion, recently, standardized blood-derived serum eye drops (SED are generating much interest as a new physiological treatment option. The scientific rationale in using SED for treating or releasing the symptoms of DES is thought to lie in its composition in multiple factors that resembles that of tears and contributes to the healing and protection of the ocular surface. This manuscript seeks to provide relevant background information on the management of DES, and on the increasing role that various types of SED or platelet lysates, from autologous or allogeneic origins, are playing in the improved therapeutic management of this pathology. The increasing role played by blood establishments in producing better-standardized SED is also addressed.

  19. [Objective assessment of the functional impact of dry eye severity on the quality of vision by double-pass aberrometry].

    Science.gov (United States)

    Habay, T; Majzoub, S; Perrault, O; Rousseau, C; Pisella, P J

    2014-03-01

    To assess the functional impact of the severity of dry eye on the quality of vision by measuring an Objective Scatter Index (OSI) using double pass aberrometry. Twenty-eight patients (56 eyes) with dry eye syndromes of varying severity participated in this study. A double-pass aberrometer was used to measure the dynamic changes in the OSI for 20 seconds. The mean and standard deviations of the OSI and the number of blinks occurring during the examination were compared as a function of the clinical severity of dry eye disease. The mean OSI increased with the severity of dry eye syndrome with a significant difference for stages 3 (P0.8) or visual acuity (P>0.2). Standard deviation of the OSI also increased with the severity of dry eye disease, with a significant difference for stages 3 (P0.2). The values of the OSI standard deviation represented the dynamic nature of aberrometric changes related to the instability of the tear film. Quality of vision of patients deteriorated in relation to the severity of their dry eye. The analysis of OSI standard deviation appears to be an objective way to assess the intensity of subjective visual disturbances reported by patients with dry eye syndrome. It also provides a new tool to assess the severity of damage to the ocular surface. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  20. Fingerprick autologous blood: a novel treatment for dry eye syndrome.

    Science.gov (United States)

    Than, J; Balal, S; Wawrzynski, J; Nesaratnam, N; Saleh, G M; Moore, J; Patel, A; Shah, S; Sharma, B; Kumar, B; Smith, J; Sharma, A

    2017-12-01

    PurposeDry eye syndrome (DES) causes significant morbidity. Trials of blood-derived products in treatment of the condition show promising results. However, their production is expensive and time-consuming. We investigate fingerprick autologous blood (FAB) as an alternative low-cost, readily accessible treatment for DES.Patients and methodsProspective, non-comparative, interventional case series. In total, 29 eyes of 16 DES patients (2 males and 14 females) from two NHS sites in the United Kingdom. Patients instructed to clean a finger, prick with a blood lancet, and apply a drop of blood to the lower fornix of the affected eye(s), 4 times daily for 8 weeks then stop and review 4 weeks later. Follow-up visits occurred ~3 days, 2, 4, 8 weeks into therapy, and 4 weeks post-cessation. At each visit, visual acuity, corneal staining, Schirmer's test, tear break-up time (TBUT), and ocular comfort index (OCI) were measured, and photographs taken. Results were analysed using Student's paired t-test.ResultsAt 8 weeks, there was improvement in mean Oxford corneal staining grade (3.31 to 2.07 (P<0.0001)), TBUT (5.00 to 7.80 s (P<0.05)), visual acuity (0.08 to 0.01 LogMAR equivalent (P<0.05)), and OCI score (56.03 to 39.72 (P<0.0001)). There was no statistically significant change in Schirmer's test results. Four weeks post-cessation versus immediately after completion of FAB therapy, mean staining grade worsened from 2.07 to 2.86 (P<0.0001). OCI score worsened from 39.72 to 44.67 (P<0.05).ConclusionsIn our limited case series FAB appears to be a safe and effective treatment for DES.

  1. Comparison of treatment with preservative-free versus preserved sodium hyaluronate 0.1% and fluorometholone 0.1% eyedrops after cataract surgery in patients with preexisting dry-eye syndrome.

    Science.gov (United States)

    Jee, Donghyun; Park, Minji; Lee, Hee Jin; Kim, Man Soo; Kim, Eun Chul

    2015-04-01

    To compare treatment with preservative-free and preserved sodium hyaluronate 0.1% and fluorometholone 0.1% eyedrops after cataract surgery in patients with preexisting dry-eye syndrome. Bucheon St. Mary's Hospital, Catholic University of Korea, Seoul, Korea. Randomized controlled study. Patients with cataract and dry-eye syndrome were randomly divided into 2 groups. Group 1 patients were treated with preservative-free sodium hyaluronate 0.1% and preservative-free fluorometholone 0.1% eyedrops 4 times a day in the first month and twice a day in the second month. Group 2 patients were treated with preserved eyedrops using the same schedule. Ocular Surface Disease Index (OSDI) score, tear-film breakup time (TBUT), Schirmer I test, corneal fluorescein staining, impression cytology, and antioxidant and inflammatory cytokine activities in tears were evaluated. Both groups comprised 40 patients. At 2 months, the OSDI score, TBUT, Schirmer I score, fluorescein staining score, impression cytology findings, and goblet cell count were significantly better in Group 1 than in Group 2 (PPreservative-free sodium hyaluronate 0.1% and fluorometholone 0.1% eyedrops can improve the symptoms and signs of dry-eye syndrome after cataract surgery. Preservative-free fluorometholone eyedrops may have antiinflammatory and antioxidant effects in tears of patients with dry-eye syndrome. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  2. Characteristics of ocular pain complaints in patients with idiopathic dry eye symptoms

    Science.gov (United States)

    Kalangara, Jerry P.; Galor, Anat; Levitt, Roy C.; Covington, Derek B.; McManus, Katherine T.; Sarantopoulos, Constantine D.; Felix, Elizabeth R.

    2016-01-01

    Objective The purpose of this study was to examine the severity and quality of ocular pain complaints in patients with dry eye symptoms. Methods Subjects with clinically-relevant dry eye symptoms (dryness, discomfort, tearing) of unknown origin seen in the Miami Veterans Affairs eye clinic were administered questionnaires for dry eye symptoms and ocular pain and underwent a standardized ocular examination. Qualities and severity ratings of ocular pain in subjects with idiopathic dry eye were compared to similar measures from published data in other chronic pain populations. Results The study sample consisted of 154 subjects, of which 91% were male and ranged in age from 27 to 89 (mean age = 61). Fifty-three percent of participants reported an average ocular pain of at least moderate intensity (numerical rating scale (NRS) ≥ 4), with specific characteristics (i.e., “burning” spontaneous pain) reported at frequencies comparable to prevalent chronic neuropathic pain syndromes as reported in the literature. Significant correlations were found between ocular pain metrics and dry eye symptom severity scores (r=0.57 to 0.66). Dry eye signs, however, did not generally correlate with ocular pain severity. Conclusions A significant proportion of subjects with idiopathic dry eye symptoms reported moderate or greater ocular pain intensity, with the majority endorsing descriptors commonly used by patients with non-ocular neuropathic pain conditions. Identifying sub-groups of dry eye patients based on the presence and characteristics of ocular pain complaints may improve dry eye sub classification and better individualize treatment strategies. PMID:26925537

  3. Lacrimal proline rich 4 (LPRR4 protein in the tear fluid is a potential biomarker of dry eye syndrome.

    Directory of Open Access Journals (Sweden)

    Saijyothi Venkata Aluru

    Full Text Available Dry eye syndrome (DES is a complex, multifactorial, immune-associated disorder of the tear and ocular surface. DES with a high prevalence world over needs identification of potential biomarkers so as to understand not only the disease mechanism but also to identify drug targets. In this study we looked for differentially expressed proteins in tear samples of DES to arrive at characteristic biomarkers. As part of a prospective case-control study, tear specimen were collected using Schirmer strips from 129 dry eye cases and 73 age matched controls. 2D electrophoresis (2DE and Differential gel electrophoresis (DIGE was done to identify differentially expressed proteins. One of the differentially expressed protein in DES is lacrimal proline rich 4 protein (LPRR4. LPRR4 protein expression was quantified by enzyme immune sorbent assay (ELISA. LPRR4 was down regulated significantly in all types of dry eye cases, correlating with the disease severity as measured by clinical investigations. Further characterization of the protein is required to assess its therapeutic potential in DES.

  4. Sjögren's syndrome associated dry eye in a mouse model is ameliorated by topical application of integrin α4 antagonist GW559090.

    Science.gov (United States)

    Contreras-Ruiz, Laura; Mir, Fayaz A; Turpie, Bruce; Krauss, Achim H; Masli, Sharmila

    2016-02-01

    Sjögren's syndrome is an autoimmune disease associated with inflammation of exocrine glands with clinical manifestations of dry eye and dry mouth. Dry eye in this disease involves inflammation of the ocular surface tissues - cornea and conjunctiva. While systemic blockade of adhesion molecules has been used to treat autoimmune diseases, the purpose of this study was to determine the therapeutic efficacy of topical application of an integrin α4 adhesion molecule antagonist in a mouse model of dry eye associated with Sjögren's syndrome. To assess this spontaneously developed ocular surface inflammation related to Sjögren's syndrome in TSP-1null mice (12 wks) was evaluated. Mice were treated with topical formulations containing 0.1% dexamethasone or 30 mg/ml GW559090 or vehicle control. Corneal fluorescein staining and conjunctival goblet cell density were assessed. Real-time PCR analysis was performed to assess expression of the inflammatory marker IL-1β in the cornea and Tbet and RORγt in the draining lymph nodes. Ocular surface inflammation was detectable in TSP-1null mice (≥12 wk old), which resulted in increased corneal fluorescein staining indicative of corneal barrier disruption and reduced conjunctival goblet cell density. These changes were accompanied by increased corneal expression of IL-1β as compared to WT controls and an altered balance of Th1 (Tbet) and Th17 (RORγt) markers in the draining lymph nodes. Topically applied dexamethasone and GW559090 significantly reduced corneal fluorescein staining compared to vehicle treatment (p = 0.023 and p syndrome. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Medial blepharosynechioplasty: a new surgical concept for severe dry eye

    Directory of Open Access Journals (Sweden)

    Sasaki T

    2012-06-01

    Full Text Available Tsugihisa Sasaki,1,2 Taeko Ota,3 Youko Ookura,4 Kazuhisa Sugiyama11Department of Ophthalmology, Kanazawa University School of Medicine, Kanazawa, Ishikawa; 2Department of Ophthalmology, Fukui Prefectural Hospital, Fukui; 3Department of Ophthalmology, Tonami General Hospital, Tonami-city, Toyama; 4Department of Ophthamology, Saiseikai Kanazawa Hospital, Kanazawa, Ishikawa, JapanBackground: The purpose of this work was to report on the performance of medial blepharosynechioplasty (MBSP, a newly devised technique for treating severe dry eye.Methods: In this retrospective, nonrandomized clinical trial, three cases with severe dry eye (Sjögren’s syndrome associated with repeated punctal plug loss were treated using MBSP to create a synechia between the upper and lower lid medial borders of the puncta to suppress the lacrimal pump.Results: Postoperative follow-up showed improvement in the corneal condition in all three cases that persisted for 12–35 months. None of the patients had visual impairment.Conclusion: MBSP is a promising treatment for severe dry eye and merits further study.Keywords: dry eye, lacrimal pump suppression, medial blepharosynechioplasty

  6. Fourier-Domain Optical Coherence Tomography for Monitoring the Lower Tear Meniscus in Dry Eye after Acupuncture Treatment

    Directory of Open Access Journals (Sweden)

    Tong Lin

    2015-01-01

    Full Text Available Dry eye is highly prevalent and has a significant impact on quality of life. Acupuncture was found to be effective to treat dry eye. However, little was known about the effect of acupuncture on different subtypes of dry eye. The objective of this study was to investigate the applicability of tear meniscus assessment by Fourier-domain optical coherence tomography in the evaluation of acupuncture treatment response in dry eye patients and to explore the effect of acupuncture on different subtypes of dry eye compared with artificial tear treatment. A total of 108 dry eye patients were randomized into acupuncture or artificial tear group. Each group was divided into three subgroups including lipid tear deficiency (LTD, Sjögren syndrome dry eye (SSDE, and non-Sjögren syndrome dry eye (Non-SSDE for data analysis. After 4-week treatment, the low tear meniscus parameters including tear meniscus height (TMH, tear meniscus depth (TMD, and tear meniscus area (TMA in the acupuncture group increased significantly for the LTD and Non-SSDE subgroups compared with both the baseline and the control groups (all P values < 0.05, but not for the SSDE. Acupuncture provided a measurable improvement of the tear meniscus dimensions for the Non-SSDE and LTD patients, but not for the SSDE patients.

  7. Changes in corneal epithelial layer inflammatory cells in aqueous tear-deficient dry eye.

    Science.gov (United States)

    Lin, Hui; Li, Wei; Dong, Nuo; Chen, Wensheng; Liu, Jing; Chen, Lelei; Yuan, Hongxia; Geng, Zhixin; Liu, Zuguo

    2010-01-01

    To investigate the morphology, distribution, and density of inflammatory cells in the corneal epithelium of aqueous tear-deficient dry eye. Thirty-two patients with non-Sjögren's syndrome (NSS) dry eye, 14 patients with Sjögren's syndrome (SS) dry eye, and 33 healthy volunteers were studied. In vivo laser scanning confocal microscopy was used to investigate both Langerhans cell (LCs) and leukocyte distribution and density in the peripheral and central corneal epithelium. LC morphology was also evaluated. Multifactor regression analysis assessed whether there is a correlation between clinical manifestations and inflammatory cell densities. LCs were present in both central (34.9 +/- 5.7 cells/mm(2)) and peripheral (90.7 +/- 8.2 cells/mm(2)) parts of the normal corneal epithelium. Moreover, LC density increased dramatically in the central corneal epithelium in patients with NSS (89.8 +/- 10.8 cells/mm(2)) and SS (127.9 +/- 23.7 cells/mm(2)). The ratio of LCs with obvious processes was much higher in patients with dry eye than in healthy volunteers. LC density also increased in peripheral corneal epithelium in patients with SS, but not in those with NSS. Leukocyte density in normal corneal epithelium was very low, whereas it increased in the central corneal epithelium (4.6 +/- 1.0 cells/mm(2)) in NSS and in both central (49.0 +/- 12.9 cells/mm(2)) and peripheral (84.2 +/- 36.8 cells/mm(2)) corneal epithelium in SS. Densities of LCs and leukocytes showed significant correlation with the severity found in clinical evaluation. The LC and leukocyte changes in the corneal epithelium suggest their involvement in aqueous tear-deficient dry eye pathophysiology. In vivo dynamic assessment of central corneal inflammatory cell density may serve as an indicator of dry eye severity and provide new insight for dry eye treatment.

  8. Autologous serum eye drops for dry eye

    Science.gov (United States)

    Pan, Qing; Angelina, Adla; Marrone, Michael; Stark, Walter J; Akpek, Esen K

    2017-01-01

    trials. We contacted investigators to ask for missing data. For both primary and secondary outcomes, we reported mean differences with corresponding 95% confidence intervals (CIs) for continuous outcomes. We did not perform meta-analysis owing to differences in outcome assessments across trials. Main results We identified five eligible RCTs (92 participants) that compared AS versus artificial tears or saline in individuals with dry eye of various origins (Sjögren’s syndrome-related dry eye, non-Sjögren’s syndrome dry eye, and postoperative dry eye induced by laser-assisted in situ keratomileusis (LASIK)). We assessed the certainty of evidence as low or very low because of lack of reporting of quantitative data for most outcomes and unclear or high risk of bias among trials. We judged most risk of bias domains to have unclear risk in two trials owing to insufficient reporting of trial characteristics, and we considered one trial to have high risk of bias for most domains. We judged the remaining two trials to have low risk of bias; however, these trials used a cross-over design and did not report data in a way that could be used to compare outcomes between treatment groups appropriately. Incomplete outcome reporting and heterogeneity among outcomes and follow-up periods prevented inclusion of these trials in a summary meta-analysis. Three trials compared AS with artificial tears; however, only one trial reported quantitative data for analysis. Low-certainty evidence from one trial suggested that AS might provide some improvement in participant-reported symptoms compared with artificial tears after two weeks of treatment; the mean difference in mean change in symptom score measured on a visual analogue scale (range 0 to 100, with higher scores representing worse symptoms) was −12.0 (95% confidence interval (CI) −20.16 to −3.84; 20 participants). This same trial found mixed results with respect to ocular surface outcomes; the mean difference in mean change in

  9. Cyclosporine Amicellar delivery system for dry eyes.

    Science.gov (United States)

    Kang, Han; Cha, Kwang-Ho; Cho, Wonkyung; Park, Junsung; Park, Hee Jun; Sun, Bo Kyung; Hyun, Sang-Min; Hwang, Sung-Joo

    2016-01-01

    The objectives of this study were to develop stable cyclosporine A (CsA) ophthalmic micelle solutions for dry-eye syndrome and evaluate their physicochemical properties and therapeutic efficacy. CsA-micelle solutions (MS-CsA) were created by a simple method with Cremophor EL, ethanol, and phosphate buffer. We investigated the particle size, pH, and osmolarity. In addition, long-term physical and chemical stability for MS-CsA was observed. To confirm the therapeutic efficacy, tear production in dry eye-induced rabbits was evaluated using the Schirmer tear test (STT). When compared to a commercial product, Restasis, MS-CsA demonstrated improvement in goblet-cell density and conjunctival epithelial morphology, as demonstrated in histological hematoxylin and eosin staining. MS-CsA had a smaller particle size (average diameter 14-18 nm) and a narrow size distribution. Physicochemical parameters, such as particle size, pH, osmolarity, and remaining CsA concentration were all within the expected range of 60 days. STT scores significantly improved in MS-CsA treated groups (Pdry eye-induced rabbits thinned with loss of goblet cells. However, after 5 days of treatment with drug formulations, rabbit conjunctivas recovered epithelia and showed a relative increase in the number of goblet cells. The results of this study indicate the potential use of a novel MS for the ophthalmic delivery of CsA in treating dry eyes.

  10. A Clinical Study of Subtype-based Prevalence of Dry Eye.

    Science.gov (United States)

    Rege, Aditya; Kulkarni, Varsha; Puthran, Neelam; Khandgave, Tejaswini

    2013-10-01

    Dry Eye is a multifactorial disease of the tearfilm and the ocular surface which may be due to reduced tear production or excessive tear evaporation resulting in discomfort, visual disturbance, and tear film instability with a potential damage to the ocular surface. Various population-based studies have been done to find out the prevalence and the magnitude of the problem. Women Health Study reported prevalence of 7.8% after screening 36995 subjects above 49 years by interview. The prevalence reported by Blue Mountain Study was 15.3% .The Beaver Dam Study and Shiphai Eye studies are other studies reporting prevalence of 14.5% and 33.7% respectively. McMonnies questionnaire is a widely used screening instrument for Dry-Eye syndromes with sensitivity reportedly varying between 87% and 98% and specificity between 87% and 97%. Prevalence studies use McMonnie's questionnaire for screening individuals for Dry Eye, whereafter tests like Schirmer's test, Tear Film Break Up Time test, Rose Bengal test, Lissamine Green test and Meibomian Gland Dysfunction test are useful for further evaluation. While these tests help to differentiate the subtypes of Dry Eye such as Lipid Anomaly Dry Eye, Aqueous Tear Deficiency and Mucin Layer Deficiency, however, their sensitivity and specificity has not been widely studied. Additionally, very few studies have reported the prevalence of the various subtypes of Dry Eye. To determine the subtype-based prevalence of Dry Eye, to study the specificity and sensitivity of clinical tests for Dry Eye and to correlate McMonnies questionnaire with Dry Eye tests results. A prospective, cross-sectional, observational study, duly approved by the Institutional Ethics Committee, was conducted from October 2010 to April 2012. A total of 4750 subjects above 18 yrs of age were screened by the McMonnies questionnaire. Respondents having a score greater than 14.5 were subjected to clinical Dry Eye tests. The data obtained was analyzed using chi-square test. p

  11. Impact of dry eye on work productivity.

    Science.gov (United States)

    Yamada, Masakazu; Mizuno, Yoshinobu; Shigeyasu, Chika

    2012-01-01

    The purpose of this study was to evaluate the impact of dry eye on work productivity of office workers, especially in terms of presenteeism. A total of 396 individuals aged ≥20 years (258 men and 138 women, mean age 43.4 ± 13.0 years) were recruited through an online survey. Data from 355 responders who did not have missing values were included in the analysis. They were classified into the following four groups according to the diagnostic status and subjective symptoms of dry eye: a definite dry eye group; a marginal dry eye group; a self-reported dry eye group; and a control group. The impact of dry eye on work productivity was evaluated using the Japanese version of the Work Limitations Questionnaire. The cost of work productivity loss associated with dry eye and the economic benefits of providing treatment for dry eye were also assessed. The degree of work performance loss was 5.65% in the definite dry eye group, 4.37% in the marginal dry eye group, 6.06% in the self-reported dry eye group, and 4.27% in the control group. Productivity in the self-reported dry eye group was significantly lower than that in the control group (P work productivity loss associated with dry eye was estimated to be USD 741 per person. Dry eye impairs work performance among office workers, which may lead to a substantial loss to industry. Management of symptoms of dry eye by providing treatment may contribute to improvement in work productivity.

  12. Neuropathic pain and dry eye.

    Science.gov (United States)

    Galor, Anat; Moein, Hamid-Reza; Lee, Charity; Rodriguez, Adriana; Felix, Elizabeth R; Sarantopoulos, Konstantinos D; Levitt, Roy C

    2018-01-01

    Dry eye is a common, multifactorial disease currently diagnosed by a combination of symptoms and signs. Its epidemiology and clinical presentation have many similarities with neuropathic pain outside the eye. This review highlights the similarities between dry eye and neuropathic pain, focusing on clinical features, somatosensory function, and underlying pathophysiology. Implications of these similarities on the diagnosis and treatment of dry eye are discussed. Published by Elsevier Inc.

  13. Impact of dry eye on work productivity

    Directory of Open Access Journals (Sweden)

    Yamada M

    2012-10-01

    Full Text Available Masakazu Yamada, Yoshinobu Mizuno, Chika ShigeyasuNational Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, JapanBackground: The purpose of this study was to evaluate the impact of dry eye on work productivity of office workers, especially in terms of presenteeism.Methods: A total of 396 individuals aged ≥20 years (258 men and 138 women, mean age 43.4 ± 13.0 years were recruited through an online survey. Data from 355 responders who did not have missing values were included in the analysis. They were classified into the following four groups according to the diagnostic status and subjective symptoms of dry eye: a definite dry eye group; a marginal dry eye group; a self-reported dry eye group; and a control group. The impact of dry eye on work productivity was evaluated using the Japanese version of the Work Limitations Questionnaire. The cost of work productivity loss associated with dry eye and the economic benefits of providing treatment for dry eye were also assessed.Results: The degree of work performance loss was 5.65% in the definite dry eye group, 4.37% in the marginal dry eye group, 6.06% in the self-reported dry eye group, and 4.27% in the control group. Productivity in the self-reported dry eye group was significantly lower than that in the control group (P < 0.05. The annual cost of work productivity loss associated with dry eye was estimated to be USD 741 per person.Conclusion: Dry eye impairs work performance among office workers, which may lead to a substantial loss to industry. Management of symptoms of dry eye by providing treatment may contribute to improvement in work productivity.Keywords: burden of disease, dry eye, presenteeism, quality of life

  14. Evaluation of treatment for dry eye with 2-hydroxyestradiol using a dry eye rat model.

    Science.gov (United States)

    Higuchi, Akihiro; Oonishi, Erina; Kawakita, Tetsuya; Tsubota, Kazuo

    2016-01-01

    2-hydroxy estradiol (2-OHE2) is a catechol derivative of 17β -Estradiol (E2) and it is synthesized from E2 catalyzed by cytochrome P4501A1. Previous studies reported that 2-OHE2 is a physiologic antioxidant in lipoproteins, liver microsomes, and the brain. Catechol derivatives show an anti-inflammatory effect through the inhibition of prostaglandin endoperoxide synthase (PGS) activity. Corneal erosion caused by dry eye is related to an increase in oxidative stress and inflammation in ocular surface cells. We investigated the therapeutic effects of 2-OHE2 on corneal damage caused by dry eye. Steroidal radical scavenging activity was confirmed through the electron spin resonance (ESR) method. PGS activity was measured using the COX Fluorescent Activity Assay Kit. To evaluate the effect of 2-OHE2 on the treatment for dry eye, 2-OHE2 was applied as an eye drop experiment using dry eye model rats. 2-OHE2 scavenged tyrosyl radical and possibly suppressed oxidative stress in corneal epithelial cells. In addition, 2-OHE2 inhibited PGS activity, and 2-OHE2 is probably a competitive inhibitor of PGS. Corneal PGS activity was upregulated in the dry eye group. Therefore, 2-OHE2 eye drops improved corneal erosion in dry eye model rats. 2-OHE2 is a candidate for the treatment of dry eye through the suppression of inflammation and oxidative stress in the cornea.

  15. The Effect of Pseudoexfoliation and Pseudoexfoliation Induced Dry Eye on Central Corneal Thickness.

    Science.gov (United States)

    Akdemir, M Orcun; Kirgiz, Ahmet; Ayar, Orhan; Kaldirim, Havva; Mert, Metin; Cabuk, Kubra Serefoglu; Taskapili, Muhittin

    2016-01-01

    The aim of this study is to investigate the effect of pseudoexfoliation (PEX) and PEX-induced dry eye on central corneal thickness (CCT). This cross-sectional study consists of total 270 eyes of 135 patients (67 females, 68 males) in total. After excluding the PEX (-) 32 eyes with PEX in the other eye, totally 130 eyes in PEX (-) group and 108 eyes in the PEX (+) group were included in the study. The PEX (+) group was regrouped as PEX syndrome (80 eyes of 50 patients) and PEX glaucoma (28 eyes of 20 patients). In the PEX (-) group, the mean Schirmer test result was 12 ± 4 mm (4-25 mm), in the PEX syndrome group 10 ± 4 mm (4-22 mm), in the PEX glaucoma group 9 ± 3 mm (4-15 mm). The difference among the PEX (-) group, the PEX syndrome and the PEX glaucoma groups was statistically significant (p eyes with PEX (r = 0.307, p = 0.001). However, there was no statistically significant correlation between CCT, Schirmer and tear break up time tests in the eyes with PEX. PEX material can cause decrease in tear film secretion and disturb tear film stability. There is no effect of PEX-induced dry eye on CCT. Lower CCT values in the eyes with PEX material may be a result of decrease in corneal stromal cell density. Moreover, higher CCT values may be because of decreased endothelial cells in PEX glaucoma patients.

  16. Comparison of postoperative corneal changes between dry eye and non-dry eye in a murine cataract surgery model.

    Science.gov (United States)

    Kwon, Jin Woo; Chung, Yeon Woong; Choi, Jin A; La, Tae Yoon; Jee, Dong Hyun; Cho, Yang Kyung

    2016-01-01

    To compare the effects of the surgical insult of cataract surgery on corneal inflammatory infiltration, neovascularization (NV) and lymphangiogenesis (LY) between the dry eye and non-dry eye in murine cataract surgery models. We established two groups of animals, one with normal eyes (non-dry eye) and the second with induced dry eyes. In both groups, we used surgical insults to mimic human cataract surgery, which consisted of lens extraction, corneal incision and suture. After harvesting of corneas on the 9(th) postoperative day and immunohistochemical staining, we compared NV, LY and CD11b+ cell infiltration in the corneas. Dry eye group had significantly more inflammatory infiltration (21.75%±7.17% vs 3.65%±1.49%; P=0.049). The dry eye group showed significantly more NV (48.21%±4.02% vs 26.24%±6.01%; P=0.016) and greater levels of LY (9.27%±0.48% vs 4.84%±1.15%; P=0.007). In corneas on which no surgery was performed, there was no induction of NV in both the dry and non-dry group, but dry eye group demonstrated more CD11b+ cells infiltration than the non-dry eye group (0.360%±0.160% vs 0.023%±0.006%; P=0.068). Dry eye group showed more NV than non-dry eye group in both topical PBS application and subconjunctival PBS injection (P=0.020 and 0.000, respectively). In a murine cataract surgery model, preexisting dry eye can induce more postoperative NV, LY, and inflammation in corneal tissue.

  17. Cost of dry eye treatment in an Asian clinic setting.

    Science.gov (United States)

    Waduthantri, Samanthila; Yong, Siew Sian; Tan, Chien Hua; Shen, Liang; Lee, Man Xin; Nagarajan, Sangeetha; Hla, Mynt Htoon; Tong, Louis

    2012-01-01

    To estimate the cost and patterns of expenditure of dry eye treatment. We retrieved data on the type and cost of dry eye treatment in Singapore National Eye Centre from pharmacy and clinic inventory databases over a 2 year period (2008-2009) retrospectively. According to the type of treatment, data were sorted into 7 groups; meibomien gland disease (MGD) treatment, preservative free lubricant eye drops, preserved lubricant eye drops, lubricant ointments and gels, cyclosporine eye drops, oral supplements and non-pharmacological treatments/procedures. Each recorded entry was considered as one patient episode (PE). Comparisons in each group between two years were carried out using Pearson Chi-Square test. Significance level was set at alpha  =  0.05. Cost data from 54,052 patients were available for analysis. Total number of recorded PEs was 132,758. Total annual expenditure on dry eye treatment for year 2008 and 2009 were US$1,509,372.20 and US$1,520,797.80 respectively. Total expenditure per PE in year 2008 and 2009 were US$22.11 and US$23.59 respectively. From 2008 to 2009, there was a 0.8% increase in total annual expenditure and 6.69% increase in expenditure per PE. Pharmacological treatment attributes to 99.2% of the total expenditure with lubricants accounting for 79.3% of the total pharmacological treatment expenditure. Total number of units purchased in preservative free lubricants, cyclosporine eye drops and MGD therapy have increased significantly (pDry eye imposes a significant direct burden to health care expenditure even without considering indirect costs. Health care planners should be aware that these direct costs appear to increase over the time and more so for particular types of medications. Given the limitations of socio-economic data, true societal costs of Dry eye syndrome are likely to be much higher than estimated.

  18. Comparison of postoperative corneal changes between dry eye and non-dry eye in a murine cataract surgery model

    Science.gov (United States)

    Kwon, Jin Woo; Chung, Yeon Woong; Choi, Jin A; La, Tae Yoon; Jee, Dong Hyun; Cho, Yang Kyung

    2016-01-01

    AIM To compare the effects of the surgical insult of cataract surgery on corneal inflammatory infiltration, neovascularization (NV) and lymphangiogenesis (LY) between the dry eye and non-dry eye in murine cataract surgery models. METHODS We established two groups of animals, one with normal eyes (non-dry eye) and the second with induced dry eyes. In both groups, we used surgical insults to mimic human cataract surgery, which consisted of lens extraction, corneal incision and suture. After harvesting of corneas on the 9th postoperative day and immunohistochemical staining, we compared NV, LY and CD11b+ cell infiltration in the corneas. RESULTS Dry eye group had significantly more inflammatory infiltration (21.75%±7.17% vs 3.65%±1.49%; P=0.049). The dry eye group showed significantly more NV (48.21%±4.02% vs 26.24%±6.01%; P=0.016) and greater levels of LY (9.27%±0.48% vs 4.84%±1.15%; P=0.007). In corneas on which no surgery was performed, there was no induction of NV in both the dry and non-dry group, but dry eye group demonstrated more CD11b+ cells infiltration than the non-dry eye group (0.360%±0.160% vs 0.023%±0.006%; P=0.068). Dry eye group showed more NV than non-dry eye group in both topical PBS application and subconjunctival PBS injection (P=0.020 and 0.000, respectively). CONCLUSION In a murine cataract surgery model, preexisting dry eye can induce more postoperative NV, LY, and inflammation in corneal tissue. PMID:26949638

  19. Treatment of dry eye syndrome with orally administered CF101: data from a phase 2 clinical trial.

    Science.gov (United States)

    Avni, Isaac; Garzozi, Hanna J; Barequet, Irina S; Segev, Fanni; Varssano, David; Sartani, Gil; Chetrit, Noa; Bakshi, Erez; Zadok, David; Tomkins, Oren; Litvin, Gilad; Jacobson, Kenneth A; Fishman, Sari; Harpaz, Zivit; Farbstein, Motti; Yehuda, Sara Bar; Silverman, Michael H; Kerns, William D; Bristol, David R; Cohn, Ilan; Fishman, Pnina

    2010-07-01

    To explore the safety and efficacy of CF101, an A(3) adenosine receptor agonist, in patients with moderate to severe dry eye syndrome. Phase 2, multicenter, randomized, double-masked, placebo-controlled, parallel-group study. Sixty-eight patients completed the study, 35 patients in the placebo group and 33 patients in the CF101 group. Patients were treated orally with either 1 mg CF101 pills or matching vehicle-filled placebo pills, given twice daily for 12 weeks, followed by a 2-week posttreatment observation. An improvement of more than 25% over baseline at week 12 in one of the following parameters: (1) tear break-up time (BUT); (2) superficial punctate keratitis assessed by fluorescein staining results; and (3) Schirmer tear test 1 results. Clinical laboratory safety tests, ophthalmic examinations, intraocular pressure (IOP) measurements, electrocardiographic evaluations, vital sign measurements, and monitoring of adverse events. A statistically significant increase in the proportion of patients who achieved more than 25% improvement in the corneal staining and in the clearance of corneal staining was noted between the CF101-treated group and the placebo group. Treatment with CF101 resulted in a statistically significant improvement in the mean change from baseline at week 12 of the corneal staining, BUT, and tear meniscus (TM) height in the CF101-treated group. CF101 was well tolerated and exhibited an excellent safety profile with no serious adverse events. A statistically significant decrease from baseline was observed in the IOP of the CF101-treated group in comparison with the placebo group. CF101, given orally, induced a statistically significant improvement in the corneal staining and an improvement in the BUT and TM in patients with moderate to severe dry eye syndrome. The drug was very well tolerated. These data and the anti-inflammatory characteristic of CF101 support further study of the drug as a potential treatment for the signs and symptoms of dry

  20. Effects of Aging in Dry Eye

    Science.gov (United States)

    de Paiva, Cintia S.

    2017-01-01

    Dry eye affects millions of people worldwide and causes eye well recognized risk factors for dry eye. Anatomical and inflammation-induced age-related changes affect all components of the lacrimal gland functional unit, inclusive of lacrimal gland, conjunctiva, meibomian gland and compromise ocular surface health. There is increased evidence that inflammation plays a role in dry eye. This review will summarize the current knowledge about aging and dry eye, inclusive of lessons learned from animal models and promising therapies. PMID:28282314

  1. Comparison of corneal biomechanics in Sjögren's syndrome and non-Sjögren's syndrome dry eyes by Scheimpflug based device.

    Science.gov (United States)

    Long, Qin; Wang, Jing-Yi; Xu, Dong; Li, Ying

    2017-01-01

    To compare the corneal biomechanics of Sjögren's syndrome (SS) and non-SS dry eyes with Corneal Visualization Scheimpflug Technology (CorVis ST). Corneal biomechanics and tear film parameters, namely the Schirmer I test value, tear film break-up time (TBUT) and corneal staining score (CSS) were detected in 34 eyes of 34 dry eye patients with SS (SSDE group) and 34 dry eye subjects without SS (NSSDE group) using CorVis ST. The differences of the above parameters between the two groups were examined, and the relationship between corneal biomechanics and tear film parameters were observed. The differences in age, sex, intraocular pressure (IOP) and central corneal thickness (CCT) were not significant between the two groups ( P >0.05). The tear film parameters had significant differences between the SSDE group and NSSDE group (all P <0.05). Patients in the SSDE group had significantly lower A1-time and HC-time, but higher DA ( P =0.01, 0.02, and 0.02, respectively) compared with the NSSDE group. In the SSDE group, DA was negatively correlated with TBUT ( rho =-0.38, P =0.03); HC-time was negatively correlated with CSS ( rho =-0.43, P =0.02). In the NSSDE group, HC-time was again negatively correlated with CSS ( rho =-0.39, P =0.02). There are differences in corneal biomechanical properties between SSDE and NSSDE. The cornea of SSDE tends to show less "stiffness", as seen by a significantly shorter A1-time and HC-time, but larger DA, compared with the cornea of NSSDE. Biomechanical parameters can be influenced by different tear film parameters in both groups.

  2. Conjunctival impression cytology evaluation of patients with dry eye disease using scleral contact lenses.

    Science.gov (United States)

    Weber, Sarah La Porta; Hazarbassanov, Rossen Mihaylov; Nasaré, Alex; Gomes, José Álvaro Pereira; Hofling-Lima, Ana Luisa

    2017-06-01

    To evaluate conjunctival impression cytology and HLADR expression changes after wearing scleral contact lenses (ScCLs) for moderate to severe dry eye disease (DED). Prospective interventional case series. Forty-one eyes from 25 patients with moderate to severe DED were evaluated for Esclera ScCL treatment. Best-corrected visual acuity (BCVA) and slit-lamp findings were assessed. Impression cytology specimens were obtained from DED patients at the baseline and after wearing ScCLs for 12 months. The impression cytology specimens were analyzed using morphological results score, and HLA-DR positive cells were detected and quantified. The values were compared to assess the IC changes after wearing ScCLs. Forty-one eyes from 25 patients were fitted with ScCLs to manage DED. The underlying diseases were Stevens-Johnson syndrome (22 eyes), Sjogren's syndrome (11 eyes), graft-versus-host disease (2 eyes), dry eye after keratomileusis (2 eyes) and undifferentiated ocular surface disease (4 eyes). The HE-PAS impression cytology score did not differ significantly before and after wearing ScCLs for 12 months in DED patients (p>0.05). The percentage of eyes expressing the HLA-DR antigen in the temporal conjunctiva after wearing ScCL for 12 months significantly increased in patients with Sjogren's syndrome (11.11% to 66.66%; p=0.0498). In groups with Stevens Johnson syndrome and other ocular surface disorders, we did not observe statistically significant differences (p>0.05). The ScCLs did not change the parameters used to evaluate inflammatory processes, which were measured using conjunctival impression cytology and HLA-DR expression, except in Sjogren syndrome, in which there was an unexpected increase in HLA expression. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  3. Perceptions of dry eye disease management in current clinical practice.

    Science.gov (United States)

    Williamson, Jennifer F; Huynh, Kyle; Weaver, Mark A; Davis, Richard M

    2014-03-01

    To assess the perceptions of eye care providers regarding the clinical management of dry eye. Invitations to complete a 17-question online survey were mailed to 400 members of the North Carolina Ophthalmology and Optometry Associations including community optometrists, comprehensive ophthalmologists, and cornea specialists. The survey was completed by 100 eye care providers (25% response rate). Providers reported burning (46.5%) as the most frequent symptom described by patients, followed by foreign body sensation (30.3%) and tearing (17.2%). Most respondents (80.8%) listed artificial tears as the recommended first-line treatment, even though providers reported high failure rates for both artificial tears and cyclosporine A (Restasis). Rheumatoid arthritis, Sjögren syndrome, affective disorders such as anxiety and depression, history of photorefractive surgery, smoking, and thyroid disease were acknowledged as common comorbid conditions. The survey provided an informative snapshot into the preferences of eye care providers concerning the diagnosis and management of dry eye disease. Overall, burning was the most common symptom reported by patients. Providers relied more on patient history in guiding their clinical decisions than objective signs. The survey underscores the incongruence when comparing subjective symptoms with objective signs, thereby highlighting the urgent need for the development of reliable metrics to better quantify dry eye symptoms and also the development of a more sensitive and specific test that can be used as the gold standard to diagnose dry eye.

  4. A randomized, double-blind, placebo-controlled study of oral antioxidant supplement therapy in patients with dry eye syndrome

    OpenAIRE

    Huang, Jehn-Yu; Yeh, Po-Ting; Hou, Yu-Chih

    2016-01-01

    Jehn-Yu Huang, Po-Ting Yeh, Yu-Chih Hou Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan Purpose: To evaluate the efficacy of oral antioxidant supplementation in the treatment of patients with dry eye syndrome (DES). Methods: A prospective, randomized, double-blinded study compared the effects of an antioxidant supplement (containing anthocyanosides, astaxanthin, vitamins A, C, and E, and several herbal extract...

  5. Herbal Supplement in a Buffer for Dry Eye Syndrome Treatment.

    Science.gov (United States)

    Chen, Hung-Chang; Chen, Zhi-Yu; Wang, Tsung-Jen; Drew, Victor J; Tseng, Ching-Li; Fang, Hsu-Wei; Lin, Feng-Huei

    2017-08-03

    Dry eye syndrome (DES) is one of the most common types of ocular diseases. There is a major need to treat DES in a simple yet efficient way. Artificial tears (AT) are the most commonly used agents for treating DES, but are not very effective. Herbal extractions of ferulic acid (FA), an anti-oxidant agent, and kaempferol (KM), an anti-inflammatory reagent, were added to buffer solution (BS) to replace ATs for DES treatment. The cytotoxicity and anti-inflammatory effects were examined in vitro by co-culture with human corneal epithelial cells (HCECs) to obtain the optimal concentration of KM and FA for treating HCECs. Physical properties of BS, such as pH value, osmolality, and refractive index were also examined. Then, rabbits with DES were used for therapeutic evaluation. Tear production, corneal damage, and ocular irritation in rabbits' eyes were examined. The non-toxic concentrations of KM and FA for HCEC cultivation over 3 days were 1 µM and 100 µM, respectively. Live/dead stain results also show non-toxicity of KM and FA for treating HCECs. Lipopolysaccharide-stimulated HCECs in inflammatory conditions treated with 100 µM FA and 1 µM KM (FA100/KM1) showed lower IL-1B , IL-6 , IL-8 , and TNFα expression when examined by real-time PCR. The BS with FA100/KM1 had neutral pH, and a similar osmolality and refractive index to human tears. Topical delivery of BS + FA100/KM1 showed no irritation to rabbit eyes. The corneal thickness in the BS + FA100/KM1 treated group was comparable to normal eyes. Results of DES rabbits treated with BS + FA100/KM1 showed less corneal epithelial damage and higher tear volume than the normal group. In conclusion, we showed that the combination of FA (100 µM) and KM (1 µM) towards treating inflamed HCECs had an anti-inflammatory effect, and it is effective in treating DES rabbits when BS is added in combination with these two herbal supplements and used as a topical eye drop.

  6. Herbal Supplement in a Buffer for Dry Eye Syndrome Treatment

    Directory of Open Access Journals (Sweden)

    Hung-Chang Chen

    2017-08-01

    Full Text Available Dry eye syndrome (DES is one of the most common types of ocular diseases. There is a major need to treat DES in a simple yet efficient way. Artificial tears (AT are the most commonly used agents for treating DES, but are not very effective. Herbal extractions of ferulic acid (FA, an anti-oxidant agent, and kaempferol (KM, an anti-inflammatory reagent, were added to buffer solution (BS to replace ATs for DES treatment. The cytotoxicity and anti-inflammatory effects were examined in vitro by co-culture with human corneal epithelial cells (HCECs to obtain the optimal concentration of KM and FA for treating HCECs. Physical properties of BS, such as pH value, osmolality, and refractive index were also examined. Then, rabbits with DES were used for therapeutic evaluation. Tear production, corneal damage, and ocular irritation in rabbits’ eyes were examined. The non-toxic concentrations of KM and FA for HCEC cultivation over 3 days were 1 µM and 100 µM, respectively. Live/dead stain results also show non-toxicity of KM and FA for treating HCECs. Lipopolysaccharide-stimulated HCECs in inflammatory conditions treated with 100 µM FA and 1 µM KM (FA100/KM1 showed lower IL-1B, IL-6, IL-8, and TNFα expression when examined by real-time PCR. The BS with FA100/KM1 had neutral pH, and a similar osmolality and refractive index to human tears. Topical delivery of BS + FA100/KM1 showed no irritation to rabbit eyes. The corneal thickness in the BS + FA100/KM1 treated group was comparable to normal eyes. Results of DES rabbits treated with BS + FA100/KM1 showed less corneal epithelial damage and higher tear volume than the normal group. In conclusion, we showed that the combination of FA (100 µM and KM (1 µM towards treating inflamed HCECs had an anti-inflammatory effect, and it is effective in treating DES rabbits when BS is added in combination with these two herbal supplements and used as a topical eye drop.

  7. Feline dry eye syndrome of presumed neurogenic origin: a case report

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    Lionel Sebbag

    2017-12-01

    Full Text Available Case summary A 14-year-old female spayed Abyssinian cat, which about 1 year previously underwent thoracic limb amputation, radiotherapy and chemotherapy for an incompletely excised vaccine-related fibrosarcoma, was presented for evaluation of corneal opacity in the left eye (OS. The ocular surface of both eyes (OU had a lackluster appearance and there was a stromal corneal ulcer OS. Results of corneal aesthesiometry, Schirmer tear test-1 (STT-1 and tear film breakup time revealed corneal hypoesthesia, and quantitative and qualitative tear film deficiency OU. Noxious olfactory stimulation caused increased lacrimation relative to standard STT-1 values suggesting an intact nasolacrimal reflex. Various lacrimostimulants were administered in succession; namely, 1% pilocarpine administered topically (15 days or orally (19 days, and topically applied 0.03% tacrolimus (47 days. Pilocarpine, especially when given orally, was associated with notable increases in STT-1 values, but corneal ulceration remained/recurred regardless of administration route, and oral pilocarpine resulted in gastrointestinal upset. Tacrolimus was not effective. After 93 days, the cat became weak and lame and a low thyroxine concentration was detected in serum. The cat was euthanized and a necropsy performed. Both lacrimal glands were histologically normal, but chronic neutrophilic keratitis and reduced conjunctival goblet cell density were noted OU. Relevance and novel information The final diagnosis was dry eye syndrome (DES of presumed neurogenic origin, associated with corneal hypoesthesia. This report reinforces the importance of conducting tearfilm testing in cats with ocular surface disease, as clinical signs of DES were different from those described in dogs.

  8. Feline dry eye syndrome of presumed neurogenic origin: a case report.

    Science.gov (United States)

    Sebbag, Lionel; Pesavento, Patricia A; Carrasco, Sebastian E; Reilly, Christopher M; Maggs, David J

    2018-01-01

    A 14-year-old female spayed Abyssinian cat, which about 1 year previously underwent thoracic limb amputation, radiotherapy and chemotherapy for an incompletely excised vaccine-related fibrosarcoma, was presented for evaluation of corneal opacity in the left eye (OS). The ocular surface of both eyes (OU) had a lackluster appearance and there was a stromal corneal ulcer OS. Results of corneal aesthesiometry, Schirmer tear test-1 (STT-1) and tear film breakup time revealed corneal hypoesthesia, and quantitative and qualitative tear film deficiency OU. Noxious olfactory stimulation caused increased lacrimation relative to standard STT-1 values suggesting an intact nasolacrimal reflex. Various lacrimostimulants were administered in succession; namely, 1% pilocarpine administered topically (15 days) or orally (19 days), and topically applied 0.03% tacrolimus (47 days). Pilocarpine, especially when given orally, was associated with notable increases in STT-1 values, but corneal ulceration remained/recurred regardless of administration route, and oral pilocarpine resulted in gastrointestinal upset. Tacrolimus was not effective. After 93 days, the cat became weak and lame and a low thyroxine concentration was detected in serum. The cat was euthanized and a necropsy performed. Both lacrimal glands were histologically normal, but chronic neutrophilic keratitis and reduced conjunctival goblet cell density were noted OU. The final diagnosis was dry eye syndrome (DES) of presumed neurogenic origin, associated with corneal hypoesthesia. This report reinforces the importance of conducting tearfilm testing in cats with ocular surface disease, as clinical signs of DES were different from those described in dogs.

  9. EVALUATION OF DRY EYES IN DIABETES MELLITUS

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    Anshu Sharma

    2017-12-01

    Full Text Available BACKGROUND According to the National Eye Institute, dry eye is a condition in which the eye does not produce tears properly. It can also involve tears not having the right consistency or evaporating too quickly. Tears are necessary to help maintain moisture on the surface of the eye and for clear vision. Diabetes is often associated with several significant ocular conditions such as retinopathy, refractive changes, cataracts, glaucoma and macular oedema. However, one of the most common ocular complications associated with diabetes is dry eye. The aim of the study is to study the prevalence of dry eyes in diabetes mellitus and to evaluate ocular and other risk factors relevant to diabetic dry eyes. MATERIALS AND METHODS A hospital-based cross-sectional clinical study of 100 diabetic patients who presented to the Department of Ophthalmology, Santosh Medical College and Hospital, Ghaziabad, between January 2016 to June 2017 was conducted. Detailed diabetic history was recorded. Assessment of anterior segment via slit-lamp biomicroscopy was done. The examinations for dry eyes included Schirmer's test, tear breakup time, fluorescein and rose Bengal staining. RESULTS Sixty two (62% diabetic patients had dry eye. The prevalence in type I was 3% and prevalence in type II was 59%. Dry eye prevalence was maximum in those above 40 years of age. Symptoms like reduced corneal sensation (44% and meibomitis (20% were major attributable risk factors. Ocular surface damage was predominantly superficial punctate keratitis. Retinopathy was not statistically associated with the prevalence of dry eyes. CONCLUSION Diabetes and dry eye appears to be a common association. Reduction in the modifiable risk factors of dry eye is essential to reduce its prevalence. No significant statistical correlation was found between retinopathy and dry eyes. However, examination for dry eyes should be an integral part of the assessment of diabetic eye disease.

  10. Safety and Efficacy of Cortisol Phosphate in Hyaluronic Acid Vehicle in the Treatment of Dry Eye in Sjogren Syndrome.

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    Rolando, Maurizio; Vagge, Aldo

    2017-06-01

    Evaluation of 0.3% cortisol phosphate eye drops in hyaluronic acid vehicle in the treatment of dry eye in Sjogren Syndrome. This prospective, single-center, masked (single blind), randomized controlled study included 40 female patients divided into 2 groups, group 1 treated with Idracemi, 0.3% cortisol phosphate eye drops twice a day, and group 2 treated with Cortivis, 0.3% cortisol phosphate in hyaluronic acid vehicle, with the same posology. Screening (day -7), randomization (day 0), follow-up (day 7), and termination (day 28) visits were conducted. Symptoms (VAS) questionnaire, tear film breakup time, corneo-conjunctival stain, intraocular pressure (IOP) measurement, and fundus examination were performed at each visit. Conjunctival impression cytology for human leukocyte antigen-DR (HLA-DR) expression at visit 1 and 4 was also performed. No changes in IOP or fundus examination were observed in either group at each time point. Group 1 showed at day 28 a statistically significant amelioration of symptoms and reduction of HLA-DR expression. Group 2 showed at day 7 statistically significant improvement of corneal and conjunctival stain versus baseline and versus group 1; the symptom score was statistically significantly better than baseline and versus group 1 after 28 days too. The HLA-DR expression and the epithelial cell area were statistically significantly reduced versus baseline and versus group 1 at the same time. Cortisol phosphate proved to be safe and effective in treating dry eye in Sjogren Syndrome patients in both formulations. However, the formula with hyaluronic acid vehicle proved to be more effective. Both formulations were very well tolerated.

  11. Does Dry Eye Affect Repeatability of Corneal Topography Measurements?

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    Aysun Şanal Doğan

    2018-04-01

    Full Text Available Objectives: The purpose of this study was to assess the repeatability of corneal topography measurements in dry eye patients and healthy controls. Materials and Methods: Participants underwent consecutive corneal topography measurements (Sirius; Costruzione Strumenti Oftalmici, Florence, Italy. Two images with acquisition quality higher than 90% were accepted. The following parameters were evaluated: minimum and central corneal thickness, aqueous depth, apex curvature, anterior chamber volume, horizontal anterior chamber diameter, iridocorneal angle, cornea volume, and average simulated keratometry. Repeatability was assessed by calculating intra-class correlation coefficient. Results: Thirty-three patients with dry eye syndrome and 40 healthy controls were enrolled to the study. The groups were similar in terms of age (39 [18-65] vs. 30.5 [18-65] years, p=0.198 and gender (M/F: 4/29 vs. 8/32, p=0.366. Intra-class correlation coefficients among all topography parameters within both groups showed excellent repeatability (>0.90. Conclusion: The anterior segment measurements provided by the Sirius corneal topography system were highly repeatable for dry eye patients and are sufficiently reliable for clinical practice and research.

  12. Does Dry Eye Affect Repeatability of Corneal Topography Measurements?

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    Doğan, Aysun Şanal; Gürdal, Canan; Köylü, Mehmet Talay

    2018-04-01

    The purpose of this study was to assess the repeatability of corneal topography measurements in dry eye patients and healthy controls. Participants underwent consecutive corneal topography measurements (Sirius; Costruzione Strumenti Oftalmici, Florence, Italy). Two images with acquisition quality higher than 90% were accepted. The following parameters were evaluated: minimum and central corneal thickness, aqueous depth, apex curvature, anterior chamber volume, horizontal anterior chamber diameter, iridocorneal angle, cornea volume, and average simulated keratometry. Repeatability was assessed by calculating intra-class correlation coefficient. Thirty-three patients with dry eye syndrome and 40 healthy controls were enrolled to the study. The groups were similar in terms of age (39 [18-65] vs. 30.5 [18-65] years, p=0.198) and gender (M/F: 4/29 vs. 8/32, p=0.366). Intra-class correlation coefficients among all topography parameters within both groups showed excellent repeatability (>0.90). The anterior segment measurements provided by the Sirius corneal topography system were highly repeatable for dry eye patients and are sufficiently reliable for clinical practice and research.

  13. Supercritical fluid-mediated liposomes containing cyclosporin A for the treatment of dry eye syndrome in a rabbit model: comparative study with the conventional cyclosporin A emulsion.

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    Karn, Pankaj Ranjan; Kim, Hyun Do; Kang, Han; Sun, Bo Kyung; Jin, Su-Eon; Hwang, Sung-Joo

    2014-01-01

    The objective of this study was to compare the efficacy of cyclosporin (CsA)-encapsulated liposomes with the commercially available CsA emulsion (Restasis) for the treatment of dry eye syndrome in rabbits. Liposomes containing CsA were prepared by the supercritical fluid (SCF) method consisted of phosphatidylcholine from soybean (SCF-S100) and egg lecithins (SCF-EPCS). An in vitro permeation study was carried out using artificial cellulose membrane in Franz diffusion cells. Dry eye syndrome was induced in male albino rabbits and further subdivided into untreated, Restasis-treated, EPCS, and S100-treated groups. Tear formation in the dry-eye-induced rabbits was evaluated using the Schirmer tear test. All formulations were also evaluated by ocular irritation tests using the Draize eye and winking methods with the determination of CsA concentration in rabbit tears. After the treatment, the Schirmer tear test value significantly improved in EPCS-treated (P=0.005) and S100-treated (P=0.018) groups compared to the Restasis-treated group. The AUC₀₋₂₄ h for rabbit's tear film after the administration of SCF-S100 was 32.75±9.21 μg·h/mg which was significantly higher than that of 24.59±8.69 μg·h/mg reported with Restasis. Liposomal CsA formulations used in this study showed lower irritation in rabbit eyes compared with Restasis. These results demonstrate that the novel SCF-mediated liposomal CsA promises a significant improvement in overcoming the challenges associated with the treatment of dry eyes.

  14. Corneal confocal microscopy alterations in Sjögren's syndrome dry eye.

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    Lanza, Michele; Iaccarino, Stefania; Varricchi, Gilda; D'Errico, Tito; Gironi Carnevale, Ugo Antonello; Bifani, Mario

    2017-08-01

    To evaluate light backscattering (LB) in corneal layers in patients with primary Sjögren's syndrome dry eye (SSDE) utilizing in vivo corneal confocal microscopy (IVCM) and to determine the eventual association with the lacrimal functional test values. A complete ophthalmic evaluation, Schirmer test with and without stimulation, break-up time (BUT) and IVCM were performed on 55 patients affected by SSDE and in an age- and sex-matched cohort of healthy participants (HP). Light backscattering, measures as light reflectivity unit (LRU), detected by IVCM at Bowman's membrane (BM) at 50 μm, at 100 μm and at 200 μm deeper than BM was compared in the two groups. The correlations between LB values and lacrimal function results were evaluated. In patients affected by SSDE, LB was significantly higher (p lacrimal function. Light backscattering (LB) could be very useful for clinical diagnosis and management of SSDE. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  15. Clinical evaluation of the additive effect of diquafosol tetrasodium on sodium hyaluronate monotherapy in patients with dry eye syndrome: a prospective, randomized, multicenter study.

    Science.gov (United States)

    Kamiya, K; Nakanishi, M; Ishii, R; Kobashi, H; Igarashi, A; Sato, N; Shimizu, K

    2012-10-01

    To assess the additive effect of diquafosol tetrasodium on sodium hyaluronate monotherapy in patients with dry eye syndrome. This study evaluated 64 eyes of 32 patients (age: 62.6±12.8 years (mean±SD)) in whom treatment with 0.1% sodium hyaluronate was insufficiently responsive. The eyes were randomly assigned to one of the two regimens in each patient: topical administration of sodium hyaluronate and diquafosol tetrasodium in one eye, and that of sodium hyaluronate in the other. Before treatment, and 2 and 4 weeks after treatment, we determined tear volume, tear film break-up time (BUT), fluorescein and rose bengal vital staining scores, subjective symptoms, and adverse events. We found a significant improvement in BUT (P=0.049, Dunnett test), fluorescein and rose bengal staining scores (P=0.02), and in subjective symptoms (P=0.004 for dry eye sensation, P=0.02 for pain, and P=0.02 for foreign body sensation) 4 weeks after treatment in the diquafosol eyes. On the other hand, we found no significant change in these parameters after treatment in the control eyes. In dry eyes, where sodium hyaluronate monotherapy was insufficient, diquafosol tetrasodium was effective in improving objective and subjective symptoms, suggesting its viability as an option for the additive treatment of such eyes.

  16. Quantification of surfactant proteins in tears of patients suffering from dry eye disease compared to healthy subjects.

    Science.gov (United States)

    Posa, Andreas; Paulsen, Friedrich; Dietz, Richard; Garreis, Fabian; Sander, Ralph; Schicht, Martin; Sel, Saadettin; Scholz, Michael; Hammer, Christian M; Bräuer, Lars

    2018-03-01

    To quantify and compare the amounts of surfactant proteins SP-A, SP-B, SP-C and SP-D in the tear fluid collected from patients with dry eye syndrome and from individuals with a healthy ocular surface. Schirmer strips were used to collect tear fluid from both eyes of 241 volunteers (99 men, 142 women; age range: 18-87 years). Dry eye syndrome was diagnosed by ophthalmologists in 125 patients, whereas the healthy control group comprised 116 individuals. The total protein concentration was determined via Bradford assay. The relative concentration of surfactant proteins SP-A through -D was measured by enzyme-linked immuno-sorbent assay (ELISA). The mean relative concentrations of SP-A, SP-C and SP-D were significantly higher in the dry eye group as compared to the healthy controls (pdry eye group, but the difference to the control group was not statistically significant. The upregulation of SP-A and SP-D in the dry eye group is probably related to these proteins' known antimicrobial and immunomodulatory effects at the ocular surface. It may represent a pathophysiological response to the inflammatory condition of the ocular surface in dry eye. The upregulation of SP-B and SP-C may represent an effort of the lacrimal system to reduce surface tension and thus to counteract the increased tendency of the tear film to tear in dry eye. Copyright © 2017 Elsevier GmbH. All rights reserved.

  17. Development and validation of the impact of dry eye on everyday life (IDEEL) questionnaire, a patient-reported outcomes (PRO) measure for the assessment of the burden of dry eye on patients.

    Science.gov (United States)

    Abetz, Linda; Rajagopalan, Krithika; Mertzanis, Polyxane; Begley, Carolyn; Barnes, Rod; Chalmers, Robin

    2011-12-08

    To develop and validate a comprehensive patient-reported outcomes instrument focusing on the impact of dry eye on everyday life (IDEEL). Development and validation of the IDEEL occurred in four phases: 1) focus groups with 45 dry eye patients to develop a draft instrument, 2) item generation, 3) pilot study to assess content validity in 16 patients and 4) psychometric validation in 210 subjects: 130 with non-Sjögren's keratoconjunctivitis sicca, 32 with Sjögren's syndrome and 48 controls, and subsequent item reduction. Focus groups identified symptoms and the associated bother, the impact of dry eye on daily life and the patients' satisfaction with their treatment as the central concepts in patients' experience of dry eye. Qualitative analysis indicated that saturation was achieved for these concepts and yielded an initial 112-item draft instrument. Patients understood the questionnaire and found the items to be relevant indicating content validity. Patient input, item descriptive statistics and factor analysis identified 55 items that could be deleted. The final 57-item IDEEL assesses dry eye impact constituting 3 modules: dry eye symptom-bother, dry eye impact on daily life comprising impact on daily activities, emotional impact, impact on work, and dry eye treatment satisfaction comprising satisfaction with treatment effectiveness and treatment-related bother/inconvenience. The psychometric analysis results indicated that the IDEEL met the criteria for item discriminant validity, internal consistency reliability, test-retest reliability and floor/ceiling effects. As expected, the correlations between IDEEL and the Dry Eye Questionnaire (a habitual symptom questionnaire) were higher than between IDEEL and Short-Form-36 and EuroQoL-5D, indicating concurrent validity. The IDEEL is a reliable, valid and comprehensive questionnaire relevant to issues that are specific to dry eye patients, and meets current FDA patient-reported outcomes guidelines. The use of this

  18. Neuropathic ocular pain due to dry eye is associated with multiple comorbid chronic pain syndromes

    Science.gov (United States)

    Galor, Anat; Covington, Derek; Levitt, Alexandra E.; McManus, Katherine T.; Seiden, Benjamin; Felix, Elizabeth R.; Kalangara, Jerry; Feuer, William; Patin, Dennis J.; Martin, Eden R.; Sarantopoulos, Konstantinos D.; Levitt, Roy C.

    2015-01-01

    Recent data demonstrate that dry eye (DE) susceptibility and other chronic pain syndromes (CPS) such as chronic widespread pain, irritable bowel syndrome and pelvic pain, may share common heritable factors. Previously, we showed that DE patients describing more severe symptoms tended to report features of neuropathic ocular pain (NOP). We hypothesize that patients with a greater number of CPS would have a different DE phenotype compared to those with fewer CPS. We recruited a cohort of 154 DE patients from the Miami Veterans Affairs Hospital and defined high and low CPS groups by cluster analysis. In addition to worse non-ocular pain complaints and higher PTSD and depression scores (Ppain assessed via 3 different pain scales (Ppain disorder, and that shared mechanistic factors may underlie vulnerability to some forms of DE and other comorbid CPS. PMID:26606863

  19. Impact of Dry Eye Disease on Work Productivity, and Patients' Satisfaction With Over-the-Counter Dry Eye Treatments.

    Science.gov (United States)

    Nichols, Kelly K; Bacharach, Jason; Holland, Edward; Kislan, Thomas; Shettle, Lee; Lunacsek, Orsolya; Lennert, Barb; Burk, Caroline; Patel, Vaishali

    2016-06-01

    To assess the effect of dry eye disease on work productivity and performance of non-work-related activities, and patients' satisfaction with over-the-counter (OTC) dry eye treatments. In this prospective, noninterventional, cross-sectional study, conducted at 10 U.S. optometry/ophthalmology practices, 158 symptomatic dry eye patients naïve to prescription medication underwent standard dry eye diagnostic tests and completed Work Productivity and Activity Impairment (WPAI) and Ocular Surface Disease Index (OSDI) questionnaires. Use of OTC dry eye medication, and satisfaction with OTC medication and symptom relief were also assessed. On average, dry eye resulted in loss of 0.36% of work time (∼5 minutes over 7 days) and ∼30% impairment of workplace performance (presenteeism), work productivity, and non-job-related activities. Presenteeism and productivity impairment scores showed significant correlation with OSDI total (r = 0.55) and symptom domain (r = 0.50) scores, but not with dry eye clinical signs. Activity impairment score showed stronger correlation with OSDI total (r = 0.61) and symptom domain (r = 0.53) scores than with clinical signs (r ≤ 0.20). Almost 75% of patients used OTC dry eye medication. Levels of patient satisfaction with OTC medication (64.2%) and symptom relief from OTC (37.3%) were unaffected by administration frequency (≥3 vs. ≤2 times daily). Dry eye causes negligible absenteeism, but markedly reduces workplace and non-job-related performances. Impairment of work performance is more closely linked to dry eye symptoms than to clinical signs. Patients' perceptions of OTC dry eye medication tend to be more positive than their perceptions of symptom relief.

  20. Health claims database study of cyclosporine ophthalmic emulsion treatment patterns in dry eye patients

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    Stonecipher KG

    2013-10-01

    Full Text Available Karl G Stonecipher,1 Jenny Chia,2 Ahunna Onyenwenyi,2 Linda Villanueva,2 David A Hollander2 1TLC Laser Eye Centers, Greensboro, NC, 2Allergan, Inc., Irvine, CA, USA Background: Dry eye is a multifactorial, symptomatic disease associated with ocular surface inflammation and tear film hyperosmolarity. This study was designed to assess patterns of topical cyclosporine ophthalmic emulsion 0.05% (Restasis® use in dry eye patients and determine if there were any differences in use based on whether dry eye is physician-coded as a primary or nonprimary diagnosis. Methods: Records for adult patients with a diagnosis of dry eye at an outpatient visit from January 1, 2008 to December 31, 2009 were selected from Truven Health MarketScan® Research Databases. The primary endpoint was percentage of patients with at least one primary versus no primary dry eye diagnosis who filled a topical cyclosporine prescription. Data analyzed included utilization of topical corticosteroids, oral tetracyclines, and punctal plugs. Results: The analysis included 576,416 patients, accounting for 875,692 dry eye outpatient visits: 74.7% were female, 64.2% were ages 40-69 years, and 84.4% had at least one primary dry eye diagnosis. During 2008–2009, 15.9% of dry eye patients with a primary diagnosis versus 6.5% with no primary diagnosis filled at least one cyclosporine prescription. For patients who filled at least one prescription, the mean months’ supply of cyclosporine filled over 12 months was 4.44. Overall, 33.9% of dry eye patients filled a prescription for topical cyclosporine, topical corticosteroid, or oral tetracycline over 2 years. Conclusion: Patients with a primary dry eye diagnosis were more likely to fill a topical cyclosporine prescription. Although inflammation is key to the pathophysiology of dry eye, most patients seeing a physician for dry eye may not receive anti-inflammatory therapies. Keywords: corticosteroids, cyclosporine, dry eye syndromes

  1. Salivation induced better lacrimal gland function in dry eyes.

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    Pramanik, T; Ghising, R

    2009-12-01

    The dry eye syndrome is a common eye symptom causing blurry vision. To meet the demand of the modem world students and professionals are compelled to expose themselves to the computer screen for long stretch of time, which is one of the causes of dry eye. It is not always feasible to instil eyes with artificial tears time to time to protect them from dryness. Rather to adopt any simple physiological process associated with optimum lacrimation is a better option to keep eyes moist during computer works. Volunteers (n = 22) having mild dry eyes participated in this study. Tear production was assessed by Schirmer test by keeping Schirmer strip on ocular surface for 5 minutes and recording the length of the moistened area. Then the subject was allowed to keep a piece of lopsy candy (a sour fruit pulp mixed with sugar that is sweet and sour in taste) in mouth for 5 minutes that caused salivation. During salivation, again tear production was assessed. [It was standardized in such a way that, the length of the moistened strip will be 25 - 30 mm for normal eyes, 15 - 10 mm for dry eye, 06 - 10 mm for mild dry eye, 02 - 05 mm for moderate dryness and 00 - 01 mm for severe dry eye.] Tear production was found to be increased significantly (supported by increased length of moistened area of Schirmer strip) during salivation especially in dry eye in all volunteers. The lacrimal gland is the major contributor to the aqueous layer of the tear film which consists of water, electrolytes and proteins; secretion of which are under tight neural control. Anticholinergic agents play an important role in ocular dryness because of hypo-secretion. The sensory root of facial nucleus contains efferent preganglionic parasympathetic fibers for submandibular and sublingual salivary gland and lacrimal gland. The sensory root conveys gustatory fibers from the presulcul area (anterior two-third) of the tongue via the chorda tympani and via the palatine and greater petrosal nerve, taste fibers from

  2. New Perspectives on Dry Eye Definition and Diagnosis: A Consensus Report by the Asia Dry Eye Society.

    Science.gov (United States)

    Tsubota, Kazuo; Yokoi, Norihiko; Shimazaki, Jun; Watanabe, Hitoshi; Dogru, Murat; Yamada, Masakazu; Kinoshita, Shigeru; Kim, Hyo-Myung; Tchah, Hung-Won; Hyon, Joon Young; Yoon, Kyung-Chul; Seo, Kyoung Yul; Sun, Xuguang; Chen, Wei; Liang, Lingyi; Li, Mingwu; Liu, Zuguo

    2017-01-01

    For the last 20 years, a great amount of evidence has accumulated through epidemiological studies that most of the dry eye disease encountered in daily life, especially in video display terminal (VDT) workers, involves short tear film breakup time (TFBUT) type dry eye, a category characterized by severe symptoms but minimal clinical signs other than short TFBUT. An unstable tear film also affects the visual function, possibly due to the increase of higher order aberrations. Based on the change in the understanding of the types, symptoms, and signs of dry eye disease, the Asia Dry Eye Society agreed to the following definition of dry eye: "Dry eye is a multifactorial disease characterized by unstable tear film causing a variety of symptoms and/or visual impairment, potentially accompanied by ocular surface damage." The definition stresses instability of the tear film as well as the importance of visual impairment, highlighting an essential role for TFBUT assessment. This paper discusses the concept of Tear Film Oriented Therapy (TFOT), which evolved from the definition of dry eye, emphasizing the importance of a stable tear film. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

  3. Cost of dry eye treatment in an Asian clinic setting.

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    Samanthila Waduthantri

    societal costs of Dry eye syndrome are likely to be much higher than estimated.

  4. Cyclosporine Amicellar delivery system for dry eyes

    Science.gov (United States)

    Kang, Han; Cha, Kwang-Ho; Cho, Wonkyung; Park, Junsung; Park, Hee Jun; Sun, Bo Kyung; Hyun, Sang-Min; Hwang, Sung-Joo

    2016-01-01

    Background The objectives of this study were to develop stable cyclosporine A (CsA) ophthalmic micelle solutions for dry-eye syndrome and evaluate their physicochemical properties and therapeutic efficacy. Materials and methods CsA-micelle solutions (MS-CsA) were created by a simple method with Cremophor EL, ethanol, and phosphate buffer. We investigated the particle size, pH, and osmolarity. In addition, long-term physical and chemical stability for MS-CsA was observed. To confirm the therapeutic efficacy, tear production in dry eye-induced rabbits was evaluated using the Schirmer tear test (STT). When compared to a commercial product, Restasis, MS-CsA demonstrated improvement in goblet-cell density and conjunctival epithelial morphology, as demonstrated in histological hematoxylin and eosin staining. Results MS-CsA had a smaller particle size (average diameter 14–18 nm) and a narrow size distribution. Physicochemical parameters, such as particle size, pH, osmolarity, and remaining CsA concentration were all within the expected range of 60 days. STT scores significantly improved in MS-CsA treated groups (P<0.05) in comparison to those of the Restasis-treated group. The number of goblet cells for rabbit conjunctivas after the administration of MS-CsA was 94.83±8.38, a significantly higher result than the 65.17±11.51 seen with Restasis. The conjunctival epithelial morphology of dry eye-induced rabbits thinned with loss of goblet cells. However, after 5 days of treatment with drug formulations, rabbit conjunctivas recovered epithelia and showed a relative increase in the number of goblet cells. Conclusion The results of this study indicate the potential use of a novel MS for the ophthalmic delivery of CsA in treating dry eyes. PMID:27382280

  5. Apoptosis of conjunctival epithelial cells before and after the application of autologous serum eye drops in severe dry eye disease.

    Science.gov (United States)

    Rybickova, Ivana; Vesela, Viera; Fales, Ivan; Skalicka, Pavlina; Jirsova, Katerina

    2016-06-01

    To assess the impact of autologous serum eye drops on the level of ocular surface apoptosis in patients with bilateral severe dry eye disease. This prospective study was conducted on 10 patients with severe dry eye due to graft versus host disease (group 1) and 6 patients with severe dry eye due to primary Sjögren's syndrome (group 2). Impression cytology specimens from the bulbar conjunctiva were obtained before and after a three-month treatment with 20% autologous serum eye drops applied a maximum of 12 times a day together with regular therapy with artificial tears. The percentage of apoptotic epithelial cells was evaluated immunochemically using anti-active caspase 3 antibody. In group 1, the mean percentage of apoptotic cells was 3.6% before the treatment. The three-month treatment led to a significant decrease to a mean percentage of 1.8% (P = 0.028). The mean percentage of apoptotic conjunctival cells decreased from 5.4% before the treatment to 3.8% in group 2; however, these results did not reach the level of significance. Three-month autologous serum treatment led to the improvement of ocular surface apoptosis, especially in the group of patients with severe dry eye due to graft versus host disease. This result supports the very positive effect of autologous serum on the ocular surface in patients suffering from severe dry eye.

  6. Expression of Lipid Peroxidation Markers in the Tear Film and Ocular Surface of Patients with Non-Sjogren Syndrome: Potential Biomarkers for Dry Eye Disease.

    Science.gov (United States)

    Choi, Won; Lian, Cui; Ying, Li; Kim, Ga Eon; You, In Cheon; Park, Soo Hyun; Yoon, Kyung Chul

    2016-09-01

    To investigate the expression of lipid peroxidation markers in the tear film and ocular surface and their correlation with disease severity in patients with dry eye disease. The concentrations of hexanoyl-lysine (HEL), 4-hydroxy-2-nonenal (HNE), and malondialdehyde (MDA) were measured with enzyme-linked immunosorbent assays in tears obtained from 44 patients with non-Sjogren syndrome dry eye and 33 control subjects. The correlations between the marker levels and the tear film and ocular surface parameters, including tear film break-up time (BUT), Schirmer tear value, tear clearance rate, keratoepitheliopathy scores, corneal sensitivity, conjunctival goblet cell density, and symptom score, were analyzed. The expression of the lipid peroxidation markers HEL, 4-HNE, and MDA in the conjunctiva was evaluated using immunohistochemistry. The concentrations of HEL, 4-HNE, and MDA were 279.84 ± 69.98 nmol/L, 0.02 ± 0.01 μg/mL, and 3.80 ± 1.05 pmol/mg in control subjects and 283.21 ± 89.67 nmol/L (p = 0.97), 0.20 ± 0.03 μg/mL (p dry eye patients. 4-HNE and MDA levels significantly correlated with BUT, Schirmer tear value, tear clearance rate, keratoepitheliopathy scores, conjunctival goblet cell density, and symptom score (p dry eye patients. The expression of late lipid peroxidation markers, 4-HNE and MDA, increases in the tear film and ocular surface of patients with dry eye. The levels correlate with various tear film and ocular surface parameters and may reflect the severity of dry eye disease.

  7. The Use of the Esclera Scleral Contact Lens in the Treatment of Moderate to Severe Dry Eye Disease.

    Science.gov (United States)

    La Porta Weber, Sarah; Becco de Souza, Rodrigo; Gomes, José Álvaro Pereira; Hofling-Lima, Ana Luisa

    2016-03-01

    To evaluate the efficacy of the Esclera scleral contact lens (SCL) treatment and its impact on clinical testing for moderate to severe dry eye disease (DED). Prospective interventional case series. A total of 41 eyes from 25 patients with moderate to severe DED were evaluated for the Esclera SCL treatment. Best-corrected visual acuity (BCVA), tear osmolarity, the Schirmer I test, tear film breakup time (TBUT), corneal and conjunctival staining, meibomian grading, and Ocular Surface Disease Index and SF-36v2 questionnaires were assessed before and after the SCL treatment. These values were compared to assess the real benefit of using SCL as a treatment for DED. Forty-one eyes from 25 patients were fitted with SCL for management of DED. The underlying diseases were Stevens-Johnson syndrome (22 eyes), Sjogren syndrome (11 eyes), graft-vs-host disease (2 eyes), dry eye after keratomileusis in situ (2 eyes), and undifferentiated ocular surface disease (4 eyes). BCVA improved from 0.703 ± 0.55 logMAR with habitual correction to 0.406 ± 0.43 logMAR with SCL (P dry eye symptoms and quality of life as assessed by the OSDI and SF-36v2 questionnaires (both with P dry eye symptoms, and quality of life. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Outcomes of Thermal Pulsation Treatment for Dry Eye Syndrome in Patients With Sjogren Disease.

    Science.gov (United States)

    Godin, Morgan R; Stinnett, Sandra S; Gupta, Preeya K

    2018-04-26

    To evaluate the clinical outcomes of thermal pulsation treatment in patients with meibomian gland dysfunction (MGD) and dry eye secondary to Sjogren disease. Twenty-four eyes from 13 patients with previously diagnosed Sjogren disease who presented to our institution with dry eye symptoms and had thermal pulsation treatment were prospectively followed up. Patients underwent comprehensive slit-lamp examination, including MGD grading, gland oil flow, corneal and conjunctival staining scores, and tear break-up time (TBUT). Tear osmolarity was tested before and after treatment. The average patient age was 62.4 years (range, 31-78 yrs); 12 were women and 1 a man. The average meibomian gland oil flow score showed an increase from pretreatment 0.71 to 1.75 at 1 year posttreatment (range 9-15 months) (P = 0.001). The average corneal staining score decreased from a pretreatment grade of 1.04 to a posttreatment grade of 0.36 (P dry eye disease in patients with Sjogren disease and should not be overlooked when considering treatment options. Thermal pulsation is a therapeutic option for patients with Sjogren disease who have MGD and dry eye symptoms. After a single treatment, patients exhibited increased oil flow and tear break-up time with an associated decrease in corneal and conjunctival staining.

  9. Effect of Lid Debridement-Scaling in Sjögren Syndrome Dry Eye.

    Science.gov (United States)

    Ngo, William; Caffery, Barbara; Srinivasan, Sruthi; Jones, Lyndon W

    2015-09-01

    To evaluate the effect of lid debridement-scaling (LDS) on dry eye signs and symptoms in subjects with Sjögren syndrome (SS). This prospective randomized controlled study enrolled 14 female subjects with SS. Seven subjects were randomized into the treatment group where they were selected to receive LDS; the remainder did not receive LDS and served as control subjects. Lid debridement-scaling was conducted using a stainless steel golf club spud (Hilco Wilson Ophthalmics, Plainville, MA) on both the upper and lower eyelids of both eyes. Outcome variables were assessed before LDS and again 1 month later. The outcome variables were the Ocular Surface Disease Index (OSDI), Symptom Assessment iN Dry Eye (SANDE) visual analog scores, ocular staining (SICCA OSS [Sjögren's International Collaborative Clinical Alliance Ocular Staining Score]), fluorescein tear breakup time (FLBUT), meibomian gland score (MGS), meibomian gland yielding liquid secretions (MGYLS) score, and line of Marx's (LOM) position. Thirteen subjects completed the study. Data from only the right eye were analyzed. For the control group (n = 6; mean [± SD] age, 62.3 [± 11.6] years), the pre-LDS, post-LDS, and significance level (pre-LDS mean [± SD] vs. post-LDS mean [± SD]; p value) were as follows: OSDI (58.3 [± 22.1] vs. 48.3 [± 29.0]; p = 0.051), SANDE (77.4 [± 22.1] vs. 89.6 [± 32.6]; p = 0.20), SICCA OSS (7.0 [± 4.5] vs. 8.2 [± 3.5]; p = 0.25), MGS (1.3 [± 1.5] vs. 1.0 [± 0.9]; p = 0.75), MGYLS (0.3 [± 0.5] vs. 0.0 [± 0.0]; p = 0.50), FLBUT (2.99 [± 1.54] vs. 2.85 [± 1.79]; p = 0.63), and LOM (2.0 [± 0.0] vs. 2.0 [± 0.0]; p = n/a). For the treatment group (n = 7; mean [± SD] age, 58.0 [± 8.1] years), the pre-LDS, post-LDS, and significance level were as follows: OSDI (63.2 [± 13.3] vs. 46.9 [± 19.4]; p = 0.04), SANDE (72.6 [± 17.1] vs. 77.0 [± 28.0]; p = 0.54), SICCA OSS (6.6 [± 2.9] vs. 5.0 [± 3.9]; p = 0.02), MGS (1.0 [± 1.2] vs. 3.1 [± 1.7]; p = 0.01), MGYLS (0.0 [± 0

  10. Post-LASIK dry eye

    OpenAIRE

    Shtein, Roni M

    2011-01-01

    Laser-assisted in situ keratomileusis (LASIK) is a frequently performed corneal refractive surgery with excellent refractive outcomes. The most common complication of LASIK is dry eyes, with virtually all patients developing some degree of dryness in the immediate postoperative period. Identifying preoperative dry eyes, and conscientious attention and treatment in the perioperative time period, can lead to enhanced patient satisfaction and more accurate visual outcomes. Improved understanding...

  11. Tear dynamics in healthy and dry eyes.

    Science.gov (United States)

    Cerretani, Colin F; Radke, C J

    2014-06-01

    Dry-eye disease, an increasingly prevalent ocular-surface disorder, significantly alters tear physiology. Understanding the basic physics of tear dynamics in healthy and dry eyes benefits both diagnosis and treatment of dry eye. We present a physiological-based model to describe tear dynamics during blinking. Tears are compartmentalized over the ocular surface; the blink cycle is divided into three repeating phases. Conservation laws quantify the tear volume and tear osmolarity of each compartment during each blink phase. Lacrimal-supply and tear-evaporation rates are varied to reveal the dependence of tear dynamics on dry-eye conditions, specifically tear osmolarity, tear volume, tear-turnover rate (TTR), and osmotic water flow. Predicted periodic-steady tear-meniscus osmolarity is 309 and 321 mOsM in normal and dry eyes, respectively. Tear osmolarity, volume, and TTR all match available clinical measurements. Osmotic water flow through the cornea and conjunctiva contribute 10 and 50% to the total tear supply in healthy and dry-eye conditions, respectively. TTR in aqueous-deficient dry eye (ADDE) is only half that in evaporative dry eye (EDE). The compartmental periodic-steady tear-dynamics model accurately predicts tear behavior in normal and dry eyes. Inclusion of osmotic water flow is crucial to match measured tear osmolarity. Tear-dynamics predictions corroborate the use of TTR as a clinical discriminator between ADDE and EDE. The proposed model is readily extended to predict the dynamics of aqueous solutes such as drugs or fluorescent tags.

  12. Dry Eye: an Inflammatory Ocular Disease

    Science.gov (United States)

    Hessen, Michelle; Akpek, Esen Karamursel

    2014-01-01

    Keratoconjunctivitis sicca, or dry eye, is a common ocular disease prompting millions of individuals to seek ophthalmological care. Regardless of the underlying etiology, dry eye has been shown to be associated with abnormalities in the pre-corneal tear film and subsequent inflammatory changes in the entire ocular surface including the adnexa, conjunctiva and cornea. Since the recognition of the role of inflammation in dry eye, a number of novel treatments have been investigated designed to inhibit various inflammatory pathways. Current medications that are used, including cyclosporine A, corticosteroids, tacrolimus, tetracycline derivatives and autologous serum, have been effective for management of dry eye and lead to measurable clinical improvement. PMID:25279127

  13. Diabetes-associated dry eye syndrome in a new humanized transgenic model of type 1 diabetes.

    Science.gov (United States)

    Imam, Shahnawaz; Elagin, Raya B; Jaume, Juan Carlos

    2013-01-01

    Patients with Type 1 Diabetes (T1D) are at high risk of developing lacrimal gland dysfunction. We have developed a new model of human T1D using double-transgenic mice carrying HLA-DQ8 diabetes-susceptibility haplotype instead of mouse MHC-class II and expressing the human beta cell autoantigen Glutamic Acid Decarboxylase in pancreatic beta cells. We report here the development of dry eye syndrome (DES) after diabetes induction in our humanized transgenic model. Double-transgenic mice were immunized with DNA encoding human GAD65, either naked or in adenoviral vectors, to induce T1D. Mice monitored for development of diabetes developed lacrimal gland dysfunction. Animals developed lacrimal gland disease (classically associated with diabetes in Non Obese Diabetic [NOD] mice and with T1D in humans) as they developed glucose intolerance and diabetes. Animals manifested obvious clinical signs of dry eye syndrome (DES), from corneal erosions to severe keratitis. Histological studies of peri-bulbar areas revealed lymphocytic infiltration of glandular structures. Indeed, infiltrative lesions were observed in lacrimal/Harderian glands within weeks following development of glucose intolerance. Lesions ranged from focal lymphocytic infiltration to complete acinar destruction. We observed a correlation between the severity of the pancreatic infiltration and the severity of the ocular disease. Our results demonstrate development of DES in association with antigen-specific insulitis and diabetes following immunization with clinically relevant human autoantigen concomitantly expressed in pancreatic beta cells of diabetes-susceptible mice. As in the NOD mouse model and as in human T1D, our animals developed diabetes-associated DES. This specific finding stresses the relevance of our model for studying these human diseases. We believe our model will facilitate studies to prevent/treat diabetes-associated DES as well as human diabetes.

  14. Minor salivary glands and labial mucous membrane graft in the treatment of severe symblepharon and dry eye in patients with Stevens-Johnson syndrome.

    Science.gov (United States)

    Sant' Anna, Ana Estela B P P; Hazarbassanov, Rossen M; de Freitas, Denise; Gomes, José Álvaro P

    2012-02-01

    To evaluate minor salivary glands and labial mucous membrane graft in patients with severe symblepharon and dry eye secondary to Stevens-Johnson syndrome (SJS). A prospective, non-comparative, interventional case series of 19 patients with severe symblepharon and dry eye secondary to SJS who underwent labial mucous membrane and minor salivary glands transplantation. A complete ophthalmic examination including the Schirmer I test was performed prior to and following surgery. All patients had a preoperative Schirmer I test value of zero. Nineteen patients with severe symblepharon and dry eye secondary to SJS were included in the study. There was a statistically significant improvement in the best spectacle-corrected visual acuity in eight patients (t test; p=0.0070). Values obtained in the Schirmer I test improved significantly in 14 eyes (73.7%) 6 months following surgery (χ(2) test; p=0.0094). A statistically significant increase in tear production (Schirmer I test) was found in eyes that received more than 10 glands per graft compared with eyes that received fewer glands (χ(2) test; p=0.0096). Corneal transparency improved significantly in 11 (72.2%) eyes and corneal neovascularisation improved significantly in five eyes (29.4%) (McNemar test; p=0.001 and p=0.0005). The symptoms questionnaire revealed improvement in foreign body sensation in 53.6% of the patients, in photophobia in 50.2% and in pain in 54.8% (Kruskal-Wallis test; p=0.0167). Labial mucous membrane and minor salivary glands transplantation were found to constitute a good option for the treatment of severe symblepharon and dry eye secondary to SJS. This may be considered as a step prior to limbal stem cell and corneal transplantation in these patients.

  15. Proteomic analysis revealed the altered tear protein profile in a rabbit model of Sjögren's syndrome-associated dry eye.

    Science.gov (United States)

    Zhou, Lei; Wei, Ruihua; Zhao, Ping; Koh, Siew Kwan; Beuerman, Roger W; Ding, Chuanqing

    2013-08-01

    Sjögren's syndrome (SS) is an autoimmune disease that results in pathological dryness of mouth and eye. The diagnosis of SS depends on both clinical evaluation and specific antibodies. The goal of this study was to use quantitative proteomics to investigate changes in tear proteins in a rabbit model of SS-associated dry eye, induced autoimmune dacryoadenitis (IAD). Proteomic analysis was performed by iTRAQ and nano LC-MS/MS on tears collected from the ocular surface, and specific proteins were verified by high resolution MRM. It was found that in the tears of IAD rabbits at 2 and 4 weeks after induction, S100 A6, S100 A9, and serum albumin were upregulated, whereas serotransferrin (TF), prolactin-inducible protein (PIP), polymeric immunoglobulin receptor (pIgR), and Ig gamma chain C region were downregulated. High resolution MRM with mTRAQ labeling verified the changes in S100 A6, TF, PIP, and pIgR. Our results indicated significant changes of tear proteins in IAD rabbits, suggesting these proteins could potentially be used as biomarkers for the diagnosis and prognosis of dry eye. Several of these proteins were also found in the tears of non-SS dry eye patients indicating a common basis of ocular surface pathology, however, pIgR appears to be unique to SS. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. Prevalence and risk factors associated with dry eye symptoms: a population based study in Indonesia

    Science.gov (United States)

    Lee, A J; Lee, J; Saw, S-M; Gazzard, G; Koh, D; Widjaja, D; Tan, D T H

    2002-01-01

    Aim: To determine the prevalence and identify associated risk factors for dry eye syndrome in a population in Sumatra, Indonesia. Methods: A one stage cluster sampling procedure was conducted to randomly select 100 households in each of the five rural villages and one provincial town of the Riau province, Indonesia, from April to June 2001. Interviewers collected demographic, lifestyle, and medical data from 1058 participants aged 21 years or over. Symptoms of dry eye were assessed using a six item validated questionnaire. Presence of one or more of the six dry eye symptoms often or all the time was analysed. Presence of pterygium was documented. Results: Prevalence of one or more of the six dry eye symptoms often or all the time adjusted for age was 27.5% (95% confidence interval (CI) 24.8 to 30.2). After adjusting for all significant variables, independent risk factors for dry eye were pterygium (p<0.001, multivariate odds ratio (OR) 1.8; 95% CI 1.4 to 2.5) and a history of current cigarette smoking (p=0.05, multivariate OR 1.5; 95% CI 1.0 to 2.2). Conclusions: This population based study provides prevalence rates of dry eye symptoms in a tropical developing nation. From our findings, pterygium is a possible independent risk factor for dry eye symptoms. PMID:12446361

  17. Dysfunctional tear syndrome: dry eye disease and associated tear film disorders - new strategies for diagnosis and treatment.

    Science.gov (United States)

    Milner, Mark S; Beckman, Kenneth A; Luchs, Jodi I; Allen, Quentin B; Awdeh, Richard M; Berdahl, John; Boland, Thomas S; Buznego, Carlos; Gira, Joseph P; Goldberg, Damien F; Goldman, David; Goyal, Raj K; Jackson, Mitchell A; Katz, James; Kim, Terry; Majmudar, Parag A; Malhotra, Ranjan P; McDonald, Marguerite B; Rajpal, Rajesh K; Raviv, Tal; Rowen, Sheri; Shamie, Neda; Solomon, Jonathan D; Stonecipher, Karl; Tauber, Shachar; Trattler, William; Walter, Keith A; Waring, George O; Weinstock, Robert J; Wiley, William F; Yeu, Elizabeth

    2017-01-01

    Dysfunctional tear syndrome (DTS) is a common and complex condition affecting the ocular surface. The health and normal functioning of the ocular surface is dependent on a stable and sufficient tear film. Clinician awareness of conditions affecting the ocular surface has increased in recent years because of expanded research and the publication of diagnosis and treatment guidelines pertaining to disorders resulting in DTS, including the Delphi panel treatment recommendations for DTS (2006), the International Dry Eye Workshop (DEWS) (2007), the Meibomian Gland Dysfunction (MGD) Workshop (2011), and the updated Preferred Practice Pattern guidelines from the American Academy of Ophthalmology pertaining to dry eye and blepharitis (2013). Since the publication of the existing guidelines, new diagnostic techniques and treatment options that provide an opportunity for better management of patients have become available. Clinicians are now able to access a wealth of information that can help them obtain a differential diagnosis and treatment approach for patients presenting with DTS. This review provides a practical and directed approach to the diagnosis and treatment of patients with DTS, emphasizing treatment that is tailored to the specific disease subtype as well as the severity of the condition.

  18. Results of a Multicenter, Randomized, Double-Masked, Placebo-Controlled Clinical Study of the Efficacy and Safety of Visomitin Eye Drops in Patients with Dry Eye Syndrome.

    Science.gov (United States)

    Brzheskiy, Vladimir V; Efimova, Elena L; Vorontsova, Tatiana N; Alekseev, Vladimir N; Gusarevich, Olga G; Shaidurova, Ksenia N; Ryabtseva, Alla A; Andryukhina, Olga M; Kamenskikh, Tatiana G; Sumarokova, Elena S; Miljudin, Eugeny S; Egorov, Eugeny A; Lebedev, Oleg I; Surov, Alexander V; Korol, Andrii R; Nasinnyk, Illia O; Bezditko, Pavel A; Muzhychuk, Olena P; Vygodin, Vladimir A; Yani, Elena V; Savchenko, Alla Y; Karger, Elena M; Fedorkin, Oleg N; Mironov, Alexander N; Ostapenko, Victoria; Popeko, Natalia A; Skulachev, Vladimir P; Skulachev, Maxim V

    2015-12-01

    This article presents the results of an international, multicenter, randomized, double-masked, placebo-controlled clinical study of Visomitin (Mitotech LLC, Moscow, Russian Federation) eye drops in patients with dry eye syndrome (DES). Visomitin is the first registered (in Russia) drug with a mitochondria-targeted antioxidant (SkQ1) as the active ingredient. In this multicenter (10 sites) study of 240 subjects with DES, study drug (Visomitin or placebo) was self-administered three times daily (TID) for 6 weeks, followed by a 6-week follow-up period. Seven in-office study visits occurred every 2 weeks during both the treatment and follow-up periods. Efficacy measures included Schirmer's test, tear break-up time, fluorescein staining, meniscus height, and visual acuity. Safety measures included adverse events, slit lamp biomicroscopy, tonometry, blood pressure, and heart rate. Tolerability was also evaluated. This clinical study showed the effectiveness of Visomitin eye drops in the treatment of signs and symptoms of DES compared with placebo. The study showed that a 6-week course of TID topical instillation of Visomitin significantly improved the functional state of the cornea; Visomitin increased tear film stability and reduced corneal damage. Significant reduction of dry eye symptoms (such as dryness, burning, grittiness, and blurred vision) was also observed. Based on the results of this study, Visomitin is effective and safe for use in eye patients with DES for protection from corneal damage. Mitotech LLC.

  19. Effects of subconjunctival administration of anti-high mobility group box 1 on dry eye in a mouse model of Sjӧgren's syndrome.

    Science.gov (United States)

    Kim, Kyeong Hwan; Kim, Dong Hyun; Jeong, Hyun Jeong; Ryu, Jin Suk; Kim, Yu Jeong; Oh, Joo Youn; Kim, Mee Kum; Wee, Won Ryang

    2017-01-01

    Extracellular high mobility group box 1 (HMGB1) acts as a damage associated molecular pattern molecule through the Toll-like receptor to promote autoreactive B cell activation, which may be involved in the pathogenesis of Sjӧgren's syndrome. The aim of this study was to investigate the effect of subconjunctival administration of anti-HMGB1 on dry eye in a mouse model of Sjӧgren's syndrome. Ten weeks-old NOD.B10.H2b mice were subconjunctivally injected with 0.02 to 2 μg of anti-HMGB1 antibodies or PBS twice a week for two consecutive weeks. Tear volume and corneal staining scores were measured and compared between before- and after-treatment. Goblet cell density was counted in PAS stained forniceal conjunctiva and inflammatory foci score (>50 cells/focus) was measured in extraorbital glands. Flow cytometry was performed to evaluate the changes in BrdU+ cells, IL-17-, IL-10-, or IFNγ-secreting cells, functional B cells, and IL-22 secreting innate lymphoid cells (ILC3s) in cervical lymph nodes. The level of IL-22 in intraorbital glands was measured by ELISA. Injection of 2 μg or 0.02 μg anti-HMGB1 attenuated corneal epithelial erosions and increased tear secretion (pdry eye. The improvement of dry eye may involve an increase of ILC3s, rather than modulation of B or plasma cells, as shown using a mouse model of Sjӧgren's syndrome.

  20. Rebamipide ophthalmic suspension for the treatment of dry eye syndrome: a critical appraisal

    Directory of Open Access Journals (Sweden)

    Kashima T

    2014-05-01

    Full Text Available Tomoyuki Kashima,1 Hirotaka Itakura,1,2 Hideo Akiyama,1 Shoji Kishi11Department of Ophthalmology, Gunma University, School of Medicine, Maebashi, Gunma, Japan; 2Department of Ophthalmology, Maebashi Red Cross Hospital, Maebashi, Gunma, JapanAbstract: Rebamipide was initially developed and approved for use in treating gastric ulcers and lesions associated with gastritis. Discovery of its ability to increase gastric mucin led to investigations of its effect on ocular surface mucin and the subsequent development for use in dry eye patients. Investigations have confirmed that rebamipide increases corneal and conjunctival mucin-like substances along with improving corneal and conjunctival injury. Clinically, rebamipide ophthalmic suspensions can effectively treat tear deficiency and mucin-caused corneal epithelial damage, and can restore the microstructure responsible for tear stability. Topical rebamipide has also been shown to be effective in treating other ocular surface disorders such as lagophthalmos, lid wiper epitheliopathy, and persistent corneal erosion. Rebamipide’s ability to modify epithelial cell function, improve tear stability, and suppress inflammation in the absence of any known major side effects suggest that it may be a beneficial first drug of choice for severe dry eye treatment and other ocular surface disorders. This review summarizes the history and development of this innovative dry eye treatment from its initial use as an effective stomach medication to its current use in the treatment of dry eye in Japan.Keywords: quinolinone derivative, tear deficiency, ocular surface disorder, mucin secretion, Mucosta

  1. Comparative Evaluation of Silicone Hydrogel Contact Lenses and Autologous Serum for Management of Sjögren Syndrome-Associated Dry Eye.

    Science.gov (United States)

    Li, Jinyang; Zhang, Xiahua; Zheng, Qinxiang; Zhu, Yirui; Wang, Hui; Ma, Huixiang; Jhanji, Vishal; Chen, Wei

    2015-09-01

    To comparatively evaluate the efficacy of a bandage contact lens (BCL) and autologous serum (AS) eye drops in the management of severe dry eye caused by Sjögren syndrome (SS). In this prospective randomized study, 40 patients with SS were enrolled. Patients were divided into 2 treatment groups: BCL and AS. A total of 37 patients were included, 18 patients (35 eyes) in the AS group and 19 patients (36 eyes) in the BCL group. At the end of 6 weeks, the best-corrected visual acuity improved significantly in the BCL group (0.5 ± 0.3 vs. 0.3 ± 0.2, P = 0.003) but not in the AS group (0.4 ± 0.3 vs. 0.3 ± 0.3, P = 0.11). The best-corrected visual acuity remained stable up to 6 weeks after discontinuation of the BCL (0.5 ± 0.3 vs. 0.4 ± 0.2, P = 0.03). Although the Ocular Surface Disease Index scores decreased significantly after treatment in both groups, patients in the BCL group had lower Ocular Surface Disease Index scores than those in the AS group (53.4 vs. 41.8 at week 3, 47.1 vs. 31.0 at week 6, 52.7 vs. 32.0 at week 12; P = 0.014, dry eye. Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT02147509.

  2. Specialized moisture retention eyewear for evaporative dry eye.

    Science.gov (United States)

    Waduthantri, Samanthila; Tan, Chien Hua; Fong, Yee Wei; Tong, Louis

    2015-05-01

    To evaluate the suitablity of commercially available moisture retention eyewear for treating evaporative dry eye. Eleven patients with evaporative dry eyes were prescibed moisture retention eyewear for 3 months in addition to regular lubricant eye drops. Frequency and severity of dry eye symptoms, corneal fluorescein staining and tear break up time (TBUT) were evaluated at baseline and 3-month post-treatment. Main outcome measure was global symptom score (based on severity and frequency of dry eye symptoms on a visual analog scale) and secondary outcomes were changes in sectoral corneal fluorescein staining and tear break up time (TBUT) from pre-treatment level. There was a significant improvement in dry eye symptoms after using moisture retention eyewear for 3 months (p eyes improved significantly (p dry eye symptoms in windy, air-conditioned environments or when doing vision-related daily tasks. This study shows that moisture retention eyewear might be a valuable adjunct in management of evaporative dry eye and this new design of commercially available eyewear could have a good acceptability rate.

  3. The effect of intravitreal injections on dry eye, and proposed management strategies

    Directory of Open Access Journals (Sweden)

    Laude A

    2017-08-01

    Full Text Available Augustinus Laude,1–3 Jimmy WK Lim,1,2 Vishwanath Srinagesh,4 Louis Tong2,5–7 1National Healthcare Group Eye Institute, Tan Tock Seng Hospital, 2Singapore Eye Research Institute, 3Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; 4Krieger Eye Institute, Baltimore, MD, USA; 5Singapore National Eye Centre, 6Duke NUS Medical School, 7Yong Loo Lin School of Medicine, National University of Singapore, Singapore Abstract: Intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF agents has become a commonly used treatment method for a number of ophthalmic conditions, including age-related macular degeneration. Although anti-VEGF therapy has shown promising results for many patients, there are several aspects of its application that have not been thoroughly investigated. One of these is the development and/or escalation of concurrent dry eye syndrome. Many patients undergoing treatment are already predisposed to dry eye disease due to their age and overall ocular health. As dry eye can have a substantial impact on quality of life, it has become increasingly apparent that the clinical signs and symptoms should be closely monitored and aggressively managed. This will allow for the optimization of patient comfort and visual potential. Here, we discuss the reasons why dry eye may develop during the course of repeated ocular anti-VEGF therapy, highlighting the key concerns about current practices and proposing possible solutions to improve the outcome for the patients. Keywords: age-related macular degeneration, povidone–iodine, toxicity, ocular health, chronic ophthalmic treatment

  4. A randomized, double-blind, placebo-controlled study of oral antioxidant supplement therapy in patients with dry eye syndrome

    Directory of Open Access Journals (Sweden)

    Huang JY

    2016-05-01

    Full Text Available Jehn-Yu Huang, Po-Ting Yeh, Yu-Chih Hou Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan Purpose: To evaluate the efficacy of oral antioxidant supplementation in the treatment of patients with dry eye syndrome (DES. Methods: A prospective, randomized, double-blinded study compared the effects of an antioxidant supplement (containing anthocyanosides, astaxanthin, vitamins A, C, and E, and several herbal extracts, including Cassiae semen and Ophiopogonis japonicus with placebo on patients with DES. We assessed dry eye symptoms, visual acuity, Schirmer’s test, tear film breakup time, cornea and conjunctiva fluorescein staining, serum anti-SSA/anti-SSB antibodies, and the level of reactive oxygen species (ROS in tears. The supplementation period was 8 weeks and patients were followed up every 4 weeks for 16 weeks. A linear mixed model was used to compare the groups, while within-group differences were tested by repeated-measures analysis of variance. Results: Forty-three patients, 20 and 23 in treatment and placebo groups, respectively, completed the study. Liver and renal functions were normal. Diastolic blood pressure decreased in the treatment group. There were no significant differences in systolic blood pressure, dry eye symptoms, serum anti-SSA and anti-SSB, visual acuity, intraocular pressure, or fluorescein corneal staining between the groups. Tear film breakup time scores and Schirmer’s test without topical anesthesia significantly improved in the treatment group. Tear ROS level differed between the groups and decreased after treatment. Overall subjective impression revealed a significant improvement with treatment compared with placebo. Conclusion: Oral antioxidant supplementations may increase tear production and improve tear film stability by reducing tear ROS. The vegetable-based antioxidant supplement used in this study is safe and can be utilized as

  5. What Is Dry Eye?

    Medline Plus

    Full Text Available ... seasonal allergens and dry eye Apr 27, 2015 Choosing Wisely When It Comes to Eye Care, Part ... Name: Member ID: * Phone Number: * Email: * Enter code: * Message: Thank you Your feedback has been sent.

  6. What Is Dry Eye?

    Medline Plus

    Full Text Available ... removed or pushed down the tear duct to insert a permanent punctal plug? Sep 12, 2017 Why ... Eye from Jennifer Aniston Sep 02, 2016 The link between seasonal allergens and dry eye Apr 27, ...

  7. Daytime Variations of Tear Osmolarity Measurement in Dry Eye Patients

    Directory of Open Access Journals (Sweden)

    Ulviye Yiğit

    2013-12-01

    Full Text Available Purpose: We have targeted primarily to show the variations of tear osmolarity during the daytime period in subjects with dry eyes and non-dry eyes and, secondarily, to evaluate the relationship of these variations with Schirmer’s test and break-up time (BUT. Material and Method: Twenty newly diagnosed dry eye patients and 20 healthy voluntary subjects with similar age and gender were included in this prospective study. In addition to the full ophthalmic examination, Schirmer’s test and BUT test were applied to all participants. Tear osmolarity measurements were done after pre-examination but in different day. The measurements were registered with TearLab Osmolarity System (TearLab Corporation, San Diego, CA, USA every 3 hours within 8:00 AM and 5:00 PM. The results were evaluated statistically. Results: No statistically significant difference was found between the mean age and gender of dry eye syndrome (DES and control groups (p>0.05. The mean measurements of Schirmer’s test and BUT in the DES group were statistically significantly lower than those in the control group (p=0.0001. The mean measurements of tear osmolarity at 8:00 AM, 11:00 AM, 2:00 PM, and 5:00 PM in the DES group were statistically significantly higher than those in the control group (p=0.001, p=0.0001. No statistically significant difference in tear osmolarity at 8:00 AM, 11: 00 AM, 2:00 PM, and 5:00 PM was found between the groups, and within DES and control groups (p>0.05. Discussion: We did not determine significant change in daytime variations of the tear osmolarity in dry eye patients and healthy subjects. As a secondary result, we can conclude that there is no difference among tear osmolarity, Shirmer’s and BUT tests in the diagnosis of DES. (Turk J Ophthalmol 2013; 43: 437-41

  8. Choosing Wisely When It Comes to Eye Care: Punctal Plugs for Dry Eye

    Science.gov (United States)

    ... of Our 5-Part Series: Punctal Plugs for Dry Eye Making healthy lifestyle choices can help you protect ... discuss each item in detail. Punctal Plugs for Dry Eye Dry eye is a condition that millions of ...

  9. Dry eyes : a commonly missed eye condition

    OpenAIRE

    Vella, Mario;

    2014-01-01

    Tears are an important component in providing moisture and lubrication for the eyes, thereby maintaining vision and comfort. Dry eyes (keratoconjunctivitis sicca) result when there is either decreased production of tears or by poor tear quality which in turn lead to more rapid evaporation.

  10. Blink patterns and lid-contact times in dry-eye and normal subjects

    Directory of Open Access Journals (Sweden)

    Ousler GW 3rd

    2014-05-01

    Full Text Available George W Ousler 3rd,1 Mark B Abelson,1,2 Patrick R Johnston,1 John Rodriguez,1 Keith Lane,1 Lisa M Smith11Ora, Andover, MA, USA; 2Department of Ophthalmology, Harvard Medical School, Boston, MA, USAPurpose: To classify blinks in dry eye and normal subjects into six subtypes, and to define the blink rate and duration within each type of blink, as well as the total lid-contact time/minute.Materials and methods: This was a single-centered, prospective, double-blind study of eleven dry-eye and ten normal subjects. Predefined subjects watched a video while blinks were recorded for 10 minutes. Partial blinks were classified by percentage closure of maximal palpebral fissure opening: 25%, 50%, 75%. Complete blinks were characterized as full (>0 seconds, extended (>0.1 seconds, or superextended (>0.5 seconds. The mean duration of each type of blink was determined and standardized per minute as total lid-contact time.Results: Total blinks observed were 4,990 (1,414 normal, 3,756 dry eye: 1,809 (50.59% partial and 1,767 (49.41% complete blinks among dry-eye subjects versus 741 (52.90% partial and 673 (47.60% complete blinks among normal subjects. Only superextended blinks of ≥0.5-second duration were significantly more frequent in dry-eye subjects than normals (2.3% versus 0.2%, respectively; P=0.023. Total contact time was seven times higher in dry-eye subjects than normals (0.565 versus 0.080 seconds, respectively; P<0.001. Isolating only extended blinks (>0.1 second, the average contact time (seconds was four times longer in dry-eye versus normal subjects (2.459 in dry eye, 0.575 in normals; P=0.003. Isolating only superextended blinks (>0.5 seconds, average contact time was also significantly different (7.134 in dry eye, 1.589 in normals; P<0.001. The contact rate for all full closures was 6.4 times longer in dry-eye (0.045 versus 0.007, P<0.001 than normal subjects.Conclusion: Dry-eye subjects spent 4.5% of a

  11. Clinical and Molecular Inflammatory Response in Sjögren Syndrome-Associated Dry Eye Patients Under Desiccating Stress.

    Science.gov (United States)

    López-Miguel, Alberto; Tesón, Marisa; Martín-Montañez, Vicente; Enríquez-de-Salamanca, Amalia; Stern, Michael E; González-García, María J; Calonge, Margarita

    2016-01-01

    To evaluate the response of the lacrimal function unit in Sjögren syndrome (SS)-associated dry eye patients exposed to 2 simulated daily life environmental conditions. Prospective crossover pilot study. Fourteen female SS dry eye patients were exposed for 2 hours to a controlled normal condition (23 C, 45% relative humidity, and air flow 0.10 m/s) and a controlled adverse condition that simulates desiccating stress (23 C, 5% relative humidity, and air flow 0.10 m/s). The following dry eye tests were performed before and after the exposure: tear osmolarity, phenol red thread test, conjunctival hyperemia, fluorescein tear break-up time, corneal fluorescein staining, conjunctival lissamine green staining, and Schirmer test. Levels of 16 molecules were analyzed in tears by multiplex immunobead analysis. Clinical evaluation showed lacrimal functional unit impairment after the desiccating stress: significantly increased tear osmolarity (315.7 ± 3.0 vs 327.7 ± 5.1 mOsm/L, P = .03), conjunctival hyperemia (1.3 ± 0.1 vs 1.6 ± 0.1, P = .05), and corneal staining in temporal (3.5 ± 0.5 vs 4.7 ± 0.4, P = .01) and nasal (3.6 ± 0.5 vs 4.5 ± 0.5, P = .04) areas. Tear concentrations increased for interleukin-1 receptor antagonist (16 557.1 ± 4047.8 vs 31 895.3 ± 5916.5 pg/mL, P = .01), interleukin-6 (63.8 ± 20.2 vs 111.5 ± 29.6 pg/mL, P = .02), interleukin-8 (2196.1 ± 737.9 vs 3753.2 ± 1106.0 pg/mL, P = .03), and matrix metalloproteinase-9 (101 515.6 ± 37 088.4 vs 145 867.1 ± 41 651.5 pg/mL, P = .03). After the simulated normal condition, only a significant increase in nasal corneal staining (2.9 ± 0.5 vs 3.6 ± 0.5, P = .03) was observed. Even a short exposure to a desiccating environment can produce a significant deterioration of the lacrimal function unit in female SS dry eye patients. The often unnoticed exposure to these conditions during daily life may increase inflammatory activity rapidly, triggering an ocular surface deterioration. Copyright © 2016

  12. Diquafosol ophthalmic solution for dry eye treatment.

    Science.gov (United States)

    Nakamura, Masatsugu; Imanaka, Takahiro; Sakamoto, Asuka

    2012-07-01

    There has been rapid progress in our understanding of dry eye pathogenesis, as well as the development of improved diagnostic clinical tests. Various types of dry eye treatment drugs have been developed. This review summarizes the basic and clinical research carried out in the development of diquafosol for ophthalmic use. Diquafosol is a dinucleotide, purinoreceptor P2Y(2) receptor agonist. Basic pharmacological studies have shown that it acts on P2Y(2) receptors at the ocular surface, to promote tear and mucin secretion via elevated intracellular Ca(2+) concentrations. Diquafosol also improves tear and mucin secretion in experimental dry eye models. Based on the results of laboratory experiments, the authors conducted a series of clinical studies in patients with dry eye disease. Diquafosol was effective in the treatment of dry eye disease at an optimal dose of 3% six times a day. In comparison to commercially available 0.1% sodium hyaluronate ophthalmic solution, 3% diquafosol ophthalmic solution showed non-inferiority in improving corneal fluorescein staining scores and superiority in improving keratoconjunctival Rose Bengal staining scores. Diquafosol ophthalmic solution has a novel mechanism of action that is characterized by its stimulatory effects on tear and mucin secretion. This drug has the potential to be effective in patients with tear film instability and short break-up time type of dry eye, which are essential factors in dry eye pathogenesis.

  13. What Is Dry Eye?

    Medline Plus

    Full Text Available ... bloodshot when I wake up? Jun 26, 2016 Why are my eyes dry after LASIK? Jun 19, 2016 Can I be tested whether I close my eyes when I sleep? Feb 10, 2016 Can light sensitivity from Parkinson’s ...

  14. Dysfunctional tear syndrome: dry eye disease and associated tear film disorders – new strategies for diagnosis and treatment

    Science.gov (United States)

    Milner, Mark S.; Beckman, Kenneth A.; Luchs, Jodi I.; Allen, Quentin B.; Awdeh, Richard M.; Berdahl, John; Boland, Thomas S.; Buznego, Carlos; Gira, Joseph P.; Goldberg, Damien F.; Goldman, David; Goyal, Raj K.; Jackson, Mitchell A.; Katz, James; Kim, Terry; Majmudar, Parag A.; Malhotra, Ranjan P.; McDonald, Marguerite B.; Rajpal, Rajesh K.; Raviv, Tal; Rowen, Sheri; Shamie, Neda; Solomon, Jonathan D.; Stonecipher, Karl; Tauber, Shachar; Trattler, William; Walter, Keith A.; Waring, George O.; Weinstock, Robert J.; Wiley, William F.; Yeu, Elizabeth

    2017-01-01

    Dysfunctional tear syndrome (DTS) is a common and complex condition affecting the ocular surface. The health and normal functioning of the ocular surface is dependent on a stable and sufficient tear film. Clinician awareness of conditions affecting the ocular surface has increased in recent years because of expanded research and the publication of diagnosis and treatment guidelines pertaining to disorders resulting in DTS, including the Delphi panel treatment recommendations for DTS (2006), the International Dry Eye Workshop (DEWS) (2007), the Meibomian Gland Dysfunction (MGD) Workshop (2011), and the updated Preferred Practice Pattern guidelines from the American Academy of Ophthalmology pertaining to dry eye and blepharitis (2013). Since the publication of the existing guidelines, new diagnostic techniques and treatment options that provide an opportunity for better management of patients have become available. Clinicians are now able to access a wealth of information that can help them obtain a differential diagnosis and treatment approach for patients presenting with DTS. This review provides a practical and directed approach to the diagnosis and treatment of patients with DTS, emphasizing treatment that is tailored to the specific disease subtype as well as the severity of the condition. PMID:28099212

  15. Coping with dry eyes: a qualitative approach.

    Science.gov (United States)

    Yeo, Sharon; Tong, Louis

    2018-01-16

    Dry eye is a common problem that affects many people worldwide, reducing quality of life and impacting daily activities. A qualitative approach often used in medicine and other disciplines is used to evaluate how people with dry eye cope with this impact. Six focus group sessions were conducted at the Singapore National Eye Centre (SNEC), premises of an eye research institute. These focus groups consist of a spectrum of dry eye sufferers (30 women, 8 men, aged 61 ± 11.8 years). Standard methods of coding followed by determination of themes were adhered to. Where classification was difficult, consensus was made between 3 assessors. Audio-recorded transcripts were coded in 10 themes by 3 assessors independently. Four of the themes involved traditional measures such as lid warming, cleansing, lubrication and oral dietary supplements. The other themes discovered were Traditional Chinese Medicine, modification of eye-care habits (e.g. wearing sunglasses), environmental humidity, lifestyle (e.g. sleeping habits), psychological attitude, and lastly sharing and communication. Holistic coping strategies were found to be prominent in dry eye sufferers from these focus groups, and people tend to find personalised ways of coping with the impact of dry eye on daily living.

  16. A randomized, double-blind, placebo-controlled study of oral antioxidant supplement therapy in patients with dry eye syndrome.

    Science.gov (United States)

    Huang, Jehn-Yu; Yeh, Po-Ting; Hou, Yu-Chih

    2016-01-01

    To evaluate the efficacy of oral antioxidant supplementation in the treatment of patients with dry eye syndrome (DES). A prospective, randomized, double-blinded study compared the effects of an antioxidant supplement (containing anthocyanosides, astaxanthin, vitamins A, C, and E, and several herbal extracts, including Cassiae semen and Ophiopogonis japonicus) with placebo on patients with DES. We assessed dry eye symptoms, visual acuity, Schirmer's test, tear film breakup time, cornea and conjunctiva fluorescein staining, serum anti-SSA/anti-SSB antibodies, and the level of reactive oxygen species (ROS) in tears. The supplementation period was 8 weeks and patients were followed up every 4 weeks for 16 weeks. A linear mixed model was used to compare the groups, while within-group differences were tested by repeated-measures analysis of variance. Forty-three patients, 20 and 23 in treatment and placebo groups, respectively, completed the study. Liver and renal functions were normal. Diastolic blood pressure decreased in the treatment group. There were no significant differences in systolic blood pressure, dry eye symptoms, serum anti-SSA and anti-SSB, visual acuity, intraocular pressure, or fluorescein corneal staining between the groups. Tear film breakup time scores and Schirmer's test without topical anesthesia significantly improved in the treatment group. Tear ROS level differed between the groups and decreased after treatment. Overall subjective impression revealed a significant improvement with treatment compared with placebo. Oral antioxidant supplementations may increase tear production and improve tear film stability by reducing tear ROS. The vegetable-based antioxidant supplement used in this study is safe and can be utilized as an adjuvant therapy to conventional artificial tear therapy for patients with DES.

  17. Micro-instillation of fluorescein with an inoculation loop for ocular surface staining in dry eye syndrome.

    Science.gov (United States)

    Courrier, Emilie; Renault, Didier; Kaspi, Mathilde; Marcon, Agathe; Lambert, Victor; Garcin, Thibaud; Chiambaretta, Frederic; Garhofer, Gerhard; Thuret, Gilles; Gain, Philippe

    2018-03-01

    To describe and validate the micro-instillation of fluorescein on the ocular surface by a disposable calibrated inoculation loop to improve corneal and conjunctival staining quality. Accuracy and precision of the volume of 0.5% sodium fluorescein collected by a single use 1 μl-calibrated inoculation loop were measured using a precision balance. Twenty patients (40 eyes) suffering from dry eye syndrome were enrolled in a prospective interventional nonrandomized study. Fluorescein was instilled with the loop, and slit-lamp images were taken within 30 seconds using cobalt blue light with and without a yellow barrier filter. For comparison, after a washout period, the same images were retaken after instillation of one drop of fluorescein from a single-dose unit. The main outcome measure was the staining quality assessed by three experts, blind to the instillation method. Patient discomfort (tolerance, by a questionnaire) was also compared. The mean volume collected by the loop was 1.18 ± 0.12 μl, compared with 33.70 ± 6.10 μl using the single-dose unit. The loop avoided excess dye responsible for unpleasant tearing, masking of lesions and rapid diffusion into the stroma. Micro-instillation greatly improved image quality without losing information. The yellow filter further improved image contrast. Tolerance was excellent. The 1 μl-calibrated inoculation loop is a safe, convenient, inexpensive, disposable, sterile, well-tolerated tool for reproducible micro-instillation of commercial fluorescein. By greatly improving staining quality, it will help standardize assessment of dry eye severity. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  18. Dry Eye Management: Targeting the Ocular Surface Microenvironment

    Science.gov (United States)

    Zhang, Xiaobo; Jeyalatha M, Vimalin; Qu, Yangluowa; He, Xin; Ou, Shangkun; Bu, Jinghua; Jia, Changkai; Wang, Junqi; Wu, Han; Liu, Zuguo

    2017-01-01

    Dry eye can damage the ocular surface and result in mild corneal epithelial defect to blinding corneal pannus formation and squamous metaplasia. Significant progress in the treatment of dry eye has been made in the last two decades; progressing from lubricating and hydrating the ocular surface with artificial tear to stimulating tear secretion; anti-inflammation and immune regulation. With the increase in knowledge regarding the pathophysiology of dry eye, we propose in this review the concept of ocular surface microenvironment. Various components of the microenvironment contribute to the homeostasis of ocular surface. Compromise in one or more components can result in homeostasis disruption of ocular surface leading to dry eye disease. Complete evaluation of the microenvironment component changes in dry eye patients will not only lead to appropriate diagnosis, but also guide in timely and effective clinical management. Successful treatment of dry eye should be aimed to restore the homeostasis of the ocular surface microenvironment. PMID:28661456

  19. Dry Eye Management: Targeting the Ocular Surface Microenvironment.

    Science.gov (United States)

    Zhang, Xiaobo; M, Vimalin Jeyalatha; Qu, Yangluowa; He, Xin; Ou, Shangkun; Bu, Jinghua; Jia, Changkai; Wang, Junqi; Wu, Han; Liu, Zuguo; Li, Wei

    2017-06-29

    Dry eye can damage the ocular surface and result in mild corneal epithelial defect to blinding corneal pannus formation and squamous metaplasia. Significant progress in the treatment of dry eye has been made in the last two decades; progressing from lubricating and hydrating the ocular surface with artificial tear to stimulating tear secretion; anti-inflammation and immune regulation. With the increase in knowledge regarding the pathophysiology of dry eye, we propose in this review the concept of ocular surface microenvironment. Various components of the microenvironment contribute to the homeostasis of ocular surface. Compromise in one or more components can result in homeostasis disruption of ocular surface leading to dry eye disease. Complete evaluation of the microenvironment component changes in dry eye patients will not only lead to appropriate diagnosis, but also guide in timely and effective clinical management. Successful treatment of dry eye should be aimed to restore the homeostasis of the ocular surface microenvironment.

  20. Effect of Omega-3 Fatty Acids Dietary Supplementation on Ocular Surface and Tear Film in Diabetic Patients with Dry Eye.

    Science.gov (United States)

    Georgakopoulos, Constantine D; Makri, Olga E; Pagoulatos, Dionisios; Vasilakis, Panagiotis; Peristeropoulou, Politimi; Kouli, Vasiliki; Eliopoulou, Maria I; Psachoulia, Caterina

    2017-01-01

    The objective of this study was to investigate the effect of dietary supplementation with omega-3 fatty acids on ocular surface and tear film in patients with type 2 diabetes suffering from dry eye. Thirty-six patients suffering from type 2 diabetes and moderate to severe dry eye syndrome were included in the study. Patients were assigned to receive omega-3 long-chain polyunsaturated fatty acids for 3 months. Tear film break-up time test, Schirmer-I test, and conjunctival impression cytology analysis were performed on all patients at baseline and after 1 and 3 months. The subjective symptoms of dry eye were evaluated with the Ocular Surface Disease Index (OSDI) questionnaire at the same time points. Patients' average age was 65.57 ± 4.27 years and the mean duration of diabetes was 14.85 ± 5.4 years. There was a statistically significant increase in Schirmer-I test results and tear break-up time score after 3 months of supplementary intake of omega-3 fatty acids compared to baseline (p dry eye syndrome in patients with type 2 diabetes.

  1. Protective effects of carbenoxolone, an 11β-HSD1 inhibitor, against chemical induced dry eye syndrome.

    Science.gov (United States)

    Na, Yoon-Ju; Choi, Kyoung-Jin; Park, Sung Bum; Sung, Hye-Rim; Jung, Won Hoon; Kim, Hee Youn; Rhee, Sang Dal; Kim, Ki Young

    2017-11-01

    Dry eye syndrome (DES) is a disorder of the eye due to tear deficiency or excessive evaporation that causes damage to the eye and is associated with discomfort and dryness. 11β-Hydroxysteroid dehydrogenase 1 (11β-HSD1) is an enzyme that converts inactive cortisone to active cortisol. Recently, 11β-HSD1 has been expressed in human and rodent eyes and has been recognized as a target of glaucoma. In this study, the therapeutic effects and underlying mechanisms of topical carbenoxolone, an 11β-HSD1 inhibitor, were investigated in benzalkonium chloride (BAC)-treated human conjunctival epithelial cells and a rat DES model. In the in vitro study, carbenoxolone dose-dependently inhibited cell death and 11β-HSD1 activity in BAC-treated human conjunctival epithelial cells. For the in vivo study, carbenoxolone or a solvent was administered to the BAC-induced DES model twice daily. BAC-treated rat eyes showed significant increases in ocular surface damage, a reduction of tears, decrease corneal thickness, corneal basement membrane destruction, apoptosis in the conjunctival epithelium, and expression of pro-inflammatory cytokines (TNF-α and IL-6) and 11β-HSD1. These effects of BAC were reversed by topical carbenoxolone treatment. These results demonstrate that carbenoxolone can prevent DES by inhibiting pro-inflammatory cytokine expression and cell death of the corneal and conjunctival epithelium via inhibition of both 11β-HSD1 activity and expression in the eyes of BAC-treated rats. It is suggested that topical 11β-HSD1 inhibitors may provide a new therapeutic window in the prevention and/or treatment of DES.

  2. Fumigation treatment of Four Yellow Qing Ling Water with artificial tears for dry eyes

    Directory of Open Access Journals (Sweden)

    Yan-Yan Chen

    2018-04-01

    Full Text Available AIM: To observe the clinical efficacy of fumigation treatment of traditional Chinese medicine(Four Yellow Qing Ling Waterfor dry eye, and to provide the reference for clinical treatment of dry eye. METHODS: Totally 82 patients(164 eyeswere randomly divided into two groups from June 2016 to December 2016 in Ophthalmology Department of our hospital. The patients in control group were given artificial tears; the patients in the observation group were given artificial tears and fumigation treatment of traditional Chinese(Four Yellow Qing Ling Wateronce a day. After treatment for 14d, the Schirmer Ⅰ test(SⅠt, break-up time(BUT, cornea fluorescein staining(FLand clinical efficacy of two groups were compared. RESULTS: The efficiency rate of observation group was significantly better than the control group(87.8% vs 70.7%, Pvs 6.38±2.52mm/5min, Pvs 6.35±2.29s, Pvs 1.26±0.84, PCONCLUSION: The fumigation treatment of traditional Chinese medicine(Four Yellow Qing Ling Watercombined with artificial tears for dry eyes can improve the clinical symptoms of dry eye syndrome.

  3. Discordant Dry Eye Disease (An American Ophthalmological Society Thesis).

    Science.gov (United States)

    Shtein, Roni M; Harper, Daniel E; Pallazola, Vincent; Harte, Steven E; Hussain, Munira; Sugar, Alan; Williams, David A; Clauw, Daniel J

    2016-08-01

    To improve understanding of dry eye disease and highlight a subgroup of patients who have a component of central sensitization and neuropathic pain contributing to their condition. Prospective, cross-sectional, IRB-approved study comparing isolated dry eye disease (n=48) to fibromyalgia (positive control; n=23) and healthy (negative control; n=26) individuals with ocular surface examination, corneal confocal microscopy, quantitative sensory testing, and self-reported ocular symptoms and systemic associations. A subset of patients also underwent skin biopsy and/or brain neuroimaging. Dry eye patients were split into concordant (ie, those with dry eyes on examination) and discordant (ie, those with dry eye symptoms but normal examination) subgroups for further analysis. We hypothesized that on the systemic measures included, concordant patients would resemble healthy controls, whereas discordant patients would show evidence of centralized mechanisms similar to fibromyalgia. Schirmer test and Ocular Surface Disease Index (OSDI) scores indicated significant decreases in tear production (Schirmer: healthy, 18.5±8.2 mm; dry, 11.2±5.4 mm; fibromyalgia, 14.4±7.5; P dry eye symptoms (OSDI: healthy, 1.9±3.0; dry, 20.3±17.7; fibromyalgia, 20.3±17.1; P dry eye and fibromyalgia patients, compared to controls. The discordant subgroup had decreased corneal nerve density and decreased visual quality-of-life scores, similar to patients with fibromyalgia. Concordant patients were more similar to healthy controls on these measures. Individuals with discordant dry eye may have a central pathophysiologic mechanism leading to their eye pain symptoms, which could be an important factor to consider in treatment of chronic idiopathic dry eye.

  4. Assessment of corneal epithelial thickness in dry eye patients.

    Science.gov (United States)

    Cui, Xinhan; Hong, Jiaxu; Wang, Fei; Deng, Sophie X; Yang, Yujing; Zhu, Xiaoyu; Wu, Dan; Zhao, Yujin; Xu, Jianjiang

    2014-12-01

    To investigate the features of corneal epithelial thickness topography with Fourier-domain optical coherence tomography (OCT) in dry eye patients. In this cross-sectional study, 100 symptomatic dry eye patients and 35 normal subjects were enrolled. All participants answered the ocular surface disease index questionnaire and were subjected to OCT, corneal fluorescein staining, tear breakup time, Schirmer 1 test without anesthetic (S1t), and meibomian morphology. Several epithelium statistics for each eye, including central, superior, inferior, minimum, maximum, minimum - maximum, and map standard deviation, were averaged. Correlations of epithelial thickness with the symptoms of dry eye were calculated. The mean (±SD) central, superior, and inferior corneal epithelial thickness was 53.57 (±3.31) μm, 52.00 (±3.39) μm, and 53.03 (±3.67) μm in normal eyes and 52.71 (±2.83) μm, 50.58 (±3.44) μm, and 52.53 (±3.36) μm in dry eyes, respectively. The superior corneal epithelium was thinner in dry eye patients compared with normal subjects (p = 0.037), whereas central and inferior epithelium were not statistically different. In the dry eye group, patients with higher severity grades had thinner superior (p = 0.017) and minimum (p dry eye corneal epithelium was thinner than normal eyes in the superior region. In more severe dry eye disease patients, the superior and minimum epithelium was much thinner, with a greater range of map standard deviation.

  5. The Role of Medications in Causing Dry Eye

    Science.gov (United States)

    Fraunfelder, Frederick T.; Sciubba, James J.; Mathers, William D.

    2012-01-01

    The purpose of this paper is to review the possible role of polypharmacy in causing dry eye disease (DED), reflecting the complex interactions and complications associated with the use of multiple systemic and topical ocular medications. The pharmacological, physiological, anatomical, and histological mechanisms causing dry mouth differ little from those causing dry eye. Oral polypharmacy is the most common cause of dry mouth, but has not been investigated as a cause of dry eye. Topical ocular polypharmacy has been shown to cause DED. Information on drugs that likely cause or aggravate DED and the controversial role of preservatives in topical ocular medications are examined. Systemic or topical ocular medications and preservatives used in topical ocular drugs may cause dry eye through the drug's therapeutic action, ocular surface effects, or preservatives, and the effects probably are additive. Long-term use of topical ocular medications, especially those containing preservatives such as BAK, may play an important role in DED and the role of polypharmacy needs further study. We review possible ways to decrease the risk of medication-related dry eye. PMID:23050121

  6. Ocular surface temperature in patients with evaporative and aqueous-deficient dry eyes: a thermographic approach.

    Science.gov (United States)

    Matteoli, S; Favuzza, E; Mazzantini, L; Aragona, P; Cappelli, S; Corvi, A; Mencucci, R

    2017-07-26

    In recent decades infrared thermography (IRT) has facilitated accurate quantitative measurements of the ocular surface temperature (OST), applying a non-invasive procedure. The objective of this work was to develop a procedure based on IRT, which allows characterizing of the cooling of the ocular surface of patients suffering from dry eye syndrome, and distinguishing among patients suffering from aqueous deficient dry eye (ADDE) and evaporative dry eyes (EDE). All patients examined (34 females and 4 males, 23-84 years) were divided into two groups according to their Schirmer I result (⩽ 7 mm for ADDE and  >  7 mm for EDE), and the OST was recorded for 7 s at 30 Hz. For each acquisition, the temperatures of the central cornea (CC) as well as those of both temporal and nasal canthi were investigated. Findings showed that the maximum temperature variation (up to 0.75  ±  0.29 °C) was at the CC for both groups. Furthermore, patients suffering from EDE tended to have a higher initial OST than those with ADDE, explained by the greater quantity of the tear film, evenly distributed over the entire ocular surface, keeping the OST higher initially. Results also showed that EDE patients had an average cooling rate higher than those suffering from ADDE, confirming the excessive evaporation of the tear film. Ocular thermography paves the way to become an effective tool for differentiating between the two different etiologies of dry eye syndrome.

  7. Comparison of in vivo efficacy of different ocular lubricants in dry eye animal models.

    Science.gov (United States)

    Zheng, Xiaodong; Goto, Tomoko; Ohashi, Yuichi

    2014-04-29

    To compare the efficacy of three types of ocular lubricants in protecting corneal epithelial cells in dry eye animal models. Ocular lubricants containing 0.1% or 0.3% sodium hyaluronate (SH), carboxymethylcellulose (CMC), or hydroxypropyl methylcellulose (HPMC) were tested. First, ocular lubricant containing 0.002% fluorescein was dropped onto the rabbit corneas. The fluorescein intensity as an index of retention was measured. Second, a rabbit dry eye model was made by holding the eye open with a speculum, and 50 μL of each ocular lubricant was dropped onto the cornea. After 3 hours, the corneas were stained with 1% methylene blue (MB), and the absorbance of MB was measured. Third, a rat dry eye model was treated with the ocular lubricants for 4 weeks, and the corneal fluorescein staining was scored. Eyes treated with physiological saline were used as controls. Finally, immunohistochemistry was used to analyze occludin, an epithelial barrier protein, in cultured human corneal epithelial cells pretreated with ocular lubricants and desiccated for 20 or 60 minutes. Our results showed that 0.3% SH had a significantly longer retention time than the other lubricants (all P eye syndrome. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  8. Radiation induced dry eye: problem and potential remedies

    International Nuclear Information System (INIS)

    Vemuganti, Geeta K.; Tiwari, Shubha

    2016-01-01

    Advances in orbital radiotherapy have significantly increased therapeutic efficiency and reduced the side effects but a significant proportion of patients are still seen with ophthalmic complication like dry eye syndrome (DES). The treatment of DES involves temporary palliative therapies like ocular surface lubrication and rehydration. We aimed at establishing the human lacrimal gland cultures and evaluating for the presence of stem cells and secretory potential. Using human lacrimal gland tissues obtained from samples of therapeutic exenteration post-radiotherapy, we established a monolayer as well as 3D lacrispheres that show evidence of stem cells, secretory acinar cells, duct like formation and other cells like myoepithelial cells and duct like cells. The stem cells were identified as CD 117 positive that co-segregated with G0/G1 phase, ALDH high, label retaining cells and high clone forming ability. The most promising evidence of its secretory function was seen in the presence of tear substances like lysosymes, lactiferrin, and scIg A in the conditioned media of the lacrimal gland cultures. This novel development would pave way for development of a functionally competent 3D construct for potential clinical application in severe cases of radiation induced dry eye. (author)

  9. Spdef null mice lack conjunctival goblet cells and provide a model of dry eye.

    Science.gov (United States)

    Marko, Christina K; Menon, Balaraj B; Chen, Gang; Whitsett, Jeffrey A; Clevers, Hans; Gipson, Ilene K

    2013-07-01

    Goblet cell numbers decrease within the conjunctival epithelium in drying and cicatrizing ocular surface diseases. Factors regulating goblet cell differentiation in conjunctival epithelium are unknown. Recent data indicate that the transcription factor SAM-pointed domain epithelial-specific transcription factor (Spdef) is essential for goblet cell differentiation in tracheobronchial and gastrointestinal epithelium of mice. Using Spdef(-/-) mice, we determined that Spdef is required for conjunctival goblet cell differentiation and that Spdef(-/-) mice, which lack conjunctival goblet cells, have significantly increased corneal surface fluorescein staining and tear volume, a phenotype consistent with dry eye. Microarray analysis of conjunctival epithelium in Spdef(-/-) mice revealed down-regulation of goblet cell-specific genes (Muc5ac, Tff1, Gcnt3). Up-regulated genes included epithelial cell differentiation/keratinization genes (Sprr2h, Tgm1) and proinflammatory genes (Il1-α, Il-1β, Tnf-α), all of which are up-regulated in dry eye. Interestingly, four Wnt pathway genes were down-regulated. SPDEF expression was significantly decreased in the conjunctival epithelium of Sjögren syndrome patients with dry eye and decreased goblet cell mucin expression. These data demonstrate that Spdef is required for conjunctival goblet cell differentiation and down-regulation of SPDEF may play a role in human dry eye with goblet cell loss. Spdef(-/-) mice have an ocular surface phenotype similar to that in moderate dry eye, providing a new, more convenient model for the disease. Copyright © 2013 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  10. Discordant Dry Eye Disease (An American Ophthalmological Society Thesis)

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    Shtein, Roni M.; Harper, Daniel E.; Pallazola, Vincent; Harte, Steven E.; Hussain, Munira; Sugar, Alan; Williams, David A.; Clauw, Daniel J.

    2016-01-01

    Purpose To improve understanding of dry eye disease and highlight a subgroup of patients who have a component of central sensitization and neuropathic pain contributing to their condition. Methods Prospective, cross-sectional, IRB-approved study comparing isolated dry eye disease (n=48) to fibromyalgia (positive control; n=23) and healthy (negative control; n=26) individuals with ocular surface examination, corneal confocal microscopy, quantitative sensory testing, and self-reported ocular symptoms and systemic associations. A subset of patients also underwent skin biopsy and/or brain neuroimaging. Dry eye patients were split into concordant (ie, those with dry eyes on examination) and discordant (ie, those with dry eye symptoms but normal examination) subgroups for further analysis. We hypothesized that on the systemic measures included, concordant patients would resemble healthy controls, whereas discordant patients would show evidence of centralized mechanisms similar to fibromyalgia. Results Schirmer test and Ocular Surface Disease Index (OSDI) scores indicated significant decreases in tear production (Schirmer: healthy, 18.5±8.2 mm; dry, 11.2±5.4 mm; fibromyalgia, 14.4±7.5; Pdry eye symptoms (OSDI: healthy, 1.9±3.0; dry, 20.3±17.7; fibromyalgia, 20.3±17.1; Pdry eye and fibromyalgia patients, compared to controls. The discordant subgroup had decreased corneal nerve density and decreased visual quality-of-life scores, similar to patients with fibromyalgia. Concordant patients were more similar to healthy controls on these measures. Conclusions Individuals with discordant dry eye may have a central pathophysiologic mechanism leading to their eye pain symptoms, which could be an important factor to consider in treatment of chronic idiopathic dry eye. PMID:28050051

  11. Dry Eye Disease and Microbial Keratitis: Is There a Connection?

    Science.gov (United States)

    Narayanan, Srihari; Redfern, Rachel L.; Miller, William L.; Nichols, Kelly K.; McDermott, Alison M.

    2013-01-01

    Dry eye is a common ocular surface disease of multifactorial etiology characterized by elevated tear osmolality and inflammation leading to a disrupted ocular surface. The latter is a risk factor for ocular surface infection, yet overt infection is not commonly seen clinically in the typical dry eye patient. This suggests that important innate mechanisms operate to protect the dry eye from invading pathogens. This article reviews the current literature on epidemiology of ocular surface infection in dry eye patients and laboratory-based studies on innate immune mechanisms operating at the ocular surface and their alterations in human dry eye and animal models. The review highlights current understanding of innate immunity in dry eye and identifies gaps in our knowledge to help direct future studies to further unravel the complexities of dry eye disease and its sequelae. PMID:23583043

  12. Aging Eye Microbiota in Dry Eye Syndrome in Patients Treated with Enterococcus faecium and Saccharomyces boulardii.

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    Chisari, Giuseppe; Chisari, Eleonora M; Borzi, Antonio M; Chisari, Clara G

    2017-01-01

    Aging and oxidative stress seem to play a key role in the onset and progression of ocular surface diseases. Dry Eye Syndrome (DES) is a multifactorial disease of the tears and ocular surface in which symptoms may interfere with the ability to work and carry out daily functions. This clinical trial was a pilot study to evaluate the effects of supplementation with mixture (Saccharomyces boulardii MUCL 53837 and Enterococcus faecium LMG S-28935) on the tear film. Following the run-in period subjects were randomized in two groups: group A (n.30 subjects) and group B (n.30 subjects). Group A (control) treated only with substitute tear and group B treated with substitute tear + mixture (probiotic). The data obtained in the two study groups A and B were, respectively the following: Schirmer I: 9.2±0.2 vs. 12.8±0.4 (pSaccharomyces boulardii MUCL 53837 and Enterococcus faecium LMG S-28935) activity integration with the action of tear substitutes, along with standardization of clinical parameters of the tear film and microbiological activity in restoring of the microbiota ocular surface subject with DES. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  13. Relationships Between Meibomian Gland Loss and Age, Sex, and Dry Eye.

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    Pult, Heiko

    2018-02-12

    This study evaluated relationships between meibomian gland loss (MGL) and age, sex, and dry eye. Dry eye and MGL of the lower eyelid was evaluated from 112 randomly selected subjects (66 women; mean age 62.8; SD ±15.7; and age range: 19-89 years) from Horst Riede GmbH, Weinheim, Germany. In addition, subjects were grouped into dry eye and non-dry eye by the Ocular Surface Disease Index (OSDI) score, lid-parallel conjunctival folds and non-invasive break-up time. Symptoms were evaluated by the OSDI. Meibography of the lower eyelid was performed using a Cobra camera (bon Optic, Lübeck, Germany), and images were analyzed by its digital grading tool. Data were analyzed by backward, multiple regression analyses and Pearson correlation. Analyzing all subjects, multiple regression analyses detected that age and dry eye status (dry eye diagnosis or OSDI) but not sex were significantly related to MGL. In both, non-dry eye (n=66) and dry eye subjects (n=46), dry eye status (OSDI) but not age or sex was significantly related to MGL. Ocular Surface Disease Index scores were significantly correlated with MGL, but this correlation was stronger among all subjects (Pearson correlation; r=0.536, Pdry eye group subjects (r=0.520, Pdry eye group subjects (r=0.275, P=0.014). Dry eye group subjects showed significantly increased MGL of the lower eyelid. Age and dry eye status were related to MGL of the lower eyelid, but sex was not; dry eye status was the dominant factor.

  14. [Oral flaxseed oil (Linum usitatissimum) in the treatment for dry-eye Sjögren's syndrome patients].

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    Pinheiro, Manuel Neuzimar; dos Santos, Procópio Miguel; dos Santos, Regina Cândido Ribeiro; Barros, Jeison de Nadai; Passos, Luiz Fernando; Cardoso Neto, José

    2007-01-01

    To evaluate if oral flaxseed oil (Linum usitatissimum), which reduces the inflammation in rheumatoid arthritis, may help keratoconjunctivitis sicca's treatment in Sjögren's syndrome patients. In a randomized clinical trial, 38 female patients with rheumatoid arthritis or systemic lupus erithematosus associated with keratoconjunctivitis sicca and Sjögren's syndrome were consecutively selected from patients of the Department of Rheumatology of the Amazonas University Hospital. Keratoconjunctivitis sicca diagnosis was based on a dry-eye symptom survey score (Ocular Surface Disease Index - OSDI), Schirmer-I test, fluorescein break-up time, 1% Rose Bengal staining of ocular surface measured by the van Bijsterveld scale. All patients had ocular surface inflammation evaluated and quantified by conjunctival impression cytology, before and after the study. The subjects were divided into three groups with 13 (Group I), 12 (Group II) and 13 (Group III) patients. Group I received flaxseed oil capsules with a final 1 g/day dosis, Group II flaxseed oil capsules with a final 2 g/day dosis and Group III - controls - placebo, for 180 days. Comparing the results at the beginning and at the end of the treatment, statistically significant changes (poral flaxseed oil capsules 1 or 2 g/day reduces ocular surface inflammation and ameliorates the symptoms of keratoconjunctivitis sicca in Sjögren's syndrome patients. Long-term studies are needed to confirm the role of this therapy for keratoconjunctivitis sicca in Sjögren's syndrome.

  15. Clinical evaluation of the effect of diquafosol ophthalmic solution in glaucoma patients with dry eye syndrome.

    Science.gov (United States)

    Jin, Sang Wook; Min, Ji Sang

    2016-05-01

    To investigate the effects of diquafosol on intraocular pressure (IOP) and dry eye symptoms in glaucoma patients with dry eye syndrome (DES). This study evaluated a total of 138 glaucoma patients with DES who were treated with diquafosol ophthalmic solution (DIQUAS(®)). Before treatment and 1, 4, 12, 36, and 52 weeks after treatment, IOP, ocular surface disease index (OSDI), tear film break-up time (BUT), Schirmer I test scores, fluorescein staining, conjunctival impression cytology, and adverse drug reactions were evaluated. Throughout the treatment period, the mean IOP for all the patients remained stable after treatment with diquafosol (15.4 ± 2.8 mmHg at baseline and 16.0 ± 2.8 mmHg at 52 weeks). The mean OSDI score improved significantly at 4, 12, and 52 weeks after diquafosol treatment. The BUT and Schirmer I test scores were significantly increased after diquafosol treatment. The Oxford scheme score was significantly decreased at 1, 4, 12, 36, and 52 weeks after diquafosol treatment. A significant improvement in goblet cell density was observed after 4 weeks of treatment with diquafosol. Adverse drug reactions were reported in 22 (15.9 %) patients. There were no serious adverse drug reactions. Diquafosol was effective in improving objective and subjective symptoms and maintained a stable IOP in glaucoma patients with DES. Therefore, the addition of diquafosol treatment in glaucoma patients with DES or ocular surface side effects using anti-glaucoma medication may be beneficial.

  16. Recent advances in laser in situ keratomileusis-associated dry eye.

    Science.gov (United States)

    Xie, Wenjia

    2016-03-01

    Dry eye is the most common complication after laser in situ keratomileusis (LASIK). The major cause of LASIK-associated dry eye is corneal nerve damage. Early identification and treatment of post-operative dry eye are essential to prevent further ocular surface damage. This article reviews the recent studies of LASIK-associated dry eye, including clinical features, aetiology, risk factors, evaluations and treatment. The applications of novel technologies in LASIK-associated dry eye evaluation like anterior segment spectral-domain optical coherence tomography (SD-OCT) and corneal confocal microscopy are also introduced in this review. © 2016 Optometry Australia.

  17. Altered Mucin and Glycoprotein Expression in Dry Eye Disease.

    Science.gov (United States)

    Stephens, Denise N; McNamara, Nancy A

    2015-09-01

    Mucins are among the many important constituents of a healthy tear film. Mucins secreted and/or associated with conjunctival goblet cells, ocular mucosal epithelial cells, and the lacrimal gland must work together to create a stable tear film. Although many studies have explored the mechanism(s) whereby mucins maintain and protect the ocular surface, the effects of dry eye on the structure and function of ocular mucins are unclear. Here, we summarize current findings regarding ocular mucins and how they are altered in dry eye. We performed a literature review of studies exploring the expression of mucins produced and/or associated with tissues that comprise the lacrimal functional unit and how they are altered in dry eye. We also summarize new insights on the immune-mediated effects of aqueous tear deficiency on ocular surface mucins that we discovered using a mouse model of dry eye. Although consistent decreases in MUC5AC and altered expression of membrane-bound mucins have been noted in both Sjögren and non-Sjögren dry eye, many reports of altered mucins in dry eye are contradictory. Mechanistic studies, including our own, suggest that changes in the glycosylation of mucins rather than the proteins themselves may occur as the direct result of local inflammation induced by proinflammatory mediators, such as interleukin-1. Altered expression of ocular mucins in dry eye varies considerably from study to study, likely attributed to inherent difficulties in analyzing small-volume tear samples, as well as differences in tear collection methods and disease severity in dry eye cohorts. To better define the functional role of ocular mucin glycosylation in the pathogenesis of dry eye disease, we propose genomic and proteomic studies along with biological pathway analysis to reveal novel avenues for exploration.

  18. Treatment of contact lens related dry eye with antibacterial honey.

    Science.gov (United States)

    Wong, Daniel; Albietz, Julie M; Tran, Huan; Du Toit, Cimonette; Li, Anita Hui; Yun, Tina; Han, Jee; Schmid, Katrina L

    2017-12-01

    Contact lens induced dry eye affects approximately 50% of contact lens wearers. The aim was to assess the effects of Manuka (Leptospermum sp.) honey eye drops (Optimel, Melcare, Australia) on dry eye in contact lens wearers. The safety of the honey eye drops in contact lens wear and contact lens wearers' compliance were also evaluated. Prospective, randomised, cross over study, examiner masked, pilot treatment trial. Twenty-four participants aged 20 to 55 years with contact lens related dry eye were recruited and randomised to two treatment groups; 20 completed the study. One group used Optimel eye drops twice a day for two weeks followed by conventional lubricant (Systane Ultra, Alcon) therapy for two weeks; the other group completed the treatments in the reverse order. Before and after each treatment dry eye symptomology, ocular surface inflammation, and tear quantity and quality were assessed. Participants completed a daily log detailing their usage of treatments and any issues. Dry eye symptoms improved significantly after Optimel treatment. Patients with more severe symptoms at baseline showed a greater improvement in symptoms. No significant differences were observed in the objective signs of dry eye; presumably because of the short treatment duration. Seventy-five% of contact lens wearers reported good adherence to Optimel treatment and 95% reported no issues using this product. Optimel Eye Drops reduce the symptoms of dry eye in contact lens wearers and are safe to use. A longer treatment period to assess the effect on clinical signs of dry eye is required. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  19. Effect of Hydroxychloroquine Treatment on Dry Eyes in Subjects with Primary Sjögren's Syndrome: a Double-Blind Randomized Control Study.

    Science.gov (United States)

    Yoon, Chang Ho; Lee, Hyun Ju; Lee, Eun Young; Lee, Eun Bong; Lee, Won-Woo; Kim, Mee Kum; Wee, Won Ryang

    2016-07-01

    The effect of hydroxychloroquine (HCQ) on dry eye has not been fully determined. This study aimed to compare the 12-week efficacy of HCQ medication with that of a placebo in the management of dry eye in primary Sjögren's syndrome (pSS). A double-blind, randomized control study was conducted in 39 pSS subjects from May 2011 through August 2013. pSS was diagnosed based on the classification criteria of the American-European Consensus Group. Subjects received 300 mg of HCQ or placebo once daily for 12 weeks and were evaluated at baseline, 6, and 12 weeks, with a re-visit at 16 weeks after drug discontinuance. The fluorescein staining score, Schirmer test score, tear film break-up time (TBUT), and ocular surface disease index (OSDI) were measured, and tears and blood were collected for ESR, IL-6, IL-17, B-cell activating factor (BAFF), and Th17 cell analysis. Color testing was performed and the fundus was examined to monitor HCQ complications. Twenty-six subjects completed the follow-up. The fluorescein staining score and Schirmer test score did not differ significantly. The OSDI improved with medication in the HCQ group but was not significantly different between the groups. TBUT, serum IL-6, ESR, serum and tear BAFF, and the proportion of Th17 cells did not change in either group. HCQ at 300 mg daily for 12 weeks has no apparent clinical benefit for dry eye and systemic inflammation in pSS (ClinicalTrials.gov. NCT01601028).

  20. The interblink interval in normal and dry eye subjects

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    Johnston PR

    2013-02-01

    Full Text Available Patrick R Johnston,1 John Rodriguez,1 Keith J Lane,1 George Ousler,1 Mark B Abelson1,21Ora, Inc, Andover, MA, USA; 2Schepens Eye Research Institute and Harvard Medical School, Boston, MA, USAPurpose: Our aim was to extend the concept of blink patterns from average interblink interval (IBI to other aspects of the distribution of IBI. We hypothesized that this more comprehensive approach would better discriminate between normal and dry eye subjects.Methods: Blinks were captured over 10 minutes for ten normal and ten dry eye subjects while viewing a standardized televised documentary. Fifty-five blinks were analyzed for each of the 20 subjects. Means, standard deviations, and autocorrelation coefficients were calculated utilizing a single random effects model fit to all data points and a diagnostic model was subsequently fit to predict probability of a subject having dry eye based on these parameters.Results: Mean IBI was 5.97 seconds for normal versus 2.56 seconds for dry eye subjects (ratio: 2.33, P = 0.004. IBI variability was 1.56 times higher in normal subjects (P < 0.001, and the autocorrelation was 1.79 times higher in normal subjects (P = 0.044. With regard to the diagnostic power of these measures, mean IBI was the best dry eye versus normal classifier using receiver operating characteristics (0.85 area under curve (AUC, followed by the standard deviation (0.75 AUC, and lastly, the autocorrelation (0.63 AUC. All three predictors combined had an AUC of 0.89. Based on this analysis, cutoffs of ≤3.05 seconds for median IBI, and ≤0.73 for the coefficient of variation were chosen to classify dry eye subjects.Conclusion: (1 IBI was significantly shorter for dry eye patients performing a visual task compared to normals; (2 there was a greater variability of interblink intervals in normal subjects; and (3 these parameters were useful as diagnostic predictors of dry eye disease. The results of this pilot study merit investigation of IBI

  1. Survey of eye practitioners' preference of diagnostic tests and treatment modalities for dry eye in Ghana.

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    Asiedu, Kofi; Kyei, Samuel; Ayobi, Benedict; Agyemang, Frank Okyere; Ablordeppey, Reynolds Kwame

    2016-12-01

    This study sought to provide an evidence-based profile of the diagnosis, treatment and knowledge or opinions on dry eye among optometrists and ophthalmologists in Ghana. This was a cross-sectional survey RESULTS: The responses of 162 participants are included in the analysis. The most commonly used test to diagnosed dry eye disease was tear break-up time followed by patient history. The most common symptom doctors heard from dry eye patients were burning sensation followed by foreign body sensation. The most often prescribed first- line treatment for dry eye was aqueous-based artificial tears followed by lipid-based artificial tears. Most practitioners considered meibomian gland dysfunction as the most common cause of dry eye followed by pterygium. The most often used test to guide or gauge therapeutic effect is patient history followed closely by tear break-up time. Most practitioners reported that 10%-20% of all their patients they see in a day are diagnosed of dry eye. This study showed tear break up time was the main test majority of practitioners in Ghana used to diagnose dry eye but patient history was the main test used to gauge therapeutic effect over time. Burning sensation was the commonest symptom practitioners heard from dry eye patients whilst artificial tears was their main and first-line treatment for dry eye. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  2. Effect of chitosan-N-acetylcysteine conjugate in a mouse model of botulinum toxin B-induced dry eye.

    Science.gov (United States)

    Hongyok, Teeravee; Chae, Jemin J; Shin, Young Joo; Na, Daero; Li, Li; Chuck, Roy S

    2009-04-01

    To evaluate the effect of a thiolated polymer lubricant, chitosan-N-acetylcysteine conjugate (C-NAC), in a mouse model of dry eye. Eye drops containing 0.5% C-NAC, 0.3% C-NAC, a vehicle (control group), artificial tears, or fluorometholone were applied in a masked fashion in a mouse model of induced dry eye from 3 days to 4 weeks after botulinum toxin B injection. Corneal fluorescein staining was periodically recorded. Real-time reverse transcriptase-polymerase chain reaction and immunofluorescence staining were performed at the end of the study to evaluate inflammatory cytokine expressions. Mice treated with C-NAC, 0.5%, and fluorometholone showed a downward trend that was not statistically significant in corneal staining compared with the other groups. Chitosan-NAC formulations, fluorometholone, and artificial tears significantly decreased IL-1beta (interleukin 1beta), IL-10, IL-12alpha, and tumor necrosis factor alpha expression in ocular surface tissues. The botulinum toxin B-induced dry eye mouse model is potentially useful in evaluating new dry eye treatment. Evaluation of important molecular biomarkers suggests that C-NAC may impart some protective ocular surface properties. However, clinical data did not indicate statistically significant improvement of tear production and corneal staining in any of the groups tested. Topically applied C-NAC might protect the ocular surface in dry eye syndrome, as evidenced by decreased inflammatory cytokine expression.

  3. Annual direct cost of dry eye in Japan

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    Mizuno Y

    2012-05-01

    Full Text Available Yoshinobu Mizuno, Masakazu Yamada, Chika ShigeyasuDivision for Vision Research, National Institute of Sensory Organs, National Tokyo Medical Center, Tokyo, JapanOn behalf of The Dry Eye Survey Group, National Hospital Organization of JapanBackground: This study was performed to estimate the annual direct cost incurred by dry eye patients, which includes expenses for treatment and drugs, as well as the cost of punctal plugs.Methods: The study group consisted of 118 dry eye patients aged 20 years or older who visited any of the 15 medical care facilities that participated in this prospective cohort dry eye study. We estimated annual direct costs from outpatient medical records and survey questionnaires obtained from patients. Results: Of the total patients enrolled, 10 were men and 108 women, and their average age was 64.1 ± 11.2 years. The number of hospital visits made by patients was 5.8 ± 3.6 per year. Among those who used ophthalmic solutions, the numbers of bottles used per year were as follows: 32.1 ± 20.8 bottles of hyaluronic acid ophthalmic solution (87 patients, 53.1 ± 42.2 bottles of artificial tears (40 patients, and 33.2 ± 23.2 bottles of over-the-counter eyedrops (15 patients. In patients with punctal plugs, 4.1 ± 3.9 plugs were used annually. The annual drug cost was 32,000 ± 21,675 Japanese yen (323 ± 219 US dollars. The clinical cost was 16,318 ± 9961 Japanese yen (165 ± 101 US dollars. The total direct costs including punctal plug treatment amounted to 52,467 ± 38,052 Japanese yen (530 ± 384 US dollars. Conclusion: Although treatment modalities for dry eye in Japan were different from those in the US and in European countries, the direct cost of dry eye patients in Japan was comparable with that reported in those countries. Considering the high prevalence of dry eye, the direct cost of this chronic condition may be significant.Keywords: burden of disease, cost, dry eye, eyedrops, quality of life

  4. Low Serum 25-Hydroxyvitamin D Levels Are Associated with Dry Eye Syndrome.

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    Sam Young Yoon

    Full Text Available Dry eye syndrome (DES is a common tear film and ocular surface disease that results in discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. Systemic diseases associated with DES include diabetes mellitus, rheumatoid arthritis, depression, anxiety, thyroid disease, allergic diseases, irritable bowel syndrome, chronic pain syndrome, and hyperlipidemia. Interestingly, it has been found that most of these are associated with low levels of serum 25-hydroxyvitamin D (25(OHD or inadequate sunlight exposure.In this cross-sectional data analysis, noninstitutionalized adults aged ≥19 years (N = 17,542 who participated in Korean National Health and Nutrition Examination Survey 2010-2012 were included. Information regarding duration of sunlight exposure was collected from the survey participants. Serum 25(OHD and zinc levels were measured. The confounding variables were age, gender, sunlight exposure time, region of residence, obesity, serum 25(OHD level, diabetes mellitus, rheumatoid arthritis, depression, thyroid disorder, atopic dermatitis, history of ocular surgery, regular exercise, and walking exercise.Mean serum 25(OHD levels of subjects with and without DES were 16.90 ± 6.0 and 17.52 ± 6.07 (p<0.001. Inadequate sunlight exposure time (odds ratio [OR], 1.554; 95% confidence interval [CI], 1.307-1.848, urban residence (OR, 1.669; 95% CI, 1.456-1.913, indoor occupation (OR, 1.578; 95% CI, 1.389-1.814, and low serum 25(OHD level (OR, 1.158; 95% CI, 1.026-1.308 were the risk factors for DES. After adjusting for age, sex, obesity, diabetes mellitus, rheumatoid arthritis, depression, thyroid disorder, atopic dermatitis, history of ocular surgery, regular exercise, and occupation, low serum 25(OHD level (OR, 1.178; 95% CI, 1.010-1.372 and deficient sunlight exposure time (OR, 1.383; 95% CI, 1.094-1.749 were the risk factors for diagnosed DES.Low serum 25(OHD levels and inadequate sunlight exposure are

  5. Dry Eye in Children with Chronic Renal Failure

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    Pınar Yüksekkaya

    2014-05-01

    Full Text Available Objectives: To evaluate the dry eye symptoms based on objective test and subjective findings in children with chronic renal failure (CRF and to compare the results with those in healthy subjects. Materials and Methods: Thirty-four children with CRF and 89 age- and sex-matched healthy subjects were included in this prospective study. Tear break-up time (TBUT and Schirmer test, subjective symptoms (burning, foreign-body sensation, hyperemia, itching, tearing, calcification of the conjunctiva, and corneal staining were evaluated. In the study group, relation between TBUT and Schirmer test results and duration of disease, duration of dialysis, serum calcium, phosphorus, urea, creatinine, and total protein levels were recorded. For statistical analysis, t-test, chi-square test, and Pearson’s correlation test were used. Results: In the study group, burning sensation was statistically higher than in the control group. Except this, according to the other subjective tests and corneal staining, there were no significant differences between the two groups (p>0.05. Conjunctival calcification was seen in 3 patients in the study group. The mean Schirmer test result was 21.1±8.0 and 23.7±8.0 mm in the study and control groups, respectively (p=0.101. The mean TBUT was 12.5±5.2 seconds (s in the study and 16.0±5.5 s in the control groups (p=0.002. None of the disease-related variables (the mean duration of disease and dialysis, serum calcium, phosphorus, urea, creatinine, and total protein levels were associated with dry eye syndrome (p>0.05. Conclusion: TBUT was statistically significantly lower, but Schirmet test result was not significantly different between children with CRF and age- and sex-matched healthy subjects. The disease-related variables have no effect in the development of dry eyes. (Turk J Ophthalmol 2014; 44: 196-200

  6. AN ANALYSIS OF PREVALENCE OF DRY EYE SYNDROME IN TYPE 2 DIABETES MELLITUS PATIENTS

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    S. Srinivasan

    2017-02-01

    Full Text Available BACKGROUND Globally, an estimate of 422 million adults are living with diabetes mellitus according to the latest 2016 data from the WHO. In India, as per 2015 data, there were 69.2 million cases of diabetes present. Of these, it remains undiagnosed in more than 30 million people. Dry Eye Workshop (DEWS in 2007 improvised the definition for DEWS as follows- “Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tear film instability with potential damage to the ocular surface. It is accompanied by occurrence of increased osmolality of tear film and inflammation of the ocular surface.” MATERIALS AND METHODS In our study, 100 cases of maturity onset of type 2 diabetic patients both male and female between age group 30 and 90 years were studied. All 100 cases of type 2 diabetes patients already on oral antidiabetic drugs, insulin or combined treatment reported to eye OPD directly as well as referred from diabetology and medical OPD and ward were subjected to routine ophthalmological examination including Schirmer's test I, TBUT, corneal sensitivity test, blood sugar fasting and postprandial, blood pressure record, HbA1C in selected cases. Clinical data of all patients, which included sex, age, duration of diabetes, family history of diabetes, BMI as well as a history of other associated hypertension and renal failure were recorded in all patients. HIV association, recent ocular surgery, corneal oedema, viral keratitis, Hansen, post LASIK surgery, meibomian gland dysfunction were excluded from our study. RESULTS Sexual prevalence in our study was female with increased prevalence of 60% compared to male of 40%. Age of the patients in the range between 30-40 years 10; 41-50 years 31; 51-60 years 35 and 61-70 years 20 in numbers. In our study, more than 15 years duration of diabetes mellitus 15 cases presented with diabetic retinopathy changes as per ETDRS criteria in the

  7. Exercise program improved subjective dry eye symptoms for office workers.

    Science.gov (United States)

    Sano, Kokoro; Kawashima, Motoko; Takechi, Sayuri; Mimura, Masaru; Tsubota, Kazuo

    2018-01-01

    We investigated the benefits of a cognitive behavior therapy-based exercise program to reduce the dry eye symptoms of office workers. We recruited 11 office workers with dry eye symptoms, aged 31-64 years, who voluntarily participated in group health guidance at a manufacturing company. Participants learned about the role of physical activity and exercise in enhancing wellness and performed an exercise program at home 3 days per week for 10 weeks. We estimated the indexes of body composition, dry eye symptoms, and psychological distress using the Dry Eye-Related Quality of Life Score and the World Health Organization's Subjective Well-Being Inventory questionnaires pre- and postintervention. The 10-week exercise program and the questionnaires were completed by 48.1% (39 of 81) of the participants. Body composition did not change pre- and postintervention. However, the average of the Dry Eye-Related Quality of Life Score scores in participants with subjective dry eye significantly improved after the intervention. Moreover, the World Health Organization's Subjective Well-Being Inventory positive well-being score tended to increase after the intervention. In this study, we showed that a 10-week exercise program improved subjective dry eye symptoms of healthy office workers. Our study suggests that a cognitive behavior therapy-based exercise program can play an important role in the treatment of patients with dry eye disease.

  8. Oral antioxidant therapy for marginal dry eye.

    Science.gov (United States)

    Blades, K J; Patel, S; Aidoo, K E

    2001-07-01

    To assess the efficacy of an orally administered antioxidant dietary supplement for managing marginal dry eye. A prospective, randomised, placebo controlled trial with cross-over. Eye Clinic, Department of Vision Sciences, Glasgow Caledonian University. Forty marginal dry eye sufferers composed of 30 females and 10 males (median age 53 y; range 38-69 y). Baseline assessments were made of tear volume sufficiency (thread test), tear quality (stability), ocular surface status (conjunctival impression cytology) and dry eye symptoms (questionnaire). Each subject was administered courses of active treatment, placebo and no treatment, in random order for 1 month each and results compared to baseline. Tear stability and ocular surface status were significantly improved following active treatment (Ptreatment (P>0.05). Absolute increase in tear stability correlated with absolute change in goblet cell population density. Tear volume was not improved following any treatment period and dry eye symptom responses were subject to placebo effect. Oral antioxidants improved both tear stability and conjunctival health, although it is not yet understood whether increased ocular surface health mediates increased tear stability or vice versa. This study was supported by a PhD scholarship funded by the Department of Vision Sciences, Glasgow Caledonian University, Scotland. Antioxidant supplements and placebos were kindly donated by Vitabiotics.

  9. Noninvasive Dry Eye Assessment Using High-Technology Ophthalmic Examination Devices.

    Science.gov (United States)

    Yamaguchi, Masahiko; Sakane, Yuri; Kamao, Tomoyuki; Zheng, Xiaodong; Goto, Tomoko; Shiraishi, Atsushi; Ohashi, Yuichi

    2016-11-01

    Recently, the number of dry eye cases has dramatically increased. Thus, it is important that easy screening, exact diagnoses, and suitable treatments be available. We developed 3 original and noninvasive assessments for this disorder. First, a DR-1 dry eye monitor was used to determine the tear meniscus height quantitatively by capturing a tear meniscus digital image that was analyzed by Meniscus Processor software. The DR-1 meniscus height value significantly correlated with the fluorescein meniscus height (r = 0.06, Bland-Altman analysis). At a cutoff value of 0.22 mm, sensitivity of the dry eye diagnosis was 84.1% with 90.9% specificity. Second, the Tear Stability Analysis System was used to quantitatively measure tear film stability using a topographic modeling system corneal shape analysis device. Tear film stability was objectively and quantitatively evaluated every second during sustained eye openings. The Tear Stability Analysis System is currently installed in an RT-7000 autorefractometer and topographer to automate the diagnosis of dry eye. Third, the Ocular Surface Thermographer uses ophthalmic thermography for diagnosis. The decrease in ocular surface temperature in dry eyes was significantly greater than that in normal eyes (P eye opening. Decreased corneal temperature correlated significantly with the tear film breakup time (r = 0.572; P dry eye, sensitivity was 0.83 and specificity was 0.80 after 10 seconds. This article describes the details and potential of these 3 noninvasive dry eye assessment systems.

  10. Dry eye signs and symptoms in night-time workers

    OpenAIRE

    Ali Makateb; Hamed Torabifard

    2017-01-01

    Purpose: To determine the effect of night-time working on dry eye signs and symptoms. Methods: A total of 50 healthy subjects completed a dry eye questionnaire and underwent clinical examinations including basic Schirmer's test and tear breakup time (TBUT) test on two consecutive days, before and after the night shift (12-hrs night-shift). Results: All dry eye symptoms were aggravated significantly after the night shift (P 

  11. What Is Dry Eye?

    Medline Plus

    Full Text Available ... month dissolvable punctal plug be removed or pushed down the tear duct to insert a permanent punctal ... Your Eyelid Nov 29, 2017 New Dry Eye Treatment is a Tear-Jerker Jul 21, 2017 Three ...

  12. SIDRE: Symptomatic Improvement of Dry Eye Study

    Directory of Open Access Journals (Sweden)

    De Paz CJ

    2017-03-01

    Full Text Available Clarissa J De Paz, Agustin L Gonzalez, Chi Ngo Eye & Vision, Richardson, TX, USA Purpose: The aim of this study was to evaluate the effectiveness of lifitegrast 5% ophthalmic solution in reducing the symptoms of eye dryness using Ocular Surface Disease Index (OSDI questionnaire. Methods: A single-center study was undertaken to evaluate the clinical outcomes. Fourteen subjects (12 female and 2 male with symptoms of dry eye and a positive history of recent use of artificial tears were included in the study. OSDI questionnaire scores on the severity of symptoms, visual functionality, and quality of life related to the condition were recorded pre- and post-therapy. Subsequently, score data were analyzed for statistical significance. Results: The mean age of the 14 subjects was 44.86 (standard deviation [SD] ±3.08 years, with a range of 23–62 years. Mean duration of the evaluation was 28.79 days with a range of 25–34 days. Baseline OSDI mean score was 49.40 (SD ±1.28, and post-therapy mean score was 42.26 (SD ±0.99. Data analysis revealed that the scores were statistically significantly improved post-lifitegrast therapy in comparison to baseline (p=0.00041. Conclusion: Lifitegrast 5% ophthalmic solution may be a beneficial therapeutic option in the management of symptoms associated with dry eye disease. Keywords: dry eye disease, ocular surface disease, dry eye treatment, lifitegrast

  13. Chronic dry eye in PRK and LASIK: manifestations, incidence and predictive factors

    Science.gov (United States)

    Bower, Kraig S.; Sia, Rose K.; Ryan, Denise S.; Mines, Michael J.; Dartt, Darlene A.

    2017-01-01

    Purpose To evaluate dry eye manifestations following photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) and determine the incidence and predictive factors of chronic dry eye using a set of dry eye criteria. Setting Walter Reed Army Medical Center, Washington, DC, USA Methods This is a prospective non-randomized clinical study of 143 active duty U.S. Army personnel aged 29.9±5.2 years with myopia or myopic astigmatism (manifest spherical equivalent −3.83±1.96 diopters) undergoing either PRK or LASIK. Dry eye evaluation was performed pre- and postoperatively. Main outcome measures included dry eye manifestations, incidence, and predictive factors of chronic dry eye. Results Schirmer scores, corneal sensitivity, ocular surface staining, surface regularity index (SRI), and responses to dry eye questionnaire significantly changed over time after PRK. After LASIK, significant changes were observed in tear breakup time, corneal sensitivity, ocular surface staining, and responses to questionnaire. At twelve months postoperatively, 5.0% of PRK and 0.8% of LASIK participants developed chronic dry eye. Regression analysis showed preoperatively lower Schirmer score will significantly influence development of chronic dry eye after PRK whereas preoperatively lower Schirmer score or higher ocular surface staining score will significantly influence the occurrence of chronic dry eye after LASIK. Conclusions Chronic dry eye is uncommon after PRK and LASIK. Ocular surface and tear film characteristics during preoperative examination may help predict chronic dry eye development in PRK and LASIK. PMID:26796443

  14. Exercise program improved subjective dry eye symptoms for office workers

    Directory of Open Access Journals (Sweden)

    Sano K

    2018-02-01

    Full Text Available Kokoro Sano,1 Motoko Kawashima,1 Sayuri Takechi,2 Masaru Mimura,2 Kazuo Tsubota1 1Department of Ophthalmology, 2Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan Introduction: We investigated the benefits of a cognitive behavior therapy-based exercise program to reduce the dry eye symptoms of office workers. Materials and methods: We recruited 11 office workers with dry eye symptoms, aged 31–64 years, who voluntarily participated in group health guidance at a manufacturing company. Participants learned about the role of physical activity and exercise in enhancing wellness and performed an exercise program at home 3 days per week for 10 weeks. We estimated the indexes of body composition, dry eye symptoms, and psychological distress using the Dry Eye-Related Quality of Life Score and the World Health Organization’s Subjective Well-Being Inventory questionnaires pre- and postintervention. Results: The 10-week exercise program and the questionnaires were completed by 48.1% (39 of 81 of the participants. Body composition did not change pre- and postintervention. However, the average of the Dry Eye-Related Quality of Life Score scores in participants with subjective dry eye significantly improved after the intervention. Moreover, the World Health Organization’s Subjective Well-Being Inventory positive well-being score tended to increase after the intervention. Conclusion: In this study, we showed that a 10-week exercise program improved subjective dry eye symptoms of healthy office workers. Our study suggests that a cognitive behavior therapy-based exercise program can play an important role in the treatment of patients with dry eye disease. Keywords: dry eye, exercise, office workers, cognitive behavioral therapy

  15. PSS32 Impact of dry eye on everyday life (Ideel) - Symptom bother: Estimating cut-off scores for dry eye severity groups

    OpenAIRE

    Acaster, S.; Verboven, Y.; Begley, C.; Chalmers, R.; Abetz, L.; Thompson, T.

    2011-01-01

    The aims of the study were to estimate score ranges associated with dry eye severity based on the Impact of Dry Eye on Everyday Life (IDEEL) Symptom Bother (SB) domain, and to evaluate the overall performance of the SB domain.

  16. ASSESSMENT OF FUNCTIONAL CHANGES TEAR PRODUCTION UNDER THE ACTION OF THE EYE DROPS ON THE BASE OF NATURAL MOLECULE OF ECTOINE AND ARTIFICIAL TEARS IN PATIENTS WITH DRY EYE SYNDROME ON THE BACKGROUND OF ENDOCRINE OPHTHALMOPATHY.

    Science.gov (United States)

    Veselovskaya, N N; Zherebko, I B

    Conducted a comparative analysis of functional changes in tear production in patients with dry eye syndrome and endocrine ophthalmopathy in the conditions of the long-term acting of preservative free medications based on natural substances. A total of 30 people, aged 35 to 53 years old with clinical manifestations of DES on the background of EO were divided on two groups. In I group eye drops of ectoine and in II - artificial tears were administered. The examination included general and specific methods. The term of follow up - 30 days. It was found that long-term use of preservative free eye drops based on ectoine leads to more expressive positive changes in the condition of the anterior surface of the eye and the secretion and quality of the tear.

  17. Effect of Hydroxychloroquine Treatment on Dry Eyes in Subjects with Primary Sjögren’s Syndrome: a Double-Blind Randomized Control Study

    Science.gov (United States)

    2016-01-01

    The effect of hydroxychloroquine (HCQ) on dry eye has not been fully determined. This study aimed to compare the 12-week efficacy of HCQ medication with that of a placebo in the management of dry eye in primary Sjögren's syndrome (pSS). A double-blind, randomized control study was conducted in 39 pSS subjects from May 2011 through August 2013. pSS was diagnosed based on the classification criteria of the American-European Consensus Group. Subjects received 300 mg of HCQ or placebo once daily for 12 weeks and were evaluated at baseline, 6, and 12 weeks, with a re-visit at 16 weeks after drug discontinuance. The fluorescein staining score, Schirmer test score, tear film break-up time (TBUT), and ocular surface disease index (OSDI) were measured, and tears and blood were collected for ESR, IL-6, IL-17, B-cell activating factor (BAFF), and Th17 cell analysis. Color testing was performed and the fundus was examined to monitor HCQ complications. Twenty-six subjects completed the follow-up. The fluorescein staining score and Schirmer test score did not differ significantly. The OSDI improved with medication in the HCQ group but was not significantly different between the groups. TBUT, serum IL-6, ESR, serum and tear BAFF, and the proportion of Th17 cells did not change in either group. HCQ at 300 mg daily for 12 weeks has no apparent clinical benefit for dry eye and systemic inflammation in pSS (ClinicalTrials.gov. NCT01601028). PMID:27366013

  18. Impact of Glaucoma and Dry Eye on Text-Based Searching

    Science.gov (United States)

    Sun, Michelle J.; Rubin, Gary S.; Akpek, Esen K.; Ramulu, Pradeep Y.

    2017-01-01

    Purpose We determine if visual field loss from glaucoma and/or measures of dry eye severity are associated with difficulty searching, as judged by slower search times on a text-based search task. Methods Glaucoma patients with bilateral visual field (VF) loss, patients with clinically significant dry eye, and normally-sighted controls were enrolled from the Wilmer Eye Institute clinics. Subjects searched three Yellow Pages excerpts for a specific phone number, and search time was recorded. Results A total of 50 glaucoma subjects, 40 dry eye subjects, and 45 controls completed study procedures. On average, glaucoma patients exhibited 57% longer search times compared to controls (95% confidence interval [CI], 26%–96%, P Dry eye subjects demonstrated similar search times compared to controls, though worse Ocular Surface Disease Index (OSDI) vision-related subscores were associated with longer search times (P dry eye (P > 0.08 for Schirmer's testing without anesthesia, corneal fluorescein staining, and tear film breakup time). Conclusions Text-based visual search is slower for glaucoma patients with greater levels of VF loss and dry eye patients with greater self-reported visual difficulty, and these difficulties may contribute to decreased quality of life in these groups. Translational Relevance Visual search is impaired in glaucoma and dry eye groups compared to controls, highlighting the need for compensatory strategies and tools to assist individuals in overcoming their deficiencies. PMID:28670502

  19. Diquafosol ophthalmic solution 3 %: a review of its use in dry eye.

    Science.gov (United States)

    Keating, Gillian M

    2015-05-01

    Diquafosol ophthalmic solution 3 % (Diquas(®)) is a P2Y2 receptor agonist that promotes tear fluid and mucin secretion and is currently approved in Japan and South Korea for the treatment of dry eye. In randomized, double-blind, multicentre trials in patients with dry eye, significantly greater improvements in fluorescein and rose bengal staining scores were seen with diquafosol ophthalmic solution 3 % than with placebo, and diquafosol ophthalmic solution 3 % was noninferior to sodium hyaluronate ophthalmic solution 0.1 % in terms of the improvement in the fluorescein staining score and more effective than sodium hyaluronate ophthalmic solution 0.1 % in terms of the improvement in the rose bengal staining score. The efficacy of diquafosol ophthalmic solution 3 % in the treatment of dry eye was maintained in the longer term, with improvements also seen in subjective dry eye symptoms, and was also shown in a real-world setting. Diquafosol ophthalmic solution 3 % also demonstrated efficacy in various specific dry eye disorders, including aqueous-deficient dry eye, short tear film break-up time dry eye, obstructive meibomian gland dysfunction, dry eye following laser in situ keratomileusis surgery and dry eye following cataract surgery, as well as in contact lens wearers and visual display terminal users. Diquafosol ophthalmic solution 3 % was generally well tolerated in patients with dry eye, with eye irritation the most commonly reported adverse event. In conclusion, diquafosol ophthalmic solution 3 % is a useful option for the treatment of dry eye.

  20. Ocular iontophoresis of EGP-437 (dexamethasone phosphate in dry eye patients: results of a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Patane MA

    2011-05-01

    Full Text Available Michael A Patane¹, Amy Cohen¹, Stephen From¹, Gail Torkildsen², Donna Welch³, George W Ousler III³¹Eyegate Pharmaceuticals, Inc, Waltham, MA, USA; ²Andover Eye Associates, Andover, MA, USA; ³Ora, Inc, Andover, MA, USAPurpose: To assess safety and efficacy of EGP-437 (dexamethasone phosphate 40 mg/mL [DP] in dry eye patients.Methods: The study employed a prospective, single-center, double-masked design utilizing a Controlled Adverse Environment (CAE. Patients (n = 103 with confirmed signs and symptoms of dry eye syndrome were randomized into 1 of 3 iontophoresis treatment groups: 7.5 mA-min at 2.5 mA (DP 7.5, n = 41; 10.5 mA-min at 3.5 mA (DP 10.5, n = 37; or 10.5 mA-min at 3.5 mA (placebo, n = 25. Three CAE visits and 4 follow-up visits occurred over 3 weeks. Patients meeting enrollment criteria received iontophoresis in both eyes after the second CAE exposure (visit 3 and before the third CAE exposure (visit 5. Primary efficacy endpoints were corneal staining and ocular discomfort. Secondary endpoints included tear film break-up time, ocular protection index (OPI, and symptomatology.Results: The DP 7.5 and DP 10.5 treatment groups showed statistically significant improvements in signs and symptoms of dry eye at various time points; however, the primary endpoints were not achieved. The DP 7.5 treatment group exhibited statistically significant improvements in corneal staining (when comparing the differences between study entry and exit, 3 weeks, P = 0.039, OPI (immediately following the second treatment, P = 0.048 and ocular discomfort at follow-up visits (a week after the first treatment, P = 0.032; 24 hours after the second treatment, P = 0.0032. Treatment-emergent adverse events (AEs were experienced by 87% of patients and were consistent across all treatment groups. Most AEs were mild and no severe AEs were observed.Conclusion: Ocular iontophoresis of EGP-437 demonstrated statistically and clinically significant improvements in

  1. The Relationship between Metabolic Syndrome, Its Components, and Dry Eye: A Cross-Sectional Study.

    Science.gov (United States)

    Erdur, Sevil Karaman; Aydin, Rukiye; Ozsutcu, Mustafa; Olmuscelik, Oktay; Eliacik, Mustafa; Demirci, Goktug; Kocabora, Mehmet Selim

    2017-08-01

    The aim of this study was to evaluate tear osmolarity and tear film function and ocular surface changes in patients with metabolic syndrome. 108 eyes of 64 patients with metabolic syndrome (group 1) and 110 eyes of 55 healthy individuals (group 2) were included in this cross-sectional study. All participants were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (TBUT), and tear osmolarity. Main outcome measures were Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (TBUT), and tear osmolarity values. Tear osmolarity values and OSDI scores were significantly higher in group 1 (314.4 ± 19.1 mOsm and 38.9 ± 1.1, respectively) compared with group 2 (295 ± 14.3 mOsm and 18.69 ± 17.2, respectively) (p = 0.01 for both). The Schirmer test values and TBUT in group 1 (10 ± 3.7 mm and 14.8 ± 3.6 sec, respectively) were significantly lower compared with group 2 (16.8 ± 2.6 mm and 18.1 ± 0.5 sec, respectively) (p syndrome can influence tear osmolarity and tear film function. Patients with metabolic syndrome showed tear hyperosmolarity and tear film dysfunction.

  2. Upregulation of NLRP3 Inflammasome in the Tears and Ocular Surface of Dry Eye Patients.

    Directory of Open Access Journals (Sweden)

    Liangliang Niu

    Full Text Available To evaluate the mRNA and protein expressions of NLRP3 inflammasome and its downstream inflammatory factors in human dry eye.We recruited 54 patients with Sjögren's syndrome dry eye (SSDE, 50 patients with non-Sjögren's syndrome dry eye (NSSDE, and 46 healthy controls. Tear film breakup time (TBUT, Schirmer I test, and fluorescein staining (FL were performed on all subjects. Tear samples were obtained to analyze the inflammatory cytokine levels of IL-1β and IL-18 via enzyme-linked immunosorbent (ELISA. Conjunctival impression cytology (CIC specimens were collected to detect the mRNA expression of NLRP3, caspase-1, IL-1β, and IL-18 using quantitative RT-PCR, and the protein expression of NLRP3 and caspase-1 by Western blotting.NLRP3 mRNA expression showed higher levels in both dry eye groups compared with controls, with a comparably significant elevation in the SSDE group (relative 2.47-fold upregulation, p<0.05. NLRP3 protein expression was also increased in SSDE group (relative1.94-fold upregulation compared with the controls. mRNA expression of caspase-1 was significantly upregulated in both SSDE (relative 1.44-fold upregulation, p<0.05 and NSSDE (relative 1.32-fold upregulation, p<0.05. Procaspase-1 protein level was increased in SSDE (relative 1.84-fold upregulation and NSSDE (relative 1.12-fold upregulation versus controls; and caspase-1 protein expression was also increased in SSDE (relative 1.49-fold upregulation and NSSDE (relative 1.17-fold upregulation compared with the controls. The patients with SSDE and NSSDE had higher IL-1β and IL-18 mRNA values and protein expressions than the controls did. The relative mRNA expression of IL-1β upregulated 3.59-fold (p<0.001 in SSDE and 2.13-fold (p<0.01 in NSSDE compared with the controls. IL-1β protein level also showed significant upregulation in SSDE (p=0.01; vs. controls groups. IL-18 mRNA expression levels were significantly upregulated in the SSDE (relative 2.97-fold upregulation, p

  3. Relationship Between Dry Eye Symptoms and Pain Sensitivity

    NARCIS (Netherlands)

    Vehof, Jelle; Kozareva, Diana; Hysi, Pirro G.; Harris, Juliette; Nessa, Ayrun; Williams, Frances K.; Bennett, David L. H.; McMahon, Steve B.; Fahy, Samantha J.; Direk, Kenan; Spector, Tim D.; Hammond, Christopher J.

    2013-01-01

    IMPORTANCE Dry eye disease (DED) is common, but little is known about factors contributing to symptoms of dry eye, given the poor correlation between these symptoms and objective signs at the ocular surface. OBJECTIVE To explore whether pain sensitivity plays a role in patients' experience of DED

  4. Mechanisms and management of dry eye in cataract surgery patients.

    Science.gov (United States)

    Sutu, Christine; Fukuoka, Hideki; Afshari, Natalie A

    2016-01-01

    To provide a summary of the mechanisms that may cause dry eye after cataract surgery and discuss available and upcoming treatment modalities. Development or worsening of dry eye symptoms after cataract surgery is multifactorial with corneal nerve transection, inflammation, goblet cell loss, and meibomian gland dysfunction commonly cited as underlying disorders. With increasing awareness of the prevalence of dry eye disease, current surgical techniques are being analyzed for their contribution to the issue. Although many classic interventions, such as artificial tears and anti-inflammatory drops, remain first-line treatment options, they may not adequately address abnormalities of the tear film. The trend has been to create new drugs and technologies that target meibomian gland deficiencies and restore goblet cell numbers. Therapy for postoperative dry eye symptoms should be determined based on symptom severity and which underlying cause is most prominent at a given time. Patients with high-level risk factors for dry eye should be evaluated preoperatively to determine whether they have preexisting dry eye disease or if they are susceptible to developing disease after surgery.

  5. Temperatures of the Ocular Surface, Lid, and Periorbital Regions of Sjögren's, Evaporative, and Aqueous-Deficient Dry Eyes Relative to Normals.

    Science.gov (United States)

    Abreau, Kerstin; Callan, Christine; Kottaiyan, Ranjini; Zhang, Aizhong; Yoon, Geunyoung; Aquavella, James V; Zavislan, James; Hindman, Holly B

    2016-01-01

    To compare the temperatures of the ocular surface, eyelid, and periorbital skin in normal eyes with Sjögren's syndrome (SS) eyes, evaporative dry eyes (EDE), and aqueous deficient dry eyes (ADDE). 10 eyes were analyzed in each age-matched group (normal, SS, EDE, and ADDE). A noninvasive infrared thermal camera captured two-dimensional images in three regions of interest (ROI) in each of three areas: the ocular surface, the upper eyelid, and the periorbital skin within a controlled environmental chamber. Mean temperatures in each ROI were calculated from the videos. Ocular surface time-segmented cooling rates were calculated over a 5-s blink interval. Relative to normal eyes, dry eyes had lower initial central OSTs (SS -0.71°C, EDE -0.55°C, ADDE -0.95°C, KW Peyes had the lowest initial central OST (Peyes had the lowest central lid temperature and lower periorbital temperatures (Pdry eye. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Etiology, prevalence, and treatment of dry eye disease

    OpenAIRE

    Gayton, Johnny L

    2009-01-01

    Johnny L GaytonEyesight Associates, Warner Robins, GA, USAPurpose: 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 peer-reviewed 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 follo...

  7. Clinical observation of Qiming granule combined with Dextran and Hypromellose eye drops for dry eye

    Directory of Open Access Journals (Sweden)

    Jin-Lan Wan

    2013-09-01

    Full Text Available AIM: To observe the efficacy of Qiming granule combined with Dextran and Hypromellose eye drops in treatment of dry eye.METHODS: A randomized, parallel-control approach was adopted, 100 cases of dry eye patients were divided into treatment group and control group equally, observation on the treatment of 3 months. The treatment group was applied Dextran and Hypromellose eye drops combined with oral Qiming granule, simply Dextran and Hypromellose eye drops for control group. Before and after treatment, tear secretion volume, break-up time, corneal fluorescein staining and symptom were observed.RESULTS: After treatment, there was statistical significance for the break-up time, SⅠt and corneal fluorescein staining in both groups when compared with before treatment(PPCONCLUSION: The combined Dextran and Hypromellose eye drops and Qiming granule perform better than Dextran and Hypromellose eye drops only in treatment of dry eye.

  8. Glaucoma and dry eye disease: the role of preservatives in glaucoma medications

    Directory of Open Access Journals (Sweden)

    Ratna Sitompul

    2011-11-01

    Full Text Available Glaucoma is a common cause of irreversible blindness with increasing prevalence. Some of glaucoma patients will also experience dry eye. Dry eye is the most frequent side effect related to benzalkonium chloride (BAC-containing eye drop  used for glaucoma patients. In addition, glaucoma and dry eyes have shared risk factors that are old age and female. Dry eye among glaucoma patients need to be treated promptly as it produces discomfort, reduces patients’ compliance and   decreases success rate of glaucoma therapy. Dry eye symptoms can be treated by applying preservative-free eye drop, giving combination of preservative containing and preservative-free eye drop to reduce BAC exposure, prescribing artificial tear and conducting surgery to minimize or eliminate the need of topical medication. (Med J Indones 2011; 20:302-5Keywords: benzalkonium chloride, dry eye, glaucoma

  9. Combining Sodium Hyaluronate and Polyvinylpyrrolidone Therapies for the Rabbit Cornea: A New Approach to Relief of the Human Dry Eye Syndrome.

    Science.gov (United States)

    Ehrenberg, Moshe; Zolotariov, Eyal; Loeb, Emmanuel; Poliansky, Vadim; Levy, Aharon

    2015-09-01

    The novel combination of 0.1% sodium hyaluronate (HA) and 5.0% polyvinylpyrrolidone (PVP) into one eyedrop was investigated to test the hypothesis of its increased relief of dry eye syndrome (DES). We evaluated HA and PVP, either alone, or in combination, by utilizing 16 rabbits, where their right eyes received one or two different eyedrops, and their left eyes, as controls, received none. The DES replica in rabbits was induced by 0.1% benzalkonium chloride (BAC) eyedrops. BAC was instilled into the right eyes of all rabbits, which were divided into four groups of four. In Group 1 M, the rabbits received only BAC. A second eyedrop given to the right eyes of Group 2 M was HA, of Group 3 M was PVP, and of Group 4 M was the combination of both HA and PVP. All eyes were followed clinically for 14 d, and thereafter, examined histopathologically. Clinically, the HA+PVP combination yielded the least perilimbal conjunctival erythema (p eyes in the combination group 4 M displayed the greatest preservation of the corneal epithelium (p < 0.001) and of the perilimbal conjunctival goblet cell density (p < 0.001). This unique combination of both HA and PVP into one eyedrop, was more potent than either treatment alone in protecting the ocular surface. A preparation, containing both HA and PVP may become useful for DES patients.

  10. [Emphasis on standardization and refinement in the diagnosis and treatment of dry eye].

    Science.gov (United States)

    Liu, Z G

    2017-09-11

    Dry eye is the second most common ocular disease. In China, the incidence rate of dry eye has reached 21% to 30%, and dry eye patients have accounted for more than 30% of the total ophthalmology outpatients. Dry eye has become a common health problem that affects the working efficiency and life quality of Chinese people. Over the past decade, due to the rapid development of diagnostic equipments and new treatments for dry eye, dry eye has become one of the areas with greatest concerns in ophthalmology, and many eye institutions have set up their dry eye clinics. Although the diagnosis and treatment of dry eye has been improved in recent years, the awareness of dry eye in Chinese ophthalmologists is still too simple. In the diagnosis, the interrogation and basic examination are not given enough attention, and we are over-relying on equipments. Clinical examination and instrument operation also have not been standardized. This article emphasizes that we should pay attention to the interrogation, basic examination and standardization of clinical examination and equipment operation in diagnosing dry eye. The treatment regimen should be mostly refined and optimized to be individualized and comprehensive based on the causes, types and severity of dry eye. In addition, the physical and adjuvant therapy of dry eye should be given sufficient attention and applied reasonably. (Chin J Ophthalmol, 2017, 53: 641-644) .

  11. Intense pulsed light therapy for the treatment of evaporative dry eye disease.

    Science.gov (United States)

    Vora, Gargi K; Gupta, Preeya K

    2015-07-01

    Evaporative dry eye disease is one of the most common types of dry eye. It is often the result of chronic meibomian gland dysfunction (MGD) and associated ocular rosacea. Evaporative dry eye and MGD significantly reduce patient's quality of life. Traditional treatments, such as artificial tears, warm compresses, and medications, such as topical cyclosporine, azithromycin, and oral doxycycline, provide some relief; however, many patients still suffer from dry eye symptoms. Intense pulsed light (IPL) therapy, which has been used extensively in dermatology to treat chronic skin conditions, is a relatively new treatment in ophthalmology for patients with evaporative dry eye disease. There are very few studies published on the use of IPL in patients with dry eye disease. The present review describes the theoretical mechanisms of IPL treatment of MGD and ocular rosacea. Personal clinical experience and recently presented data are reported as well. IPL therapy has promising results for evaporative dry eye patients. There are statistically significant improvements in clinical exam findings of dry eye disease. More importantly, patients report subjective improvement in their symptoms. More research is needed in this area to help understand the mechanism of dry eye disease and how it can be effectively treated.

  12. Clinical observation of Qiming granule combined with Dextran and Hypromellose eye drops for dry eye

    OpenAIRE

    Jin-Lan Wan; Ming-Chang Zhang

    2013-01-01

    AIM: To observe the efficacy of Qiming granule combined with Dextran and Hypromellose eye drops in treatment of dry eye.METHODS: A randomized, parallel-control approach was adopted, 100 cases of dry eye patients were divided into treatment group and control group equally, observation on the treatment of 3 months. The treatment group was applied Dextran and Hypromellose eye drops combined with oral Qiming granule, simply Dextran and Hypromellose eye drops for control group. Before and after tr...

  13. Clinical utility of 3% diquafosol ophthalmic solution in the treatment of dry eyes

    Science.gov (United States)

    Koh, Shizuka

    2015-01-01

    Diquafosol is a drug used for dry eye treatment with a novel mechanism of action. It stimulates the secretion of tear fluid and mucin on the ocular surface, thus enabling us to selectively treat the tear film layer, playing an important role in the establishment of the concept of “Tear Film Oriented Therapy (TFOT)”, an effective therapeutic approach to dry eye in Japan. The 3% diquafosol ophthalmic solution has been widely used for the treatment of dry eye in clinical practice, and it is currently available in Japan and South Korea. This review provides an overview of the clinical utility of 3% diquafosol ophthalmic solution, focusing on the results of clinical studies on various types of dry eye, including aqueous-deficient dry eye, short tear film breakup time-type dry eye, and post dry eye after laser in situ keratomileusis. It also introduces the additive effect of diquafosol on sodium hyaluronate monotherapy for dry eye, and the effect of 3% diquafosol ophthalmic solution for dry eye-related conditions. Additionally, it summarizes the ocular effects of diquafosol in healthy human eyes. Lastly, the importance of improving tear film stability in dry eye treatment, as well as general advances in dry eye treatments, are described. PMID:26028958

  14. Clinical utility of 3% diquafosol ophthalmic solution in the treatment of dry eyes.

    Science.gov (United States)

    Koh, Shizuka

    2015-01-01

    Diquafosol is a drug used for dry eye treatment with a novel mechanism of action. It stimulates the secretion of tear fluid and mucin on the ocular surface, thus enabling us to selectively treat the tear film layer, playing an important role in the establishment of the concept of "Tear Film Oriented Therapy (TFOT)", an effective therapeutic approach to dry eye in Japan. The 3% diquafosol ophthalmic solution has been widely used for the treatment of dry eye in clinical practice, and it is currently available in Japan and South Korea. This review provides an overview of the clinical utility of 3% diquafosol ophthalmic solution, focusing on the results of clinical studies on various types of dry eye, including aqueous-deficient dry eye, short tear film breakup time-type dry eye, and post dry eye after laser in situ keratomileusis. It also introduces the additive effect of diquafosol on sodium hyaluronate monotherapy for dry eye, and the effect of 3% diquafosol ophthalmic solution for dry eye-related conditions. Additionally, it summarizes the ocular effects of diquafosol in healthy human eyes. Lastly, the importance of improving tear film stability in dry eye treatment, as well as general advances in dry eye treatments, are described.

  15. Dry eye following cataract surgery in Women Over 50 Years Old

    Directory of Open Access Journals (Sweden)

    N. Bazzazi

    2016-11-01

    Full Text Available Introduction: Dry eye is a common problem amongst post-menopausal women. Cataract surgery may worsen symptoms of dry eye and this can inflence the quality of life in patients. Ths study was performed to evaluate the incidence and severity of dry eye symptoms aftr phacoemulsifiation surgery. Methods: Ths case-series study was performed on 43 women aged over 50 years during 2013-2014. Patients underwent phacoemulsifiation surgery on one eye. Symptoms of the operated and contra lateral eye were analyzed by χ2 statistical test and SPSS softare, preoperative and one month aftr the surgery. Results: One month aftr the surgery, the mean value of incidence and severity of dry eye in operated and non-operated eyes were 90.06 ± 3.5, 80.96 ± 3.55, 71.11 ± 3.52, and 63.51 ± 3.04, respectively. Th diffrence between the two groups was signifiant (P > 0.001. Schirmer’s test, TBUT and corneal staining showed no signifiant diffrence (P ≥ 0.05. conclusions: Cataract surgery may lead to worsening of dry eye symptoms. Treatment of dry eye before cataract surgery is an important issue to prevent ocular surface damage.

  16. Omega-3 fatty acid supplementation improves dry eye symptoms in patients with glaucoma: results of a prospective multicenter study

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    Tellez-Vazquez J

    2016-04-01

    Full Text Available Jesús Tellez-Vazquez On behalf of the Dry Eye In Glaucoma Study Group (DEIGSG Glaucoma Section, Ophthalmology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain Purpose: The purpose of this study is to assess the effectiveness and tolerability of a dietary supplement with a combination of omega-3 fatty acids and antioxidants on dry eye symptoms caused by chronic instillation of antihypertensive eye drops in patients with glaucoma. Patients and methods: A total of 1,255 patients with glaucoma and dry eye symptoms related to antiglaucoma topical medication participated in an open-label, uncontrolled, prospective, and multicenter study and were instructed to take three capsules a day of the nutraceutical formulation (Brudypio® 1.5 g for 12 weeks. Dry eye symptoms (graded as 0–3 [none to severe, respectively], conjunctival hyperemia, tear breakup time, Schirmer I test, Oxford grading scheme, and intraocular pressure were assessed. Results: After 12 weeks of administration of the dietary supplement, all dry eye symptoms improved significantly (P<0.001 (mean 1.3 vs 0.6 for scratching, 1.4 vs 0.7 for stinging sensation, 1.6 vs 0.7 for grittiness, 1.0 vs 0.4 for tired eyes, 1.1 vs 0.5 for grating sensation, and 0.8 vs 0.3 for blurry vision. The Schirmer test scores and the tear breakup time also increased significantly. There was an increase in the percentage of patients grading 0–I in the Oxford scale and a decrease in those grading IV–V. Compliance was recorded in 62.5% of patients. In compliant patients, the mean differences at 12 weeks vs baseline of dry eye symptoms were statistically significant as compared to noncompliant patients. Conclusion: Dietary supplementation with Brudypio® may be a clinically valuable additional option for the treatment of dry eye syndrome in patients with glaucoma using antiglaucoma eye drops. These results require confirmation with an appropriately designed randomized controlled study

  17. Clinical utility of 3% diquafosol ophthalmic solution in the treatment of dry eyes

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    Koh S

    2015-05-01

    Full Text Available Shizuka Koh Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan Abstract: Diquafosol is a drug used for dry eye treatment with a novel mechanism of action. It stimulates the secretion of tear fluid and mucin on the ocular surface, thus enabling us to selectively treat the tear film layer, playing an important role in the establishment of the concept of “Tear Film Oriented Therapy (TFOT”, an effective therapeutic approach to dry eye in Japan. The 3% diquafosol ophthalmic solution has been widely used for the treatment of dry eye in clinical practice, and it is currently available in Japan and South Korea. This review provides an overview of the clinical utility of 3% diquafosol ophthalmic solution, focusing on the results of clinical studies on various types of dry eye, including aqueous-deficient dry eye, short tear film breakup time-type dry eye, and post dry eye after laser in situ keratomileusis. It also introduces the additive effect of diquafosol on sodium hyaluronate monotherapy for dry eye, and the effect of 3% diquafosol ophthalmic solution for dry eye-related conditions. Additionally, it summarizes the ocular effects of diquafosol in healthy human eyes. Lastly, the importance of improving tear film stability in dry eye treatment, as well as general advances in dry eye treatments, are described. Keywords: diquafosol, dry eye, mucin secretion, fluid secretion, ocular surface, vision

  18. Prevalence of Dry Eye in Uyghur and Han Ethnic Groups in Western China.

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    Gong, Ying-Ying; Zhang, Fan; Zhou, Jin; Li, Jing; Zhang, Guang-Hui; Wang, Jun-Liang; Gu, Zhen-Sheng

    2017-06-01

    To describe and compare the prevalence and characteristics of dry eye among Han and Uyghur persons living in Kashi, the most inland city of China. A total of 1015 residents of Kashi participated in this 2013 cross-sectional study. To evaluate clinical characteristics, each subject completed (1) a dry-eye questionnaire detailing symptoms of dry eye, (2) Schirmer's I-test (SIT), (3) tear-film break-up time (BUT) test, and fluorescein staining of the cornea. Dry eye was defined as the existence of dry eye symptoms and at least two positive clinical signs. Data were analyzed using SPSS software. The prevalence and risk factors of dry eye were evaluated using a multivariate model. Overall, 282 (27.8%) of the 1015 participants were diagnosed with dry eye (95% confidence interval (CI): range, 25.5-30.1). The prevalence of dry eye among Han persons (37.9 %) (95% CI: range, 35.8-40.0) was higher than that among Uyghurs (21.8%) (95% CI: 19.6-24.0) (p dry eye was 25.6% (95% CI: range, 23.3-27.8) among men and 28.7% (95% CI: 26.5-30.9) among women (p > 0.05). Risk factors for dry eye included ethnicity, age, occupation, arthritis, and dry mouth. Our study revealed a higher prevalence of dry eye among Han than Uyghur persons in Kashi. Dry eye was significantly associated with environment and ethnicity.

  19. Short-term consumption of oral omega-3 and dry eye syndrome.

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    Kangari, Haleh; Eftekhari, Mohammad Hossein; Sardari, Sara; Hashemi, Hassan; Salamzadeh, Jamshid; Ghassemi-Broumand, Mohammad; Khabazkhoob, Mehdi

    2013-11-01

    To assess the effect of oral omega-3 fatty acids on tear break-up time (TBUT), Schirmer's score, and Ocular Surface Disease Index (OSDI) through a double-blind clinical trial. Randomized, double-blind clinical trial. Sixty-four patients with dry eye symptoms between the ages of 45 and 90 years were randomized into 2 groups: 33 persons in the treatment group and 31 persons in the placebo group. The treatment group received 2 capsules of omega-3 (each containing 180 mg eicosapentaenoic acid [EPA] and 120 mg docosahexaenoic acid [DHA]) daily for 30 days, and the placebo group received 2 medium-chain triglyceride oil capsules daily for 1 month. The outcomes were measured 1 month after the intervention. The primary outcome measure was an increase from baseline in TBUT at day 30. Secondary outcome measures were a decrease from baseline in the OSDI score and an increase in the Schirmer's score at day 30. In the placebo group, before the intervention, the mean TBUT, OSDI, and Schirmer's scores were 4.5 ± 2.1 seconds, 36.4 ± 13.8, and 6.0 ± 2.6 mm, respectively, and 1 month later were 4.7 ± 2.6 seconds, 37.6 ± 13.5, and 6.2 ± 2.5 mm, respectively. In the treatment group, these values were 3.9 ± 1.7 seconds, 38.7 ± 16.5, and 5.8 ± 2.5 mm before the intervention and 5.67 ± 2.6 seconds, 29.3 ± 15.9, and 6.8 ± 2.8 mm after the intervention, respectively. Repeated-measures analysis of variance showed that improvements in TBUT, OSDI, and Schirmer's scores were significantly better in the treatment group than in the placebo group. The changes in the treatment and placebo groups were 71% and 3.3% for TBUT (P dry eye symptoms, and 22.3% and 5.1% for Schirmer's score (P=0.033), respectively. This study demonstrated that oral consumption of omega-3 fatty acids (180 mg EPA and 120 mg DHA twice daily for 30 days) is associated with a decrease in the rate of tear evaporation, an improvement in dry eye symptoms, and an increase in tear secretion. Copyright © 2013 American

  20. Clinical efficacy of pranoprofen and sodium hyaluronate for dry eye

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    Hong-Chao Hou

    2016-01-01

    Full Text Available AIM:To observe the clinical efficacy of pranoprofen and sodium hyaluronate for dry eye, and to provide the reference for clinical treatment of dry eye. METHODS: From January 2012 to January 2015 inour hospital, 106 patients with dry eye were tested and observed. In accordance with the number table, patients were divided into observation group and control group, 53 patients in the control group using conventional treatment plus single sodium hyaluronate eye drops, observation group using pranoprofen combined sodium hyaluronate eye drops, besides conventional treatment. Clinical outcomes between the two groups before and after treatments, dry eye score, fluorescein staining score, Schirmer I test and tear film break up time(BUTwere observed and analyzed. RESULTS:The effective rates of the two groups were 94.3%(50/53and 84.9%(45/53. Dry eye score of observation group before and after treatment were 3.24±0.52 and 0.32±0.06points, those of the control group were 3.26±0.48 and 0.75±0.24points. BUT of the experimental group before and after treatments were 5.67±3.052 and 12.95±2.865s, those of the control group were 6.23±2.985 and 9.85±2.714s.The differences between the two groups on the indicators above were statistically significant(PCONCLUSION: The combination of pranoprofen and sodium hyaluronate for the treatment of dry eye is effective, with high security and water holding capacity, which can improve the symptoms of dry eye and the patients' life quality.

  1. Dry Eye Syndrome After Proton Therapy of Ocular Melanomas

    International Nuclear Information System (INIS)

    Thariat, Juliette; Maschi, Celia; Lanteri, Sara; Peyrichon, Marie Laure; Baillif, Stephanie; Herault, Joel; Salleron, Julia; Caujolle, Jean Pierre

    2017-01-01

    Purpose: To investigate whether proton therapy (PT) performs safely in superotemporal melanomas, in terms of risk of dry-eye syndrome (DES). Methods and Materials: Tumor location, DES grade, and dose to ocular structures were analyzed in patients undergoing PT (2005-2015) with 52 Gy (prescribed dose, not accounting for biologic effectiveness correction of 1.1). Prognostic factors of DES and severe DES (sDES, grades 2-3) were determined with Cox proportional hazard models. Visual acuity deterioration and enucleation rates were compared by sDES and tumor locations. Results: Median follow-up was 44 months (interquartile range, 18-60 months). Of 853 patients (mean age, 64 years), 30.5% had temporal and 11.4% superotemporal tumors. Five-year incidence of DES and sDES was 23.0% (95% confidence interval [CI] 19.0%-27.7%) and 10.9% (95% CI 8.2%-14.4%), respectively. Multivariable analysis showed a higher risk for sDES in superotemporal (hazard ratio [HR] 5.82, 95% CI 2.72-12.45) and temporal tumors (HR 2.63, 95% CI 1.28-5.42), age ≥70 years (HR 1.90, 95% CI 1.09-3.32), distance to optic disk ≥5 mm (HR 2.71, 95% CI 1.52-4.84), ≥35% of retina receiving 12 Gy (HR 2.98, 95% CI 1.54-5.77), and eyelid rim irradiation (HR 2.68, 95% CI 1.49-4.80). The same risk factors were found for DES. Visual acuity deteriorated more in patients with sDES (0.86 ± 1.10 vs 0.64 ± 0.98 logMAR, P=.034) but not between superotemporal/temporal and other locations (P=.890). Enucleation rates were independent of sDES (P=.707) and tumor locations (P=.729). Conclusions: Severe DES was more frequent in superotemporal/temporal melanomas. Incidence of vision deterioration and enucleation was no higher in patients with superotemporal melanoma than in patients with tumors in other locations. Tumor location should not contraindicate PT.

  2. Dry Eye Syndrome After Proton Therapy of Ocular Melanomas

    Energy Technology Data Exchange (ETDEWEB)

    Thariat, Juliette, E-mail: jthariat@gmail.com [Proton Therapy Unit, Department of Radiation Therapy, Centre Antoine Lacassagne, Nice (France); Maschi, Celia; Lanteri, Sara [Department of Ophthalmology, Pasteur 2 Hospital, Eye University Clinic, Nice (France); Peyrichon, Marie Laure [Proton Therapy Unit, Department of Radiation Therapy, Centre Antoine Lacassagne, Nice (France); Baillif, Stephanie [Department of Ophthalmology, Pasteur 2 Hospital, Eye University Clinic, Nice (France); Herault, Joel [Proton Therapy Unit, Department of Radiation Therapy, Centre Antoine Lacassagne, Nice (France); Salleron, Julia [Department of Biostatistics, Institut de Cancérologie de Lorraine, Vandoeuvre les Nancy (France); Caujolle, Jean Pierre [Department of Ophthalmology, Pasteur 2 Hospital, Eye University Clinic, Nice (France)

    2017-05-01

    Purpose: To investigate whether proton therapy (PT) performs safely in superotemporal melanomas, in terms of risk of dry-eye syndrome (DES). Methods and Materials: Tumor location, DES grade, and dose to ocular structures were analyzed in patients undergoing PT (2005-2015) with 52 Gy (prescribed dose, not accounting for biologic effectiveness correction of 1.1). Prognostic factors of DES and severe DES (sDES, grades 2-3) were determined with Cox proportional hazard models. Visual acuity deterioration and enucleation rates were compared by sDES and tumor locations. Results: Median follow-up was 44 months (interquartile range, 18-60 months). Of 853 patients (mean age, 64 years), 30.5% had temporal and 11.4% superotemporal tumors. Five-year incidence of DES and sDES was 23.0% (95% confidence interval [CI] 19.0%-27.7%) and 10.9% (95% CI 8.2%-14.4%), respectively. Multivariable analysis showed a higher risk for sDES in superotemporal (hazard ratio [HR] 5.82, 95% CI 2.72-12.45) and temporal tumors (HR 2.63, 95% CI 1.28-5.42), age ≥70 years (HR 1.90, 95% CI 1.09-3.32), distance to optic disk ≥5 mm (HR 2.71, 95% CI 1.52-4.84), ≥35% of retina receiving 12 Gy (HR 2.98, 95% CI 1.54-5.77), and eyelid rim irradiation (HR 2.68, 95% CI 1.49-4.80). The same risk factors were found for DES. Visual acuity deteriorated more in patients with sDES (0.86 ± 1.10 vs 0.64 ± 0.98 logMAR, P=.034) but not between superotemporal/temporal and other locations (P=.890). Enucleation rates were independent of sDES (P=.707) and tumor locations (P=.729). Conclusions: Severe DES was more frequent in superotemporal/temporal melanomas. Incidence of vision deterioration and enucleation was no higher in patients with superotemporal melanoma than in patients with tumors in other locations. Tumor location should not contraindicate PT.

  3. [Research progress of conscious pain and neurosensory abnormalities in dry eye disease].

    Science.gov (United States)

    Lin, X; Liu, Z L; Wu, J L; Liu, Z G

    2018-02-11

    Dry eye is one of the most common ocular problems in ophthalmology clinic. With the change of social environment and people's life style, the prevalence of dry eye disease is increasing. Currently, the diagnosis criteria for dry eye is controversial, diagnosis of dry eye mainly rely on the comprehensive assessment of symptoms and the presence of associated ocular surface signs. However, previous studies have shown a poor correlation between dry eye symptoms and objective clinical signs in patients. Recent studies have found that neuropathic pain plays an important role in the occurrence of discordance between symptoms and signs in dry eye disease. The purpose of this paper is to present the conception of pain, the distribution and function of sensory nerves in ocular surface, the prevalence and mechanism of neuropathic pain and analgesic treatment in dry eye disease. (Chin J Ophthalmol, 2018, 54: 144-148) .

  4. The Efficacy of Diquafosol Ophthalmic Solution in Non-Sjögren and Sjögren Syndrome Dry Eye Patients Unresponsive to Artificial Tear.

    Science.gov (United States)

    Jeon, Hyun Sun; Hyon, Joon Young

    2016-09-01

    This study evaluates the efficacy of 3% diquafosol tetrasodium ophthalmic solution in Sjögren's syndrome (SS) and non-SS dry eye patients unresponsive to conventional artificial tear. This retrospective study included 38 dry eye patients (11 with SS and 27 with non-SS) who were treated with 3% diquafosol due to lack of response to artificial tear treatment for more than 3 months. Signs such as tear film break-up time (TBUT), Schirmer-I test, and total ocular staining score (OSS), which consisted of corneal OSS and conjunctival OSS, were evaluated at baseline and the first visit after treatment. Symptoms were quantified using visual analog scale (VAS) and ocular surface disease index (OSDI) scores. Changes of parameters after treatment in all the patients and differences of changes in SS and non-SS were evaluated. In total population, total OSS and corneal OSS improved average 6 weeks after diquafosol treatment (all P < 0.05, paired t-test), although conjunctival OSS had no improvement. TBUT increased after treatment (P = 0.036), while Schirmer-I test, OSDI, and VAS showed no improvement. With respect to comparisons, total and corneal OSS improved in non-SS patients and TBUT improved in SS patients (all P < 0.05). Three percent diquafosol tetrasodium treatment could be considered as an additive or substitute treatment when artificial tear treatment is insufficient, as it improved OSS and TBUT. This study also demonstrated that diquafosol treatment is beneficial for TBUT improvement in SS, while it is beneficial for OSS improvement in non-SS dry eye patients.

  5. Lifitegrast Ophthalmic Solution 5%: A Review in Dry Eye Disease.

    Science.gov (United States)

    Keating, Gillian M

    2017-02-01

    Lifitegrast is a novel small molecule integrin antagonist that blocks the binding of intercellular adhesion molecule 1 (ICAM-1) to lymphocyte function-associated antigen 1 (LFA-1). Lifitegrast ophthalmic solution 5% (Xiidra™) was recently approved in the USA for the treatment of dry eye disease. The efficacy of lifitegrast ophthalmic solution 5% was compared with vehicle in a 12-week phase 2 study and three 12-week phase 3 studies (OPUS-1, OPUS-2 and OPUS-3) in patients with dry eye disease. Taken as a whole, results of these trials support the treatment effect of lifitegrast ophthalmic solution 5% in improving a symptom of dry eye disease (i.e. the change from baseline to day 84 in the eye dryness visual analogue scale score) and a sign of dry eye disease (i.e. the change from baseline to day 84 in the inferior corneal fluorescein staining score). Lifitegrast ophthalmic solution 5% was generally well tolerated. In conclusion, lifitegrast ophthalmic solution 5% provides a new option for the treatment of dry eye disease.

  6. Simple Solutions for Dry Eye

    Science.gov (United States)

    Patient Education Sheet Simple Solutions for Dry Eye The SSF thanks J. Daniel Nelson, MD, Associate Medical Director, Specialty Care HealthPartners Medical Group & Clinics, and Professor of Ophthalmology, University of ...

  7. Fluorophotometry as a diagnostic tool for the evaluation of dry eye disease

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    Fan Vincent C

    2006-05-01

    Full Text Available Abstract Background Dry eye disease is a common debilitating ocular disease. Current diagnostic tests used in dry eye disease are often neither sensitive nor reproducible, making it difficult to accurately diagnose and determine end points for clinical trials, or evaluate the usefulness of different medications in the treatment of dry eye disease. The recently developed fluorophotometer can objectively detect changes in the corneal epithelium by quantitatively measuring its barrier function or permeability. The purpose of the study is to investigate the use of corneal fluorescein penetration measured by the fluorophotometer as a diagnostic tool in the evaluation of dry eye patients. Methods Dry eye patients (16 eyes, who presented with a chief complaint of ocular irritation corresponding with dry eye, low Schirmer's one test ( Results Ten minutes after fluorescein installition, patients with dry eye disease averaged a five-fold increase in corneal tissue fluorescein concentration (mean = 375.26 ± 202.67 ng/ml compared with that of normal subjects (mean = 128.19 ± 85.84 ng/ml. Sixty minutes after dye installation, patients with dry eye disease still revealed higher corneal tissue fluorescein concentration (mean = 112.87 ± 52.83 ng/ml compared with that of controls (mean = 40.64 ± 7.96 ng/ml, averaging a three-fold increase. Conclusion Patients with dry eye disease demonstrated an increased corneal permeability and a slower rate of elimination to topically administered fluorescein when measured by the fluorophotometer. This suggests that fluorophotometry may serve as a valuable quantitative and objective tool for the diagnosis of dry eye disease, and in following patients' response to new treatment modalities. Fluorophotometry may serve as an objective non-invasive tool for end-point analysis in clinical trials of new treatments for dry eye disease.

  8. Serum 25-Hydroxyvitamin D Levels and Dry Eye Syndrome: Differential Effects of Vitamin D on Ocular Diseases.

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    Donghyun Jee

    Full Text Available To investigate associations between serum 25-hydroxyvitamin D levels and dry eye syndrome (DES, and to evaluate the differential effect of vitamin D on ocular diseases including age-related macular disease (AMD, diabetic retinopathy (DR, cataract, and DES.A total of 16,396 participants aged >19 years were randomly selected from the Korean National Health and Nutrition Examination Survey. All participants participated in standardized interviews, blood 25-hydroxyvitamin D level evaluations, and comprehensive ophthalmic examinations. DES was defined by a history of clinical diagnosis of dry eyes by a physician. The association between vitamin D and DES was compared to the associations between vitamin D and AMD, DR, cataract, and DES from our previous studies.The odds of DES non-significantly decreased as the quintiles of serum 25-hydroxyvitamin D levels increased (quintile 5 versus 1, OR = 0.85, 95%CI: 0.55-1.30, P for trend = 0.076 after adjusting for potential confounders including age, sex, hypertension, diabetes, smoking status, and sunlight exposure times. The relative odds of DES (OR = 0.70, 95% CI: 0.30-1.64 and cataract (OR = 0.76, 95% CI: 0.59-0.99 were relatively high, while those of DR (OR = 0.37, 95% CI: 0.18-0.76 and late AMD (OR = 0.32, 95% CI: 0.12-0.81 were lower in men.The present study does not support an association between serum 25-hydroxyvitamin D levels and DES. The preventive effect of serum 25-hydroxyvitamin D may be more effective for DR and late AMD than it is for cataract and DES.

  9. Phantom Eye Syndrome: A Review of the Literature

    Directory of Open Access Journals (Sweden)

    Agda M. Andreotti

    2014-01-01

    Full Text Available The purpose of this literature review was to describe the main features of phantom eye syndrome in relation to their possible causes, symptoms, treatments, and influence of eye amputation on quality of life of anophthalmic patients. For this, a bibliographical research was performed in Pubmed database using the following terms: “eye amputation,” “eye trauma,” “phantom eye syndrome,” “phantom pain,” and “quality of life,” associated or not. Thirteen studies were selected, besides some relevant references contained in the selected manuscripts and other studies hallowed in the literature. Thus, 56 articles were included in this review. The phantom eye syndrome is defined as any sensation reported by the patient with anophthalmia, originated anophthalmic cavity. In phantom eye syndrome, at least one of these three symptoms has to be present: phantom vision, phantom pain, and phantom sensations. This syndrome has a direct influence on the quality of life of the patients, and psychological support is recommended before and after the amputation of the eyeball as well as aid in the treatment of the syndrome. Therefore, it is suggested that, for more effective treatment of phantom eye syndrome, drug therapy should be associated with psychological approach.

  10. [Efficacy of physiotherapy and hygienic procedures in treatment of adults and children with chronic blepharitis and dry eye syndrome].

    Science.gov (United States)

    Prozornaia, L P; Brzhevskiĭ, V V

    2013-01-01

    110 patients aged from 3 to 42 years old were examined to estimate the efficacy of chronic blepharitis treatment: 50 patients with chronic blepharitis and dry eye syndrome (DES), 28 with DES due to computer vision syndrome and 32 with isolated chronic blepharitis. All patients received eyelid massage. If the secretion was too thick and difficult to evacuate from meibomian glands then duct probing was performed. In addition a complex of hygienic procedures was performed using phytoproducts ("Geltec-Medika", Russia): blepharoshampoo, blepharolotion, blepharogel 1 and 2. Moist warm pads (with blepharolotion and calendula extraction) were applied on the eyelids in 25 patients. Massage and probing of meibomian gland ducts and hygienic procedures were showed to be effective in management of clinical signs of chronic blepharitis including coexisting DES. Moist warm pads improve efficacy of background therapy in patients with meibomian gland hypofunction and have no effect in blepharitis with excessive meibomian gland secretion. Eyelid hygiene was showed to be effective in adults and children as well including infants.

  11. Evidence that dry eye is a comorbid pain condition in a U.S. veteran population

    Science.gov (United States)

    Lee, Charity J.; Levitt, Roy C.; Felix, Elizabeth R.; Sarantopoulos, Constantine D.; Galor, Anat

    2017-01-01

    Abstract Introduction: Recent evidence suggests that dry eye (DE) may be comorbid with other chronic pain conditions. Objectives: To evaluate DE as a comorbid condition in the U.S. veteran population. Methods: Retrospective review of veterans seen in the Veterans Administration Healthcare System (Veteran Affairs) between January 1, 2010, and December 31, 2014. Dry eye and nonocular pain disorders were ascertained by International Classification of Diseases, Ninth Revision (ICD-9) codes. Dry eye was further separated into ICD-9 codes representing tear film dysfunction or ocular pain. χ2 and logistic regression analyses were used to examine frequency and risk of DE, ocular pain, and tear film dysfunction by pain disorders. Results: Of 3,265,894 veterans, 959,881 had a DE diagnosis (29.4%). Dry eye frequency increased with the number of pain conditions reported (P < 0.0005). Ocular pain was most strongly associated with headache (odds ratio [OR] 2.98; 95% confidence interval [CI] 2.95–3.01), tension headache (OR 2.64; 95% CI 2.58–2.71), migraine (OR 2.58; 95% CI 2.54–2.61), temporomandibular joint dysfunction (OR 2.39; 95% CI 2.34–2.44), pelvic pain (OR 2.30; 95% CI 2.24–2.37), central pain syndrome (OR 2.24; 95% CI 1.94–2.60), and fibromyalgia/muscle pain (OR 2.23; 95% CI 2.20–2.26), all P < 0.0005. Tear film dysfunction was most closely associated with osteoarthritis (OR 1.97; 95% CI 1.96–1.98) and postherpetic neuralgia (OR 1.95; 95% CI 1.90–2.00), both P < 0.0005. Conclusions: Dry eye, including both ocular pain and tear film dysfunction, is comorbid with pain conditions in this nationwide population, implying common mechanisms. PMID:29392243

  12. Efficacy of a New Ocular Surface Modulator in Restoring Epithelial Changes in an In Vitro Model of Dry Eye Syndrome.

    Science.gov (United States)

    Barabino, Stefano; De Servi, Barbara; Aragona, Salvatore; Manenti, Demetrio; Meloni, Marisa

    2017-03-01

    So far tear substitutes have demonstrated a limited role in restoring ocular surface damage in dry eye syndrome (DES). The aim of this study was to assess the efficacy of a new ocular surface modulator in an in vitro model of human corneal epithelium (HCE) damaged by severe osmotic stress mirroring the features of dry eye conditions. A reconstructed HCE model challenged by the introduction of sorbitol in the culture medium for 16 h was used to induce an inflammatory pathway and to impair the tight junctions integrity determining a severe modification of the superficial layer ultrastructure. At the end of the overnight stress period in the treated HCE series, 30 μl of the ocular surface modulator (T-LysYal, Sildeha, Switzerland) and of hyaluronic acid (HA) in the control HCE series were applied for 24 h. The following parameters were quantified: scanning electron microscopy (SEM), trans-epithelial electrical resistance (TEER), immunofluorescence analysis of integrin β1 (ITG-β1), mRNA expression of Cyclin D-1 (CCND1), and ITG-β1. In the positive control after the osmotic stress the HCE surface damage was visible at the ultrastructural level with loss of cell-cell interconnections, intercellular matrix destruction, and TEER reduction. After 24 h of treatment with T-LysYal, HCE showed a significant improvement of the ultrastructural morphological organization and increased expression of ITG-β1 at the tissue level when compared to positive and control series. A significant increase of mRNA expression for ITG-β1 and CCND1 was shown in the HA-treated cells compared to T-LysYal. TEER measurement showed a significant reduction in all groups after 16 h without modifications after the treatment period. This study has shown the possibility of a new class of agents denominated ocular surface modulators to restore corneal cells damaged by dry eye conditions. Further in vivo studies are certainly necessary to confirm these results.

  13. Effects of silk fibroin in murine dry eye

    Science.gov (United States)

    Kim, Chae Eun; Lee, Ji Hyun; Yeon, Yeung Kyu; Park, Chan Hum; Yang, Jaewook

    2017-03-01

    The study aimed to investigate the effects of silk fibroin in a mouse model of dry eye. The experimental dry eye mouse model was developed using more than twelve-weeks-old NOD.B10.H2b mice exposing them to 30-40% ambient humidity and injecting them with scopolamine hydrobromide for 10 days. Tear production and corneal irregularity score were measured by the instillation of phosphate buffered saline or silk fibroin. Corneal detachment and conjunctival goblet cell density were observed by hematoxylin and eosin or periodic acid Schiff staining in the cornea or conjunctiva. The expression of inflammatory markers was detected by immunohistochemistry in the lacrimal gland. The silk group tear production was increased, and corneal smoothness was improved. The corneal epithelial cells and conjunctival goblet cells were recovered in the silk groups. The expression of inflammatory factors was inhibited in the lacrimal gland of the silk group. These results show that silk fibroin improved the cornea, conjunctiva, and lacrimal gland in the mouse model of dry eye. These findings suggest that silk fibroin has anti-inflammatory effects in the experimental models of dry eye.

  14. Corneal Mechanical Thresholds Negatively Associate With Dry Eye and Ocular Pain Symptoms.

    Science.gov (United States)

    Spierer, Oriel; Felix, Elizabeth R; McClellan, Allison L; Parel, Jean Marie; Gonzalez, Alex; Feuer, William J; Sarantopoulos, Constantine D; Levitt, Roy C; Ehrmann, Klaus; Galor, Anat

    2016-02-01

    To examine associations between corneal mechanical thresholds and metrics of dry eye. This was a cross-sectional study of individuals seen in the Miami Veterans Affairs eye clinic. The evaluation consisted of questionnaires regarding dry eye symptoms and ocular pain, corneal mechanical detection and pain thresholds, and a comprehensive ocular surface examination. The main outcome measures were correlations between corneal thresholds and signs and symptoms of dry eye and ocular pain. A total of 129 subjects participated in the study (mean age 64 ± 10 years). Mechanical detection and pain thresholds on the cornea correlated with age (Spearman's ρ = 0.26, 0.23, respectively; both P Dry eye symptom severity scores and Neuropathic Pain Symptom Inventory (modified for the eye) scores negatively correlated with corneal detection and pain thresholds (range, r = -0.13 to -0.27, P eye pain (pain to wind, light, temperature) and explained approximately 32% of measurement variability (R = 0.57). Mechanical detection and pain thresholds measured on the cornea are correlated with dry eye symptoms and ocular pain. This suggests hypersensitivity within the corneal somatosensory pathways in patients with greater dry eye and ocular pain complaints.

  15. Corneal Mechanical Thresholds Negatively Associate With Dry Eye and Ocular Pain Symptoms

    Science.gov (United States)

    Spierer, Oriel; Felix, Elizabeth R.; McClellan, Allison L.; Parel, Jean Marie; Gonzalez, Alex; Feuer, William J.; Sarantopoulos, Constantine D.; Levitt, Roy C.; Ehrmann, Klaus; Galor, Anat

    2016-01-01

    Purpose To examine associations between corneal mechanical thresholds and metrics of dry eye. Methods This was a cross-sectional study of individuals seen in the Miami Veterans Affairs eye clinic. The evaluation consisted of questionnaires regarding dry eye symptoms and ocular pain, corneal mechanical detection and pain thresholds, and a comprehensive ocular surface examination. The main outcome measures were correlations between corneal thresholds and signs and symptoms of dry eye and ocular pain. Results A total of 129 subjects participated in the study (mean age 64 ± 10 years). Mechanical detection and pain thresholds on the cornea correlated with age (Spearman's ρ = 0.26, 0.23, respectively; both P Dry eye symptom severity scores and Neuropathic Pain Symptom Inventory (modified for the eye) scores negatively correlated with corneal detection and pain thresholds (range, r = −0.13 to −0.27, P eye pain (pain to wind, light, temperature) and explained approximately 32% of measurement variability (R = 0.57). Conclusions Mechanical detection and pain thresholds measured on the cornea are correlated with dry eye symptoms and ocular pain. This suggests hypersensitivity within the corneal somatosensory pathways in patients with greater dry eye and ocular pain complaints. PMID:26886896

  16. The Matrix Metalloproteinase 9 Point-of-Care Test in Dry Eye.

    Science.gov (United States)

    Lanza, Nicole L; Valenzuela, Felipe; Perez, Victor L; Galor, Anat

    2016-04-01

    Dry eye is a common, multifactorial disease currently diagnosed by a combination of symptoms and signs. However, the subjective symptoms of dry eye poorly correlate to the current gold standard for diagnostic tests, reflecting the need to develop better objective tests for the diagnosis of dry eye. This review considers the role of ocular surface matrix metalloproteinase 9 (MMP-9) in dry eye and the implications of a novel point-of-care test that measures MMP-9 levels, InflammaDry (RPS, Sarasota, FL) on choosing appropriate therapeutic treatments. Published by Elsevier Inc.

  17. Dexamethasone nanowafer as an effective therapy for dry eye disease.

    Science.gov (United States)

    Coursey, Terry G; Henriksson, Johanna Tukler; Marcano, Daniela C; Shin, Crystal S; Isenhart, Lucas C; Ahmed, Faheem; De Paiva, Cintia S; Pflugfelder, Stephen C; Acharya, Ghanashyam

    2015-09-10

    Dry eye disease is a major public health problem that affects millions of people worldwide. It is presently treated with artificial tear and anti-inflammatory eye drops that are generally administered several times a day and may have limited therapeutic efficacy. To improve convenience and efficacy, a dexamethasone (Dex) loaded nanowafer (Dex-NW) has been developed that can release the drug on the ocular surface for a longer duration of time than drops, during which it slowly dissolves. The Dex-NW was fabricated using carboxymethyl cellulose polymer and contains arrays of 500 nm square drug reservoirs filled with Dex. The in vivo efficacy of the Dex-NW was evaluated using an experimental mouse dry eye model. These studies demonstrated that once a day Dex-NW treatment on alternate days during a five-day treatment period was able to restore a healthy ocular surface and corneal barrier function with comparable efficacy to twice a day topically applied dexamethasone eye drop treatment. The Dex-NW was also very effective in down regulating expression of inflammatory cytokines (TNF-α, and IFN-γ), chemokines (CXCL-10 and CCL-5), and MMP-3, that are stimulated by dry eye. Despite less frequent dosing, the Dex-NW has comparable therapeutic efficacy to topically applied Dex eye drops in experimental mouse dry eye model, and these results provide a strong rationale for translation to human clinical trials for dry eye. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Oral supplementation with a nutraceutical formulation containing omega-3 fatty acids, vitamins, minerals, and antioxidants in a large series of patients with dry eye symptoms: results of a prospective study.

    Science.gov (United States)

    Gatell-Tortajada, Jordi

    2016-01-01

    To assess the benefits and tolerability of a dietary supplement based on omega-3 fatty acids to relieve dry eye symptoms. A total of 1,419 patients (74.3% women, mean age 58.9 years) with dry eye syndrome using artificial tears participated in a 12-week prospective study. Patients were instructed to take 3 capsules/day of the nutraceutical formulation (Brudysec(®) 1.5 g). Study variables were dry eye symptoms (scratchy and stinging sensation, eye redness, grittiness, painful and tired eyes, grating sensation, and blurry vision), conjunctival hyperemia, tear breakup time (TBUT), Schrimer I test, and Oxford grading scheme. At 12 weeks, each dry eye symptom improved significantly (Pdry eye symptoms were also found in compliant versus noncompliant patients as well as in those with moderate/severe versus none/mild conjunctival hyperemia. Oral ω-3 fatty acids supplementation was an effective treatment for dry eye symptoms.

  19. Study of wavefront aberration in DR patients with different degree of dry eye

    Directory of Open Access Journals (Sweden)

    Jin-Ran Fang

    2018-05-01

    Full Text Available AIM: To compare the changes of wavefront aberrations in patients with diabetic retinopathy(DRand with different degrees of dry eye and to explore the reasons of visual quality decline in them. METHODS: We randomly selected 40 eyes in our hospital for treatment with DR and varying degrees of dry eye, and 40 eyes of normal control group. Topcon KR-1W visual quality analyzer was used to record the mean square the total high order corneal aberration, spherical aberration, comatic aberration and trefoil aberration of cornea with pupil diameters of 4mm and 6mm. Analysis of variance were used to compare the wavefront aberrations and the aberration values in the control group and in patients with diabetic retinopathy and with different degrees of dry eye. RESULTS: For 4mm and 6mm pupil diameters, nondiabetic retinopathy(NDRwith dry eye group, the nonproliferative diabetic retinopathy(NPDRwith dry eye group and proliferative diabetic retinopathy(PDRdry eye group had significantly increased tHOA, coma and trefoil compared with the contrast group(PPCONCLUSION: Dry eye of diabetic retinopathy with different degrees is closely related to the increase of wavefront aberration. Increased wavefront aberration may be one of the reasons to reduced visual quality in patients with diabetic retinopathy and with dry eye, and provide the basis for the decline of visual function of diabetic patients with dry eye.

  20. Dry Eye Post-Laser-Assisted In Situ Keratomileusis: Major Review and Latest Updates

    Science.gov (United States)

    Spierer, Oriel

    2018-01-01

    Dry eye is one of the most common complications occurring after laser-assisted in situ keratomileusis (LASIK), with virtually all patients experiencing some degree of postoperative dry eye symptoms. Enhanced understanding of the pathophysiology and mechanism of dry eye development in addition to preoperative screening of patients who are prone to dry eye is essential for better patient satisfaction and for improving short-term visual outcome postoperatively. This article reviews the latest studies published on LASIK-associated dry eye, including epidemiology, pathophysiology, risk factors, preoperative assessment, and management. PMID:29619255

  1. Corneal permeability changes in dry eye disease: an observational study.

    Science.gov (United States)

    Fujitani, Kenji; Gadaria, Neha; Lee, Kyu-In; Barry, Brendan; Asbell, Penny

    2016-05-13

    Diagnostic tests for dry eye disease (DED), including ocular surface disease index (OSDI), tear breakup time (TBUT), corneal fluorescein staining, and lissamine staining, have great deal of variability. We investigated whether fluorophotometry correlated with previously established DED diagnostic tests and whether it could serve as a novel objective metric to evaluate DED. Dry eye patients who have had established signs or symptoms for at least 6 months were included in this observational study. Normal subjects with no symptoms of dry eyes served as controls. Each eye had a baseline fluorescein scan prior to any fluorescein dye. Fluorescein dye was then placed into both eyes, rinsed with saline solution, and scanned at 5, 10, 15, and 30 min. Patients were administered the following diagnostic tests to correlate with fluorophotometry: OSDI, TBUT, fluorescein, and lissamine. Standard protocols were used. P eyes from 25 patients (DED = 22 eyes, 11 patients; Normal = 28 eyes, 14 patients) were included. Baseline scans of the dry eye and control groups did not show any statistical difference (p = 0.84). Fluorescein concentration of DED and normal patients showed statistical significance at all time intervals (p eyes up to 30 min after fluorescein dye instillation. There may be an aspect of DED that is missed in the current regimen of DED tests and only captured with fluorophotometry. Adding fluorophotometry may be useful in screening, diagnosing, and monitoring patients with DED.

  2. Dry Eye Treatment Based on Contact Lens Drug Delivery: A Review.

    Science.gov (United States)

    Guzman-Aranguez, Ana; Fonseca, Begoña; Carracedo, Gonzalo; Martin-Gil, Alba; Martinez-Aguila, Alejandro; Pintor, Jesús

    2016-09-01

    Dry eye disease affects a substantial segment of the word population with increasing frequency. It is a multifactorial disease of the ocular surface and tear film, which causes ocular discomfort, visual disturbances, and tear instability with potential damage to the cornea and conjunctiva. Because of its multifactorial etiology, the use of different pharmacological treatment for dry eye treatment has been proposed, which include anti-inflammatory molecules, lubricants or comfort agents, and secretagogues. However, in some cases these pharmacological approaches only relieve symptoms temporarily, and consequently, eye care professionals continue to have difficulties managing dry eye. To improve pharmacological therapy that allows a more efficient and long-term action, effective ocular drug delivery of the currently available drugs for dry eye treatment is required. Contact lenses are emerging as alternative ophthalmic drugs delivery systems that provide an increased residence time of the drug at the eye, thus leading to enhanced bioavailability and more convenient and efficacious therapy. In this article, we reviewed the different techniques used to prepare contact lens-based drug delivery systems and focused on articles that describe the delivery of compounds for dry eye treatment through contact lenses.

  3. Topical cyclosporine a treatment in corneal refractive surgery and patients with dry eye.

    Science.gov (United States)

    Torricelli, Andre A M; Santhiago, Marcony R; Wilson, Steven E

    2014-08-01

    To evaluate preoperative and postoperative dry eye and the effect of cyclosporine A treatment in patients screened for corneal refractive surgery and treated with photorefractive keratectomy (PRK) or LASIK. A consecutive case series of 1,056 patients screened for corneal refractive surgery from 2007 to 2012 was retrospectively analyzed. The level of preoperative and postoperative dry eye and the responsiveness to topical cyclosporine A treatment were assessed. One eye of each patient was randomly selected. A total of 642 eyes progressed to surgery: 524 (81.6%) and 118 (18.4%) underwent LASIK and PRK, respectively. Of 81 (7.7%) diagnosed as having dry eye, 55 were deemed potential candidates and optimized for refractive surgery. Thirty-seven patients with moderate dry eye were treated with topical cyclosporine A prior to surgery (mean duration: 3.2 ± 2.1 months; range: 1 to 12 months). After cyclosporine A treatment, 28 (75.7%) eyes underwent LASIK, 4 (10.8%) eyes underwent PRK, and 5 (13.5%) eyes were not operated on due to failed treatment of dry eye. Postoperative refractive surgery-induced neurotrophic epitheliopathy (LINE in LASIK) was noted in 132 (27.3%) and 12 (11.1%) eyes that underwent LASIK and PRK, respectively. Topical cyclosporine A was prescribed in 79 LASIK-induced and 3 PRK-induced dry eyes. After 12 months or more of cyclosporine A treatment, 5 (6.1%) eyes continued to have dry eye symptoms or signs. Topical cyclosporine A treatment is effective therapy for optimizing patients for refractive surgery and treatment of new onset or worsened dry eye after surgery. Copyright 2014, SLACK Incorporated.

  4. Specialist report : Dry eye disease and aging

    NARCIS (Netherlands)

    van Tilborg, M.M.A.; Kort, H.S.M.; Murphy, P.J.

    2017-01-01

    The common ocular pathologies relating to the aging eye, such as cataract, diabetic retinopathy, glaucoma, or macular degeneration, are all known to reduce visual functioning. Less wellknown is the effect of common, age-related dry eye disease (DED). The impact of DED on daily activities can be

  5. Associations between subjective happiness and dry eye disease: a new perspective from the Osaka study.

    Science.gov (United States)

    Kawashima, Motoko; Uchino, Miki; Yokoi, Norihiko; Uchino, Yuichi; Dogru, Murat; Komuro, Aoi; Sonomura, Yukiko; Kato, Hiroaki; Kinoshita, Shigeru; Mimura, Masaru; Tsubota, Kazuo

    2015-01-01

    Dry eye disease has become an important health problem. A lack of concordance between self-reported symptoms and the outcome of dry eye examinations has raised questions about dry eye disease. To explore the association between subjective happiness and objective and subjective symptoms of dry eye disease. The study adopted a cross-sectional design. All the employees of a company in Osaka, Japan. 672 Japanese office workers using Visual Display Terminals (age range: 26-64 years). The dry eye measurement tools included the Schirmer test, conjunctivocorneal staining, the tear film break-up time, as well as the administration of a dry eye symptoms questionnaire. Happiness was measured by the Subjective Happiness Scale. Dry eye examination parameters, dry eye symptoms questionnaires, and the Subjective Happiness Scale score. Of the 672 workers, 561 (83.5%) completed the questionnaires and examinations. The mean Subjective Happiness Scale score was 4.91 (SD = 1.01). This score was inversely correlated with the dry eye symptom score (r = -0.188, p happiness was the lowest in the group without objective results, but reported subjective symptoms of dry eyes (p happiness and self-reported symptoms of dry eyes. Findings of this study revealed a new perspective on dry eye disease, including the potential for innovative treatments of a specific population with dry eye disease.

  6. Knowledge, Attitude, and Practice of Dry Eye Treatment by Institutional Chinese Physicians in Singapore

    Science.gov (United States)

    Lan, Wanwen; Lee, Sze Yee; Lee, Man Xin; Tong, Louis

    2012-01-01

    Dry eye is a common health problem worldwide, causing significant discomfort and inconvenience to sufferers. The conventional treatment of dry eye via topical administration of eye drops is deemed palliative and unsatisfactory to many. Traditional Chinese medicine (TCM) has shown some promise in dry eye treatment; however, the extent of its use and acceptance is uncertain. We evaluated the knowledge, attitude, and practice of institutional TCM practitioners in the treatment of dry eye in Singapore. A questionnaire was generated to address the study aims and sent to TCM practitioners listed in the Singapore TCM practitioners' board database. About three quarters of respondents thought that dry eye was not severe enough to be a public health burden but most thought that TCM was effective in the treatment of dry eye. Acupuncture and herbal medicine were most commonly used TCM modalities in dry eye treatment, and a single TCM treatment session would be charged S$20–50 by the practitioner. The majority of surveyed institutional TCM practitioners in Singapore believe that TCM is relevant in dry eye treatment. Public awareness should be raised regarding the availability of TCM as alternative medicine for dry eye. PMID:23213306

  7. Oral supplementation with a nutraceutical formulation containing omega-3 fatty acids, vitamins, minerals, and antioxidants in a large series of patients with dry eye symptoms: results of a prospective study

    OpenAIRE

    Gatell-Tortajada, Jordi

    2016-01-01

    Jordi Gatell-TortajadaOn behalf of the Large Dry Eye Clinical Study Group (LDECSG)Cornea and Ocular Surface Department, Institut Català de Retina, Barcelona, SpainPurpose: To assess the benefits and tolerability of a dietary supplement based on omega-3 fatty acids to relieve dry eye symptoms.Methods: A total of 1,419 patients (74.3% women, mean age 58.9 years) with dry eye syndrome using artificial tears participated in a 12-week prospective study. Patients were instructed to take ...

  8. Exploring the Predisposition of the Asian Eye to Development of Dry Eye.

    Science.gov (United States)

    Craig, Jennifer P; Wang, Michael T M; Kim, Dabin; Lee, Jung Min

    2016-07-01

    To investigate the influence of eyelid shape on tear film quality, ocular surface characteristics and dry eye symptomatology by comparing Asian and Caucasian populations. Seventy-four age-matched participants were recruited in a cross-sectional study. Participants were classified into Asian single lid (ASL), Asian double lid (ADL), and Caucasian double lid (CDL) groups. Dry eye symptomatology, ocular surface characteristics, and tear film quality were evaluated in a single clinical session. Meibomian gland dropout was significantly greater in both the ASL and ADL groups than in the CDL group (all Pdry eye symptomatology between the three groups (all P>.05). Exposed ocular surface area, lissamine green staining, and lid wiper epitheliopathy were significantly greater in the ADL group compared to the CDL group (all Pdry eye. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Solvent/Detergent Virally Inactivated Serum Eye Drops Restore Healthy Ocular Epithelium in a Rabbit Model of Dry-Eye Syndrome.

    Science.gov (United States)

    Tseng, Ching-Li; Chen, Zhi-Yu; Renn, Ting-Yi; Hsiao, Shun-Hung; Burnouf, Thierry

    2016-01-01

    Application of autologous serum eye drops (SEDs) is a recognized means to treat severe dry-eye syndrome (DES). Due to the inconvenience and difficulty of preparing SEDs from some patients, producing SEDs from allogeneic blood donations is gaining popularity. A major safety concern associated with allogeneic blood is virus transmission. We therefore herein evaluated the possibility of applying a solvent/detergent (S/D) treatment to inactivate viruses and studied the impacts of such treatment of SEDs to resolve DES in a rabbit model. Sera prepared from the blood of five rabbits were pooled and divided into two sub-pools. One was untreated (SEDs), while the other was virally-inactivated with 1% Tri-n-butyl phosphate/1% Triton X-45 at 31°C for 1 h (S/D-SEDs). DES was induced in rabbits using 0.1% benzalkonium chloride (BAC). Rabbits were divided into five groups of two rabbits each. One group was untreated (control), three were treated twice daily for 3 weeks using PBS, SEDs, or S/D-SEDs, and the last received an additional 0.1% BAC (as the negative control). The DES condition was determined by measuring aqueous tear secretion (Schirmer's test), corneal fluorescein staining, a corneal histologic examination, TUNEL stain apoptosis, and corneal inflammatory marker (tumor necrosis factor-α, interleukin (IL)-1β, IL-8, and IL-6) expressions. We first confirmed that SEDs and S/D-SEDs had similar protein profiles and transforming growth factor (TGF)-β contents. Animal experiments showed that tear secretion did not significantly differ between the SED and S/D-SED groups but was significantly higher than in the PBS group. Eye fluorescein staining revealed dramatic improvements in epithelial defects in groups treated with SEDs or S/D-SEDs, and hematoxylin/eosin staining revealed microscopic epithelial layers similar to those of the untreated controls. Inflammatory markers and TUNEL studies showed that healthy epithelium had been restored in groups treated with SEDs or S

  10. Efficacy of osmoprotectants on prevention and treatment of murine dry eye.

    Science.gov (United States)

    Chen, Wei; Zhang, Xin; Li, Jinyang; Wang, Yu; Chen, Qi; Hou, Chao; Garrett, Qian

    2013-09-19

    To evaluate the efficacy of osmoprotectants on prevention and treatment of dry eye in a murine model. Dry eye was induced in mice by using an intelligently controlled environmental system (ICES). Osmoprotectants betaine, L-carnitine, erythritol, or vehicle (PBS) were topically administered to eyes four times daily following two schedules: schedule 1 (modeling prevention): dosing started at the beginning of housing in ICES and lasted for 21 or 35 days; schedule 2 (modeling treatment): dosing started after ICES-housed mice developed dry eye (day 21), continuing until day 35. Treatment efficacy was evaluated for corneal fluorescein staining; corneal epithelial apoptosis by TUNEL and caspase-3 assays; goblet cell numbers by PAS staining; and expression of inflammatory mediators, TNF-α, IL-17, IL-6, or IL-1β by using RT-PCR on days 0, 14, 21, and/or 35. Compared with vehicle, prophylactic administration of betaine, L-carnitine, or erythritol significantly decreased corneal staining and expression of TNF-α and IL-17 on day 21 (schedule 1). Treatment of mouse dry eye with osmoprotectants significantly reduced corneal staining on day 35 compared with day 21 (schedule 2). Relative to vehicle, L-carnitine treatment of mouse dry eye for 14 days (days 21 to 35) resulted in a significant reduction in corneal staining, number of TUNEL-positive cells, and expression of TNF-α, IL-17, IL-6, or IL-1β, as well as significantly increased the number of goblet cells. Topical application of betaine, L-carnitine, or erythritol systematically limited progression of environmentally induced dry eye. L-carnitine can also reduce the severity of such dry-eye conditions.

  11. The Effect of Ocular Surface Regularity on Contrast Sensitivity and Straylight in Dry Eye

    OpenAIRE

    Koh, Shizuka; Maeda, Naoyuki; Ikeda, Chikako; Asonuma, Sanae; Ogawa, Mai; Hiraoka, Takahiro; Oshika, Tetsuro; Nishida, Kohji

    2017-01-01

    Purpose: To investigate the association between visual function and ocular surface regularity in dry eye.Methods: We enrolled 52 eyes of 52 dry eye patients (34 dry eyes with superficial punctate keratopathy [SPK] in the central corneal region [central SPK] and 18 dry eyes without central SPK) and 20 eyes of 20 normal control subjects. All eyes had a best-corrected distance visual acuity better than 20/20. We measured two indices of contrast sensitivity function under photopic conditions: con...

  12. Health claims database study of cyclosporine ophthalmic emulsion treatment patterns in dry eye patients.

    Science.gov (United States)

    Stonecipher, Karl G; Chia, Jenny; Onyenwenyi, Ahunna; Villanueva, Linda; Hollander, David A

    2013-01-01

    Dry eye is a multifactorial, symptomatic disease associated with ocular surface inflammation and tear film hyperosmolarity. This study was designed to assess patterns of topical cyclosporine ophthalmic emulsion 0.05% (Restasis®) use in dry eye patients and determine if there were any differences in use based on whether dry eye is physician-coded as a primary or nonprimary diagnosis. Records for adult patients with a diagnosis of dry eye at an outpatient visit from January 1, 2008 to December 31, 2009 were selected from Truven Health MarketScan® Research Databases. The primary endpoint was percentage of patients with at least one primary versus no primary dry eye diagnosis who filled a topical cyclosporine prescription. Data analyzed included utilization of topical corticosteroids, oral tetracyclines, and punctal plugs. The analysis included 576,416 patients, accounting for 875,692 dry eye outpatient visits: 74.7% were female, 64.2% were ages 40-69 years, and 84.4% had at least one primary dry eye diagnosis. During 2008-2009, 15.9% of dry eye patients with a primary diagnosis versus 6.5% with no primary diagnosis filled at least one cyclosporine prescription. For patients who filled at least one prescription, the mean months' supply of cyclosporine filled over 12 months was 4.44. Overall, 33.9% of dry eye patients filled a prescription for topical cyclosporine, topical corticosteroid, or oral tetracycline over 2 years. Patients with a primary dry eye diagnosis were more likely to fill a topical cyclosporine prescription. Although inflammation is key to the pathophysiology of dry eye, most patients seeing a physician for dry eye may not receive anti-inflammatory therapies.

  13. Comparison of novel lipid-based eye drops with aqueous eye drops for dry eye: a multicenter, randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Simmons PA

    2015-04-01

    Full Text Available Peter A Simmons, Cindy Carlisle-Wilcox, Joseph G Vehige Ophthalmology Research and Development, Allergan, Inc., Irvine, CA, USA Background: Dry eye may be caused or exacerbated by deficient lipid secretion. Recently, lipid-containing artificial tears have been developed to alleviate this deficiency. Our study compared the efficacy, safety, and acceptability of lipid-containing eye drops with that of aqueous eye drops.Methods: A non-inferiority, randomized, parallel-group, investigator-masked multicenter trial was conducted. Subjects with signs and symptoms of dry eye were randomized to use one of two lipid-containing artificial tears, or one of two aqueous artificial tears. Subjects instilled assigned drops in each eye at least twice daily for 30 days. The primary efficacy analysis tested non-inferiority of a preservative-free lipid tear formulation (LT UD to a preservative-free aqueous tear formulation (AqT UD for change in Ocular Surface Disease Index (OSDI score from baseline at day 30. Secondary measures included OSDI at day 7, tear break-up time (TBUT, corneal and conjunctival staining, Schirmer’s test, acceptability and usage questionnaires, and safety assessments.Results: A total of 315 subjects were randomized and included in the analyses. Subjects reported instilling a median of three doses of study eye drops per day in all groups. At days 7 and 30, all groups showed statistically significant improvements from baseline in OSDI (P<0.001 and TBUT (P≤0.005. LT UD was non-inferior to AqT UD for mean change from baseline in OSDI score at day 30. No consistent or clinically relevant differences for the other efficacy variables were observed. Acceptability was generally similar across the groups and there was a low incidence of adverse events.Conclusion: In this heterogeneous population of dry eye subjects, there were no clinically significant differences in safety, effectiveness, and acceptability between lipid-containing artificial tears

  14. Effect of Viscous Agents on Corneal Density in Dry Eye Disease.

    Science.gov (United States)

    Wegener, Alfred R; Meyer, Linda M; Schönfeld, Carl-Ludwig

    2015-10-01

    To investigate the effect of the viscous agents, hydroxypropyl methylcellulose (HPMC), carbomer, povidone, and a combination of HPMC and povidone on corneal density in patients with dry eye disease. In total, 98 eyes of 49 patients suffering from dry eye and 65 eyes of 33 healthy age-matched individuals were included in this prospective, randomized study. Corneal morphology was documented with Scheimpflug photography and corneal density was analyzed in 5 anatomical layers (epithelium, bowman membrane, stroma, descemet's membrane, and endothelium). Corneal density was evaluated for the active ingredients HPMC, carbomer, povidone, and a combination of HPMC and povidone as the viscous agents contained in the artificial tear formulations used by the dry eye patients. Data were compared to the age-matched healthy control group without medication. Corneal density in dry eye patients was reduced in all 5 anatomical layers compared to controls. Corneal density was highest and very close to control in patients treated with HPMC containing ocular lubricants. Patients treated with lubricants, including carbomer as the viscous agent displayed a significant reduction of corneal density in layers 1 and 2 compared to control. HPMC containing ocular lubricants can help to maintain physiological corneal density and may be beneficial in the treatment of dry eye disease.

  15. Effectiveness and relevant factors of 2% rebamipide ophthalmic suspension treatment in dry eye.

    Science.gov (United States)

    Ueda, Kaori; Matsumiya, Wataru; Otsuka, Keiko; Maeda, Yoshifumi; Nagai, Takayuki; Nakamura, Makoto

    2015-06-06

    Rebamipide with mucin secretagogue activity was recently approved for the treatment of dry eye. The efficacy and safety in the treatment of rebamipide were shown in two pivotal clinical trials. It was the aim of this study to evaluate the effect of 2% rebamipide ophthalmic suspension in patients with dry eye and analyze relevant factors for favorable effects of rebamipide in clinical practice. This was a retrospective cohort study of 48 eyes from 24 patients with dry eye treated with 2% rebamipide ophthalmic suspension. Dry eye-related symptom score, tear film break-up time (TBUT), fluorescein ocular surface staining score (FOS) and the Schirmer test were used to collect the data from patients at baseline, and at 2, 4, 8, and 12 week visits. To determine the relevant factors, multiple regression analyses were then performed. Mean dry eye-related symptom score showed a significant improvement from the baseline (14.5 points) at 2, 4, 8 and 12 weeks (9.80, 7.04, 7.04 and 7.83 points, corrected P value treatment. For ocular symptoms, three parameters (foreign body sensation, dry eye sensation and ocular discomfort) showed significant improvements at all visits. The multiple regression analyses showed that the fluorescein conjunctiva staining score was significantly correlated with the changes of dry eye-related symptom score at 12 weeks (P value = 0.017) and dry eye-related symptom score was significantly correlated with independent variables for the changes of FOS at 12 weeks (P value = 0.0097). Two percent rebamipide ophthalmic suspension was an effective therapy for dry eye patients. Moreover the fluorescein conjunctiva staining score and dry eye-related symptom score might be good relevant factors for favorable effects of rebamipide.

  16. Tear Osmolarity and Correlation With Ocular Surface Parameters in Patients With Dry Eye.

    Science.gov (United States)

    Mathews, Priya M; Karakus, Sezen; Agrawal, Devika; Hindman, Holly B; Ramulu, Pradeep Y; Akpek, Esen K

    2017-11-01

    To analyze the distribution of tear film osmolarity in patients with dry eye and its association with other ocular surface parameters. Tear osmolarity and other quantitative dry eye parameters were obtained from patients with 1) clinically significant dry eye (significant symptoms and ocular surface staining, n = 131), 2) symptoms-only dry eye (significant symptoms but no significant ocular surface staining, n = 52), and 3) controls (no significant symptoms or staining, n = 42). Tear osmolarity varied significantly across groups (P = 0.01), with patients with clinically significant dry eye having the highest tear osmolarity (312.0 ± 16.9 mOsm/L), control patients having the lowest tear osmolarity (305.6 ± 9.7 mOsm/L), and patients with symptoms-only dry eye falling in between (307.4 ± 5.6 mOsm/L). Patients with clinically significant dry eye also tended to have a greater intereye difference in osmolarity (12.0 ± 13.4) than did the individuals with symptoms-only dry eye (9.1 ± 12.4) and controls (9.0 ± 7.4) (P = 0.06). In multivariable regression models, higher tear osmolarity was associated with higher Ocular Surface Disease Index, discomfort subscore (P = 0.02), and higher corneal and conjunctival staining scores (P eye tear osmolarity was not correlated with the corresponding tear film breakup time or Schirmer test (P > 0.05 for both). Individuals with symptomatic dry eye that is not yet clinically significant seem to have higher and more variable osmolarity measurements than controls, potentially indicating that changes in osmolarity precede clinical findings.

  17. Dry Eye Following Phacoemulsification Surgery and its Relation to Associated Intraoperative Risk Factors.

    Science.gov (United States)

    Sahu, P K; Das, G K; Malik, Aman; Biakthangi, Laura

    2015-01-01

    The purpose was to study dry eye following phacoemulsification surgery and analyze its relation to associated intra-operative risk factors. A prospective observational study was carried out on 100 eyes of 100 patients without preoperative dry eye. Schirmer's Test I, tear meniscus height, tear break-up time, and lissamine green staining of cornea and conjunctiva were performed preoperatively and at 5 days, 10 days, 1-month, and 2 months after phacoemulsification surgery, along with the assessment of subjective symptoms, using the dry eye questionnaire. The correlations between these values and the operating microscope light exposure time along with the cumulative dissipated energy (CDE) were investigated. There was a significant deterioration of all dry eye test values following phacoemulsification surgery along with an increase in subjective symptoms. These values started improving after 1-month postoperatively, but preoperative levels were not achieved till 2 months after surgery. Correlations of dry eye test values were noted with the operating microscope light exposure time and CDE, but they were not significant. Phacoemulsification surgery is capable of inducing dry eye, and patients should be informed accordingly prior to surgery. The clinician should also be cognizant that increased CDE can induce dry eyes even in eyes that were healthy preoperatively. In addition, intraoperative exposure to the microscopic light should be minimized.

  18. Post-blink tear film dynamics in healthy and dry eyes during spontaneous blinking.

    Science.gov (United States)

    Szczesna-Iskander, Dorota H

    2018-01-01

    The aim was to investigate the dynamics of post-blink tear film leveling in natural blinking conditions (NBC) for healthy subjects and those diagnosed with dry eye syndrome (DES) and to relate this phase to the tear film surface quality (TFSQ) before the following blink. The study included 19 healthy persons and 10 with dry eye, grouped according to symptoms and signs observed during examination. Lateral shearing interferometry was used to examine TFSQ. Post-blink tear film dynamics was modeled by an exponential function, characterized by the decay parameter b, and a constant, describing the level of the stabilized TFSQ. Pre-next-natural-blink TFSQ dynamics was modeled with a linear trend, described by a parameter A. The post-blink tear film dynamics reached its plateau at a significantly (P = 0.006) lower level in the normal tear film group than in the dry eye group. The median exponential decay parameter b was statistically significantly higher for the control group than for the DES group, P = 0.026. The parameter b calculated for each interblink interval was significantly correlated with the corresponding parameter A (Spearman's R = 0.35; P film fluorescein break-up time for each subject was also found (R = 0.41, P = 0.029). Significantly faster leveling of post-natural-blink tear film was observed in the group with DES than in healthy eyes. This dynamic was correlated with the pre-next-natural-blink TFSQ and tear film stability. The results of this pilot study support previous works that advocate the importance of polar lipids in the mechanism of tear film lipid spreading. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Animal models to assess the therapeutic efficacy of human serum and serum-converted platelet lysates for dry eye syndrome: Seeing is believing.

    Science.gov (United States)

    Tseng, Ching-Li; Seghatchian, Jerard; Burnouf, Thierry

    2015-08-01

    There is much interest in the clinical use of serum-converted human blood or platelet concentrates in regenerative medicine, most specifically for wound healing and tissue repair of soft and hard tissues. The scientific rationale supporting the clinical efficacy of these preparations is based on the expectation that their physiological mixture of natural growth factors can orchestrate cell expansion and differentiation in vivo. However, a lack of standardization and regulatory oversight of these blood materials maintain a perception of uncertainty in the scientific and medical community on the value of these preparations for some clinical indications. More studies are needed to understand the mechanism of action underlying their expected efficacy and standardize their use, and benefit from their biological versatility. One application of serum is as eye drop for treating dry eye syndrome (DES), a multifactorial disease of the ocular surface, which has a prevalence of 15% of more in the population. DES can lead to chronic inflammation of the ocular surface, surface impairment in the cornea and conjunctiva, and, in patients with Sjogren syndrome, result in a disruption of the ocular surface epithelium. Objective experimental assessment of safety and efficacy of serum eye drops can help establish scientific rationale in optimal product composition and use. This can be achieved, first, through cell cultures with relevant cell models, before considering, then, animal studies using DES animal models. Several models have been evaluated and are reported in this concise review. The model we have developed encompasses the use of rabbits, where their eyes are treated with 0.1% benzalkonium chloride (BAC), a common preservative in ophthalmic agents, 3 times daily for 4 weeks. This relatively mild treatment results in moderate DES pathology, with a stable shortage of tear secretion throughout a 7-week study period, which we found suitable for assessing efficacy of serum eye

  20. Health claims database study of cyclosporine ophthalmic emulsion treatment patterns in dry eye patients

    Science.gov (United States)

    Stonecipher, Karl G; Chia, Jenny; Onyenwenyi, Ahunna; Villanueva, Linda; Hollander, David A

    2013-01-01

    Background Dry eye is a multifactorial, symptomatic disease associated with ocular surface inflammation and tear film hyperosmolarity. This study was designed to assess patterns of topical cyclosporine ophthalmic emulsion 0.05% (Restasis®) use in dry eye patients and determine if there were any differences in use based on whether dry eye is physician-coded as a primary or nonprimary diagnosis. Methods Records for adult patients with a diagnosis of dry eye at an outpatient visit from January 1, 2008 to December 31, 2009 were selected from Truven Health MarketScan® Research Databases. The primary endpoint was percentage of patients with at least one primary versus no primary dry eye diagnosis who filled a topical cyclosporine prescription. Data analyzed included utilization of topical corticosteroids, oral tetracyclines, and punctal plugs. Results The analysis included 576,416 patients, accounting for 875,692 dry eye outpatient visits: 74.7% were female, 64.2% were ages 40–69 years, and 84.4% had at least one primary dry eye diagnosis. During 2008–2009, 15.9% of dry eye patients with a primary diagnosis versus 6.5% with no primary diagnosis filled at least one cyclosporine prescription. For patients who filled at least one prescription, the mean months’ supply of cyclosporine filled over 12 months was 4.44. Overall, 33.9% of dry eye patients filled a prescription for topical cyclosporine, topical corticosteroid, or oral tetracycline over 2 years. Conclusion Patients with a primary dry eye diagnosis were more likely to fill a topical cyclosporine prescription. Although inflammation is key to the pathophysiology of dry eye, most patients seeing a physician for dry eye may not receive anti-inflammatory therapies. PMID:24179335

  1. Comparison of Dry Eye Parameters between Diabetics and Non-Diabetics in District of Kuantan, Pahang.

    Science.gov (United States)

    Aljarousha, Mohammed; Badarudin, Noor Ezailina; Che Azemin, Mohd Zulfaezal

    2016-05-01

    Diabetes may affect the human body's systems and organs, including the eye. Diabetic retinopathy is the 5th leading cause of blindness globally. Diabetic subjects demonstrated dry eye symptoms that were also supported by the low values of the clinical tests. This study aimed to compare the dry eye symptoms and signs between diabetics and non-diabetics and tear functions between diabetic subjects with and without dry eye. This retrospective study was based on the observation of 643 medical files. Using a convenience sampling method, 88 subjects were found to report diabetes mellitus. The information extracted from the files included: date of first examination, age at first visit, gender, past ocular history, systemic disease, symptoms of dry eye disease and details of clinical diagnostic signs. Non-contact lens wearers were excluded. A group of 88, age and gender matched, control subjects were included for this comparison study. The percentage of dry eye symptoms was higher in diabetic subjects (15.9%) compared with non-diabetic subjects (13.6%; p<0.001). The percentage of dry eye symptoms was also higher in diabetics with dry eye (63%) than in diabetics without dry eye (36.9%; p<0.001). Tear break up time was significantly different between diabetics and non-diabetics (p<0.001) and between diabetics with and without dry eye (p=0.046). The corneal staining was significantly different between diabetic subjects with and without dry eye (p=0.028). Dry eye symptoms were significantly associated with diabetics. Tear break up time was significantly shorter in diabetics with dry eye compared to diabetics without dry eye.

  2. Cytologic status changes of the conjunctiva and tears qualitative composition in patients with «dry eye» syndrome after instillation of modern topical fluoroquinolones

    Directory of Open Access Journals (Sweden)

    N. G. Zavgorodnyaya

    2014-06-01

    Full Text Available Aim. Use of the antibiotics for eye was approved as a rational method for reducing the risk of postoperative endophthalmitis. The aim of our investigation was to study the influence of the modern topical fluoroquinolones on the qualitative composition of tears and cytological status of the conjunctiva in patients with cataract and «dry eye» syndrome. Methods and results. 102 patients (109 eyes aged 36–87 years was examined. Qualitative composition of tear fluid was studied with method of native tears crystallography and conjunctiva cytological study using impression cytoscopy method. In 72.3% of cases the tears crystallography showed signs of pathology. Cytological examination of conjunctiva showed dystrophy in 86,8% of cases. In 11% of the patients typical cross-shaped crystals were detected. Conclusion. Correlation dependence analysis showed statistically significant positive relationship (Spearman’s correlation r=0.53 between the presence of cross-shaped crystals in crystallography and severe dystrophy of conjunctiva epithelium. Instillation of modern topical fluoroquinolones worsen the cytological status of conjunctiva epithelium.

  3. Knowledge, Attitude, and Practice of Dry Eye Treatment by Institutional Chinese Physicians in Singapore

    OpenAIRE

    Lan, Wanwen; Lee, Sze Yee; Lee, Man Xin; Tong, Louis

    2012-01-01

    Dry eye is a common health problem worldwide, causing significant discomfort and inconvenience to sufferers. The conventional treatment of dry eye via topical administration of eye drops is deemed palliative and unsatisfactory to many. Traditional Chinese medicine (TCM) has shown some promise in dry eye treatment; however, the extent of its use and acceptance is uncertain. We evaluated the knowledge, attitude, and practice of institutional TCM practitioners in the treatment of dry eye in Sing...

  4. Assessment of tear osmolarity and other dry eye parameters in post-LASIK eyes.

    Science.gov (United States)

    Hassan, Ziad; Szalai, Eszter; Berta, Andras; Modis, Laszlo; Nemeth, Gabor

    2013-07-01

    To assess the tear osmolarity using the TearLab device after laser in situ keratomileusis (LASIK) and to compare the values with those obtained by traditional tear film tests before and after the procedure. Thirty eyes of 15 refractive surgery candidates (5 men and 10 women of mean age: 30.55 ± 11.79 years) were examined. Using a special questionnaire (Ocular Surface Disease Index), subjective dry eye complaints were evaluated, and then, the tear osmolarity was measured with the TearLab system (TearLab Corporation) and conventional dry eye tests were carried out. Examinations were performed preoperatively and at 1, 30, and 60 days after the surgery. The mean value of tear osmolarity was 303.62 ± 12.29 mOsm/L before the surgery and 303.58 ± 20.14 mOsm/L at 60 days after the treatment (P = 0.69). Mean lid parallel conjunctival folds value was 0.68 ± 0.68 before the procedure and 0.58 ± 0.65 subsequent to surgery (P = 0.25). Meibomian gland dysfunction was not detected. No significant deviation was observed in the values of Schirmer test, corneal staining, tear break-up time, and lid parallel conjunctival folds when compared with postoperatively obtained values during the follow-up period (P > 0.05). During LASIK flap creation, intact corneal innervation is damaged, and the ocular surface lacrimal functional unit can be impaired. In our study, no abnormal dry eye test results were observed before or after the procedure. Based on our results, LASIK treatment is safe for dry eye involving the administration of adequate artificial tears for a minimum of 3 months.

  5. Neuropathic ocular pain: an important yet underevaluated feature of dry eye

    Science.gov (United States)

    Galor, A; Levitt, R C; Felix, E R; Martin, E R; Sarantopoulos, C D

    2015-01-01

    Dry eye has gained recognition as a public health problem given its prevalence, morbidity, and cost implications. Dry eye can have a variety of symptoms including blurred vision, irritation, and ocular pain. Within dry eye-associated ocular pain, some patients report transient pain whereas others complain of chronic pain. In this review, we will summarize the evidence that chronicity is more likely to occur in patients with dysfunction in their ocular sensory apparatus (ie, neuropathic ocular pain). Clinical evidence of dysfunction includes the presence of spontaneous dysesthesias, allodynia, hyperalgesia, and corneal nerve morphologic and functional abnormalities. Both peripheral and central sensitizations likely play a role in generating the noted clinical characteristics. We will further discuss how evaluating for neuropathic ocular pain may affect the treatment of dry eye-associated chronic pain. PMID:25376119

  6. Efficacy of plasma rich in growth factors for the treatment of dry eye.

    Science.gov (United States)

    López-Plandolit, Silvia; Morales, María-Celia; Freire, Vanesa; Grau, Arturo E; Durán, Juan A

    2011-12-01

    To evaluate the efficacy of plasma rich in growth factors (PRGF) for the treatment of moderate/severe dry eye. PRGF treatment was administered to 16 patients who had moderate/severe dry eye diagnosed and who had not responded previously to other standard treatments. We quantified several growth factors present in the PRGF of each patient and obtained quantitative registers of the symptoms (modified score dry eye questionnaire), both before and after PRGF treatment. We also performed impression cytology to determine the degree of squamous metaplasia before and after PRGF treatment. PRGF treatment was associated with a statistically significant improvement in score dry eye questionnaire values (P PRGF, no further treatments were required, whereas in the remaining 25% other ocular treatments could be reduced. PRGF led to symptom improvement in patients with moderate/severe dry eye. Surprisingly, the symptoms recorded in the dry eye questionnaire do not always agree with the degree of squamous metaplasia measured by impression cytology.

  7. The Effect of Immunologically Safe Plasma Rich in Growth Factor Eye Drops in Patients with Sjögren Syndrome.

    Science.gov (United States)

    Sanchez-Avila, Ronald Mauricio; Merayo-Lloves, Jesus; Riestra, Ana Cristina; Anitua, Eduardo; Muruzabal, Francisco; Orive, Gorka; Fernández-Vega, Luis

    2017-06-01

    The objective was to provide preliminary information about the efficacy and safety of immunologically safe plasma rich in growth factor (immunosafe PRGF) eye drops in the treatment of moderate to severe dry eye in patients with primary and secondary Sjögren's syndrome (SS) and to analyze the influence of several variables on treatment outcomes. This retrospective study included patients with SS. All patients were treated with previously immunosafe PRGF eye drops to reduce the immunologic component contents. Ocular Surface Disease Index (OSDI) scale, best-corrected visual acuity (BCVA), visual analog scale (VAS) frequency, and VAS severity outcome measures were evaluated before and after treatment with immunosafe PRGF. The potential influence of some patient clinical variables on results was also assessed. Safety assessment was also performed reporting all adverse events. Twenty-six patients (12 patients with primary SS, and 14 patients suffering secondary SS) with a total of 52 affected eyes were included and evaluated. Immunosafe PRGF treatment showed a significant reduction (P PRGF with corticosteroids. Only 2 adverse events were reported in 2 patients (7.7% of patients). Signs and symptoms of dry eye syndrome in patients with SS were reduced after treatment with PRGF-Endoret eye drops. Immunosafe PRGF-Endoret is safe and effective for treating patients with primary and secondary SS.

  8. Clinical characterisation and cytological study of dry eye in patients with autoimmune disease.

    Science.gov (United States)

    Guannan, Huang; Long, Su; Xia, Hua; Dong, Wang; Shaozhen, Zhao

    2018-03-01

    To assess the clinical characteristics and changes in ocular surface cytology of dry eye in patients with systemic autoimmune disease. The case-control study was conducted in the Second Hospital of Tianjin Medical University, Tianjin, China, from February 2016 to January 2017, and comprised systemic autoimmune disease patients and healthy controls. Schirmer's I test, tear breakup time test, and fluorescein staining were performed on all subjects. Both groups were evaluated for dry eye with the current diagnostic criteria. Conjunctival impression cytology and the morphology of epithelial cells were observed in both groups of subjects. Flow cytometry was used to identify the amount of apoptosis. SPSS 15 was used to analyse the data. Each of the two groups had 60(50%) subjects each. The morbidity of dry eye in the control group was 17(28.3%), while it was 31(51.7%) in the patients (pdry eye, the severity level of cells obtained by conjunctival impression sampling was significantly higher in patients than in controls (pdry eye than in patients without dry eye in each group, and among patients with dry eye, the percentage of conjunctival epithelial cells undergoing apoptosis was higher in the patients than in controls (pdry eye in systemic autoimmune disease than in subjects with dry eye in healthy controls.

  9. Prevalence of dry eye in diabetics

    Directory of Open Access Journals (Sweden)

    Silviana S Kamel

    2017-01-01

    Diabetic patients are more prone to suffering from dry eye than normal subjects. These abnormalities can result in severe complications. Early examination of the diabetic patients for the detection of the ocular surface disorders is indicated.

  10. New testing options for diagnosing and grading dry eye disease.

    Science.gov (United States)

    Foulks, Gary N; Pflugfelder, Stephen C

    2014-06-01

    To describe new options for diagnosis and severity grading of dry eye disease. Perspective on technological advancements to identify tear dysfunction and their value in diagnosing and grading dry eye disease. Evidence is presented on new and evolving technologies to measure tear stability, composition, and meniscus height and their role in dry eye diagnosis and therapeutic efficacy grading is assessed. Evolving concepts regarding pathogenesis and new technologies to evaluate the tears and ocular surface have improved the ability to diagnose, classify, and grade the severity of dry eye disease. New technologies include noninvasive imaging of tear stability and tear meniscus height as a measure of tear volume and tear composition (osmolarity, lacrimal factors, inflammatory mediators, growth and differentiation factors). Approved tests, such as tear osmolarity and tear imaging, are being integrated into clinical practice and may eventually supplant certain traditional tests that have greater variability and less sensitivity. Other tests, such as molecular assays of tears and conjunctival cells, are currently being used in studies investigating pathogenesis and therapeutic mechanism of action. They may eventually translate to routine clinical practice. New technologies have emerged that can noninvasively evaluate the tears and measure disease-associated compositional changes. These tests are being integrated into clinical practice and therapeutic trials for diagnosis, classification, and severity grading of dry eye disease. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Lost to follow-up for appointments in a dedicated dry eye clinic

    Science.gov (United States)

    Poon, Kip Hoe; Yeo, Sharon; Tong, Louis

    2014-01-01

    Objective Dry eye is a prevalent condition with significant socioeconomic burden. This study evaluates the extent and reasons for loss to follow-up (LTF) in a dedicated dry eye clinic. LTF refers to patient who discontinued visits for >2 years. Method The proportion of patients LTF and the demographics in a cohort of dry eye patients (2006 to 2010) were determined. A telephone survey was prospectively conducted for patients who were LTF. Results Of 505 patients, 240 (47.5%) were LTF. Associated demographic factors for LTF were male sex, non-Chinese ethnicity, and age group dry eye condition (47%), personal/social factors (25%) and perceived insufficiency of healthcare delivery (28%). Only two (1.1%) were considered as management failures. The younger patients (age dry eye disease, compared to older patients who were more likely to be LTF due to personal/social reasons (P=0.02). Poor communication and service factors under healthcare delivery were found to be higher (P=0.002) in those who visited once before they were LTF (8.5%) compared to those who visited multiple times before they were LTF (0.1%). Conclusion LTF was relatively common in hospital-based dry eye management. Female and older patients were less likely to stop consultation. Stabilized dry eye condition, common in younger patients, was the most common reason for LTF. Elderly patients have difficulty attending clinics due to nonmedical problems, which may require a more holistic approach. PMID:25336929

  12. Effect of rb-bFGF eye drops and hydroxyl indican eye drops on tear film stability and dry eye symptoms after age-related cataract surgery

    Directory of Open Access Journals (Sweden)

    Jing Chen

    2017-10-01

    Full Text Available AIM: To compare and analyze the effect of recombinant bovine basic fibroblast growth factor(bFGFeye drops and hydroxyl indican eye drops on the tear film stability and dry eye symptoms after age-related cataract surgery. METHODS: A total of 115 patients(115 affected eyeswith dry eyes after age-related cataract surgery were divided into the bFGF group, the hydroxyl indican group and the blank control group by the random number table method. The blank control group was only given routine anti-inflammatory treatment, and on the basis, the bFGF group and the hydroxyl indican group were treated with bFGF eye drops and hydroxyl indican eye drops respectively. The clinical efficacy, adverse reactions, changes in scores of dry eye symptoms, Schirmer test(SⅠt, tear film break-up time(BUTand corneal fluorescein staining(CFSscores at different time points were compared among the three groups. RESULTS: The total markedly effective rates in the bFGF group(89.5%was higher than that in the hydroxyl indican group(70.3%or the blank control group(47.5%(PPPCONCLUSION: The tear film is unstable in early stage after age-related cataract surgery, and there are dry eye symptoms. The intervention with bFGF eye drops and hydroxyl indican eye drops can effectively restore the tear film stability and significantly relieve dry eye symptoms, and the effect of bFGF eye drops is more significant.

  13. Iris coloboma in one eye and pigment dispersion syndrome in the fellow eye.

    Science.gov (United States)

    Galvis, Virgilio; Tello, Alejandro; Valarezo, Paul; Prada, Angélica M

    2013-05-22

    We report a case of a 43-year-old patient with coloboma of the iris, zonule, ciliary body, choroid and retina in the right eye and pigment dispersion syndrome in the left eye. Considering the hypothesis of the pigment dispersion syndrome pathogenesis in which a difference of pressures in the anterior and posterior chambers creates a posterior convexity of the iris leading to reverse pupillary block, iris touch and consequently causing pigment dispersion, we suggest that the presence of an iris coloboma, by equalising the pressures in the two chambers, prevented the onset of syndrome in that eye.

  14. Association between dry eye symptoms and suicidal ideation in a Korean adult population.

    Science.gov (United States)

    Um, Sun-Bi; Yeom, Hyungseon; Kim, Na Hyun; Kim, Hyeon Chang; Lee, Hyung Keun; Suh, Il

    2018-01-01

    This study assessed the association of dry eyes with depression and suicidal ideation in a Korean adult population. Data from 16408 participants (6972 men and 9436 women) aged ≥ 19 years included in the fifth Korea National Health and Nutrition Examination Survey, conducted from 2010-2012, were analyzed. For dry eyes, surveys of previous diagnosis of dry eye disease (DED) by an ophthalmologist and experience of subjective dry eye symptoms were separately used. Diagnosis of depression and suicidal ideation were obtained via responses to an interviewer-assisted questionnaire, and questions were asked in a closed-ended response format. Logistic regression was used to examine the associations between dry eyes, depression, and suicidal ideation. DED diagnosis exhibited an odds ratio (OR) of 1.32 (95% confidence interval [CI] 1.11-1.57) for depression and 1.24 (95% CI 1.05-1.48) for suicidal ideation compared to those without DED, after adjusting for sex, age, education, occupation, household income, body mass index, smoking behavior, alcohol consumption, physical activity, hypertension, diabetes, dyslipidemia, thyroid diseases, major cardiovascular disease, and cancer. Similarly, the adjusted OR (95% CI) of dry eye symptoms was 1.50 (95% CI 1.30-1.73) for depression and 1.47 (95% CI 1.27-1.70) for suicidal ideation. Our findings suggest that dry eyes (either DED diagnosis or dry eye symptoms) may be associated with the prevalence of depression and suicidal ideation in the Korean adult population.

  15. Efficiency and safety of subconjunctival injection of anti-VEGF agent - bevacizumab - in treating dry eye.

    Science.gov (United States)

    Jiang, Xiaodan; Lv, Huibin; Qiu, Weiqiang; Liu, Ziyuan; Li, Xuemin; Wang, Wei

    2015-01-01

    Dry eye is a chronic inflammatory ocular surface disease with high prevalence. The current therapies for dry eye remain to be unspecific and notcomprehensive. This study aims to explore safety and efficacy of a novel treatment - subconjunctival injection of bevacizumab - in dry eye patients. Sixty-four eyes of 32 dry eye patients received subconjunctival injection of 100 μL 25 mg/mL bevacizumab. Dry eye symptoms, signs (corrected visual acuity, intraocular pressure, conjunctival vascularity, corneal staining, tear break-up time, Marx line score, and blood pressure), and conjunctival impression cytology were evaluated 3 days before and 1 week, 1 month, and 3 months after injection. Significant improvements were observed in dry eye symptoms, tear break-up time, and conjunctival vascularization area at all the visits after injection compared to the baseline (Pdry eye disease.

  16. Dynamic Ocular Surface and Lacrimal Gland Changes Induced in Experimental Murine Dry Eye

    Science.gov (United States)

    Xiao, Bing; Wang, Yu; Reinach, Peter S.; Ren, Yueping; Li, Jinyang; Hua, Shanshan; Lu, Huihui; Chen, Wei

    2015-01-01

    Dry eye disease can be a consequence of lacrimal gland insufficiency in Sjögren’s Syndrome or increased tear film evaporation despite normal lacrimal gland function. To determine if there is a correlation between severity effects in these models and underlying pathophysiological responses, we compared the time dependent changes in each of these parameters that occur during a 6 week period. Dry eye was induced in 6-week-old female C57BL/6 mice by exposing them to an Intelligently Controlled Environmental System (ICES). Sixty mice were housed in ICES for 1, 2, 4 and 6 weeks respectively. Twelve were raised in normal environment and received subcutaneous injections of scopolamine hydrobromide (SCOP) 3 times daily for 5 days. Another sixty mice were housed in a normal environment and received no treatment. Corneal fluorescein staining along with corneal MMP-9 and caspase-3 level measurements were performed in parallel with the TUNEL assay. Interleukin-17(IL-17), IL-23, IL-6, IL-1, TNF-α, IFN-γ and TGF-β2 levels were estimated by real-time PCR measurements of conjunctival and lacrimal gland samples (LGs). Immunohistochemistry of excised LGs along with flow cytometry in cervical lymph nodes evaluated immune cell infiltration. Light and transmission electron microscopy studies evaluated LGs cytoarchitectural changes. ICES induced corneal epithelial destruction and apoptosis peaked at 2 weeks and kept stable in the following 4 weeks. In the ICES group, lacrimal gland proinflammatory cytokine level increases were much lower than those in the SCOP group. In accord with the lower proinflammatory cytokine levels, in the ICES group, lacrimal gland cytosolic vesicular density and size exceeded that in the SCOP group. ICES and SCOP induced murine dry eye effects became progressively more severe over a two week period. Subsequently, the disease process stabilized for the next four weeks. ICES induced local effects in the ocular surface, but failed to elicit lacrimal gland

  17. Dynamic ocular surface and lacrimal gland changes induced in experimental murine dry eye.

    Science.gov (United States)

    Xiao, Bing; Wang, Yu; Reinach, Peter S; Ren, Yueping; Li, Jinyang; Hua, Shanshan; Lu, Huihui; Chen, Wei

    2015-01-01

    Dry eye disease can be a consequence of lacrimal gland insufficiency in Sjögren's Syndrome or increased tear film evaporation despite normal lacrimal gland function. To determine if there is a correlation between severity effects in these models and underlying pathophysiological responses, we compared the time dependent changes in each of these parameters that occur during a 6 week period. Dry eye was induced in 6-week-old female C57BL/6 mice by exposing them to an Intelligently Controlled Environmental System (ICES). Sixty mice were housed in ICES for 1, 2, 4 and 6 weeks respectively. Twelve were raised in normal environment and received subcutaneous injections of scopolamine hydrobromide (SCOP) 3 times daily for 5 days. Another sixty mice were housed in a normal environment and received no treatment. Corneal fluorescein staining along with corneal MMP-9 and caspase-3 level measurements were performed in parallel with the TUNEL assay. Interleukin-17(IL-17), IL-23, IL-6, IL-1, TNF-α, IFN-γ and TGF-β2 levels were estimated by real-time PCR measurements of conjunctival and lacrimal gland samples (LGs). Immunohistochemistry of excised LGs along with flow cytometry in cervical lymph nodes evaluated immune cell infiltration. Light and transmission electron microscopy studies evaluated LGs cytoarchitectural changes. ICES induced corneal epithelial destruction and apoptosis peaked at 2 weeks and kept stable in the following 4 weeks. In the ICES group, lacrimal gland proinflammatory cytokine level increases were much lower than those in the SCOP group. In accord with the lower proinflammatory cytokine levels, in the ICES group, lacrimal gland cytosolic vesicular density and size exceeded that in the SCOP group. ICES and SCOP induced murine dry eye effects became progressively more severe over a two week period. Subsequently, the disease process stabilized for the next four weeks. ICES induced local effects in the ocular surface, but failed to elicit lacrimal gland

  18. Clinical effect of 1g/L anthocyanin eye-patch for mild and moderate dry eye

    Directory of Open Access Journals (Sweden)

    Ke-Hua Wang

    2018-05-01

    Full Text Available AIM:To evaluate the clinic efficacy of 1g/L anthocyanin eye-patch for mild and moderate dry eye. METHODS: In this prospective and multicenter study, a total of 320 cases(640 eyeswith mild and moderate dry eye were enrolled from 8 Aier Eye Hospitals in Changsha, Chongqing, Wuhan and so on from October 2016 to April 2017. The patients were assigned to eye patch group(160 casesand artificial tears group(160 casesbased on random number table. The patients in eye-patch group used 1g/L of anthocyanin eye-patch for more than 6h during night sleep, while the patients in artificial tears group used polyvinyl alcohol eye drops for 4 times per day. The evaluation of symptoms and signs were conducted on 1d before the treatment and 14d after the treatment. The evaluation of symptoms adopted the Ocular Surface Disease Index(OSDI, while the observation of signs included tear secretion test(Schirmer Ⅰ test, SⅠt, first noninvasive tear breakup time(NITBUTfas well as average noninvasive tear breakup time(NITBUTavmeasured by Oculus ocular surface analyser. RESULTS: OSDI score, NITBUTf and NITBUTav in the two groups after treatment were significantly improved compared with that before treatment, and the difference had a statistical significance(PP>0.05. There was no significant difference in OSDI score, NITBUTf, NITBUTav and SⅠt between the two groups after treatment(P>0.05.CONCLUSION: The 1g/L anthocyanin eye-patch has similar efficacy with artificial tears for mild and moderate dry eye, which can effectively improve the symptoms and tear film stability.

  19. Effects of Quercetin in a Mouse Model of Experimental Dry Eye.

    Science.gov (United States)

    Oh, Ha Na; Kim, Chae Eun; Lee, Ji Hyun; Yang, Jae Wook

    2015-09-01

    To evaluate the effect of treatment with quercetin in a mouse model of dry eye. 0.5% quercetin eye drops were prepared and an experimental dry eye model was induced in NOD.B10.H2(b) mice through desiccation stress. The mice were divided into 3 groups according to the treatment regimen: the DS 10D group (desiccation stress for 10 days), the phosphate buffered saline (PBS) group, and the quercetin group. Tear volumes and corneal irregularity scores were measured at 3, 5, 7, and 10 days after treatment. Hematoxylin and eosin staining, periodic acid-Schiff staining, and immunohistochemistry were performed at the end of the experiment. The quercetin group had increased tear volumes (0.2 ± 0.03 μm, P lacrimal gland than did the PBS group. Topical application of quercetin can help to improve ocular surface disorders of dry eye not only by decreasing the corneal surface irregularity but also by increasing the tear volume and goblet cell density. Moreover, quercetin has the potential for use in eye drops as a treatment for dry eye disease with antiinflammatory effects on the lacrimal functional unit.

  20. Expression of chemokine receptor CXCR3 in female patients with dry eye at perimenopause

    Directory of Open Access Journals (Sweden)

    Hong Zhang

    2013-09-01

    Full Text Available AIM: To explore the expression and clinical significance of chemotactic factor receptor-3(CXCR3of female patients conjunctival with dry eye at perimenopause. METHODS: Thirty dry eye case(60 eyesin the patient at perimenopause of the First Affiliated Hospital of Xinjiang Medical University and thirty dry eye cases(60 eyesin patient at non-perimenopause were selected. The conjunctival epithelial cells at perimenopause and non-perimenopause in dry eye cases were obtained by impression cytology methods, and then immersed into the centrifugal tube with corresponding number respectively and the expression of CXCR3 in conjunctival epithelium of at perimenopause and non-perimenopause in dry eye cases were detected by flow cytometry. RESULTS: The break-up time(BUTand Schirmer Ⅰ test result of perimenopause was significantly lower than those of non-perimenopause(F=4.076, 5.023; PPr=-0.753, r=-0.684; PP>0.05.CONCLUSION: CXCR3 plays an inflammatory mediators role in dry eye mechanism and its expression level reflects the progress of dry eye at perimenopause.

  1. Case control study of dry eye and related ocular surface abnormalities in Ibadan, Nigeria.

    Science.gov (United States)

    Bekibele, C O; Baiyeroju, A M; Ajaiyeoba, A; Akang, E E U; Ajayi, B G K

    2010-02-01

    Tear instability is associated with symptoms of ocular discomfort and irritation. Many patients with dry eyes remain untreated due to improper diagnoses. To identify symptoms and surface abnormalities associated with dry eyes. One hundred and fifty-six eyes of 78 subjects attending the Eye Clinic of the University College Hospital Ibadan were screened for dry eyes/tear instability using rose Bengal stain (graded 0-9), tear break-up time (TBUT), Schirmer's 1 tests, tear meniscus height and a standardised symptoms questionnaire. Grades 4-9 rose Bengal staining were considered as positive dry eye and were compared with grades 0-3 staining eyes as negative controls. Mean tear meniscus height, Schirmer's test and TBUT were lower among cases than their corresponding control eyes. The difference between the mean Schirmer's test values of cases and their controls were statistically significant (P = 0.00 for right eyes and P = 0.002 for left eyes). Rose Bengal grades were inversely correlated with the mean Schirmer's values (Pearson correlation -0.429, P = 0.05 for right eyes and -0.335, P = 0.03 for left eyes) and TBUT (Pearson correlation -0.316, P = 0.05 for right eyes and -0.212, P = 0.06 for left eyes). About 95.8% of the cases were symptomatic, as opposed to 70.4% of the controls (P = 0.01, Fisher's exact test) and 95.8% of dry right eyes compared to 61.1% of their controls had ocular surface abnormalities (P = 0.001), while 89.5% of dry left eyes compared to 62.7% of controls had surface abnormalities (P = 0.07). A close relationship exists between ocular irritation symptoms, surface abnormalities and functional evidence of tear instability. Such patients should be treated empirically or screened for dry eyes.

  2. Dry Eye as a Mucosal Autoimmune Disease

    Science.gov (United States)

    Stern, Michael E.; Schaumburg, Chris S.; Pflugfelder, Stephen C.

    2013-01-01

    Dry eye is a common ocular surface inflammatory disease that significantly affects quality of life. Dysfunction of the lacrimal function unit (LFU) alters tear composition and breaks ocular surface homeostasis, facilitating chronic inflammation and tissue damage. Accordingly, the most effective treatments to date are geared towards reducing inflammation and restoring normal tear film. The pathogenic role of CD4+ T cells is well known, and the field is rapidly realizing the complexity of other innate and adaptive immune factors involved in the development and progression of disease. The data support the hypothesis that dry eye is a localized autoimmune disease originating from an imbalance in the protective immunoregulatory and proinflammatory pathways of the ocular surface. PMID:23360156

  3. Dry Eye Disease Patients with Xerostomia Report Higher Symptom Load and Have Poorer Meibum Expressibility.

    Science.gov (United States)

    Fostad, Ida G; Eidet, Jon R; Utheim, Tor P; Ræder, Sten; Lagali, Neil S; Messelt, Edvard B; Dartt, Darlene A

    2016-01-01

    The purpose of the study was to investigate if xerostomia (dry mouth) is associated with symptoms and signs of dry eye disease (DED). At the Norwegian Dry Eye Clinic, patients with symptomatic DED with different etiologies were consecutively included in the study. The patients underwent a comprehensive ophthalmological work-up and completed self-questionnaires on symptoms of ocular dryness (Ocular Surface Disease Index [OSDI] and McMonnies Dry Eye Questionnaire) and the Sjögren's syndrome (SS) questionnaire (SSQ). Three hundred and eighteen patients (52% women and 48% men) with DED were included. Patient demographics were: 0 to 19 years (1%), 20 to 39 (25%), 40 to 59 (34%), 60 to 79 (35%) and 80 to 99 (5%). Xerostomia, defined as "daily symptoms of dry mouth the last three months" (as presented in SSQ) was reported by 23% of the patients. Female sex was more common among patients with xerostomia (81%) than among non-xerostomia patients (44%; Pxerostomia (60 ± 15 years) were older than those without xerostomia (51 ± 17; Pxerostomia patients (65%) than among non-xerostomia patients (35%; Pxerostomia had a higher OSDI score (19.0 ± 10.0) than those without xerostomia (12.9 ± 8.0; Pxerostomia patients had more pathological meibum expressibility (0.9 ± 0.7) than those without xerostomia (0.7 ± 0.8; P = 0.046). Comparisons of OSDI and ocular signs were performed after controlling for the effects of sex, age and the number of systemic prescription drugs used. In conclusion, xerostomia patients demonstrated a higher DED symptom load and had poorer meibum expressibility than non-xerostomia patients.

  4. Gaps in Current Knowledge and Priorities for Future Research in Dry Eye.

    Science.gov (United States)

    Saldanha, Ian J; Dickersin, Kay; Hutfless, Susan T; Akpek, Esen K

    2017-12-01

    Dry eye, a common yet underrecognized and evolving field, has few recommended treatment algorithms, mostly based on expert consensus rather than robust research evidence. There are high costs associated with managing dry eye and conducting research to identify effective and safe long-term treatments. To support evidence-based management of dry eye, our purpose was to identify and prioritize important clinical research questions for future clinical research. We translated recommendations from the American Academy of Ophthalmology's 2013 Preferred Practice Patterns for dry eye into answerable clinical research questions about treatment effectiveness. Clinicians around the world who manage patients with dry eye rated each question's importance from 0 (not important) to 10 (very important) using a 2-round online Delphi survey. We considered questions as "important" if ≥75% of respondents assigned a rating of 6 or more in round 2. We mapped the identified important clinical research questions to reliable systematic reviews published up to March 2016. Seventy-five clinicians from at least 21 countries completed both Delphi rounds. Among the 58 questions, 24 met our definition of "important": 9/24 and 7/24 addressed topical and systemic treatments, respectively. All 4 questions with the highest 25th percentiles addressed topical treatments. Although 6/24 "important" questions were associated with 4 existing reliable systematic reviews, none of these reviews came to a definitive conclusion about treatment effectiveness. We identified gaps pertaining to treatment options for dry eye. Future clinical research on the management of dry eye should strongly consider these prioritized questions.

  5. Efficacy of nutritional supplementation with omega-3 and omega-6 fatty acids in dry eye syndrome: a systematic review of randomized clinical trials.

    Science.gov (United States)

    Molina-Leyva, Ignacio; Molina-Leyva, Alejandro; Bueno-Cavanillas, Aurora

    2017-12-01

    To critically appraise scientific evidence regarding the efficacy of nutritional supplementation with omega-3 and omega-6 fatty acids for the treatment of dry eye syndrome (DES). A systematic review of randomized clinical trials was performed. Two independent reviewers selected and analysed the scientific papers that met inclusion and exclusion criteria. Objective and subjective efficacy outcomes were assessed. The trials involved a total of 2591 patients in fifteen independent studies. All studies were published between 2005 and 2015. The supplements used were mostly omega-3 and omega-6 in different proportions. Subjective improvement was measured using mainly Ocular Surface Disease Index (OSDI) test and Dry Eye Severity Score (DESS) test: significant differences in favour of the experimental group were found in seven of the studies. The objective amelioration was assessed by lacrimal function parameters: Tear break-up time (TBUT) significantly increased in nine studies and Schirmer's test in four studies. We observed a discrete improvement in the parameters of tear function. Scientific evidence is not strong enough to systematically recommend the use of omega-3 and omega-6 fatty acids as a standalone treatment of DES independently from its aetiology. However, they could be considered as an effective alternative to topical treatment in patients with DES secondary to certain pathologies. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  6. Efficacy of a new topical cationic emulsion of cyclosporine A on dry eye clinical signs in an experimental mouse model of dry eye.

    Science.gov (United States)

    Daull, Philippe; Feraille, Laurence; Barabino, Stefano; Cimbolini, Nicolas; Antonelli, Sophie; Mauro, Virgine; Garrigue, Jean-Sébastien

    2016-12-01

    Dry eye disease (DED) is a complex, multifactorial pathology characterized by corneal epithelium lesions and inflammation. The aim of the present study was to evaluate the efficacy of a cationic emulsion of cyclosporine A (CsA) in a mouse model that mimics severe dry eye. Eight to 12-week-old female C57BL/6N mice with tail patches of scopolamine were housed in controlled environment chambers to induce dry eye. At day three, following dry eye confirmation by corneal fluorescein staining (CFS, score 0-15) and phenol red thread (PRT) lacrimation test, the mice (n = 10/gp) were either treated 3 times a day in both eyes with drug-free cationic emulsion, a 0.1% CsA cationic emulsion, or 1% methylprednisolone (positive control), or non-treated. Aqueous tear production and CFS scores were evaluated at baseline and throughout the treatment period. The lacrimation test confirmed the scopolamine-induced decrease in aqueous production by the lacrimal gland. A reduction of 59% in induced-CFS was observed following topical treatment with 0.1% CsA. The beneficial effect of the cationic emulsion vehicle itself on keratitis was also clearly evidenced by its better performance over 1% methylprednisolone, -36%, vs. -28% on the CFS scores, respectively. This study indicates that the cationic emulsion of CsA (0.1%) was a very effective formulation for the management of corneal epithelium lesions in a severe DED mouse model. In addition, it performed better than a potent glucocorticosteroid (1% methylprednisolone). This cationic emulsion of CsA (0.1%), combining CsA and a tear film oriented therapy (TFOT), i.e. with vehicle properties that mechanically stabilize the tear film, represents a promising new treatment strategy for the management of the signs of dry eye. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Successful treatment of dry eye in two patients with chronic graft-versus-host disease with systemic administration of FK506 and corticosteroids.

    Science.gov (United States)

    Ogawa, Y; Okamoto, S; Kuwana, M; Mori, T; Watanabe, R; Nakajima, T; Yamada, M; Mashima, Y; Tsubota, K; Oguchi, Y

    2001-05-01

    We present two cases of severe dry eye in patients with chronic graft-versus-host disease (CGVHD) after hematopoietic stem cell transplantation (SCT) who were successfully treated by the systemic administration of FK506 and corticosteroids. A 29-year-old man with chronic myelogenous leukemia underwent SCT. Oral and lung CGVHD developed on approximately day 130, and dry eye associated with CGVHD was diagnosed on day 168. The patient began receiving cyclosporin A (150 mg/d) for the treatment of oral and lung CGVHD. Treatment with prednisolone (1 mg/kg/d) began on approximately day 300. Oral and lung GVHD improved slightly, but worsened again although systemic administration of cyclosporin A and prednisolone were continued. Cyclosporin A was discontinued, and systemic administration of FK506 was started on day 376. Forty-four days later, marked improvement in the ocular surface and other organs was observed. However, the dry eye worsened while tapering FK506, with no flare of other affected organs. A 43-year-old woman with myelodysplastic syndrome underwent SCT. She received FK506 for prophylaxis of CGVHD. She had mild dry eye before SCT. Oral and intestinal CGVHD developed, and the dry eye worsened significantly on approximately day 150 while tapering FK506. Treatment with prednisolone (1 mg/kg/d) began, and the dose of FK506 was increased. By day 240, the symptoms of dry eye and the findings of the ocular surface markedly improved, and CGVHD in other organs was completely resolved. However, the improvement in the dry eye was lost when FK506 was tapered for the second time. Systemic administration of FK506 with corticosteroids is an effective treatment of severe dry eye in patients with CGVHD, but long-term administration may be required to achieve a lasting response. These cases also suggest that further investigation into the use of topical FK506 and prednisolone as a maintenance therapy should be pursued.

  8. Analysis of the Pathogenic Factors and Management of Dry Eye in Ocular Surface Disorders.

    Science.gov (United States)

    Nebbioso, Marcella; Del Regno, Paola; Gharbiya, Magda; Sacchetti, Marta; Plateroti, Rocco; Lambiase, Alessandro

    2017-08-13

    The tear film represents the interface between the eye and the environment. The alteration of the delicate balance that regulates the secretion and distribution of the tear film determines the dry eye (DE) syndrome. Despite having a multifactorial origin, the main risk factors are female gender and advanced age. Likewise, morphological changes in several glands and in the chemical composition of their secretions, such as proteins, mucins, lipidics, aqueous tears, and salinity, are highly relevant factors that maintain a steady ocular surface. Another key factor of recurrence and onset of the disease is the presence of local and/or systemic inflammation that involves the ocular surface. DE syndrome is one of the most commonly encountered diseases in clinical practice, and many other causes related to daily life and the increase in average life expectancy will contribute to its onset. This review will consider the disorders of the ocular surface that give rise to such a widespread pathology. At the end, the most recent therapeutic options for the management of DE will be briefly discussed according to the specific underlying pathology.

  9. Dry eyes and corneal sensation after laser in situ keratomileusis with femtosecond laser flap creation Effect of hinge position, hinge angle, and flap thickness.

    Science.gov (United States)

    Mian, Shahzad I; Li, Amy Y; Dutta, Satavisha; Musch, David C; Shtein, Roni M

    2009-12-01

    To determine whether corneal sensation and dry-eye signs and symptoms after myopic laser in situ keratomileusis (LASIK) surgery with a femtosecond laser are affected by varying hinge position, hinge angle, or flap thickness. University-based academic practice, Ann Arbor, Michigan, USA. This prospective randomized contralateral-eye study evaluated eyes after bilateral myopic LASIK with a femtosecond laser (IntraLase). Superior and temporal hinge positions, 45-degree and 90-degree hinge angles, and 100 microm and 130 microm corneal flap thicknesses were compared. Postoperative follow-up at 1 week and 1, 3, 6, and 12 months included central Cochet-Bonnet esthesiometry, the Ocular Surface Disease Index questionnaire, a Schirmer test with anesthesia, tear breakup time (TBUT), corneal fluorescein staining, and conjunctival lissamine green staining. The study evaluated 190 consecutive eyes (95 patients). Corneal sensation was reduced at all postoperative visits, with improvement over 12 months (P<.001). There was no difference in corneal sensation between the different hinge positions, angles, or flap thicknesses at any time point. The overall ocular surface disease index score was increased at 1 week, 1 month, and 3 months (P<.0001, P<.0001, and P = .046, respectively). The percentage of patients with a TBUT longer than 10 seconds was significantly lower at 1 week and 1 month (P<.0001). Dry-eye syndrome after myopic LASIK with a femtosecond laser was mild and improved after 3 months. Corneal flap hinge position, hinge angle, and thickness had no effect on corneal sensation or dry-eye syndrome.

  10. Efficacy and safety of short-term application of pranoprofen eye drops for senile patients with dry eyes

    Directory of Open Access Journals (Sweden)

    Yu-Chan Li

    2018-06-01

    Full Text Available AIM:To investigate the efficacy and safety of short-term application of pranoprofen eye drops in the treatment of dry eyes in senile patients. METHODS: Totally 100 elderly patients with dry eyes treated in our hospital from June 2016 to May 2017 were randomly divided into 2 groups. All cases were bilateral onset, and the right eyes were marked as the observation eyes. The 50 eyes in the observation group were treated with 1g/L pranoprofen eye drops combined with 1g/L sodium hyaluronate eye drops, while 50 in the control group were treated with 1g/L sodium hyaluronate eye drops. The results of Schirmer Ⅰ, ocular surface disease index(OSDI, break-up time(BUT, ocular surface staining(OSS, human leukocyte antigen-DR(HLA-DRand CD11b in conjunctival epithelial cells before and at 2wk after treatment, and adverse reactions in 2 groups were observed. RESULTS: Before treatment, results of Schirmer I, OSDI, BUT, OSS, HLA-DR and CD11b in the two groups were similar, there were no statistically significant differences(P>0.05. After treatment, OSDI, OSS, HLA-DR, CD11b significantly decreased, BUT significantly increased in both groups, the differences were statistically significant(PPPCONCLUSION: Short term application of pranoprofen eye drops can effectively enhance the efficacy in treating elderly patients with dry eyes, release clinical symptoms, and the therapeutic mechanism may be related to the inhibitory effect on HLA-DR.

  11. A clinical study of the efficacy of topical corticosteroids on dry eye

    OpenAIRE

    Yang, Chong-qing; Sun, Wen; Gu, Yang-shun

    2006-01-01

    Objective: To evaluate the effect of topical corticosteroid for treatment of moderate or severe dry eye. Methods: Sixty eyes of 30 patients with moderate or severe dry eye, who were not sensitive to artificial tears, were treated with 0.1% fluorometholone eye drops. Subjective symptom and objective tests were used to evaluate the efficacy of treatment before and after application of 0.1% fluorometholone eye drops for 1 week and 1 month. Side effects were also evaluated. Results: After 1 week ...

  12. Chronic dry eye in photorefractive keratectomy and laser in situ keratomileusis: Manifestations, incidence, and predictive factors.

    Science.gov (United States)

    Bower, Kraig S; Sia, Rose K; Ryan, Denise S; Mines, Michael J; Dartt, Darlene A

    2015-12-01

    To evaluate dry-eye manifestations after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) and determine the incidence and predictive factors of chronic dry eye using a set of dry-eye criteria. Walter Reed Army Medical Center, Washington, DC, USA. Prospective, non-randomized clinical study. Dry-eye evaluation was performed before and after surgery. Main outcome measures included dry-eye manifestations, incidence, and predictive factors of chronic dry eye. This study comprised 143 active-duty U.S. Army personnel, ages 29.9 ± 5.2 years, with myopia or myopic astigmatism (manifest spherical equivalent -3.83 ± 1.96 diopters) having PRK or LASIK. Schirmer scores, corneal sensitivity, ocular surface staining, surface regularity index, and responses to dry-eye questionnaire significantly changed over time after PRK. After LASIK, significant changes were observed in tear breakup time, corneal sensitivity, ocular surface staining, and responses to questionnaire. Twelve months postoperatively, 5.0% of PRK and 0.8% of LASIK participants developed chronic dry eye. Regression analysis showed that pre-operatively lower Schirmer score will significantly influence development of chronic dry eye after PRK, whereas preoperatively, lower Schirmer score or higher ocular surface staining score will significantly influence the occurrence of chronic dry eye after LASIK. Chronic dry eye was uncommon after PRK and LASIK. Ocular surface and tear-film characteristics during pre-operative examination might help to predict chronic dry-eye development in PRK and LASIK. The authors have no financial interest in any product, drug, instrument, or equipment discussed in this manuscript. Copyright © 2015 ASCRS and ESCRS. All rights reserved.

  13. [Comparison of objective optical quality measured by double-pass aberrometry in patients with moderate dry eye: Normal saline vs. artificial tears: A pilot study].

    Science.gov (United States)

    Vandermeer, G; Chamy, Y; Pisella, P-J

    2018-03-01

    Dry eye is defined by a tear film instability resulting in variable but systematic fluctuations in the quality of vision. Variability in optical quality can be demonstrated using a double pass aberrometer such as the OQAS (Optical Quality Analyzing System, Visiometrics). The goal of this work is to compare fluctuations in objective quality of vision measured by OQAS between treatment with normal saline eye drops and treatment with carmellose 0.5% and hyaluronic acid 0.1% (Optive Fusion [OF], Allergan) in patients with moderate dry eye syndrome. Optical quality was measured by evaluating the variations in the Optical Scattering Index (OSI) over 20seconds using the OQAS. Inclusion criteria were dry eye syndrome with an Ocular Surface Disease Index (OSDI) score>23 treated only with artificial tears. The patients were their own controls: OF in one eye and normal saline in the fellow eye. The choice of the subject eye and control eye was determined in a randomized fashion. OSI variations were measured in each eye before instillation, 5minutes and 2hours after instillation. The primary endpoint was OSI fluctuation over 20seconds of measurement. Secondary endpoints were the number of blinks and patient's preference (preferred eye). Preliminary results were obtained on 19 patients. Average OSDI score was 36.8. Visual acuity was 10/10 with no significant difference between the two eyes. Prior to instillation, there was no significant difference between "normal saline" and "OF" eyes in terms of OSI, OSI variability or number of blinks. In the normal saline eye, there was no significant variation in mean OSI, OSI variability, OSI slope, or number of blinks. However, in the "OF" eye, there was a significant variation between initial and 2-hour OSI variability (0.363 versus 0.204; Peye, 24% did not have a preference, and 11% preferred the normal saline eye. Objective quality of vision measured by OQAS is an interesting parameter for evaluating the effectiveness of a lacrimal

  14. Comparison of objective optical quality measured by double-pass aberrometry in patients with moderate dry eye: Normal saline vs. artificial tears: A pilot study.

    Science.gov (United States)

    Vandermeer, G; Chamy, Y; Pisella, P-J

    2018-02-01

    Dry eye is defined by a tear film instability resulting in variable but systematic fluctuations in quality of vision. Variability in optical quality can be demonstrated using a double pass aberrometer such as the Optical Quality Analyzing System, Visiometrics (OQAS). The goal of this work is to compare fluctuations in objective quality of vision measured by OQAS between treatment with normal saline eye drops and treatment with carmellose 0.5% and hyaluronic acid 0.1% (Optive Fusion [OF], Allergan) in patients with moderate dry eye syndrome. Optical quality was measured by evaluating the variations in the Optical Scattering Index (OSI) over 20seconds using the OQAS. Inclusion criteria were dry eye syndrome with an ocular surface disease index (OSDI) score >23 treated only with artificial tears. The patients were their own controls: OF in one eye and normal saline in the fellow eye. The choice of the subject eye and control eye was determined in a randomized fashion. OSI variations were measured in each eye before instillation, 5minutes and 2hours after instillation. The primary endpoint was OSI fluctuation over 20seconds of measurement. Secondary endpoints were the number of blinks and patient preference (preferred eye). Preliminary results were obtained on 19 patients. Average OSDI score was 36.8. Visual acuity was 10/10 with no significant difference between the two eyes. Prior to instillation, there was no significant difference between "normal saline" and "OF" eyes in terms of OSI, OSI variability or number of blinks. In the normal saline eye, there were no significant variations in mean OSI, OSI variability, OSI slope, or number of blinks. However, in the "OF" eye, there was a significant variation between initial and 2-hour OSI variability (0.363 versus 0.204, Peye, 24% did not have a preference, and 11% preferred the normal saline eye. Objective quality of vision measured by OQAS is an interesting parameter for evaluating the effectiveness of a lacrimal

  15. Effect of diquafosol ophthalmic solution on the optical quality of the eyes in patients with aqueous-deficient dry eye.

    Science.gov (United States)

    Koh, Shizuka; Maeda, Naoyuki; Ikeda, Chikako; Oie, Yoshinori; Soma, Takeshi; Tsujikawa, Motokazu; Watanabe, Hitoshi; Nishida, Kohji

    2014-12-01

    To investigate the short- and long-term effects of diquafosol ophthalmic solution on the optical quality of the eyes in patients with aqueous-deficient dry eye. Sixteen eyes in 16 patients with mild or moderate aqueous-deficient dry eye were treated with 3% diquafosol ophthalmic solution. Ocular higher-order aberrations (HOAs) were measured with a wavefront sensor before and at 15 min after diquafosol instillation at the baseline visit and at 4 weeks after treatment initiation. Dry eye symptoms, tear break-up time (BUT), corneal/conjunctival fluorescein staining and Schirmer's test were also evaluated before and after treatment with diquafosol. Treatment with diquafosol ophthalmic solution significantly improved dry eye symptoms, corneal staining and BUT. Compared with mean total HOAs at baseline (0.180 ± 0.06 μm), those at 4 weeks after treatment significantly decreased (0.148 ± 0.039 μm; p = 0.035), whereas those 15 min after diquafosol instillation at the baseline visit did not change significantly (0.170 ± 0.049 μm; p = 0.279). Although no significant change in HOAs was observed as a short-term effect of a single-drop instillation of diquafosol, long-term use of diquafosol to treat aqueous-deficient dry eye reduced HOAs as well as improved corneal epithelial damage and tear film stability. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  16. Ocular forward light scattering and corneal backward light scattering in patients with dry eye.

    Science.gov (United States)

    Koh, Shizuka; Maeda, Naoyuki; Ikeda, Chikako; Asonuma, Sanae; Mitamura, Hayato; Oie, Yoshinori; Soma, Takeshi; Tsujikawa, Motokazu; Kawasaki, Satoshi; Nishida, Kohji

    2014-09-18

    To evaluate ocular forward light scattering and corneal backward light scattering in patients with dry eye. Thirty-five eyes in 35 patients with dry eye and 20 eyes of 20 healthy control subjects were enrolled. The 35 dry eyes were classified into two groups according to whether superficial punctate keratopathy in the central 6-mm corneal zone (cSPK) was present or not. Ocular forward light scattering was quantified with a straylight meter. Corneal backward light scattering from the anterior, middle, and posterior corneal parts was assessed with a corneal densitometry program using the Scheimpflug imaging system. Both dry eye groups had significantly higher intraocular forward light scattering than the control group (both Pdry eye group with cSPK had significantly higher values in anterior and total corneal backward light scattering than the other two groups. Moderate positive correlations were observed between the cSPK score and corneal backward light scattering from the anterior cornea (R=0.60, Pdry eyes than in normal eyes. Increased corneal backward light scattering in dry eye at least partially results from cSPK overlying the optical zone. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  17. Long-term results of treatment with diquafosol ophthalmic solution for aqueous-deficient dry eye.

    Science.gov (United States)

    Koh, Shizuka; Ikeda, Chikako; Takai, Yoshihiro; Watanabe, Hitoshi; Maeda, Naoyuki; Nishida, Kohji

    2013-09-01

    To evaluate the preliminary long-term efficacy of diquafosol ophthalmic solution for aqueous-deficient dry eye. Fifteen patients with mild-to-moderate aqueous-deficient dry eye were enrolled. After a washout period, the patients were treated with 3 % diquafosol ophthalmic solution for 6 months. We assessed 12 subjective dry eye symptoms, corneal and conjunctival staining with fluorescein, tear film break-up time (BUT), lower tear meniscus height measured with anterior-segment optical coherence tomography, Schirmer's testing, and adverse reactions at baseline and 1, 3, and 6 months after the start of treatment. Treatment with diquafosol ophthalmic solution significantly improved dry eye symptoms, corneal staining, BUT, and tear meniscus height at 1 month and maintained the effectiveness for 6 months. Conjunctival staining significantly improved 3 and 6 months after treatment. No significant adverse reactions developed. Prolonged use of diquafosol ophthalmic solution for 6 months produced significant improvement both subjectively (dry eye symptom score) and objectively (ocular staining score and tear function tests) for aqueous-deficient dry eye.

  18. Eye Development Genes and Known Syndromes

    Science.gov (United States)

    Slavotinek, Anne M.

    2011-01-01

    Anophthalmia and microphthalmia (A/M) are significant eye defects because they can have profound effects on visual acuity. A/M is associated with non-ocular abnormalities in an estimated 33–95% of cases and around 25% of patients have an underlying genetic syndrome that is diagnosable. Syndrome recognition is important for targeted molecular genetic testing, prognosis and for counseling regarding recurrence risks. This review provides clinical and molecular information for several of the commonest syndromes associated with A/M: Anophthalmia-Esophageal-Genital syndrome, caused by SOX2 mutations, Anophthalmia and pituitary abnormalities caused by OTX2 mutations, Matthew-Wood syndrome caused by STRA6 mutations, Oculocardiafaciodental syndrome and Lenz microphthalmia caused by BCOR mutations, Microphthalmia Linear Skin pigmentation syndrome caused by HCCS mutations, Anophthalmia, pituitary abnormalities, polysyndactyly caused by BMP4 mutations and Waardenburg anophthalmia caused by mutations in SMOC1. In addition, we briefly discuss the ocular and extraocular phenotypes associated with several other important eye developmental genes, including GDF6, VSX2, RAX, SHH, SIX6 and PAX6. PMID:22005280

  19. Diquafosol sodium ophthalmic solution for the treatment of dry eye: clinical evaluation and biochemical analysis of tear composition.

    Science.gov (United States)

    Shigeyasu, Chika; Yamada, Masakazu; Akune, Yoko; Tsubota, Kazuo

    2015-11-01

    To evaluate the clinical efficacy of 3% diquafosol sodium ophthalmic solution for dry eye, and to analyze the concentration of tear proteins and mucin-like substances after the treatment. Fifty eyes of 25 patients with dry eye syndrome were prospectively enrolled. The patients were treated with diquafosol solution at a dose of 1 drop in each eye 6 times daily for 4 weeks. The parameters of clinical efficacy were tear osmolarity, tear breakup time (BUT), fluorescein staining scores for the cornea and conjunctiva, Schirmer test values, and subjective symptoms evaluated using the ocular surface disease index (OSDI). Tears collected with Schirmer test strips were analyzed by high-performance liquid chromatography, and the concentrations of the total protein and the 4 major tear proteins, namely, secretory IgA, lactoferrin, lipocalin-1, lysozyme, and N-acetyl-neuraminic acid (Neu5Ac), were measured. Neu5Ac is a major sialic acid, a marker of secretory mucins. The BUT, keratoconjunctival staining scores, and Schirmer test values were improved with statistical significance after the treatment with diquafosol solution, while changes in the other parameters, including tear osmolarity, corneal staining scores, and OSDI scores were not significant. The Neu5Ac concentration was significantly increased, which was not accompanied by changes in tear proteins. Topical application of diquafosol significantly improved the clinical parameters of the BUT, keratoconjunctival staining scores, and Schirmer test values and was accompanied by increased sialic acid content in the tears of patients with dry eye.

  20. Clusterin Seals the Ocular Surface Barrier in Mouse Dry Eye.

    Science.gov (United States)

    Bauskar, Aditi; Mack, Wendy J; Mauris, Jerome; Argüeso, Pablo; Heur, Martin; Nagel, Barbara A; Kolar, Grant R; Gleave, Martin E; Nakamura, Takahiro; Kinoshita, Shigeru; Moradian-Oldak, Janet; Panjwani, Noorjahan; Pflugfelder, Stephen C; Wilson, Mark R; Fini, M Elizabeth; Jeong, Shinwu

    2015-01-01

    Dry eye is a common disorder caused by inadequate hydration of the ocular surface that results in disruption of barrier function. The homeostatic protein clusterin (CLU) is prominent at fluid-tissue interfaces throughout the body. CLU levels are reduced at the ocular surface in human inflammatory disorders that manifest as severe dry eye, as well as in a preclinical mouse model for desiccating stress that mimics dry eye. Using this mouse model, we show here that CLU prevents and ameliorates ocular surface barrier disruption by a remarkable sealing mechanism dependent on attainment of a critical all-or-none concentration. When the CLU level drops below the critical all-or-none threshold, the barrier becomes vulnerable to desiccating stress. CLU binds selectively to the ocular surface subjected to desiccating stress in vivo, and in vitro to the galectin LGALS3, a key barrier component. Positioned in this way, CLU not only physically seals the ocular surface barrier, but it also protects the barrier cells and prevents further damage to barrier structure. These findings define a fundamentally new mechanism for ocular surface protection and suggest CLU as a biotherapeutic for dry eye.

  1. Clusterin Seals the Ocular Surface Barrier in Mouse Dry Eye.

    Directory of Open Access Journals (Sweden)

    Aditi Bauskar

    Full Text Available Dry eye is a common disorder caused by inadequate hydration of the ocular surface that results in disruption of barrier function. The homeostatic protein clusterin (CLU is prominent at fluid-tissue interfaces throughout the body. CLU levels are reduced at the ocular surface in human inflammatory disorders that manifest as severe dry eye, as well as in a preclinical mouse model for desiccating stress that mimics dry eye. Using this mouse model, we show here that CLU prevents and ameliorates ocular surface barrier disruption by a remarkable sealing mechanism dependent on attainment of a critical all-or-none concentration. When the CLU level drops below the critical all-or-none threshold, the barrier becomes vulnerable to desiccating stress. CLU binds selectively to the ocular surface subjected to desiccating stress in vivo, and in vitro to the galectin LGALS3, a key barrier component. Positioned in this way, CLU not only physically seals the ocular surface barrier, but it also protects the barrier cells and prevents further damage to barrier structure. These findings define a fundamentally new mechanism for ocular surface protection and suggest CLU as a biotherapeutic for dry eye.

  2. Chronic migraine is associated with reduced corneal nerve fiber density and symptoms of dry eye.

    Science.gov (United States)

    Kinard, Krista I; Smith, A Gordon; Singleton, J Robinson; Lessard, Margaret K; Katz, Bradley J; Warner, Judith E A; Crum, Alison V; Mifflin, Mark D; Brennan, Kevin C; Digre, Kathleen B

    2015-04-01

    We used in vivo corneal confocal microscopy to investigate structural differences in the sub-basal corneal nerve plexus in chronic migraine patients and a normal population. We used a validated questionnaire and tests of lacrimal function to determine the prevalence of dry eye in the same group of chronic migraine patients. Activation of the trigeminal system is involved in migraine. Corneal nociceptive sensation is mediated by trigeminal axons that synapse in the gasserian ganglion and the brainstem, and serve nociceptive, protective, and trophic functions. Noninvasive imaging of the corneal sub-basal nerve plexus is possible with in vivo corneal confocal microscopy. For this case-control study, we recruited chronic migraine patients and compared them with a sex- and age-similar group of control subjects. Patients with peripheral neuropathy, a disease known to be associated with a peripheral neuropathy, or prior corneal or intraocular surgery were excluded. Participants underwent in vivo corneal confocal microscopy using a Heidelberg Retinal Tomography III confocal microscope with a Rostock Cornea Module. Nerve fiber length, nerve branch density, nerve fiber density, and tortuosity coefficient were measured using established methodologies. Migraine participants underwent testing of basal tear production with proparacaine, corneal sensitivity assessment with a cotton-tip applicator, measurement of tear break-up time, and completion of a validated dry eye questionnaire. A total of 19 chronic migraine patients and 30 control participants completed the study. There were no significant differences in age or sex. Nerve fiber density was significantly lower in migraine patients compared with controls (48.4 ± 23.5 vs. 71.0 ± 15.0 fibers/mm2 , P dry eye syndrome. We found that in the sample used in this study, the presence of structural changes in nociceptive corneal axons lends further support to the hypothesis that the trigeminal system plays a critical role

  3. Expression of SIRT1 and oxidative stress in diabetic dry eye.

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    Liu, Hao; Sheng, Minjie; Liu, Yu; Wang, Peng; Chen, Yihui; Chen, Li; Wang, Weifang; Li, Bing

    2015-01-01

    To explore the expression of SIRT1 with oxidative stress and observe physiological and pathological changes in the corneas as well as the association between SIRT1 and oxidative stress of diabetic dry eyes in mice. Forty-eight C57BL/6Jdb/db mice at eight weeks of age were divided randomly into two groups: the diabetic dry eye group and the diabetic group. An additional forty-eight C57BL/6J mice at eight weeks of age were divided randomly into two groups: the dry eye group and the control group. Every mouse in the dry eye groups (diabetic and normal) was injected with scopolamine hydrobromide three times daily, combined with low humidity to establish a dry eye model. After the intervention, phenol red cotton string tests and corneal fluorescein staining were performed. In addition, HE staining and immunofluorescence were done. Expression of SIRT1 in the cornea was examined by real-time PCR and Western Blot and expression of FOXO3 and MnSOD proteins was detected by Western Blot. At one, four, and eight weeks post intervention, all of the groups except the controls showed significant decreases in tear production and increases in the corneal fluorescein stain (Pdry eye group had the least tear production and the highest corneal fluorescein stain score (Pdry eye group. In the 1(st) and 4(th) week, the expression of SIRT1, FOXO3, and MnSOD were significantly higher in the diabetic DE and DM groups but lower in the DE group compared to the controls (Pdry eye, tear production declined markedly coupled with seriously wounded corneal epithelium. Oxidative stress in the cornea was enhanced significantly and the expression of SIRT1 was decreased.

  4. Treatment, material, care, and patient-related factors in contact lens-related dry eye.

    Science.gov (United States)

    Ramamoorthy, Padmapriya; Sinnott, Loraine T; Nichols, Jason J

    2008-08-01

    To examine the effect of general contact lens and material characteristics, care solutions, treatment, and patient-related factors on contact lens-related dry eye. The data were derived from the Contact Lens and Dry Eye Study, designed as a cross-sectional and nested case-control study including 360 subjects. In separate statistical models, logistic regression was used to examine general contact lens characteristics, specific hydrogel lens materials, care solutions, and patient-related factors associated with dry eye status (controlled for age, gender, and current treatments). Several factors were significantly associated with dry eye, including treatment factors such as a recent contact lens refitting (odds ratios [OR] = 5.75, 95% confidence intervals [CI] = 2.14 to 15.46) and use of artificial tears/rewetting drops (OR = 1.09, 95% CI = 1.02 to 1.16), in addition, currently worn materials including Food and Drug Administration (FDA) group II (OR = 2.98, 95% CI = 1.14 to 6.19) and IV (OR = 1.87, 95% CI = 1.08 to 3.24). Significant patient-related factors included decreased overall satisfaction (OR = 3.57, 95% CI = 2.08 to 5.88,), dry eye in the absence of contact lens wear (OR = 6.54, 95% CI = 2.57 to 16.62), reduced daily lens wear duration (OR = 1.16, 95% CI = 1.06 to 1.26), and reduced ability to wear lenses as long as desired (OR = 2.44, 95% CI = 1.30 to 4.54). Care solutions were not associated with contact lens-related dry eye. The strong association of common treatment factors with dry eye status in contact lens wearers suggests that these treatments are not entirely effective. The use of high water content materials was strongly related to dry eye in lens wearers, whereas care solutions were not. Contact lens-related dry eye was also associated with several patient-related factors such as greater ocular discomfort (without lenses), dissatisfaction, and inability to wear lenses for desired durations.

  5. Severe Dry Eye Syndrome After Radiotherapy for Head-and-Neck Tumors

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    Bhandare, Niranjan, E-mail: bhandn@shands.ufl.edu [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Moiseenko, Vitali [Vancouver Cancer Centre, Vancouver, BC (Canada); Song, William Y. [University of California, San Diego, San Diego, CA (United States); Morris, Christopher G. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Bhatti, M. Tariq [Department of Ophthalmology and Medicine (Division of Neurology), Duke University Medical Center, Durham, NC (United States); Mendenhall, William M. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States)

    2012-03-15

    Purpose: To investigate the incidence of severe dry eye syndrome (DES) after external beam radiotherapy for head-and-neck cancer and its dependence on the parameters relevant to external beam radiotherapy. Methods and Materials: The present retrospective study included 78 patients treated for primary extracranial head-and-neck tumors between 1965 and 2000, whose lacrimal apparatus/entire globe was exposed to fractionated external beam radiotherapy. The dose received by the major lacrimal gland was used for analysis. The end point of the present study was the ophthalmologic diagnosis of severe DES leading to vision compromise. Results: Of the 78 patients, 40 developed severe DES leading to visual compromise. The incidence of DES increased steadily from 6% at 35-39.99 Gy to 50% at 45-49.99 Gy and 90% at 60-64.99 Gy. With a mean of 0.9 years (range, 1 month to 3 years), the latency of DES was observed to be a function of the total dose and the dose per fraction. On univariate and multivariate analysis, the total dose (p < .0001 and p < .0001, respectively) and dose per fraction (p {<=} .0001 and p = .0044, respectively) were significant. However, age, gender, and the use of chemoradiotherapy were not. The actuarial analysis indicated a 5-year probability of freedom from DES of 93% for doses <45 Gy, 29% for 45-59.9 Gy, and 3% doses {>=}60 Gy. A logistic normal tissue complication probability model fit to our data obtained a dose of 34 and 38 Gy corresponding to a 5% and 10% incidence of DES. Conclusion: With a dose of 34 Gy corresponding to a 5% incidence of DES, the risk of severe DES increased, and the latency decreased with an increase in the total dose and dose per fraction to the lacrimal gland. The effect of chemoradiotherapy and hyperfractionation on the risk of DES needs additional investigation.

  6. Severe Dry Eye Syndrome After Radiotherapy for Head-and-Neck Tumors

    International Nuclear Information System (INIS)

    Bhandare, Niranjan; Moiseenko, Vitali; Song, William Y.; Morris, Christopher G.; Bhatti, M. Tariq; Mendenhall, William M.

    2012-01-01

    Purpose: To investigate the incidence of severe dry eye syndrome (DES) after external beam radiotherapy for head-and-neck cancer and its dependence on the parameters relevant to external beam radiotherapy. Methods and Materials: The present retrospective study included 78 patients treated for primary extracranial head-and-neck tumors between 1965 and 2000, whose lacrimal apparatus/entire globe was exposed to fractionated external beam radiotherapy. The dose received by the major lacrimal gland was used for analysis. The end point of the present study was the ophthalmologic diagnosis of severe DES leading to vision compromise. Results: Of the 78 patients, 40 developed severe DES leading to visual compromise. The incidence of DES increased steadily from 6% at 35–39.99 Gy to 50% at 45–49.99 Gy and 90% at 60–64.99 Gy. With a mean of 0.9 years (range, 1 month to 3 years), the latency of DES was observed to be a function of the total dose and the dose per fraction. On univariate and multivariate analysis, the total dose (p < .0001 and p < .0001, respectively) and dose per fraction (p ≤ .0001 and p = .0044, respectively) were significant. However, age, gender, and the use of chemoradiotherapy were not. The actuarial analysis indicated a 5-year probability of freedom from DES of 93% for doses <45 Gy, 29% for 45–59.9 Gy, and 3% doses ≥60 Gy. A logistic normal tissue complication probability model fit to our data obtained a dose of 34 and 38 Gy corresponding to a 5% and 10% incidence of DES. Conclusion: With a dose of 34 Gy corresponding to a 5% incidence of DES, the risk of severe DES increased, and the latency decreased with an increase in the total dose and dose per fraction to the lacrimal gland. The effect of chemoradiotherapy and hyperfractionation on the risk of DES needs additional investigation.

  7. Clinical effect observation of pranoprofen combined with deproteinized calf blood extract eye drops for moderate to severe dry eye

    Directory of Open Access Journals (Sweden)

    Jing-Hua Qiu

    2018-04-01

    Full Text Available AIM: To explore clinical effect of pranoprofen combined with deproteinized calf blood extract eye drops for moderate to severe dry eye. METHODS: A total of 84 patients(132 eyeswho received treatment at the Zhengzhou Second Hospital were selected from January 2016 to January 2017. According to random number table method they were divided into control group 42 cases(68 eyesand observation group 42 cases(64 eyes, the control group using polyvinyl alcohol eye drops with pranoprofen, observation group with pranoprofen with deproteinized extract of calf blood eye drops. Subjective and objective scores before and after treatment were recorded. RESULTS: There was no statistically significant difference on the four objective indicators of pretreatment FL, BUT, SⅠt, and vision between the two groups(P>0.05. Dry eye symptom scores of the two groups decreased after treatment, both with significantly different(PPPPCONCLUSION: The clinical effect of praprofen on the treatment of moderate to severe dry eye with the deproteinized calf blood extract is better.

  8. Development towards compact nitrocellulose interferometric biochips for dry eye diagnosis based on MMP9, S100A6 and CST4 biomarkers using a Point-of-Care device

    Science.gov (United States)

    Santamaría, Beatriz; Laguna, María. Fe; López-Romero, David; López-Hernandez, A.; Sanza, F. J.; Lavín, A.; Casquel, R.; Maigler, M.; Holgado, M.

    2018-02-01

    A novel compact optical biochip based on a thin layer-sensing BICELL surface of nitrocellulose is used for in-situ labelfree detection of dry eye disease (DED). In this work the development of a compact biosensor that allows obtaining quantitative diagnosis with a limited volume of sample is reported. The designed sensors can be analyzed with an optical integrated Point-of-Care read-out system based on the "Increase Relative Optical Power" principle which enhances the performance and Limit of Detection. Several proteins involved with dry eye dysfunction have been validated as biomarkers. Presented biochip analyzes three of those biomarkers: MMP9, S100A6 and CST4. BICELLs based on nitrocellulose permit to immobilize antibodies for each biomarker recognition. The optical response obtained from the biosensor through the readout platform is capable to recognize specifically the desired proteins in the concentrations range for control eye (CE) and dry eye syndrome (DES). Preliminary results obtained will allow the development of a dry eye detection device useful in the area of ophthalmology and applicable to other possible diseases related to the eye dysfunction.

  9. iDEAS: A web-based system for dry eye assessment.

    Science.gov (United States)

    Remeseiro, Beatriz; Barreira, Noelia; García-Resúa, Carlos; Lira, Madalena; Giráldez, María J; Yebra-Pimentel, Eva; Penedo, Manuel G

    2016-07-01

    Dry eye disease is a public health problem, whose multifactorial etiology challenges clinicians and researchers making necessary the collaboration between different experts and centers. The evaluation of the interference patterns observed in the tear film lipid layer is a common clinical test used for dry eye diagnosis. However, it is a time-consuming task with a high degree of intra- as well as inter-observer variability, which makes the use of a computer-based analysis system highly desirable. This work introduces iDEAS (Dry Eye Assessment System), a web-based application to support dry eye diagnosis. iDEAS provides a framework for eye care experts to collaboratively work using image-based services in a distributed environment. It is composed of three main components: the web client for user interaction, the web application server for request processing, and the service module for image analysis. Specifically, this manuscript presents two automatic services: tear film classification, which classifies an image into one interference pattern; and tear film map, which illustrates the distribution of the patterns over the entire tear film. iDEAS has been evaluated by specialists from different institutions to test its performance. Both services have been evaluated in terms of a set of performance metrics using the annotations of different experts. Note that the processing time of both services has been also measured for efficiency purposes. iDEAS is a web-based application which provides a fast, reliable environment for dry eye assessment. The system allows practitioners to share images, clinical information and automatic assessments between remote computers. Additionally, it save time for experts, diminish the inter-expert variability and can be used in both clinical and research settings. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Primary Sjogren Syndrome: Case report

    Directory of Open Access Journals (Sweden)

    Eylem Yaman Pinarci

    2013-08-01

    Full Text Available The importance of systemic evaluation of dry eye patients and choosing appropriate treatment based on the severity of disease were emphasized with this case. 48 years old woman complained about decreased vision, burning, itching in both eyes which got worse over the years, for about 20 years. Schirmer I test value was 0 mm/5min in both eyes. Slit lamp examination revealed filamentary keratitis in both eyes. Anti-Ro/ SSA, anti-La/ SS-B antibodies and salivary gland biopsy for Sjogren syndrome were positive. Temporary punctal occlusion and oral hydroxychloroquine were added to her treatment. After 10 days, her overall dry eye condition improved and permanent punctual plugs were inserted in both lower puctums.Dry eye patients should be evaluated systemically and severity of disease should be considered before treatment is started. Addition to topical application of artificial tears, punctal occlusion may be a proper option in dry eye patients with Sjogren syndrome. [Cukurova Med J 2013; 38(4.000: 818-822

  11. Alteration of galectin-3 in tears of patients with dry eye disease.

    Science.gov (United States)

    Uchino, Yuichi; Mauris, Jerome; Woodward, Ashley M; Dieckow, Julia; Amparo, Francisco; Dana, Reza; Mantelli, Flavio; Argüeso, Pablo

    2015-06-01

    To investigate the expression, release, and proteolytic degradation of galectin-3 in patients with dry eye disease. Observational case series with a comparison group. Tear washes and conjunctival impression cytology specimens were collected through standard procedures from 16 patients with dry eye and 11 age-matched healthy subjects. Galectin-3 content in tears was analyzed by quantitative Western blot, using recombinant galectin-3 protein to generate a calibration curve. The relative expression of galectin-3 and matrix metalloproteinase 9 (MMP9) was evaluated by quantitative polymerase chain reaction. The cleavage of galectin-3 was studied in vitro using activated recombinant MMP9 and protease inhibitors. The concentration of galectin-3 protein in tears, but not galectin-3 expression in conjunctival epithelium, was significantly higher in tears of patients with dry eye (0.38 ng/μg total protein, range 0.04-1.36) compared to healthy subjects (0.12 ng/μg total protein, range 0.00-0.41) (P tear samples from healthy subjects, whereas 50% of the dry eye samples were characterized by the additional presence of a partially degraded form (∼25.4 kDa). In our experiments, elevated expression of MMP9 in dry eye subjects correlated with the ability of active MMP9 to cleave galectin-3 from recombinant origin. Interestingly, cleavage of endogenous galectin-3 in tear samples was impaired using a broad-spectrum proteinase inhibitor cocktail, but not the pan-specific MMP inhibitor GM6001, suggesting the presence of proteases other than MMPs in promoting galectin-3 degradation in dry eye. Our results indicate that release of cellular galectin-3 into tears is associated with epithelial dysfunction in dry eye, and that galectin-3 proteolytic cleavage may contribute to impaired ocular surface barrier function. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Impact of lifestyle intervention on dry eye disease in office workers: a randomized controlled trial.

    Science.gov (United States)

    Kawashima, Motoko; Sano, Kokoro; Takechi, Sayuri; Tsubota, Kazuo

    2018-04-04

    To evaluate the effects of a 2-month lifestyle intervention for dry eye disease in office workers. Prospective interventional study (randomized controlled study). Forty-one middle-aged Japanese office workers (men, 22; women, 19; 39.2 ± 8.0 years) with definite and probable dry eye disease were enrolled and randomized to an intervention group (n = 22) and a control group (n = 19). The intervention aimed at modifying diet, increasing physical activity, and encouraging positive thinking. The primary outcome was change in dry eye disease diagnoses. Secondary outcome was change in disease parameters, including dry eye symptoms, as assessed using the Dry Eye-Related Quality of Life Score, corneal and conjunctival staining scores, tear break-up time, and Schirmer test results. A total of 36 participants (intervention group, 17; control group, 19) completed the study. The number of definite dry eye disease diagnoses decreased from four to none (p =.05), and the dry eye symptom score showed a significant decrease in the intervention group (p =.03). In contrast, the corneal and conjunctival staining scores, tear break-up time, and Schirmer test results did not differ significantly between groups. The 2-month lifestyle intervention employed in this study improved dry eye disease status among office workers, with a considerable decrease in subjective symptoms. Lifestyle intervention may be a promising management option for dry eye disease, although further investigation of long-term effects are required.

  13. Evaluation of Dry Eye and Meibomian Gland Dysfunction in Teenagers with Myopia through Noninvasive Keratograph

    Science.gov (United States)

    Wang, Xiu; Lu, Xiaoxiao; Yang, Jun; Wei, Ruihua; Yang, Liyuan; Zhao, Shaozhen; Wang, Xilian

    2016-01-01

    Purpose. This study aims to evaluate dry eye and ocular surface conditions of myopic teenagers by using questionnaire and clinical examinations. Methods. A total of 496 eyes from 248 myopic teenagers (7–18 years old) were studied. We administered Ocular Surface Disease Index (OSDI) questionnaire, slit-lamp examination, and Keratograph 5M. The patients were divided into 2 groups based on OSDI dry eye standard, and their ocular surfaces and meibomian gland conditions were evaluated. Results. The tear meniscus heights of the dry eye and normal groups were in normal range. Corneal fluorescein scores were significantly higher whereas noninvasive break-up time was dramatically shorter in the dry eye group than in the normal group. All three meibomian gland dysfunction parameters (i.e., meibomian gland orifice scores, meibomian gland secretion scores, and meibomian gland dropout scores) of the dry eye group were significantly higher than those of the normal group (P dry eye in myopic teenagers is 18.95%. Meibomian gland dysfunction plays an important role in dry eye in myopic teenagers. The Keratograph 5M appears to provide an effective noninvasive method for assessing ocular surface situation of myopic teenagers. PMID:26881059

  14. [Novel current and future therapy options for treatment of dry eye disease].

    Science.gov (United States)

    Messmer, E M

    2018-02-01

    Dry eye disease was redefined by the dry eye workshop (DEWS II) in May 2017. According to the new definition "dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film and accompanied by ocular symptoms". The current definition encompasses etiological factors, such as instability and hyperosmolarity of the tear film, ocular surface inflammation and damage as well as a new aspect compared to the former definition, neurosensory abnormalities. Recent and future therapeutic options for dry eye focus on treatment of the aforementioned pathogenetic events. New tear substitutes, medications and devices to stimulate tear production, innovative anti-inflammatory treatment, medications to influence corneal innervation and new methods for treatment of Meibomian gland dysfunction are already available or will be available in the near future.

  15. Effect of rb-bFGF eye drops and hydroxyl indican eye drops on tear film stability and dry eye symptoms after age-related cataract surgery

    Directory of Open Access Journals (Sweden)

    Yu Ling

    2018-01-01

    Full Text Available AIM: To investigate the effect of recombinant bovine basic fibroblast growth factor(rb-bFGFeye drops and hydroxyl indican eye drops on tear film stability and dry eye symptoms after age-related cataract surgery. METHODS: Totally 80 patients with 80 affected eyes undergoing age-related cataract surgery in our hospital from January 2015 to October 2016 were selected as study subjects, and they were randomly divided into control group and experimental group with 40 patients(40 affected eyesin each group. The two groups were treated with hydroxyl indican eye drops and rb-bFGF eye drops, respectively. The clinical curative effect, inflammation related factors \\〖interleukin 6(IL-6, tumor necrosis factor α(TNF-α\\〗, Schirmer test(SⅠt, break-up time(BUTof tear film, corneal sodium fluorescein staining(FLand scores of dry eye symptoms in the two groups were observed. RESULTS: The total treatment effective rate of experimental group after treatment was significantly higher than that of the control group(90.0% vs 72.5%; χ2=4.021, PP>0.05. After treatment, IL-6, TNF-α, SⅠt, FL score and scores of dry eye symptoms in two groups significantly decreased while BUT significantly increased(PPCONCLUSION: In the treatment of patients after age-related cataract after surgery, rb-bFGF eye drops has more advantages over hydroxyl indican eye drops in regulating the expression of inflammatory factors, improving the tear film stability and relieving dry eye symptoms.

  16. Symptomatic Dry Eye and Its Associated Factors: A Study of University Undergraduate Students in Ghana.

    Science.gov (United States)

    Asiedu, Kofi; Kyei, Samuel; Boampong, Frank; Ocansey, Stephen

    2017-07-01

    To estimate the prevalence and risk factors of symptomatic dry eye disease (DED) among undergraduate students in a Ghanaian university. This cross-sectional study included 700 undergraduate students of the University of Cape Coast, aged 18 to 34 years. Participants completed questionnaires delivered directly to randomly and systematically selected subjects to detect symptomatic dry eye and its predictive factors. Symptomatic dry eye was defined as any reported symptom on the Standard Patient Evaluation Eye Dryness (SPEED) questionnaire reported as often or constant or if any symptom on the Ocular Surface Disease Index (OSDI) was reported as most of the time or all of the time. Furthermore, OSDI ≥13 and SPEED ≥6 were used to defined symptomatic dry eye and prevalence were also estimated with these criteria as secondary measures. Current symptoms of dry eye and possible risk factors such as age, gender, current alcohol drinking, use of oral contraceptives, use of computer more than an hour daily, environmental conditions, allergies, and self-medication with over-the-counter eye drops were the main outcome measures. We used logistic regression analysis to examine the associations between dry eye and its predictive factors. Of the 700 participants, 650 completed the questionnaire. The prevalence of symptomatic dry eye was 44.3% (95% confidence interval [CI], 40.6%-48.2%). There was a significant association between symptomatic dry eye and discomfort with eyes in windy conditions (χ=110.1; df=4; Peye drops (OR 4.20; 95% CI, 2.61-6.74; Pdry eye. Sex was predictive in univariate analysis but was not significantly associated in multivariate analysis. The prevalence of symptomatic dry eye among undergraduate students in Ghana is high and it is associated with self-medication with over-the-counter eye drops, allergies, use of oral contraceptive, windy conditions, very low humid areas, air-conditioned rooms, and sex. Relevant input directed against modifiable risks

  17. Efficacy of vitrectomy and epiretinal membrane peeling in eyes with dry age-related macular degeneration.

    Science.gov (United States)

    Mason, John O; Patel, Shyam A

    2015-01-01

    To study the efficacy of epiretinal membrane (ERM) peeling in eyes with dry age-related macular degeneration (AMD). We retrospectively analyzed patient charts on 17 eyes (16 patients) that underwent ERM peeling with a concurrent diagnosis of dry AMD. Eyes with concurrent dry AMD and with a good preoperative best-corrected visual acuity (BCVA) (better than or equal to 20/50) had a statistically significant mean BCVA improvement at 6 months after ERM peeling. There was a statistical increase in mean BCVA from 20/95 to 20/56 in dry AMD eyes, and no eyes showed worsening in BCVA at 6 months or at most recent follow-up. Five/seventeen (29.4%) eyes had cataract formation or progression. There were no other complications, reoperations, or reoccurrences. ERM peeling in eyes with dry AMD may show significant improvement, especially in eyes with good preoperative BCVA. The procedure is relatively safe with low complications and reoccurrences.

  18. Predictive factors for the placebo effect in clinical trials for dry eye: a pooled analysis of three clinical trials.

    Science.gov (United States)

    Imanaka, Takahiro; Sato, Izumi; Tanaka, Shiro; Kawakami, Koji

    2017-11-01

    Placebo effect is one of the methodological difficulties in dry eye clinical trials. If we could elucidate the tendencies of the placebo response and find predictors, we could reduce the placebo response in clinical trials for dry eye. In this study, we investigated the predictive factors for the placebo effect in dry eye clinical trials. A total of 205 patients with dry eye assigned to the placebo arms of three placebo-controlled randomised clinical trials were analysed by simple and multivariable regression analysis. The corneal fluorescein (FL) staining score and dry eye symptoms were studied at week 4. The variables of interest included gender, age, complications of Sjögren's syndrome, Schirmer's test I value, tear break-up time and conjunctival hyperaemia score. We also conducted a stratified analysis according to the patients' age. Among all the studied endpoints, the baseline scores were significantly related to the corresponding placebo response. In addition, for the FL score and the dryness score, age was a significant predictor of the placebo response (p=0.04 and p<0.0001, respectively). Stratified analysis by age showed that patients more than 40 years of age are more likely to have a stronger placebo response in the FL and dryness scores. The baseline scores and age were predictive factors of the placebo response in frequently used endpoints, such as FL score or dryness symptoms. These patient characteristics can be controlled by study design, and our findings enable the design of more efficient placebo-controlled studies with good statistical power. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Investigation of extended blinks and interblink intervals in subjects with and without dry eye

    Directory of Open Access Journals (Sweden)

    Rodriguez JD

    2013-02-01

    Full Text Available John D Rodriguez,1 George W Ousler III,1 Patrick R Johnston,1 Keith Lane,1 Mark B Abelson1,21Ora, Inc, Andover, MA, 2Schepens Eye Research Institute and Harvard Medical School, Boston, MA, USABackground: The purpose of this study was to investigate the occurrence and duration of extended blinks ≥ 70 msec and their associated interblink intervals in normal subjects and in subjects with mild to moderate dry eye.Methods: This single-center, prospective, double-blind study included 11 subjects with dry eye and eight subjects with normal eyes. Extended blinks were defined as lid closure in at least two successive video frames (≥ 70 msec. Digital video imaging of each subject's eyes was recorded while the subject viewed a 10-minute documentary. The subjects did not know that blink was the outcome being measured. Following capture, the videos were manually analyzed in a masked fashion for the occurrence of extended blinks. The length of the interblink interval (ie, time between blinks before and after these extended blinks (the interblink interval ratio was calculated, as well as differences in lid contact times.Results: The dry eye group had a median extended blink duration which was 2.53 times longer than that of the normal group. For subjects with dry eye, interblink intervals post-extended blink were significantly longer than interblink intervals pre-extended blink (P < 0.001. Interblink intervals did not lengthen significantly in normal subjects. In both groups, the duration of the extended blink was significantly (P = 0.001 and positively correlated with interblink interval ratio (post-extended to pre-extended blink interblink interval, such that for each doubling of extended blink duration, the interblink interval ratio increased by 10%. Blinks longer than one second in duration occurred almost exclusively in subjects with dry eye.Conclusion: This study reports three central findings: blink duration tended to be longer in subjects with dry

  20. Influence of preoperative artificial tears on tear film after phacoemulsification on dry eye of diabetes patients

    Directory of Open Access Journals (Sweden)

    Rui Su

    2015-05-01

    Full Text Available AIM: To discuss the artificial tears on the tear film of diabetic patients with dry eye preoperatively, and the influence on the tear film's fuctional after phacoemulsification.METHODS: Fifty-four diabetic patients with dry eye(60 eyeswere followed up before phacoemulsification. Preoperatively, group A(30 eyes in 28 caseswas treated with Hydroxyl Indican eye drops and group B(30 eyes in 26 caseswas not treated. Postoperatively, both group A and B were treated with Tobramycin Dexamethasone eye drops, Oprah Winfrey Ibuprofen eye drops and Hydroxyl Indican eye drops. Dry eye symptoms, break up time(BUT, Schirmer Ⅰ test(S Ⅰ t, fluorescein stain test(FIwere measured at 3d preoperatively, and 1, 7, 30, 90d postoperatively.RESULTS: At 3d preoperatively, there was no statistical differences between the two groups for dry eye symptoms, BUT, SⅠt, FI(P>0.05. At 1 and 7d postoperatively, there were significant statistical differents between the two groups for dry eye symptoms(PPP>0.05.CONCLUSION: Using artificial tears before phacoemulsification can improve symptoms of the diabetic patients with dry eye and accelerate the recovery of the tear film.

  1. Presence of Dry Eye in Patients with Hashimoto’s Thyroiditis

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    Emrah Kan

    2014-01-01

    Full Text Available Purpose. To evaluate the tear function tests in patients with Hashimoto’s thyroiditis and to compare the results with healthy subjects. Methods. A hundred and ten patients with Hashimoto’s thyroiditis and 100 healthy subjects were included in this study. The presence of thyroid-associated ophthalmopathy and tear function tests were evaluated clinically. The results were first compared between the patients and the control groups and then compared between patients with NOSPECS and patients without NOSPECS. Logistic regression analyses of the risk factors for dry eye including sex, gender, free plasma thyroxine, proptosis, upper eyelid margin-reflex distance, and duration of the disease were also evaluated. Results. The mean ocular surface disease index score was significantly higher and mean Schirmer and mean tear break-up time scores were significantly lower in patients compared to control subjects. Mean Schirmer and tear break-up time scores were found to be significantly lower in patients with NOSPECS when compared to the patients without NOSPECS. Both proptosis and free plasma thyroxine levels were significantly associated with dry eye. Conclusions. Patients with Hashimoto’s thyroiditis tend to develop dry eye more common than healthy subjects. Proptosis and lower free plasma thyroxine levels were found to be risk factors for the presence of dry eye.

  2. The application of autologous serum eye drops in severe dry eye patients; subjective and objective parameters before and after treatment.

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    Jirsova, Katerina; Brejchova, Kristyna; Krabcova, Ivana; Filipec, Martin; Al Fakih, Aref; Palos, Michalis; Vesela, Viera

    2014-01-01

    To assess the impact of autologous serum (AS) eye drops on the ocular surface of patients with bilateral severe dry eye and to draw a comparison between the clinical and laboratory examinations and the degree of subjective symptoms before and after serum treatment. A three-month prospective study was conducted on 17 patients with severe dry eye. AS eye drops were applied a maximum of 12 times a day together with regular therapy. Dry eye status was evaluated by clinical examination (visual acuity, Schirmer test, tear film breakup time, vital staining, tear film debris and meniscus), conjunctival impression cytology (epithelial and goblet cell density, snake-like chromatin, HLA-DR-positive and apoptotic cells) and subjectively by the patients. The application of AS eye drops led to a significant improvement in the Schirmer test (p treatment. A significant decrease (p eyes. We found that three-month AS treatment led especially to the improvement of ocular surface dryness and damage of the epithelium. The improvement of dry eye after AS treatment correlated well with the clinical, laboratory and subjective findings. From the patients' subjective point of view, the positive effect of AS decreased with time, but still persisted up to three months after the end of therapy.

  3. Plasma Rich in Growth Factors for the Treatment of Dry Eye after LASIK Surgery.

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    Sanchez-Avila, Ronald Mauricio; Merayo-Lloves, Jesus; Fernandez, Maria Laura; Rodriguez-Gutierrez, Luis Alberto; Jurado, Nancy; Muruzabal, Francisco; Orive, Gorka; Anitua, Eduardo

    2018-06-08

    The aim of this study was to evaluate the use of plasma rich in growth factors (PRGF) eye drops in patients with dry eye disease after laser-assisted in situ keratomileusis (LASIK) surgery. This is a longitudinal, retrospective, comparative, and descriptive study of 77 eyes of 42 patients with dry eye disease following LASIK surgery. This study was designed to evaluate the efficacy of PRGF treatment compared to conventional therapy (control group). Outcome measures including signs and symptoms of dry eye disease were evaluated before and after treatment. The percentage of change before and after treatment for each clinical variable measured was compared between both groups. There were 1-4 treatment cycles with PRGF eye drops (1 cycle = 6 weeks). Results showed a statistically significant improvement in the Ocular Surface Disease Index (38.12%), visual analogue scale scores for frequency (41.89%) and severity (42.47%), and the Schirmer test scores (88.98%) after PRGF treatment (p eye drops are effective for the improvement of dry eye symptoms in patients who underwent LASIK surgery in comparison to the conventional therapy. The treatment with PRGF is an alternative for patients who suffer from postoperative dry eye. © 2018 S. Karger AG, Basel.

  4. Rethinking dry eye disease: a perspective on clinical implications.

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    Bron, Anthony J; Tomlinson, Alan; Foulks, Gary N; Pepose, Jay S; Baudouin, Christophe; Geerling, Gerd; Nichols, Kelly K; Lemp, Michael A

    2014-04-01

    Publication of the DEWS report in 2007 established the state of the science of dry eye disease (DED). Since that time, new evidence suggests that a rethinking of traditional concepts of dry eye disease is in order. Specifically, new evidence on the epidemiology of the disease, as well as strategies for diagnosis, have changed the understanding of DED, which is a heterogeneous disease associated with considerable variability in presentation. These advances, along with implications for clinical care, are summarized herein. The most widely used signs of DED are poorly correlated with each other and with symptoms. While symptoms are thought to be characteristic of DED, recent studies have shown that less than 60% of subjects with other objective evidence of DED are symptomatic. Thus the use of symptoms alone in diagnosis will likely result in missing a significant percentage of DED patients, particularly with early/mild disease. This could have considerable impact in patients undergoing cataract or refractive surgery as patients with DED have less than optimal visual results. The most widely used objective signs for diagnosing DED all show greater variability between eyes and in the same eye over time compared with normal subjects. This variability is thought to be a manifestation of tear film instability which results in rapid breakup of the tearfilm between blinks and is an identifier of patients with DED. This feature emphasizes the bilateral nature of the disease in most subjects not suffering from unilateral lid or other unilateral destabilizing surface disorders. Instability of the composition of the tears also occurs in dry eye disease and shows the same variance between eyes. Finally, elevated tear osmolarity has been reported to be a global marker (present in both subtypes of the disease- aqueous-deficient dry eye and evaporative dry eye). Clinically, osmolarity has been shown to be the best single metric for diagnosis of DED and is directly related to

  5. Severe Psychomotor Delay in a Severe Presentation of Cat-Eye Syndrome

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    Guillaume Jedraszak

    2015-01-01

    Full Text Available Cat-eye syndrome is a rare genetic syndrome of chromosomal origin. Individuals with cat-eye syndrome are characterized by the presence of preauricular pits and/or tags, anal atresia, and iris coloboma. Many reported cases also presented with variable congenital anomalies and intellectual disability. Most patients diagnosed with CES carry a small supernumerary bisatellited marker chromosome, resulting in partial tetrasomy of 22p-22q11.21. There are two types of small supernumerary marker chromosome, depending on the breakpoint site. In a very small proportion of cases, other cytogenetic anomalies are reportedly associated with the cat-eye syndrome phenotype. Here, we report a patient with cat-eye syndrome caused by a type 1 small supernumerary marker chromosome. The phenotype was atypical and included a severe developmental delay. The use of array comparative genomic hybridization ruled out the involvement of another chromosomal imbalance in the neurological phenotype. In the literature, only a few patients with cat-eye syndrome present with a severe developmental delay, and all of the latter carried an atypical partial trisomy 22 or an uncharacterized small supernumerary marker chromosome. Hence, this is the first report of a severe neurological phenotype in cat-eye syndrome with a typical type 1 small supernumerary marker chromosome. Our observation clearly complicates prognostic assessment, particularly when cat-eye syndrome is diagnosed prenatally.

  6. Investigation of the morbidity of dry eye among special crowd in Shunde district

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    Zhi-Hui Li

    2013-08-01

    Full Text Available AIM: To investigate the morbidity of dry eye in policeman of Shunde district, and to analyze the related factors and proposed methods of preventing and treating dry eye.METHODS:Totally 650 policemen who came for physical examination in Shunde district recived questionnaire survey. The patients with dye eye disease were finally diagnosed through slit lamp examination, Schirmer test, tear film break-up time(BUTmeasurement and keratoconjunctival fluorescent staining. The morbidity among different policemen was further analyzed and stasticed.RESULTS:The results showed that 152 in 650 policemen suffered from dry eye disease, the ratio was 23.4%. Comparied with security police and crimanl police, the ratio in traffic police, patrolman,and back office police was significantly higher. The prevalence was higher when the ages were greater than 40.CONCLUSION: Unsuitable working environment, air contamination are high risk factors of dry eye disease.

  7. An update on dry eye disease molecular treatment: advances in drug pipelines.

    Science.gov (United States)

    Colligris, Basilio; Crooke, Almudena; Huete-Toral, Fernando; Pintor, Jesus

    2014-07-01

    Dry eye disease is a common disorder provoking changes in tear film and ocular surface. Untreated dry eye could cause ocular infections, corneal ulcer and blindness. Only a few drugs are authorized so far for the treatment of dry eye disease and the possibilities of evolution in this sector are immense. Consequently, a significant number of new potential solutions are under development or placed in the pharmaceutical pipeline, promising better results and lesser side effects. In this article, the corresponding literature and recent Phase III clinical trial data and the corresponding literature, for dry eye disease treatment are reviewed, revealing the new strategic movements in drug pipelines. From the clinical trial results, the advancement in tear substitutes and secretagogues in addressing specific deficiencies of tear components even though not resolving the underlying conditions of the disease is evident. The vast majority of new compounds under development are anti-inflammatories, steroids, non-steroids and antibiotics; however, there are also some novel lubricating drops and mucin-tear secretagogues. A future aggressive therapy for dry eye, depending on the severity of the symptoms, would include combinations of soft steroids, anti-inflammatories, such as cyclosporine A, with the addition of the new polyvalent mucin and tear secretagogues.

  8. Safety and Efficacy of Lacrimal Drainage System Plugs for Dry Eye Syndrome: A Report by the American Academy of Ophthalmology.

    Science.gov (United States)

    Marcet, Marcus M; Shtein, Roni M; Bradley, Elizabeth A; Deng, Sophie X; Meyer, Dale R; Bilyk, Jurij R; Yen, Michael T; Lee, W Barry; Mawn, Louise A

    2015-08-01

    To review the published literature assessing the efficacy and safety of lacrimal drainage system plug insertion for dry eye in adults. Literature searches of the PubMed and Cochrane Library databases were last conducted on March 9, 2015, without date restrictions and were limited to English language abstracts. The searches retrieved 309 unique citations. The primary authors reviewed the titles and abstracts. Inclusion criteria specified reports that provided original data on plugs for the treatment of dry eyes in at least 25 patients. Fifty-three studies of potential relevance were assigned to full-text review. The 27 studies that met the inclusion criteria underwent data abstraction by the panels. Abstracted data included study characteristics, patient characteristics, plug type, insertion technique, treatment response, and safety information. All studies were observational and rated by a methodologist as level II or III evidence. The plugs included punctal, intracanalicular, and dissolving types. Fifteen studies reported metrics of improvement in dry eye symptoms, ocular-surface status, artificial tear use, contact lens comfort, and tear break-up time. Twenty-five studies included safety data. Plug placement resulted in ≥50% improvement of symptoms, improvement in ocular-surface health, reduction in artificial tear use, and improved contact lens comfort in patients with dry eye. Serious complications from plugs were infrequent. Plug loss was the most commonly reported problem with punctal plugs, occurring on average in 40% of patients. Overall, among all plug types, approximately 9% of patients experienced epiphora and 10% required removal because of irritation from the plugs. Canaliculitis was the most commonly reported problem for intracanalicular plugs and occurred in approximately 8% of patients. Other complications were reported in less than 4% of patients on average and included tearing, discomfort, pyogenic granuloma, and dacryocystitis. On the basis of

  9. Acupuncture for dry eye: a randomised controlled trial protocol

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    Kim Ae-Ran

    2009-12-01

    Full Text Available Abstract Background Dry eye is usually managed by conventional medical interventions such as artificial tears, anti-inflammatory drugs and surgical treatment. However, since dry eye is one of the most frequent ophthalmologic disorders, safer and more effective methods for its treatment are necessary, especially for vulnerable patients. Acupuncture has been widely used to treat patients with dry eye. Our aim is to evaluate the effectiveness and safety of acupuncture for this condition. Methods/Design A randomised, patient-assessor blinded, sham (non-acupuncture point, shallow acupuncture controlled study was established. Participants allocated to verum acupuncture and sham acupuncture groups will be treated three times weekly for three weeks for a total of nine sessions per participant. Seventeen points (GV23; bilateral BL2, GB4, TE23, Ex1 (Taiyang, ST1 and GB20; and left SP3, LU9, LU10 and HT8 for men, right for women have been selected for the verum acupuncture; for the sham acupuncture, points have been selected that do not coincide with a classical acupuncture point and that are located close to the verum points, except in the case of the rim of the eye. Ocular surface disease index, tear film breakup time, the Schirmer I test, medication quantification scale and general assessment of improvement will be used as outcome variables for evaluating the effectiveness of acupuncture. Safety will also be assessed at every visit. Primary and secondary outcomes will be assessed four weeks after screening. All statistical analyses will be performed using analysis of covariance. Discussion The results of this trial will be used as a basis for clarifying the efficacy of acupuncture for dry eye. Trial registration ClinicalTrials.gov NCT00969280.

  10. Oral supplementation with a nutraceutical formulation containing omega-3 fatty acids, vitamins, minerals, and antioxidants in a large series of patients with dry eye symptoms: results of a prospective study

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    Gatell-Tortajada J

    2016-05-01

    Full Text Available Jordi Gatell-TortajadaOn behalf of the Large Dry Eye Clinical Study Group (LDECSGCornea and Ocular Surface Department, Institut Català de Retina, Barcelona, SpainPurpose: To assess the benefits and tolerability of a dietary supplement based on omega-3 fatty acids to relieve dry eye symptoms.Methods: A total of 1,419 patients (74.3% women, mean age 58.9 years with dry eye syndrome using artificial tears participated in a 12-week prospective study. Patients were instructed to take 3 capsules/day of the nutraceutical formulation (Brudysec® 1.5 g. Study variables were dry eye symptoms (scratchy and stinging sensation, eye redness, grittiness, painful and tired eyes, grating sensation, and blurry vision, conjunctival hyperemia, tear breakup time (TBUT, Schrimer I test, and Oxford grading scheme.Results: At 12 weeks, each dry eye symptom improved significantly (P<0.001, and the use of artificial tears decreased significantly from 3.77 (standard deviation [SD] =2.08 at baseline to 3.45 (SD =1.72 (P<0.01. In addition, the Schirmer test scores and the TBUT increased significantly, and there was an increase in patients grading 0–I in the Oxford scale and a decrease of those grading IV–V. Significant differences in improvements of dry eye symptoms were also found in compliant versus noncompliant patients as well as in those with moderate/severe versus none/mild conjunctival hyperemia.Conclusion: Oral ω-3 fatty acids supplementation was an effective treatment for dry eye symptoms.Keywords: dry eye symptoms, artificial tears, omega-3 polyunsaturated fatty acids, nutraceutical supplement, ocular inflammation, eye discomfort

  11. Evaluating of Tear Meniscus Parameters with Optical Coherent Tomography in Dry-Eye Patients

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    Gülizar Soyugelen Demirok

    2013-08-01

    Full Text Available Purpose: To evaluate the changes in meniscus parameters with optical coherence tomography (OCT after treatment and consider the correlation between the OCT parameters and dry-eye tests. Material and Method: Thirty-two dry-eye patients and 30 healthy individuals were included. Visual acuities, biomicroscopic evaluation, Schirmer-I test, tear-break-up time (T-BUT, and lower-tear meniscus parameters measured with OCT were evaluated. Ocular surface disease index (OSDI was performed. The measurements were repeated on the 10th day and 1st month of the treatment. Lower tear meniscus height (LTMH, depth (LTMD, area (LTMA and α-angle were measured. The tear meniscus parameters of the dry-eye group were compared with the control group before treatment, and the correlation between the dry-eye tests and OCT measurements were evaluated. The change in the results of the dry-eye tests and OCT measurements with treatment were assessed. Results: There was statistically no significant difference between the age and gender of the patients in groups. Before treatment the mean Schirmer-I test, TBUT and OSDI scores were different. The LTMH and LTMA were higher in the control group. In the dry-eye group before treatment, there was a negative correlation between the OSDI score and OCT parameters, however, no meaningful correlation was observed between any other test and OCT parameters. Although there were no change in LTMD and α-angle with treatment, the 1st month values of LTMH and LTMA were significantly higher from the pre-treatment and 10th day values. Discussion: When diagnosing dry-eye, TBUT and OSDI scores were found to be more effective compared to Schirmer-I test for the diagnosis of dry eye. Although not adequate by itself, tear meniscus parameters measured with OCT, LTMH and LTMA, may be helpful for evaluating the efficacy of treatment, and the correlation of these two parameters with the OSDI score may increase the objectivity while questioning the

  12. The influence of protein free calf blood extract eye gel on dry eye after pterygium surgery

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    Cai-Ni Ji

    2013-07-01

    Full Text Available AIM: To investigate the influence of protein free calf blood extract eye gel on dry eye after pterygium surgery. METHODS: Thirty six patients(40 eyeswith primary nasal pterygium were enrolled in this study, which were divided into study group and control group randomly, with 20 eyes in each group. All patients received pterygium excision and limbal stem cell autograft surgery and tobramicin dexamethasone eye drops after surgery. Patients of the study group received protein free calf blood extract eye gel while those of the control group received 0.1% sodium hyaluronate eye drops furthermore. Ocular surface disease index(OSDIquestionnaire, tear film break-up time(BUTand Schirmer's Ⅰ test Ⅰ(SⅠtwere carried before and 3 months after surgery to evaluate the dry eye degree of the patients. RESULTS: There was no statistical difference between the age, gender and size of the pterygium of the study and control groups preoperatively. There was no statistical difference between the OSDI(2.33±1.02 vs 2.32±0.93, BUT(8.80±2.48 vs 8.35±2.28seconds and SⅠt(4.30±2.30 vs 4.40±2.44of the two groups preoperatively. There was statistical difference between the OSDI(1.45±0.47 vs 1.81±0.60, BUT(11.20±2.07 vs 9.50±2.40seconds and SⅠt(8.35±3.13 vs 6.35±2.18of the two groups 3 months postoperatively, which was also different from that of the preoperative data correspondingly. CONCLUSION: Protein free calf blood extract eye gel could reduce the dry eye after pterygium surgery.

  13. Investigation on risk factors of dry eye in type 2 diabetes patients

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    Hu-Xing Shen

    2018-01-01

    Full Text Available AIM: To estimate the correlation between diabetic duration, blood glucose levels, plasma C-peptide and dry eye, and the risk factors for dry eye in patients with type 2 diabetes mellitus(T2DMMETHODS: The clinical data of 51 patients(102 eyeswith type 2 diabetes diagnosed by the Department of Endocrinology, Jiangsu Provincial Hospital of Traditional Chinese Medicine was collected, in that 44 cases(88 eyesof patients diagnosed with dry eye. Those patients were detected for the levels of glycosylated hemoglobin A1c(HbA1c, fasting blood-glucose(FBG, postprandial 2h blood-glucose(2h PBG, fasting plasma C-peptide and insulin, 1h C-peptide and insulin. Corneal fluorescein staining(FL, tear break-up time(BUTand Schirmer Ⅰ test(SⅠtwere collected from all subjects. Compared biochemistry index and ocular surface index. The multiple Logistic regression was used to analyze the risk factors for dry eye in patients with T2DM. RESULTS: There was no significant differences between the patients with different diabetic duration, on BUT, SⅠt, winking frequency, vision, FL and the scores of dry eye symptoms(P>0.05. HbA1c was significantly correlated with FL(P0.05. There were significant differences in FL among patients with HbA1c in 8.1% to 11.8%(P0.01. FBG was significantly correlated with FL and winking frequency(P0.05. The 2h PBG was significantly correlated with tear secretion and vision(P0.05. Plasma C-peptide was significantly correlated with BUT(PP0.05. FBG and plasma C-peptide in T2DM patients were risk factors for occurrence of dry eye(P0.05. CONCLUSION: Poor function of insulin secretion and poor control of blood glucose in T2DM patients are risk factors for dry eye. Both of them can decline tear film stability. High blood glucose levels easily lead to decrease of tear secretion, vision and corneal epithelial defect.

  14. Calorie restriction: A new therapeutic intervention for age-related dry eye disease in rats

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    Kawashima, Motoko; Kawakita, Tetsuya; Okada, Naoko; Ogawa, Yoko; Murat, Dogru; Nakamura, Shigeru; Nakashima, Hideo; Shimmura, Shigeto; Shinmura, Ken; Tsubota, Kazuo

    2010-01-01

    A decrease in lacrimal gland secretory function is closely related to aging and leads to an increased prevalence of dry eye syndrome. Since calorie restriction (CR) is considered to prevent functional decline of various organs due to aging, we hypothesized that CR could prevent age-related lacrimal dysfunction. Six-month-old male Fischer 344 rats were randomly divided into ad libitum (AL) and CR (-35%) groups. After 6 months of CR, tear function was examined under conscious state. After euthanasia, lacrimal glands were subjected to histological examination, tear protein secretion stimulation test with Carbachol, and assessment of oxidative stress with 8-hydroxy-2 deoxyguanosine (8-OHdG) and 4-hydroxynonenal (HNE) antibodies. CR significantly improved tear volume and tended to increase tear protein secretion volume after stimulation with Carbachol compared to AL. The acinar unit density was significantly higher in the CR rats compared to AL rats. Lacrimal glands in the CR rats showed a lesser degree of interstitial fibrosis. CR reduced the concentration of 8-OHdG and the extent of staining with HNE in the lacrimal gland, compared to AL. Furthermore, our electron microscopic observations showed that mitochondrial structure of the lacrimal gland obtained from the middle-aged CR rats was preserved in comparison to the AL rats. Collectively, these results demonstrate for the first time that CR may attenuate oxidative stress related damage in the lacrimal gland with preservation of lacrimal gland functions. Although molecular mechanism(s) by which CR maintains lacrimal gland function remains to be resolved, CR might provide a novel therapeutic strategy for treating dry eye syndrome.

  15. Calorie restriction: A new therapeutic intervention for age-related dry eye disease in rats

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    Kawashima, Motoko; Kawakita, Tetsuya; Okada, Naoko; Ogawa, Yoko [Department of Ophthalmology, Keio University School of Medicine, Tokyo (Japan); Murat, Dogru [Department of Ocular Surface and Visual Optics, Keio University School of Medicine, Tokyo (Japan); Nakamura, Shigeru; Nakashima, Hideo [Research Center, Ophtecs Corporation, Hyogo (Japan); Shimmura, Shigeto [Department of Ophthalmology, Keio University School of Medicine, Tokyo (Japan); Shinmura, Ken [Division of Geriatric Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo (Japan); Tsubota, Kazuo, E-mail: tsubota@sc.itc.keio.ac.jp [Department of Ophthalmology, Keio University School of Medicine, Tokyo (Japan)

    2010-07-09

    A decrease in lacrimal gland secretory function is closely related to aging and leads to an increased prevalence of dry eye syndrome. Since calorie restriction (CR) is considered to prevent functional decline of various organs due to aging, we hypothesized that CR could prevent age-related lacrimal dysfunction. Six-month-old male Fischer 344 rats were randomly divided into ad libitum (AL) and CR (-35%) groups. After 6 months of CR, tear function was examined under conscious state. After euthanasia, lacrimal glands were subjected to histological examination, tear protein secretion stimulation test with Carbachol, and assessment of oxidative stress with 8-hydroxy-2 deoxyguanosine (8-OHdG) and 4-hydroxynonenal (HNE) antibodies. CR significantly improved tear volume and tended to increase tear protein secretion volume after stimulation with Carbachol compared to AL. The acinar unit density was significantly higher in the CR rats compared to AL rats. Lacrimal glands in the CR rats showed a lesser degree of interstitial fibrosis. CR reduced the concentration of 8-OHdG and the extent of staining with HNE in the lacrimal gland, compared to AL. Furthermore, our electron microscopic observations showed that mitochondrial structure of the lacrimal gland obtained from the middle-aged CR rats was preserved in comparison to the AL rats. Collectively, these results demonstrate for the first time that CR may attenuate oxidative stress related damage in the lacrimal gland with preservation of lacrimal gland functions. Although molecular mechanism(s) by which CR maintains lacrimal gland function remains to be resolved, CR might provide a novel therapeutic strategy for treating dry eye syndrome.

  16. Amniotic membrane extract ameliorates benzalkonium chloride-induced dry eye in a murine model.

    Science.gov (United States)

    Xiao, Xinye; Luo, Pingping; Zhao, Hui; Chen, Jingyao; He, Hui; Xu, Yuxue; Lin, Zhirong; Zhou, Yueping; Xu, Jianjiang; Liu, Zuguo

    2013-10-01

    Human amniotic membrane (AM) is avascular but contains various beneficial bioactive factors, its extract (AE) is also effective in treating many ocular surface disorders. In this study, we for the first time evaluated the therapeutic effects of AE on dry eye induced by benzalkonium chloride in a BALB/c mouse model. Topical application of AE (1.5 and 3 μg/eye/day) resulted in significantly longer tear break-up time on Day 3 and 6, lower fluorescein staining scores on Day 3, and lower inflammatory index on Day 6. AE reduced corneal epithelial K10 expression, inflammatory infiltration, and levels of TNF-α, IL-1β and IL-6 in BAC treated mice than that in the control mice. Moreover, decreased TUNEL positive cells in cornea and increased goblet cells in conjunctiva were also observed in AE treated corneas. Finally, AE induced more Ki-67 positive cells in corneal epithelium of dry eye mouse. Taken together, our data provide further support for BAC induced dry eye model as a valuable for dry eye study and suggest a great potential for AE as a therapeutic agent in the clinical treatment of dry eye. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Effects of PUVA on the eye

    International Nuclear Information System (INIS)

    Backman, H.A.

    1982-01-01

    Psoriasis is a common skin disease which may be treated with 8-methoxy psoralen and long-wave ultraviolet light (PUVA). Eye protection is provided during and after treatment to prevent the development of photokeratitis and cataracts. Fifteen patients, treated with medication and ultraviolet A (UVA) had an initial complete eye examination and a repeat examination after each treatment. No patients developed cataracts but almost one-half of the patients had a mild form of photokeratoconjunctivitis. The ocular manifestations included photophobia, conjunctivitis, keratitis, and dry eyes. Tear break-up time was reduced significantly immediately after treatment for two patients but returned to normal 8 hr later. Dermatologists who employ PUVA treatments should be concerned about photokeratoconjunctivitis and the dry-eye ocular manifestations included photophobia, conjunctivitis, keratitis, and dry eyes. Tear break-up time was reduced significantly immediately after treatment for two patients but returned to normal 8 hr later. Dermatologists who employ PUVA treatments should be concerned about photokeratoconjunctivitis and the dry-eye ocular manifestations included photophobia, conjunctivitis, keratitis, and dry eyes. Tear break-up time was reduced significantly immediately after treatment for two patients but returned to normal 8 hr later. Dermatologists who employ PUVA treatments should be concerned about photokeratoconjunctivitis and the dry-eye syndrome

  18. Evaluation of a novel dry eye model induced by oral administration of finasteride.

    Science.gov (United States)

    Li, Kai; Zhang, Chuanwei; Yang, Zichao; Wang, Yuliang; Si, Haipeng

    2017-12-01

    Dry eye is a common eye disease, and suitable animal models are indispensable for investigating the pathogenesis and developing treatments for dry eye. The present study was conducted to develop an androgen deficiency dry eye model induced by finasteride, and to evaluate ocular surface status and inflammatory cytokine gene expression in the lacrimal gland using a cytokine antibody array system. The results revealed that the antiandrogenic drug finasteride induced significant tear deficiency, and the histopathology results revealed significant inflammatory cell infiltration in the lacrimal gland. The cytokine antibody array system identified increased B7‑2 (also known as cluster of differentiation 86), interleukin (IL)‑1β, IL‑4, IL‑6, IL‑10, matrix metalloproteinase‑8, Fas ligand, tumor necrosis factor (TNF)‑α and metalloproteinase inhibitor 1 levels in the lacrimal gland of the dry eye model. These cytokines were validated as candidate markers through the use of western blot analysis and reverse transcription‑quantitative polymerase chain reaction. Both analyses confirmed a significant increase in proinflammatory cytokines, including IL‑1β, IL‑6 and TNF‑α, and anti‑inflammatory cytokines, including IL‑4 and IL‑10. The aforementioned data suggested that inflammation in antiandrogenic models resulted from a balance between inflammatory and anti‑inflammatory responses. Thus, direct finasteride administration may produce an applicable model for dry eye mediated by androgen deficiency. In addition, there may be a correlation between sex, steroid deficiency and the inflammatory response. The findings of the present study have provided useful information for the pathogenesis and diagnosis of dry eye mediated by androgen deficiency.

  19. Immunological impression cytology of the conjunctival epithelium in patients with thyroid orbitopathy-related dry eye.

    Science.gov (United States)

    Hsu, S L; Lee, P Y; Chang, C H; Chen, C H

    2016-08-30

    Thyroid orbitopathy (TO) is an autoimmune disease that is complicated by ocular surface disorders, leading to discomfort. Dry eye is very prevalent in patients with TO. Recent studies on the pathogenesis of dry eye have focused on the inflammatory process, and some supporting evidence has been discovered. Because TO is a disorder of autoimmune origin, we assumed that the association between TO and dry eye is related to inflammation. Inflammation of the ocular surface in TO-related dry eye has not been well studied. In this study, we assessed cellular inflammation of the ocular surface and the cytokine profiles in patients with TO-related dry eye. Conjunctival impression cytology (CIC) was assessed with an immunofluorescent assay. TO-related dry eye was diagnosed by using the Schirmer test, tear break-up time, thyroid function, and clinical signs. CIC was combined with immunological staining of interleukin-1a (IL-1a), IL-1b, and IL- 6. The immunological impression cytology (IC) grade was compared to the clinical activity score of TO. All TO patients with dry eye were positive for IL-1a, IL-1b, and IL-6. However, the normal controls were also positive for IL-1a. A trend was observed between the clinical inflammatory score and immunological IC grade. This study was the first to delineate the immunological IC of TO-related dry eye. Our study aimed to investigate the pathogenesis of dry eye in TO. Our findings suggest that the conjunctival cytokines IL-1a, IL-1b, and IL-6 may play a role. The results of this study will be useful for future studies of additional inflammatory cytokines, and the levels of these cytokines could be used as an outcome to assess the efficacy of treatment, such as anti-cytokine or immunosuppression therapy, in patients with TO-related dry eye or other ocular surface inflammatory disorders.

  20. Changes of Corneal Wavefront Aberrations in Dry Eye Patients after Treatment with Artificial Lubricant Drops

    Directory of Open Access Journals (Sweden)

    Ning Lu

    2016-01-01

    Full Text Available Purpose. To evaluate the corneal aberration changes in dry eye patients after treatment with artificial eye drops. Methods. Thirty mild to moderate dry eye patients treated with artificial eye drops and twenty comparable dry eye patients were recruited as controls. Anterior corneal aberrations over 3 mm and 5 mm analytical zones including total, 3rd to 5th high order aberrations (HOAs, spherical aberration (SA, and vertical (V-coma and horizontal coma (H-coma obtained from corneal topography data at baseline and 2 weeks after treatment were evaluated. Results. For 3 mm zone, trefoils, V-coma, H-coma terms, and 3rd and 5th HOAs were significantly decreased (p0.05. Conclusions. Treatment with artificial eye drops can effectively improve the corneal optical quality of dry eye patients by ameliorating the HOAs of anterior corneal surface.

  1. Evaluation of point-of-care test for elevated tear matrix metalloproteinase 9 in post-LASIK dry eyes.

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    Chan, Tommy C Y; Ye, Cong; Chan, Kwok Ping; Chu, Kai On; Jhanji, Vishal

    2016-09-01

    To evaluate the performance of a point-of-care test for detection of matrix metalloproteinase 9 (MMP-9) levels in post-laser-assisted in situ keratomileusis (LASIK) dry eyes. A comparative study between patients with mild to moderate post-LASIK dry eyes and age-matched normal subjects was conducted. Ocular surface disease index (OSDI), tear break-up time (TBUT), and tear film MMP-9 and total protein levels were compared between the two groups. A point-of-care test device (RPS InflammaDry, Sarasota, Florida, USA) was utilised to confirm elevated MMP-9 levels in tear film. Fourteen post-LASIK dry eyes and 34 normal eyes were included. There was no significant difference in age and gender between both groups (p>0.175). The OSDI was significantly higher (25.5±7.7 vs 7.4±2.5; pdry eye compared with normal subjects. The tear film MMP-9 levels were 52.7±32.5 ng/mL in dry eyes and 4.1±2.1 ng/mL in normal eyes (p40 ng/mL in 7/14 (50.0%) post-LASIK dry eyes. The InflammaDry was positive in 8/14 (57.1%) post-LASIK eyes. All positive cases had tear film MMP-9 levels ≥38.03 ng/mL. Agreement between InflammaDry and MMP-9 was excellent with Cohen κ value of 0.857 in post-LASIK dry eyes. Only half of post-LASIK dry eyes were found to have significant inflammation associated with elevated MMP-9. The OSDI is useful to non-specifically identify patients with symptomatic dry eye while the InflammaDry determined which patients with dry eye were associated with significant inflammation that may guide therapeutic management decisions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Effect of Oral Lactoferrin on Cataract Surgery Induced Dry Eye: A Randomised Controlled Trial.

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    Devendra, Jaya; Singh, Sneha

    2015-10-01

    Cataract surgery is one of the most frequently performed intra-ocular surgeries, of these manual Small Incision Cataract Surgery (SICS) is a time tested technique of cataract removal. Any corneal incisional surgery, including cataract surgery, can induce dry eye postoperatively. Various factors have been implicated, of which oneis the inflammation induced by the surgery. Lactoferrin, a glycoprotein present in tears is said to have anti-inflammatory effects, and promotes cell growth. It has been used orally in patients of immune mediated dry eye to alleviate symptoms. This study was aimed to evaluate the dry eyes induced by manual Small Incision Cataract Surgery, and the effect if any, of oral lactoferrin on the dry eyes. A single centre, prospective randomised controlled trial with a concurrent parallel design. The study was carried out on patients presenting in the OPD of Rohilkhand Medical College hospital for cataract surgery. Sixty four patients of cataract surgery were included in the study. Patients with pre-existing dry eyes, ocular disease or systemic disease predisposing to dry eyes were excluded from the study. The selected patients were assigned into two groups by simple randomisation-Control Group A-32 patients that did not receive oral lactoferrin postoperatively. Group B-32 patients that received oral lactoferrin 350 gm postoperatively from day 1 after SICS. All patients were operated for cataract and their pre and postoperative (on days 7, 14, 30 and 60) dry eye status was assessed using the mean tear film break-up time (tBUT) and Schirmer test 1 (ST 1) as the evaluating parameters. Subjective evaluation of dry eye was done using Ocular Surface Disease Index (OSDI) scoring. Data was analysed for 58 patients, as 6 did not complete the follow up. Unpaired t-test was used to calculate the p-values. There was a statistically significant difference between the tBUT values of the Control and Lactoferrin group from day 14 onwards. The tBUT of control group

  3. Clinical observation on individualized therapy for dry eye

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    Jing Tang

    2013-05-01

    Full Text Available AIM:To evaluate the efficacy of individualized therapy on dry eye induced by different reasons. METHODS: Totally 140 cases(140 eyesof dry eye were divided into three categories according to eye symptoms. First category: 60 cases(60 eyeswith meibomian gland dysfunction(MGDwere divided into A1 group(palpebralis margin treatment groupand B1 group(control group; Second category: 50 cases(50 eyeswith corneal epithelium damage(corneal fluorescence staining FL Score≥5were divided into A2 group(bandage contact lens groupand B2 group(control group; Third category: 30 cases(30 eyeswith low Schirmer test(Schirmer Ⅰ≤5mmwere divided into A3 group(lacrimal punctum plug groupand B3 group(control group. Both former categories treated by 1g/L fluorometholone eye drops and 1g/L hyaluronate sodium eye drops, but received limbus palpebralis cleaning, oral doxycycline in A1 group and bandage contact lens in A2 group else. The third category was treated by 10g/L cyclosporine A and carbomer eye gel, but lacrimal punctum plug in A3 group before received the drug treatment. Two weeks follow up, each case was examined by subjective symptom, cornea fluorescence colouration test, tear break-up time(BUT, and Schirmer test Ⅰ(SⅠtin the treatment groups(A1,A2,A3and the control groups(B1,B2,B3, the results pre- and post-treatment were compared. The t test was used for inferential statistics. RESULTS: There was no statistical difference between treatment groups(A1, A2, A3and control groups(B1, B2, B3before treatment. Two weeks after treatment, there was statistical difference between the treatment groups(A1, A2, A3and control groups(B1, B2, B3in subjective symptoms and BUT. The difference among A3 group(lacrimal punctum plug group, in which the lacrimal river line formed were observed 2 weeks after treatmentand B3 (control groupwas statistically significant in SⅠt. CONCLUSION:On base of anti-inflammatory and use of artificial tears, individualized therapy is an

  4. Safety and efficacy of autologous serum eye drop for treatment of dry eyes in graft-versus-host disease.

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    Azari, Amir A; Karadag, Remzi; Kanavi, Mozhgan Rezaei; Nehls, Sarah; Barney, Neal; Kim, Kyungmann; Longo, Walter; Hematti, Peiman; Juckett, Mark

    2017-06-01

    To evaluate the treatment of autologous serum eye drops (ASED) on dry eyes in patients with graft-versus-host disease (GVHD). A retrospective chart review of 35 patients with a history of ocular GVHD following hematopoietic stem cell transplantation that used ASED to alleviate dry eye symptoms was performed. Patients were categorized into three different groups. If patients had available ophthalmic data before and after starting treatment was group 1 (n = 14), had available ophthalmic data after starting treatment in group 2 (n = 10) and had available ophthalmic data before treatment or did not have any data after starting treatment in group 3 (n = 11). Data were collected on patient's age, gender, primary diagnosis, visual acuity and fluorescein corneal staining were collected on individual eyes in order to evaluate the efficacy of the ASED on alleviating dry eye-related signs and symptoms. No adverse ocular effect from the ASED was found in our series (except one fungal keratitis). All patients reported either improvement (55%) or stability (45%) in their ocular symptoms upon the use of ASED. In patients with available data before and after starting treatment, the corneal staining score improved by a median of 1 (p = 0.003) and the LogMAR visual acuity had a non-significant improvement. In our study, ASED used by patients with ocular GVHD were both safe and effective. ASED should be considered in patients with GVHD who suffer from dry eyes.

  5. Dry Eye Disease Incidence Associated with Chronic Graft-Host Disease: Nonconcurrent Cohort Study (An American Ophthalmological Society Thesis)

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    Mian, Shahzad I.; De la Parra-Colín, Paola; De Melo-Franco, Rafael; Johnson, Christopher; Barrientos-Gutierrez, Tonatiuh

    2015-01-01

    Purpose: To determine if chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (HSCT) is associated with stable or progressive dry eye disease and to determine the true incidence in patients with no prior history of dry eye disease. Methods: A nonconcurrent cohort study at a single institution with 136 patients who had no previous history of dry eye disease before HSCT. Survival analysis was used to estimate dry eye disease incidence. The incidence rate was calculated using life tables as the number of observed dry eye disease cases divided by the person-time at risk accumulated by the cohort. Transition probabilities were calculated from time of transplant to time of diagnosis, and then to last recorded visit. Results: Incidence rate was 0.8 cases of dry eye disease per person-year, and half of the population at risk developed dry eye disease during the first 10 months post transplant. Time to develop dry eye disease was 2.5 months for mild dry eye disease, 9.6 months for moderate dry eye disease, and 13.2 months for severe dry eye disease. In terms of cumulative incidence, 73% of subjects developed dry eye disease (50% mild, 16% moderate, and 7% severe) at the time of diagnosis. Conclusions: Our findings suggest that dry eye disease associated with cGVHD is an extremely frequent event and shows a wide spectrum of severity, with a mild form presenting early and a moderate to severe form presenting later after HSCT. These findings need to be studied further to elucidate if these are two different pathophysiological entities or just different expressions of the same pathology. PMID:27507907

  6. Assessment of Corneal Biomechanical Properties by CorVis ST in Patients with Dry Eye and in Healthy Subjects

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    Qin Long

    2015-01-01

    Full Text Available Purpose. To investigate corneal biomechanical properties in patients with dry eye and in healthy subjects using Corneal Visualization Scheimpflug Technology (CorVis ST. Methods. Biomechanical parameters were measured using CorVis ST in 28 eyes of 28 patients with dry eye (dry eye group and 26 normal subjects (control group. The Schirmer I test value, tear film break-up time (TBUT, and corneal staining score (CSS were recorded for each eye. Biomechanical properties were compared between the two groups and bivariate correlation analysis was used to assess the relationship between biomechanical parameters and dry eye signs. Results. Only one of the ten biomechanical parameters was significantly different between the two groups. Patients in the dry eye group had significantly lower highest concavity time (HC-time (P=0.02 than the control group. Correlation analysis showed a significant negative correlation between HC-time and CSS with marginal P value (ρ=-0.39, P=0.04 in the dry eye group. Conclusions. The corneal biomechanical parameter of HC-time is reduced in dry eyes compared to normal eyes. There was also a very weak but significant negative correlation between HC-time and CSS in the dry eye group, indicating that ocular surface damage can give rise to a more compliant cornea in dry eyes.

  7. Dry eye disease: pathophysiology, classification, and diagnosis.

    Science.gov (United States)

    Perry, Henry D

    2008-04-01

    Dry eye disease (DED) is a multifactorial disorder of the tear film and ocular surface that results in eye discomfort, visual disturbance, and often ocular surface damage. Although recent research has made progress in elucidating DED pathophysiology, currently there are no uniform diagnostic criteria. This article discusses the normal anatomy and physiology of the lacrimal functional unit and the tear film; the pathophysiology of DED; DED etiology, classification, and risk factors; and DED diagnosis, including symptom assessment and the roles of selected diagnostic tests.

  8. Effectiveness and Optical Quality of Topical 3.0% Diquafosol versus 0.05% Cyclosporine A in Dry Eye Patients following Cataract Surgery

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    Jang Hoon Lee

    2016-01-01

    Full Text Available Purpose. To evaluate the effectiveness and optical quality of 3.0% topical diquafosol versus 0.05% cyclosporine A in dry eye patients following cataract surgery. Methods. In total, 40 eyes of 40 patients newly diagnosed with dry eye syndrome 1 week after cataract surgery were randomized to receive either 3.0% diquafosol ophthalmic solution six times daily or 0.05% cyclosporine A twice daily for 3 months. Outcome measures were tear film break-up time (TBUT, results on Schirmer 1 test, ocular surface staining score, the ocular surface disease index (OSDI score, and higher-order aberrations (HOAs. Measurements were taken at baseline and at 1, 2, and 3 months. Results. In the diquafosol group, TBUT showed higher outcomes than the cyclosporine A group at 1 and 3 months. Both groups showed increased scores on Schirmer 1 test. The ocular surface staining score decreased in all periods in both groups. Vertical coma and total HOAs decreased more in the cyclosporine A group than in the diquafosol group at 3 months. Conclusion. Both 3.0% diquafosol and 0.05% cyclosporine A were effective in treating dry eye after cataract surgery. Diquafosol was more effective in increasing the tear secretion, but cyclosporine A was more effective in improving optical aberrations.

  9. Conjunctival impression cytology versus routine tear function tests for dry eye evaluation in contact lens wearers.

    Science.gov (United States)

    Kumar, Prachi; Bhargava, Rahul; Arora, Yogesh C; Kaushal, Sidharth; Kumar, Manjushri

    2015-01-01

    Prolonged contact lens wear is often accompanied by dryness of the eyes. The aim of this study was to compare conjunctival impression cytology (CIC) and tear film tests such as tear film break up time (TBUT) and Schirmer test for dry eye evaluation in contact lens wearers and measure their correlation with dry eye symptoms. A case control study was done at three referral eye centers. The eyes of 230 contact lens users were compared to 250 eyes of age- and sex-matched controls. Participants were recruited based on their response to a questionnaire of dry eye symptoms, (Dry Eye Scoring System, DESS(©)) and measurements of TBUT, Schirmer test, and CIC was done. A correlation analysis between symptom severity and tear film tests was performed. Pearson's coefficient, R(2) > 0.5 was considered significant. As compared to controls (r (2) = 0.010), Nelson grade correlated significantly with dry eye symptoms (r (2) = 0.765), among cases. However, there was moderate correlation between dry eye symptoms, Schirmer test, and TBUT (r (2) = 0.557 and 0.530, respectively) among cases and a weak correlation among controls (r (2) = 0.130 and 0.054, respectively). The sensitivity of TBUT was 86.4%, specificity was 82.4%, positive likelihood ratio (LR) was 4.50 [95% confidence interval (CI) 3.46-5.85)], and negative LR was 0.09. The sensitivity of the Schirmer test was 48.2%, specificity 88%, LR 2.12 (95% CI 1.48-2.96), and negative LR 0.83. CIC correlates better than Schirmer and TBUT with dry eye symptoms. It may be the most appropriate test for dry-eye evaluation in contact lens wearers.

  10. Oral omega-6 essential fatty acid treatment in contact lens associated dry eye.

    Science.gov (United States)

    Kokke, Karolien H; Morris, Judith A; Lawrenson, John G

    2008-06-01

    Symptoms of dry eye are commonly reported in contact lens wearers and are a frequent cause of non-tolerance. The purpose of the present study is to evaluate the effects of oral treatment with particular omega-6 fatty acids in the form of evening primrose oil (EPO) on subjective symptoms, ocular surface signs and tear film characteristic in patients with contact lens associated dry eye. The study design was randomised, double-masked and placebo controlled. 76 female soft contact lens wearers were treated for 6 months with either EPO or placebo (olive oil). Subjects underwent three examinations (baseline, 3 and 6 months). At each examination subjects were given a questionnaire relating to lens comfort and dry eye symptoms and underwent a series of tests of tear film characteristics (tear meniscus height, break-up time), meibomian gland function (lipid layer thickness and quality) and ocular surface parameters (hyperaemia and staining). The EPO group showed a significant improvement in the specific symptom of 'dryness' at 3 and 6 months (porally administered omega-6 fatty acids in alleviating dry eye symptoms and improving overall lens comfort in patients suffering from contact lens associated dry eye.

  11. Treatment outcomes in the DRy Eye Amniotic Membrane (DREAM study

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    McDonald MB

    2018-04-01

    Full Text Available Marguerite B McDonald,1 Hosam Sheha,2–5 Sean Tighe,2,3 Susan B Janik,6 Frank W Bowden,7 Amit R Chokshi,8 Michael A Singer,9 Seema Nanda,10 Mujtaba A Qazi,11 Damon Dierker,12 Adam T Shupe,13 Brittany J McMurren14 1Ophthalmic Consultants of Long Island, Lynbrook, NY, USA; 2Ocular Surface Center and TissueTech, Inc., Miami, FL, USA; 3Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA; 4Hofstra University School of Medicine, Hempstead, NY, USA; 5Research Institute of Ophthalmology, Cairo, Egypt; 6Solinsky Eye Care, Kensington, CT, USA; 7Bowden Eye & Associates, Jacksonville, FL, USA; 8Florida Eye Specialists, Jacksonville, FL, USA; 9Medical Center Ophthalmology Associates, San Antonio, TX, USA; 10TX Eye Institute, Houston, TX, USA; 11Pepose Vision Institute, Chesterfield, MO, USA; 12Eye Surgeons of Indiana, Indianapolis, IN, USA; 13Royo Eye Care, Marysville, CA, USA; 14Gordon and Weiss Vision Institute, San Diego, CA, USA Purpose: To evaluate the efficacy of cryopreserved amniotic membrane (CAM in reducing signs and symptoms of dry eye disease (DED in a large patient population. Methods: A retrospective chart review at 10 clinical sites was done of patients with refractory DED who received CAM and completed at least 3 months of follow-up. Data collected were demographics; medical history including previous and current ocular treatment, diagnosis, clinical presentations, comorbidity, duration and frequency of treatment with CAM; and concomitant medications. The primary outcome was the change in dry eye workshop (DEWS score after treatment. Results: A total of 97 eyes of 84 patients exhibited severe dry eye despite maximal medical treatments including topical artificial tears, cyclosporine-A, serum, antibiotics, and steroids. Patients manifested with superficial punctate keratitis (86%, filamentary keratitis (13%, exposure keratitis (19%, neurotrophic keratitis (2%, and corneal epithelial defect (7%. After CAM

  12. Tear osmolarity and dry eye symptoms in diabetics

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    Fuerst N

    2014-03-01

    Full Text Available Nicole Fuerst,1 Nicole Langelier,1 Mina Massaro-Giordano,1 Maxwell Pistilli,1 Kalliopi Stasi,1 Carrie Burns,2 Serena Cardillo,2 Vatinee Y Bunya1 1Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 2Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Purpose: To assess the relationship between tear osmolarity and dry eye symptoms in patients with diabetes. Patients and methods: Fifty patients with diabetes were enrolled. Demographic information and past medical history were recorded. Symptoms were assessed using the ocular surface disease index (OSDI. Tear osmolarity of each eye was measured with the TearLab® Osmolarity System. Results: The majority of the subjects were female (76%, African American (56%, and/or had a diagnosis of type 2 diabetes (82%. The mean ± standard deviation (SD for age was 54.6±13.4, and maximum tear osmolarity was 304.6±12.7 mOsm/L. Men had higher osmolarity than women (mean ± standard error (SE 311.8±4.0 mOsm/L versus 302.3±1.9 mOsm/L, P=0.02. Age, race, use of artificial tears, years of diabetes, and hemoglobin A1c did not have a statistically significant association with tear osmolarity. Longer duration of diabetes was associated with lower (less severe OSDI scores (r=-0.35, P=0.01. Higher tear osmolarity was associated with lower (less severe OSDI scores (r=-0.29, P=0.04. Conclusion: Approximately half of the diabetic subjects in our study had elevated tear osmolarity, and half of our population also reported symptoms consistent with dry eye disease. However, the two were slightly inversely related in that those with higher osmolarity reported fewer symptoms. Subjects with a longer duration of diabetes also reported fewer dry eye symptoms. Therefore, health care providers should be aware that patients who are most likely to have ocular surface disease, including those with

  13. Meibomian gland dropout in patients with dry eye disease in China.

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    Feng, Yun; Gao, Ziqing; Feng, Kang; Qu, Hongqiang; Hong, Jing

    2014-10-01

    To examine the morphological changes in the meibomian glands of eyes of patients with dry eye disease using the non-contact infrared meibography system and to assess their relationship with meibomian dropout, signs, and tear-film function. Subjects included 264 randomly selected patients (528 eyes) suffering from dry eye disease (95 males, 169 females; age range, 7-85 years; mean male age, 39.83 ± 19.17 years; mean female age, 46.16 ± 17.38 years). Tear-film break-up time (BUT) was measured and tear-film production was evaluated by the Schirmer test I (SIT). Subjective symptoms were also scored. The upper and lower eyelids were turned over, and the meibomian glands were observed using the non-contact meibography system. Partial or complete loss of the meibomian glands (meibomian dropout) was scored for each eyelid from grade 0 (no loss) through grade 3 (lost area was >2/3 of the total meibomian gland area). The average SIT result was 6.71 ± 6.13 mm (range 0-30 mm) and that for BUT was 3.13 ± 2.39 s (range 0-10 s). The average fluorescein staining score was 4.25 ± 4.05 (range 0-12). In addition, the mean meibomian gland photographic score was 4.35 ± 1.39. The correlation between the meibomian gland photographic scores and various ocular surface examinations were evaluated using Kendall's correlation. SIT and BUT were significantly negatively correlated with the meibomian gland photographic score, whereas corneal fluorescein staining was positively correlated. The results suggest a large proportion of meibomian dropout cases among patients with dry eye disease, indicating that treatment targeted at the meibomian gland will become an important direction for treating dry eye disease. Meibography is recommended as a routine test for dry eye disease.

  14. The Association between Symptoms of Dry Eye Syndrome and Metabolic Outcome in a General Population in Korea.

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    Park, Hye Won; Park, Jong Woon

    2016-07-01

    Dry eye syndrome (DES) is recognized as a public health concern. One of the pathophysiologies in the development of DES is inflammation, and metabolic syndrome (MetS), which is highly prevalent in the general population, is a well-known chronic and systemic inflammatory condition. Despite the increasing interest regarding a relationship between DES and MetS, information is lacking on the association between DES and MetS and its individual components. We investigated the association between DES symptoms and MetS and its components among adults aged ≥ 19 years using population-based data from the Korea National Health and Nutrition Examination Survey V. A sample group of 15,294 adults (42.67% men and 57.33% women) completed household interviews in which they provided blood (for high-density lipoprotein cholesterol, triglyceride, and glucose) and anthropometric measurements (including waist circumference, weight, and height) to define MetS. We also collected information regarding sociodemographic and behavioral risk factors. The survey results showed that 11.50% of men and 22.35% of women experienced DES and 5.30% of patients had both DES and diagnosis of MetS, including 204 men and 606 women. Thus, no significant difference was observed between DES and the diagnosis of MetS according to sex (P = 0.4008 in men; P = 0.0804 in women); however, a significant association was observed between DES and hypertriglyceridemia in women (OR, 1.13; 95% CI, 1.01-1.29). Therefore, hypertriglyceridemia might be an important factor in the association between DES and MetS. Further longitudinal research is needed to evaluate this relationship.

  15. Dry eye syndrome: developments and lifitegrast in perspective

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    Lollett, Ivonne V; Galor, Anat

    2018-01-01

    Dry eye (DE) is a chronic ocular condition with high prevalence and morbidity. It has a complex pathophysiology and is multifactorial in nature. Chronic ocular surface inflammation has emerged as a key component of DE that is capable of perpetuating ocular surface damage and leading to symptoms of ocular pain, discomfort, and visual phenomena. It begins with stress to the ocular surface leading to the production of proinflammatory mediators that induce maturation of resident antigen-presenting cells which then migrate to the lymph nodes to activate CD4 T cells. The specific antigen(s) targeted by these pathogenic CD4+ T cells remains unknown. Two emerging theories include self-antigens by autoreactive CD4 T cells or harmless exogenous antigens in the setting of mucosal immunotolerance loss. These CD4 T cells migrate to the ocular surface causing additional inflammation and damage. Lifitegrast is the second topical anti-inflammatory agent to be approved by the US Food and Drug Administration for the treatment of DE and the first to show improvement in DE symptoms. Lifitegrast works by blocking the interaction between intercellular adhesion molecule-1 and lymphocyte functional associated antigen-1, which has been shown to be critical for the migration of antigen-presenting cells to the lymph nodes as well as CD4+ T cell activation and migration to the ocular surface. In four large multicenter, randomized controlled trials, lifitegrast has proven to be effective in controlling both the signs and symptoms of DE with minimal side effects. Further research should include comparative and combination studies with other anti-inflammatory therapies used for DE. PMID:29391773

  16. Effect of trapping vascular endothelial growth factor-A in a murine model of dry eye with inflammatory neovascularization.

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    Kwon, Jin Woo; Choi, Jin A; Shin, Eun Young; La, Tae Yoon; Jee, Dong Hyun; Chung, Yeon Woong; Cho, Yang Kyung

    2016-01-01

    To evaluate whether trapping vascular endothelial growth factor A (VEGF-A) would suppress angiogenesis and inflammation in dry eye corneas in a murine corneal suture model. We established two groups of animals, one with non-dry eyes and the other with induced dry eyes. In both groups, a corneal suture model was used to induce inflammation and neovascularization. Each of two groups was again divided into three subgroups according to the treatment; subgroup I (aflibercept), subgroup II (dexamethasone) and subgroup III (phosphate buffered saline, PBS). Corneas were harvested and immunohistochemical staining was performed to compare the extents of neovascularization and CD11b+ cell infiltration. Real-time polymerase chain reaction was performed to quantify the expression of inflammatory cytokines and VEGF-A in the corneas. Trapping VEGF-A with aflibercept resulted in significantly decreased angiogenesis and inflammation compared with the dexamethasone and PBS treatments in the dry eye corneas (all P dry eyes. The anti-inflammatory and anti-angiogenic effects of VEGF-A trapping were stronger than those of dexamethasone in both dry eye and non-dry eye corneas (all P dry eye group. Compared with non-dry eye corneas, dry eye corneas have greater amounts of inflammation and neovascularization and also have a more robust response to anti-inflammatory and anti-angiogenic agents after ocular surface surgery. Trapping VEGF-A is effective in decreasing both angiogenesis and inflammation in dry eye corneas after ocular surface surgery.

  17. Analysis of Factors Associated With the Tear Film Lipid Layer Thickness in Normal Eyes and Patients With Dry Eye Syndrome.

    Science.gov (United States)

    Jung, Ji Won; Park, Si Yoon; Kim, Jin Sun; Kim, Eung Kweon; Seo, Kyoung Yul; Kim, Tae-Im

    2016-08-01

    To determine the effects of clinical variables, including age, sex, history of refractive or cataract surgery, contact lens use, and ocular surface and meibomian gland parameters on the lipid layer thickness (LLT) in normal subjects and patients with dry eye syndrome (DES). A total of 64 normal subjects and 326 patients with DES were enrolled, and they underwent measurements of LLT with a LipiView interferometer and tear meniscus height using optical coherence tomography, tear film break-up time (TBUT) determination, ocular surface staining, Schirmer's test, examination of the lid margins and meibomian glands, and assessment using the Ocular Surface Disease Index (OSDI). In normal subjects, the median (range) LLT was 67 (33-100) nm, and age was the only factor that was significantly associated with LLT (β = 0.678, P = 0.028). In patients with DES, the median (range) LLT was 84 (20-100) nm, and 79.0% of the participants fulfilled the diagnostic criteria for meibomian gland dysfunction (MGD). In a multivariate analysis, increased age and female sex were significantly related to increased LLT (β = 0.282, P = 0.005 and β = 11.493, P < 0.001), and hypersecretory MGD and lid margin inflammation were independently associated with increased LLT (β = 11.299, P = 0.001 and β = 12.747, P = 0.001). Lipid layer thickness measurements using a new interferometer are significantly affected by demographic factors such as age, sex, ocular surgical history, and MGD type. Therefore, all of these factors must be considered in the diagnosis of ocular surface diseases.

  18. Validity of subjective assessment as screening tool for dry eye disease and its association with clinical tests

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    Kavita R Bhatnagar

    2015-02-01

    Full Text Available AIM: To determine the role of subjective assessment using McMonnies dry eye questionnaire in diagnosing dry eye disease and its association with clinical tests. METHODS: There were 500 patients screened for dry eye using McMonnies dry eye questionnaire between May to October 2013 at the outpatient Department of Ophthalmology of a medical college hospital. All 500 patients were subjected to clinical tests. Dry eye was defined as having one or more symptoms often or all the time. Positive signs were if one or both eyes revealed tear film breakup time (TBUT of ≤10s, a Schirmer test score of ≤10 mm, a Rose Bengal staining score of ≥1, a Lissamine green staining score of ≥1 or existence of meibomian gland disease (≥grade 1. Statistical analysis was performed to describe the distribution of symptoms and signs, to assess the correlations between McMonnies score (MS and variable clinical signs of dry eye, and to explore the association between dry eye symptoms and variable clinical signs. Analysis was performed using software package Epi info. A Probability (P value using Chi-square test of RESULTS: Dry eye prevalence with symptoms (questionnaire, Schirmer test, TBUT, Rose Bengal staining and Lissamine green staining was 25.6%, 15.20%, 20.80%, 23.60%, and 22.60% respectively. Among those with severe symptoms (MS>20, 75.86% had a low TBUT (CONCLUSION: Subjective assessment plays an important role in diagnosing dry eye disease. There is strong correlation between MS and Schirmer test, TBUT, Rose Bengal staining and Lissamine green staining in normal as well as marginal and pathological dry eye.

  19. Prospective Randomized Trial Comparing Efficacy of Topical Loteprednol Etabonate 0.5% Versus Cyclosporine-A 0.05% for Treatment of Dry Eye Syndrome Following Hematopoietic Stem Cell Transplantation.

    Science.gov (United States)

    Boynton, Grace E; Raoof, Duna; Niziol, Leslie M; Hussain, Munira; Mian, Shahzad I

    2015-07-01

    To evaluate the safety and efficacy of topical lotepr