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Sample records for evaporative-type dry eye

  1. Tear cytokine and chemokine analysis and clinical correlations in evaporative-type dry eye disease

    Science.gov (United States)

    Castellanos, Evangelina; Stern, Michael E.; Fernández, Itziar; Carreño, Ester; García-Vázquez, Carmen; Herreras, Jose M.; Calonge, Margarita

    2010-01-01

    Purpose Inflammatory molecules have been demonstrated in the tear film of patients with severe dry eye disease (DED). However, little attention has been paid to the most frequent moderate forms of DED. This study analyzes tear cytokine levels and their clinical correlations in patients with moderate evaporative-type DED due to meibomian gland disease (MGD). Methods Twenty three evaporative-type DED patients (46 eyes) of mild-to-moderate intensity and nine healthy subjects (18 eyes) were recruited. Two symptom questionnaires were self-answered and multiple DED-related clinical tests were performed. Unstimulated tears from each eye were isolated and were not pooled. Levels of 15 cytokines and chemokines were measured by multiplex bead analysis, compared with control levels, and correlated with clinical tests. Results Fourteen out of the 15 molecules were reliably detected in 1 μl of unstimulated tears from DED patients. Epidermal growth factor (EGF), fractalkine/CX3CL1, interleukin (IL) 1-receptor antagonist (Ra), IL-8/CXCL8, interferon inducible protein (IP)-10/CXCL10, and vascular endothelial growth factor (VEGF) were found in 94%–100% of samples; IL-6 in 65% (significantly more detected in older patients); IL-1β, interferon gamma (IFN-γ), and IL-10 in 30%–48%; IL-17 in 13%; granulocyte macrophage colony stimulating factor (GM-CSF), IL-13, and tumor necrosis factor alpha (TNF-α) in 2%–9%; and IL-5 was never detected. EGF, fractalkine/CX3CL1, IL-1Ra, IP-10/CXCL10, and VEGF levels were significantly increased compared to normal controls. Pain was correlated with IL-6 and IL-8/CXCL8. Tear break-up time correlated inversely with IL1-Ra. Schirmer test and tear lysozyme levels negatively correlated with IL-1Ra, IL-8/CXCL8, fracktalkine/CX3CL1, IL-6, IP-10/CXCL10, and VEGF had the same tendency. Conjunctival staining correlated negatively with EGF and positively with IL-6. Conclusions In this sample of moderate evaporative-type DED patients, five inflammatory

  2. What Is Dry Eye?

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  3. What Is Dry Eye?

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  4. What Is Dry Eye?

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  5. What Is Dry Eye?

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  6. What Is Dry Eye?

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  8. What Is Dry Eye?

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  11. What Is Dry Eye?

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  12. What Is Dry Eye?

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  13. What Is Dry Eye?

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  15. What Is Dry Eye?

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  16. What Is Dry Eye?

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  17. What Is Dry Eye?

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  19. What Is Dry Eye?

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  20. What Is Dry Eye?

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  13. What Is Dry Eye?

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  16. What Is Dry Eye?

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  18. What Is Dry Eye?

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  19. What Is Dry Eye?

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  1. What Is Dry Eye?

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  2. What Is Dry Eye?

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  4. What Is Dry Eye?

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  5. What Is Dry Eye?

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  10. What Is Dry Eye?

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  11. What Is Dry Eye?

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  12. What Is Dry Eye?

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  13. What Is Dry Eye?

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  14. What Is Dry Eye?

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  15. 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

  16. Dry Eye in Vernal Keratoconjunctivitis

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    Villani, Edoardo; Strologo, Marika Dello; Pichi, Francesco; Luccarelli, Saverio V.; De Cillà, Stefano; Serafino, Massimiliano; Nucci, Paolo

    2015-01-01

    Abstract The purpose of this comparative cross-sectional study was to investigate the use of standardized clinical tests for dry eye in pediatric patients with active and quiet vernal keratoconjunctivitis (VKC) and to compare them with healthy children. We recruited 35 active VKC, 35 inactive VKC, and 70 age-matched control healthy subjects. Each child underwent a complete eye examination, including visual analog scale symptoms assessment, biomicroscopy, fluorescein break-up time (BUT), corneal fluorescein and conjunctival lissamine green staining, corneal esthesiometry, Schirmer test with anesthetic, and meibomian glands inspection and expression. Active VKC patients showed significantly increased symptoms and signs of ocular surface disease, compared with the other 2 groups. Inactive VKC patients, compared with control subjects, showed increased photophobia (P < 0.05; Mann-Whitney U test), conjunctival lissamine green staining and Schirmer test values, and reduced BUT and corneal sensitivity [P < 0.05 by analysis of variance (ANOVA) least significant difference posthoc test for BUT and Schirmer; P < 0.001 by Mann-Whitney U test for lissamine green staining and corneal sensitivity]. Our results confirm the association between VKC and short-BUT dry eye. This syndrome seems to affect the ocular surface in quiescent phases too, determining abnormalities in tear film stability, epithelial cells integrity, and corneal nerves function. The very long-term consequences of this perennial mechanism of ocular surface damage have not been fully understood yet. PMID:26496269

  17. 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.

  18. Aging: A Predisposition to Dry Eyes

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    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.

  19. 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.

  20. SIDRE: Symptomatic Improvement of Dry Eye Study

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    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

  1. Conjunctival impression cytology in dry eye states

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    Reddy Madhavati

    1991-01-01

    Full Text Available Impression cytology technique was used to study the cytological changes of in 30 patients with various diseases (Xerophthalmia, Steven-Johnson′s syndrome, trachoma, alkali burns, kerato conjunctivitis sicca resulting in dry eye syndrome. The main features of impression cytology were squamous metaplasia of epithelial cells and altered goblet cell density. The comparison between conjunctival biopsy findings and impression cytology confirm that impression cytology provides the same information as that of biopsy. Hence, the authors advocate that this non-invasive simple technique can replace conjunctival biopsy in confirmation of diagnosis in dry eye syndrome.

  2. Corneal hysteresis in patients with dry eye.

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    Firat, P G; Doganay, S

    2011-12-01

    To measure corneal hysteresis and intraocular pressure (IOP) in patients with dry eye and to compare with normal subjects. This cross-sectional study consists of 70 eyes of 40 patients with dry eye (group 1) and 75 eyes of 40 normal subjects (group 2). Eyes were diagnosed as dry eye or normal according to the clinical symptoms, biomicroscopical evaluation, and Schirmer test. Corneal hysteresis (CH), corneal resistance factor (CRF), and cornea-compensated intraocular pressure (IOPcc) were measured by the Ocular Response Analyser (ORA). Mean CH values were 10.56±0.25 mm Hg and 10.34±0.26 mm Hg, mean CRF values were 10.75±0.28 mm Hg and 10.70±0.28 mm Hg, mean CCT values were 542±3.20 μm and 543±3.89 μm in group 1 and group 2, respectively. There was no statistically significant difference between the groups for these three parameters. IOPcc values measured with ORA were 15.73±0.36 mm Hg in group 1 and 16.60±0.33 mm Hg in group 2, and there was no statistically significant difference between the two groups. Corneal biomechanical parameters such as CH and CRF are not influenced in dry eye. Also statistical difference was not found between the two groups according to CCT and IOPcc values.

  3. Dry Eye as a Mucosal Autoimmune Disease

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    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

  4. Classification and diagnosis of dry eye.

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    Kaercher, Thomas; Bron, Anthony J

    2008-01-01

    Dry eye, or keratoconjunctivitis sicca (KCS), is divided into two subgroups, tear-deficient and evaporative. Each form calls for a different therapeutic approach and it is therefore essential to apply a combination of diagnostic tests in order to establish the exact diagnosis. The diagnosis of KCS is based in part on the patient's history and symptoms and in part on the application of specific tests. Several non-invasive tests exist (e.g. slit-lamp examination, meniscometry, interferometry). Mildly invasive tests are the fluorescein tests, staining with lissamine green, meibometry and meibography. Markedly invasive tests include the Schirmer test and staining with rose bengal. Additional histological procedures are the ocular ferning test and impression cytology. A combination of diagnostic tests leads to one of the two forms of KCS. Its severity is calculated according to grading systems, which exist for several tests. The longitudinal observation of the dry eye patient is provided on the basis of this same grading system, although limited reproducibility is reported for some tests. The diagnostic steps for dry eye patients can be efficiently arranged. In most of the cases, non-invasive or mildly invasive tests provide an accurate diagnosis.

  5. Application effect of recombinant human epidermal growth factor derivative Eye drops in treatment of dry eye

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    Paerzhati·Tuerdi; Yan-Chun Wang

    2015-01-01

    AIM: To investigate the application effect of recombinant human epidermal growth factor derivative eye drops(Jinyinshu)in treatment of dry eye.METHODS:Sixty cases(87 eyes)of dry eye patients were randomly divided into control group and observation group, 42 eyes and 45 eyes respectively. The control group received Chondroitin sulfate eye drops treatment, and the observation group were used for treatment of Jinyinshu. The changes of clinical efficacy, correlation index(symptom score, BUT, S I ...

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

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    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

  7. Improvement in the signs and symptoms of dry eye disease with dobesilate eye drops.

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    Cuevas, Pedro; Outeiriño, Luis Antonio; Azanza, Carlos; Angulo, Javier; Giménez-Gallego, Guillermo

    2015-01-01

    Dry eye is a multifactor disease of the tear film and ocular surface that substantially affects quality of life. Dobesilate administered as eye drops was well tolerated and effective in treating both the objective signs and subjective symptoms of dry eye disease in this 2-week study. To the best of our knowledge, this is the first clinical report of using dobesilate in eye drops. Dobesilate may provide a novel approach to treating drying diseases of the eye.

  8. 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

  9. 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

  10. Pharmaceutical and herbal products that may contribute to dry eyes.

    Science.gov (United States)

    Askeroglu, Ufuk; Alleyne, Brendan; Guyuron, Bahman

    2013-01-01

    Symptomatic dryness of the eyes is a most common blepharoplasty complication. The authors reviewed the medications and herbal products that may potentiate this complication. The MEDLINE and PubMed databases were searched for the years 1991 to 2011. Search terms included "dry eye syndrome," "keratitis sicca," "keratoconjunctivitis sicca," "ocular side effects," "herbal supplements," "herbals and dry eye," "dry eye risk factors," "etiology of dry eye," "drugs side effects," "drugs and dry eye," "dietary supplements," "ocular toxicity," and "tear film." References from herbal product reviews and eligible medication reports were searched for additional articles. A manual search was also conducted based on citations in the published literature. Of 232 articles found to be related to dry eye syndrome and possible risk factors, 196 were excluded because they did not discuss medications or herbal products as risk factors in dry eye syndrome. Thirty-six articles that examined the pathophysiology and risk factors of dry eye were included. Nine books were reviewed that contained some information regarding the association of medications and herbal products with dry eye. These agents were then categorized based on mechanism of action and usage. Medications listed include antihistamines, decongestants, antidepressants, anticonvulsants, antipsychotics, antiparkinson drugs, beta-blockers, and hormone replacement therapy. The three main herbal products that contribute to dry eye are niacin, echinacea, and kava. There was a strong association between anticholinergic alkaloids and dry eye. This study identifies the medications and herbal products that should be considered when a patient undergoes blepharoplasty and complains of symptoms associated with dryness of the eyes.

  11. Corneal thickness in dry eyes in an Iraqi population

    Directory of Open Access Journals (Sweden)

    Ali NM

    2017-02-01

    Full Text Available Noora Mauwafak Ali,1 Furkaan M Hamied,1 Qasim K Farhood2 1Department of Surgery, College of Medicine, Al-Qadisiya University, Diwaniyah, 2Department of Surgery, College of Medicine, University of Babylon, Hillah, Iraq Background: Dry eye disorder is a multifactorial disease of the tears and ocular surface that results in discomfort and visual disturbance. Corneal pachymetry becomes increasingly important in refractive surgery, for the accurate assessment of intraocular pressure, and in the preoperative assessment of other ocular surgeries. Purpose: To assess the effect of dry eye disorder on the central corneal thickness (CCT by comparing with CCT of normal eyes of age-matched individuals. Patients and methods: The total number of eyes examined was 280 (140 dry eyes from 70 patients and 140 normal eyes from 70 individuals. Pentacam (Scheimpflug imaging system was used for measuring the CCT of all eyes. Results: Patients with dry eye syndrome had significantly lower CCT compared to the control group (P<0.01. Its mean was 536.5 versus 561.3, respectively. Conclusion: CCT of dry eyes was significantly reduced when compared with age- and gender-matched population. This result can be attributed to chronic desiccation by the inflammatory mediators in dry eyes, leading to corneal thinning. Keywords: central corneal thickness, pentacam, dry eye syndrome

  12. Improvement in the signs and symptoms of dry eye disease with dobesilate eye drops

    OpenAIRE

    Cuevas, Pedro; Outeiri?o, Luis Antonio; Azanza, Carlos; Angulo, Javier; Gim?nez-Gallego, Guillermo

    2015-01-01

    Background Dry eye is a multifactor disease of the tear film and ocular surface that substantially affects quality of life. Case presentation Dobesilate administered as eye drops was well tolerated and effective in treating both the objective signs and subjective symptoms of dry eye disease in this 2-week study. Conclusion To the best of our knowledge, this is the first clinical report of using dobesilate in eye drops. Dobesilate may provide a novel approach to treating drying diseases of the...

  13. The relationship between Graves' ophthalmopathy and dry eye syndrome.

    Science.gov (United States)

    Selter, Jessica H; Gire, Anisa I; Sikder, Shameema

    2015-01-01

    A complex relationship between Graves' ophthalmopathy (GO) and dry eye syndrome exists. New research brings more insight into the association between these two diseases. A review of the literature was conducted using the query terms "Graves' Ophthalmopathy", "Thyroid Eye Disease", and "Dry Eye" in MedLine (PubMed) and Scopus. A total of 55 papers were reviewed. Case reports were excluded. This review paper shows the close relationship between dry eye syndrome and GO. The underlying mechanisms behind their association suggest mechanical impairment of orbital muscles and immune-mediated lacrimal gland dysfunction as the causes of dry eye in GO patients. However, there are a variety of treatment options available for patients with GO with signs of dry eye, which help combat this issue.

  14. New drugs for the treatment of dry eye disease

    Directory of Open Access Journals (Sweden)

    Ridder III WH

    2015-09-01

    Full Text Available William H Ridder III, Apoorva Karsolia Southern California College of Optometry, Marshall B Ketchum University, Fullerton, CA, USA Abstract: Dry eye disease (DED is one of the most commonly encountered conditions for eye care practitioners. The prevalence of DED can be as high as 30% of the population. In the past decade, only one drug has been approved for the treatment of DED by the US Food and Drug Administration (FDA in the USA (ie, Restasis® by Allergan, Inc.. The total annual cost (ie, treatment and lost productivity due to symptoms to the US economy of dry eye can be more than $55 billion. Thus, the development of new drug treatments for dry eye is important for both the dry eye patient and the ophthalmic industry. There are many drugs in development for the treatment of dry eye. This manuscript reviews the drugs listed on the ClinicalTrials.gov website (FDA list of clinical trials being investigated for the treatment of dry eye. A large number of these drugs are designed to target a specific cause of dry eye and some of these drugs will be approved for clinical use in the next 10 years. This will result in a significant increase in the clinician’s choice of treatment and potentially better control of the dry eye patient's condition. Keywords: keratoconjunctivitis sicca, clinical trials, anti-inflammatory, secretagogues

  15. Treatment of chronic dry eye: focus on cyclosporine

    Directory of Open Access Journals (Sweden)

    George D Kymionis

    2008-08-01

    Full Text Available George D Kymionis, Dimitrios I Bouzoukis, Vassilios F Diakonis, Charalambos SiganosDepartment of Ophthalmology, Vardinoyannion Eye Institute of Crete, University of Crete, GreeceAbstract: To review the current treatment of chronic dry eye syndrome, focusing on cyclosporine A (CsA, a systematic literature search was performed using PubMed databases in two steps. The first step was oriented to articles published for dry eye. The second step was focused on the use of CsA in dry eye. A manual literature search was also undertaken based on citations in the published articles. The knowledge on the pathogenesis of dry eye syndrome has changed dramatically during the last few years. Inflammation and the interruption of the inflammatory cascade seem to be the main focus of the ophthalmologic community in the treatment of dry eye, giving the anti-inflammatory therapy a new critical role. The infiltration of T-cells in the conjuctiva tissue and the presence of cytokines and proteasis in the tear fluid were the main reason introducing the use of immunomodulator agents such as corticosteroids, cyclosporine, and doxycicline in order to treat dry eye syndrome. CsA emulsion is approved by the FDA for the treatment of dry eye, while clinical trials of this agent have demonstrated efficacy and safety of CsA. CsA seems to be a promising treatment against dry eye disease. New agents focused on the inflammatory pathogenesis of this syndrome in combination with CsA may be the future in the quest of treating dry eye. More studies are needed to determine the efficacy, safety, timing, and relative cost/effect of CsA.Keywords: dry eye, cyclosporine A, inflammation, immunomodulator agents

  16. 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 <.001) and increases in self-reported dry eye symptoms (OSDI: healthy, 1.9±3.0; dry, 20.3±17.7; fibromyalgia, 20.3±17.1; P <.001) in the 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.

  17. 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

  18. 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.

  19. The relationship between Graves’ ophthalmopathy and dry eye syndrome

    Science.gov (United States)

    Selter, Jessica H; Gire, Anisa I; Sikder, Shameema

    2015-01-01

    Background A complex relationship between Graves’ ophthalmopathy (GO) and dry eye syndrome exists. New research brings more insight into the association between these two diseases. Methods A review of the literature was conducted using the query terms “Graves’ Ophthalmopathy”, “Thyroid Eye Disease”, and “Dry Eye” in MedLine (PubMed) and Scopus. A total of 55 papers were reviewed. Case reports were excluded. Conclusion This review paper shows the close relationship between dry eye syndrome and GO. The underlying mechanisms behind their association suggest mechanical impairment of orbital muscles and immune-mediated lacrimal gland dysfunction as the causes of dry eye in GO patients. However, there are a variety of treatment options available for patients with GO with signs of dry eye, which help combat this issue. PMID:25584018

  20. Clinical analysis of diclofenac sodium eye drops combined with sodium hyaluronate eye drops for dry eye after ophthalmic surgery

    Directory of Open Access Journals (Sweden)

    Li-Ping Liu

    2017-07-01

    Full Text Available AIM: To study and analyze the clinical efficacy of diclofenac sodium eye drops combined with sodium hyaluronate eye drops in treating dry eyes after ophthalmic surgery. METHODS: Totally 94 eyes from 94 patients with dry eyes were slected, and they were randomly divided into orbervation group and control group. Fouty-seven patients in the control group using conventional treatment combined with sodium hyaluronate eye drops. Other 47 patients in orbervation group were treated with diclofenac sodium eye drops on the basis of control group. We compared symptoms, fluorescein station, tear film break time, Schirmer Ⅰ test between the two groups.RESULTS: Compared with before treatment, patients of both groups with sympotom, fluorescein station score, BUT, and Schirmer Ⅰ test were significantly improved(PPPCONCLUSION: Diclofenac sodium eye drops combined with sodium hyaluronate eye drops have significant efficacy in treatment of dry eyes after ophthalmic surgery, which can effectively relieve clinical symptoms, improve BUT and Schirmer Ⅰ test.

  1. 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.

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

    OpenAIRE

    Gayton, Johnny

    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...

  3. [Dry eye as a therapeutic problem].

    Science.gov (United States)

    Dimoski, N; Latinović, S; Radnović, D

    1992-01-01

    Effects of substitution therapy was investigated in 42 patients having the dry eye syndrome associated with systemic diseases of connective tissues (systemic lupus, Sjögren's syndrome, etc). Artificial tears were applied: Liquifilm sol, Hydroxypropyl methylcellulose 0.3% (HPMC) and Ocutal sol. After the one-month application of each preparation, mean values of Schirmer's test were approximately identical and the differences were not statistically significant (4.5 +/- 3.5; 4.95 +/- 4.4; 4.01 +/- 3.6), differing slightly from mean values of Schirmer's test prior to the treatment (4.4 +/- 3.4; 3.9 +/- 2.5). The lacrimal secretion did not increase after the administration of the above therapy. The therapy with artificial tears resulted in the improvement of subjective complaints (scratching, dryness and burning sensation) in 65% of cases treated with Liquifilm sol, in 69% upon the administration of HMPC 0.3% and in 60% after the application of Ocutal sol.

  4. Functional impairment of reading in patients with dry eye.

    Science.gov (United States)

    Mathews, Priya M; Ramulu, Pradeep Y; Swenor, Bonnielin S; Utine, Canan A; Rubin, Gary S; Akpek, Esen K

    2017-04-01

    To evaluate the impact of dry eye on reading performance. Out-loud and silent reading in patients with clinically significant dry eye (n=41) and controls (n=50) was evaluated using standardised texts. Dry eye measures included tear film break-up time, Schirmer's test and corneal epithelial staining. Symptoms were assessed by the Ocular Surface Disease Index (OSDI). The dry eye group had a greater proportion of women as compared with the control group but did not differ in age, race, education level or visual acuity (p≥0.05 for all). Out-loud reading speed averaged 148 words per minute (wpm) in dry eye subjects and 163 wpm in controls (p=0.006). Prolonged silent reading speed averaged 199 wpm in dry eye subjects versus 226 wpm in controls (p=0.03). In multivariable regression models, out-loud and sustained silent reading speeds were 10 wpm (95% CI -20 to -1 wpm, p=0.039) and 14% (95% CI -25% to -2%, p=0.032) slower, respectively, in dry eye subjects as compared with controls. Greater corneal staining was associated with slower out-loud (-2 wpm/1 unit increase in staining score, 95% CI =-3 to -0.3 wpm) and silent (-2%, 95% CI -4 to -0.6 wpm) reading speeds (preading speed (preading speeds, providing direct evidence regarding the functional impact of dry eye. Reading speed represents a measurable clinical finding that correlates directly with dry eye severity. 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/.

  5. 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

  6. Current progress in postmenopausal women with dry eye

    Directory of Open Access Journals (Sweden)

    Jun-Ling Liu

    2015-08-01

    Full Text Available Dry eye is one of the most frequently ocular surface diseases. Recent researches found that many reasons caused decrease of ocular surface damage and the quality of tears, such as the change of ocular surface, immuno-inflammatory responses, apoptosis and the reduction of sex hormone. It is reported that the decline of ovarian function and hormone level in postmenopausal women which leads to abnormal structure and function of tear film is more likely to develop dry eye. In this paper, the ocular surface, pathogenesis and progresses of treatment on postmenopausal women with dry eye are reviewed.

  7. The relationship between Graves’ ophthalmopathy and dry eye syndrome

    Directory of Open Access Journals (Sweden)

    Selter JH

    2014-12-01

    Full Text Available Jessica H Selter,1 Anisa I Gire,2 Shameema Sikder2 1Johns Hopkins School of Medicine, 2Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA Background: A complex relationship between Graves’ ophthalmopathy (GO and dry eye syndrome exists. New research brings more insight into the association between these two diseases.Methods: A review of the literature was conducted using the query terms “Graves’ Ophthalmopathy”, “Thyroid Eye Disease”, and “Dry Eye” in MedLine (PubMed and Scopus. A total of 55 papers were reviewed. Case reports were excluded.Conclusion: This review paper shows the close relationship between dry eye syndrome and GO. The underlying mechanisms behind their association suggest mechanical impairment of orbital muscles and immune-mediated lacrimal gland dysfunction as the causes of dry eye in GO patients. However, there are a variety of treatment options available for patients with GO with signs of dry eye, which help combat this issue. Keywords: Graves’ ophthalmopathy, dry eye, thyroid eye disease, ocular inflammation

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

    Directory of Open Access Journals (Sweden)

    Johnny L Gayton

    2009-07-01

    Full Text Available 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 following words or phrases: prevalence, postmenopausal, etiology, risk factors, therapy, medications, surgery, tear film, and quality of life. Articles were selected based on their direct applicability to the subject matter. A manual search was also conducted based on citations in the published literature.Results: Epidemiologic studies identified prevalence rates ranging from 7% in the United States to 33% in Taiwan and Japan. Risk factors include advanced age, female sex, smoking, extreme heat or cold weather conditions, low relative humidity, use of video display terminals, refractive surgery, contact lens wear, and certain medications.Conclusion: The last decade has brought about a better understanding of the etiology of dry eye disease. New therapies that can alleviate the signs and symptoms of dry eye disease and, consequently, improve the quality of life of dry eye patients are available in the market.Keywords: dry eye disease, etiology, prevalence, postmenopausal women

  9. Application effect of recombinant human epidermal growth factor derivative Eye drops in treatment of dry eye

    Directory of Open Access Journals (Sweden)

    Paerzhati·Tuerdi

    2015-01-01

    Full Text Available AIM: To investigate the application effect of recombinant human epidermal growth factor derivative eye drops(Jinyinshuin treatment of dry eye.METHODS:Sixty cases(87 eyesof dry eye patients were randomly divided into control group and observation group, 42 eyes and 45 eyes respectively. The control group received Chondroitin sulfate eye drops treatment, and the observation group were used for treatment of Jinyinshu. The changes of clinical efficacy, correlation index(symptom score, BUT, S I t, FLbefore and after treatment, quality of life after treatment and the incidence of adverse reactions were compared.RESULTS: In the control group, the total clinical effective rate was 71%, which was significantly lower than that in the observation group(91%, the difference was statistically significant(PPPPP>0.05.CONCLUSION: Jinyinshu is significantly effective in the treatment of dry eye, and its clinical efficacy is better than chondroitin sulfate.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Dry eyes among information technology professionals in India

    OpenAIRE

    Amaravathy Karuppaiah Brindha; Shruti Murthy; Kate Trout; Awnish Kumar Singh; Krishna Mohan Surapaneni; Ashish Joshi

    2015-01-01

    AIM: To perform the determination ofthe burden of dry eye syndrome among information technology(IT)professionals 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 perio...

  12. The interblink interval in normal and dry eye subjects

    Directory of Open Access Journals (Sweden)

    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

  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. 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.

  15. 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.

  16. Clinical study on high concentrations of sodium hyaluronate eye drops for moderate to severe dry eye

    OpenAIRE

    Yu-Jing Tian; Qin Zhang

    2014-01-01

    AIM: To observe the efficacy of high concentrations of sodium hyaluronate(3g/L SH)for moderate to severe dry eye. METHODS: Forty moderate to severe dry eye patients were included in the study according to the diagnosis criteria and randomized into two groups. The patients of the trial group received topical administration of high concentration sodium hyaluronate(3g/L), and those of the control group received sodium hyaluronate(1g/L)plus recombinant human epidermal growth factor. The dry eye s...

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

    Science.gov (United States)

    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.

  18. Impression cytology implicates cell autophagy in aqueous deficiency dry eye

    Directory of Open Access Journals (Sweden)

    Lin T

    2017-04-01

    Full Text Available Tony Lin,1,2,* Richard Filek,3,* Joy M Wang,4 Chong H Wu,4 Hong Liu,2 Cindy ML Hutnik1–3 1Department of Ophthalmology, Western University, 2Ivey Eye Institute, St Joseph’s Health Care, St Joseph’s Hospital, 3Department of Pathology and Laboratory Medicine, 4Department of Biology, Western University, London, ON, Canada *These authors contributed equally to this work Purpose: Impression cytology in combination with a cell autophagy marker was used to demonstrate the utility of a novel frozen section technique, to assess the health of the ocular surface, as well as to correlate autophagic cell death with the commonly used clinical tests for dry eye. Methods: Female patients over the age of 18 years who attended an outpatient ophthalmology clinic were invited to participate. Schirmer’s test, tear film break-up time and the ocular surface disease index questionnaire were used as objective and subjective clinical tests for dry eye. The cellular biomarker microtubule-associated protein light chain 3 (LC3 was used as a marker of autophagic cell death. Results: Low LC3 nuclear staining was positively correlated with Schirmer’s test <10 mm. No correlation was found between other clinical tests for dry eye. Conclusion: This study demonstrates a positive linear relationship between Schirmer’s testing and LC3. There is a lack of correlation between the commonly used diagnostics tests for dry eye, highlighting our incomplete understanding and assessment of dry eye. Keywords: impression cytology, cell autophagy, dry eye, technique, Schirmer’s test, LC3

  19. Improvement in the signs and symptoms of dry eye disease with dobesilate eye drops

    National Research Council Canada - National Science Library

    Pedro Cuevas; Luis Antonio Outeirino; Carlos Azanza; Javier Angulo; Guillermo Gimenez-Gallego

    2015-01-01

      Dry eye disease (DED) is a progressive and multifactorial disease affecting the tear film and ocular surface that causes discomfort, visual disturbances and tear film instability with potential damage to the ocular surface [1...

  20. Effect of polyethylene glycol eye drops in management of dry eyes after cataract surgery

    Directory of Open Access Journals (Sweden)

    Dong-Mei Cai

    2013-11-01

    Full Text Available AIM: To evaluate the effect of polyethylene glycol eye drops on tear film break-up time and symptoms for dry eyes after cataract surgery.METHODS: Eighty patients with dry eyes secondary to cataract surgery who were treated in our hospital from January to August 2013 were randomly divided into group A and group B. Group A was treated with sodium hyaluronate eye drops for one week, and Group B was treated with polyethylene glycol eye drops for one week. The break-up time of tear film was measured and the subjective symptoms were graded before and after the treatment.RESULTS: The tear film break-up time of group A was respectively 3.87±1.12s and 4.21±1.06s before and after the treatment, with no significant difference(P>0.05; it was respectively 3.98±1.04s and 8.98±1.30s with significant difference for group B(PPPPCONCLUSION: Polyethylene glycol eye drops can extend tear film break-up time and improve symptoms of dry eyes. It is an effective drug in treatment of dry eyes after cataract surgery.

  1. Lifitegrast: A novel drug for treatment of dry eye disease

    OpenAIRE

    Abidi, Afroz; Shukla, Pooja; Ahmad, Ali

    2016-01-01

    Dry eye disease (DED) is an inflammatory disorder of ocular surfaces leading to severe disability, especially in the elderly age group. The mainstay of therapy includes artificial tears, punctual plugs, topical anti-inflammatory agents, and corticosteroids. In the past few years, only cyclosporine-A emulsions have been added to the existing therapy, but it is discontinued by most patients as it causes burning sensation in the eye. Hence, progress in new research for a better therapeutic optio...

  2. Dry eye syndrome: developments and lifitegrast in perspective

    OpenAIRE

    Lollett,Ivonne V; Galor,Anat

    2018-01-01

    Ivonne V Lollett,1 Anat Galor2,3 1University of Miami, Miller School of Medicine, Miami, FL, 2Ophthalmology Department, Miami Veterans Administration Medical Center, Miami, FL, 3Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA Abstract: 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 ...

  3. Blink Animation Software to Improve Blinking and Dry Eye Symptoms.

    Science.gov (United States)

    Nosch, Daniela S; Foppa, Curdin; Tóth, Mike; Joos, Roland E

    2015-09-01

    To evaluate if the animation "blink blink" increases blink rate and improves dry eye symptoms during prolonged computer use. Study part A: Blink rate was recorded at baseline and during computer work of normal subjects without symptoms of dry eye. Half of the subjects used "blink blink," instructed to blink on animation appearance; the other half used a placebo version for 1 week during computer use. Thereafter, blink rate was recorded again with the use of "blink blink." Study part B: Blink rate was recorded during computer work with dry eye symptoms (modified Ocular Surface Disease Index > 15.0). Subjects used the test and placebo version of "blink blink" each for 1 week (1 week washout; crossover) and were instructed to blink twice on presentation of the animation. Blink rate and dry eye symptoms were assessed after each phase and compared with baseline. Study part A: Ten subjects participated (mean [± SD] age, 38.3 [± 16.0] years; 5 women). A greater increase in blink rate was observed in the test group (5.62 blinks/min for the test group and 0.96 blinks/min for the control group). Study part B: Twenty-four subjects participated (mean [± SD] age, 39.3 [± 19.1] years; 11 women). Dry eye symptoms improved during both phases (with test and placebo) to a statistically significant degree (each, p Blink rate increased with the program by 6.75 (± 3.80) blinks/min (p blinks/min with placebo (p = 0.396). This difference between test and placebo was statistically significant (p blink blink" well during computer use. Blink rate and dry eye symptoms improved with "blink blink." The double blink prompted by the animation allowed a decrease in number of presentations and improved acceptance of "blink blink."

  4. Annual direct cost of dry eye in Japan

    Directory of Open Access Journals (Sweden)

    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

  5. Occult thyroid eye disease in patients presenting with dry eye symptoms.

    Science.gov (United States)

    Gupta, Anita; Sadeghi, Pooyan Badihian; Akpek, Esen Karamursel

    2009-05-01

    To describe the clinical presentation, laboratory features, and treatment outcomes in a series of patients with occult thyroid eye disease (TED). Retrospective observational case series. Among 539 patients who were referred for dry eye evaluation over 2 years, 21 were diagnosed with occult TED, based on typical findings in orbital echography. Medical records of these patients were reviewed to collect information on demographics, clinical findings, laboratory studies, and treatment response. All patients presented with symptoms of dry eye. Median age of patients was 57 years (range, 24 to 78 years), with the majority female (86%). No patients carried prior diagnosis of TED or had typical findings of TED such as proptosis, dysmotility, or diplopia. Suspicion of TED was based on conjunctival hyperemia with or without chemosis localized to extraocular muscles (100%), and subtle widening of interpalpebral fissure (48%). Clinical findings included corneal fluorescein staining (57%), rapid tear break-up time (31%), and abnormal Schirmer test (19%). Nineteen percent of patients had other rheumatologic disorders commonly associated with dry eye: Sjögren syndrome (n = 3), and rheumatoid arthritis (n = 1). Patients were treated topically using cyclosporine 0.05% 2 to 4 times a day, with or without steroid. Other treatments were also employed as necessary including warm compresses, artificial tears, and puntal plugs. Majority of patients (76%) had improvement of their symptoms. Occult TED is a potential cause of inflammatory ocular surface disease with dry eye symptomatology and should be considered in the differential diagnosis when evaluating dry eye patients.

  6. 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.

  7. 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.

  8. 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

  9. 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

  10. 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. PMID:26402857

  11. 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.

  12. Acupuncture for dry eye: a randomised controlled trial protocol

    Directory of Open Access Journals (Sweden)

    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.

  13. The influence of protein free calf blood extract eye gel on dry eye after pterygium surgery

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  15. 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.

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

    OpenAIRE

    McMonnies, Charles W.

    2016-01-01

    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 nociceptiv...

  17. Olho seco: etiopatogenia e tratamento Dry eye: etiopathogenesis and treatment

    Directory of Open Access Journals (Sweden)

    Ellen Carrara Fonseca

    2010-04-01

    Full Text Available Olho seco é uma doença multifatorial das lágrimas e da superfície ocular que resulta em desconforto, distúrbios visuais e instabilidade do filme lacrimal. É uma desordem comum que afeta principalmente adultos e mulheres e que pode causar impacto na qualidade de vida comparável a enxaqueca, dispnéia e insuficiência renal crônica, dependendo dos sintomas ou complicações que a acompanham. Novos conceitos com relação à fisiopatologia, classificação e tratamento têm sido apresentados e devem ser conhecidos pelos oftalmologistas pela sua larga aplicação no dia-a-dia. Estima-se que haja 100 medicações diferentes em uso para olho seco atualmente, além de outros métodos de tratamento, sendo necessário se estabelecer o que é realmente seguro e eficaz. Este texto faz uma revisão sobre etiopatogênese e tratamento da síndrome do Olho Seco.Dry eye is a multifactorial disease of tears and ocular surface that causes discomfort, visual disturbance and tear film instability. It is a common disorder that affects specially adults and women and can cause quality of life impairment comparable to migraine, shortness of breath and chronic renal insufficiency, depending on its symptoms or complications. New concepts regarding physiopathology, classification and treatment have been presented and should be known by ophthalmologists because of their relevance on day-by-day application. There are about 100 different medications currently in use for dry eye besides other methods of treatment, so it is necessary to establish what is really safe and effective for dry eye. This paper presents a review about Dry Eye Syndrome etiopathogenesis and treatment.

  18. 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

  19. Clinical study on high concentrations of sodium hyaluronate eye drops for moderate to severe dry eye

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    Yu-Jing Tian

    2014-06-01

    Full Text Available AIM: To observe the efficacy of high concentrations of sodium hyaluronate(3g/L SHfor moderate to severe dry eye. METHODS: Forty moderate to severe dry eye patients were included in the study according to the diagnosis criteria and randomized into two groups. The patients of the trial group received topical administration of high concentration sodium hyaluronate(3g/L, and those of the control group received sodium hyaluronate(1g/Lplus recombinant human epidermal growth factor. The dry eye symptom scores, ocular surface disease index(OSDIscores, tear film break-up time(BUT, Schirmer Ⅰ test and corneal fluorescein staining score were evaluated.All the indexes were compared between the two groups 2wk before and after treatment. RESULTS: There were no significant differences of the indicators between the two groups before treatment. After 2wk treatment, the differences were statistically significant compared to former except for the Schirmer Ⅰ test. Compared with the control group, the symptom scores and the OSDI scores were lowered. No significant differences were found in the other indicators between these two groups. CONCLUSION: Topical usage of highconcentrations of sodium hyaluronate(3g/Lis beneficial for remitting the ocular symptoms in moderate to severe dry eyes, and also improve the quality of life of patients.

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

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    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

  1. Tear osmolarity and dry eye symptoms in diabetics

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    Fuerst, Nicole; Langelier, Nicole; Massaro-Giordano, Mina; Pistilli, Maxwell; Stasi, Kalliopi; Burns, Carrie; Cardillo, Serena; Bunya, Vatinee Y

    2014-01-01

    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 long-standing diabetes, may not experience symptoms and seek care in a timely manner. PMID:24648714

  2. Screening for dry eye disease using infrared ocular thermography.

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    Tan, Li Li; Sanjay, Srinivasan; Morgan, Philip B

    2016-12-01

    To evaluate the efficacy of infrared (IR) ocular thermography in screening for dry eye disease (DED). IR ocular thermography was performed on 62 dry eye and 63 age- and sex-matched control subjects. Marking of ocular surface and temperature acquisition was done using a novel 'diamond' demarcation method. 30 static- and 30 dynamic-metrics were studied and receiver operating characteristic curves were plotted. Efficacy of the temperature metrics in detecting DED were evaluated singly and in combination in terms of their area under the curve (AUC), Youden's index and discrimination power (DP). Absolute temperature of the extreme nasal conjunctiva 5s and 10s after eye opening were best detectors for DED. With threshold value for the first metric set at 34.7°C, sensitivity and specificity was 87.1% (95% CI: 76.2-94.3%) and 50.8% (95% CI: 37.9-63.6%) respectively. With threshold value for the second metric set at 34.5°C, sensitivity and specificity was 77.6% (95% CI: 64.7-87.5%) and 61.9% (95% CI: 48.8-73.9%) respectively. The two metrics had moderate accuracy and limited performances with AUC of 72% (95% CI: 63-81%) and 73% (95% CI: 64-82%); Youden index of about 0.4 and DP of 1.07 and 1.05 respectively. None of the dynamic metrics was good detector for DED. Combining metrics was not able to increase the AUC. This work suggests some utility for the application of IR ocular thermography for evaluation of dry eye patients. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  3. 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

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

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    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

  5. Relationship of Corneal Pain Sensitivity With Dry Eye Symptoms in Dry Eye With Short Tear Break-Up Time.

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    Kaido, Minako; Kawashima, Motoko; Ishida, Reiko; Tsubota, Kazuo

    2016-03-01

    The purpose of this prospective comparative study was to investigate corneal sensitivity in subjects with unstable tear film, with and without dry eye (DE) symptoms. Forty-one eyes of 41 volunteers (mean age: 45.1 ± 9.4 years; age range, 23-57 years), with normal tear function and ocular surface except for tear stability, were studied. The eyes were divided into two groups depending on the presence or absence of DE symptoms: 21 eyes with DE symptoms (symptomatic group); and 20 eyes without DE symptoms (asymptomatic group). Three types of corneal sensitivity values were measured using a Cochet-Bonnet esthesiometer: the sensitivity for perception of touch (S-touch), the sensitivity for blinking (S-blink), and the sensitivity for pain (S-pain). Mean S-blink and S-pain were significantly higher in the symptomatic group than in the asymptomatic group (P 0.05). Corneal sensitivity for blinking and pain evoked by increased stimuli was higher in the symptomatic group (subjects with short break-up time DE) compared with subjects who have no DE symptoms despite decreased tear stability. The presence of both tear instability and hyperesthesia, rather than tear instability alone, may contribute to DE pathogenesis.

  6. Analysis of correlation between dry eye and diabetic retinopathy in type 2 diabetic patients

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    Jian-Feng Yu

    2016-06-01

    Full Text Available AIM:To investigate the correlation between dry eye and different degrees of diabetic retinopathy(DRin type 2 diabetic patients. METHODS: In the cross-sectional study, 340 patients(340 eyeswith type 2 diabetes were enrolled. Tear film function tests including tear meniscus height, tear film breakup time(BUT, fluorescein staining, Schirmer Ⅰ test were performed followed by surveying questionnaires about dry eye. Retinal status was evaluated by retinal color photography and indirect ophthalmoscopy exam with dilated pupils to evaluate DR and whether companied by macular edema. RESULTS: The prevalence of dry eye was 49.41%. The mean duration of diabetes in patients with dry eye was 11.15±7.07a, while 6.92±5.45a without dry eye(PCONCLUSION: Dry eye was more prevalent in people with type 2 diabetes. The incidence of dry eye increased gradually with the occurrence and development of diabetic retinopathy.

  7. In vivo Confocal Microscopy Evaluation of Meibomian Gland Dysfunction in Dry Eye Patients with Different Symptoms

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    Hui Zhao

    2016-01-01

    Conclusions: IVCM application provides a strong support to differentiate dry eye patients with different symptoms: meibomian gland dysfunction (MGD plays a pivotal role in dry eye aggravation, and using IVCM to observe MG fibrosis, changes in size and density of MG as well as status of inflammation cells can help not only correctly diagnose the type and severity of dry eye, but also possibly prognosticate in routine eye examination in the occurrence of MGD.

  8. Efficacy of hypotonic 0.18% sodium hyaluronate eye drops in patients with dry eye disease.

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    Lee, Hyo Seok; Ji, Yong Sok; Yoon, Kyung Chul

    2014-09-01

    The aim of this study was to evaluate the efficacy of hypotonic 0.18% sodium hyaluronate (SH) eye drops under the clinical settings of the dry eye workshop treatment guideline for mild dry eye disease (DED). This analysis included 60 patients with DED. Patients with level 1 DED were treated with either isotonic 0.1% SH (group 1) or with hypotonic 0.18% SH eye drops (group 2). Patients with level 2 DED were treated with 0.1% fluorometholone, 0.05% cyclosporine A, and either isotonic 0.1% SH (group 3) or hypotonic 0.18% SH (group 4) eye drops. Tear film breakup time (TBUT), Schirmer test, corneal staining with fluorescein, and ocular surface disease index score were recorded at baseline, 1 month, and 3 months after treatment. In group 2, TBUT at 3 months (P = 0.03) and corneal staining scores at 1 and 3 months (P ≤ 0.03) were significantly improved after the treatment compared with baseline scores, whereas these parameters were not changed during the follow-up period in group 1. In groups 3 and 4, TBUT and corneal staining scores at 1 and 3 months, and ocular surface disease index score and Schirmer test results at 3 months after the treatment showed significant improvements compared with the baseline score (P Hypotonic 0.18% SH eye drops seemed to be effective in improving tear film stability and ocular surface integrity compared with isotonic 0.1% SH eye drops in patients with mild DED.

  9. Lifitegrast: A novel drug for treatment of dry eye disease.

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    Abidi, Afroz; Shukla, Pooja; Ahmad, Ali

    2016-01-01

    Dry eye disease (DED) is an inflammatory disorder of ocular surfaces leading to severe disability, especially in the elderly age group. The mainstay of therapy includes artificial tears, punctual plugs, topical anti-inflammatory agents, and corticosteroids. In the past few years, only cyclosporine-A emulsions have been added to the existing therapy, but it is discontinued by most patients as it causes burning sensation in the eye. Hence, progress in new research for a better therapeutic option led to the discovery of lymphocyte function-associated antigen intercellular adhesion molecule 1 antagonist, lifitegrast. It hinders the T-cell activation, release of inflammatory mediators, and consequently inhibits the inflammatory pathways in DED. It was approved by the US Food and Drug Administration in July 2016 for the treatment of DED. This review highlights the development process and approval of lifitegrast.

  10. Reduced tear meniscus dynamics in dry eye patients with aqueous tear deficiency.

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    Yuan, Yimin; Wang, Jianhua; Chen, Qi; Tao, Aizhu; Shen, Meixiao; Shousha, Mohamed Abou

    2010-06-01

    To measure the tear meniscus dynamics in aqueous tear deficiency dry eye patients using optical coherence tomography. Clinical research study of a laboratory technique. Twenty-five aqueous tear deficiency dry eye patients and 30 healthy subjects were recruited. Upper and lower tear menisci of 1 randomly selected eye of each participant were imaged during normal and delayed blinking using optical coherence tomography. Measured parameters included upper tear meniscus height and volume, lower tear meniscus height and volume, the blink outcome defined as the meniscus volume change during blink action, and open eye outcome defined as the meniscus volume change during the open eye period. During normal blinking, both tear meniscus height and volume before blink in dry eye patients were significantly smaller than those in healthy subjects, except for the upper tear meniscus volume. During normal blinking, the blink outcome and open eye outcome of lower tear meniscus were significantly smaller in dry eye patients compared with healthy subjects. During delayed blinking, the upper and lower tear menisci heights and volumes significantly increased in both groups. However, dry eye patients had smaller increases than healthy subjects. During delayed blinking, the open eye outcomes of upper and lower tear menisci were smaller in dry eye patients than healthy subjects. Dry eye patients seem to have reduced tear meniscus dynamics during normal blinking and smaller increases of meniscus volume during delayed blinking. Analysis of tear meniscus dynamics may provide more insight in the altered tear system in dry eye patients. Copyright 2010 Elsevier Inc. All rights reserved.

  11. 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

  12. Prevalence of dry eye amongst black and Indian university students aged 18–30 years

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    Bryce Castelyn

    2015-03-01

    Full Text Available Background: The overall prevalence of dry eye in South Africa seems to be increasing. University students work under conditions predisposing them to dry eye, which may affect some tasks. The predominant race groups at the University of KwaZulu-Natal (UKZN are black and Indian, which suggested a study in this student population to assist the diagnosis and management of such subjects.Aim and setting: To compare the prevalence of dry eye amongst black and Indian students at the UKZN’s Westville campus.Methods: One hundred participants, equally divided by gender and race, between 18 and 30 years old were enrolled. Dry eye symptoms were investigated by the ocular surface disease index (OSDI, tear thinning time (TTT, tear breakup time (TBUT and Schirmer’s 2 in that sequence on both eyes of each participant.Results: The OSDI revealed that 41% of participants had some dry eye symptoms whilst 59% had no symptoms. Clinical testing showed that 81% of participants had dry eye. Half of the black participants had dry eye symptoms and 82% had clinical signs of dry eye. Of the 50 Indian participants, 32% had dry eye symptoms and 80% had clinical signs. Of the 50 male participants, 34% were symptomatic and 86% had clinical signs. Of the 50 female participants, 48% had dry eye symptoms and 76% had clinical signs. Participants were asymptomatic even in the presence of clinical dry eye signs.Conclusion: For both races and genders, clinical signs of dry eye were more common than symptoms. Black participants were more likely to report symptoms than Indians, and more women than men reported having symptoms. Male participants were more likely than female to have clinical signs of dry eye.

  13. Relation of accommodative microfluctuation with dry eye symptoms in short tear break-up time dry eye.

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    Kaido, Minako; Kawashima, Motoko; Shigeno, Yuta; Yamada, Yoshiaki; Tsubota, Kazuo

    2017-01-01

    To investigate accommodative microfluctuations (AMFs) and visual function in short tear break-up time (BUT)-type dry eye (DE) and non-DE subjects. This prospective comparative study included 48 volunteers with DE symptoms (mean age 34.8 ± 5.5 years, age range 25-42 years) and 73 without DE symptoms (mean age 30.6 ± 4.7 years, age range 25-42 years). The eyes were divided into two groups: (1) DE group with DE symptoms and BUT ≤ 5 s and (2) non-DE group without DE symptoms and BUT > 5 s. We excluded eyes with Schirmer score ≤ 5 mm and positive keratoconjunctival epithelial damage. Tear evaluation, AMF, and functional visual acuity (VA) examinations were performed. AMF parameters included total high-frequency component (HFC), HFC with low accommodation for the task of staring into the distance (HFC1), and HFC with high accommodation for deskwork (HFC2). Functional VA parameters included starting VA, functional VA, visual maintenance ratio, and blink frequency. A total of 33 and 34 eyes were categorized in the DE and non-DE groups, respectively. Mean blink frequency and HFC1 values were significantly higher in the DE group than they were in the non-DE group. DEs with symptoms showed abnormal AMF and visual function, which may be associated with DE symptoms.

  14. [Dry eye syndrome. Occupational risk factors, valuation and prevention].

    Science.gov (United States)

    Vicente-Herrero, M T; Ramírez-Iñiguez de la Torre, M V; Terradillos-García, M J; López González, Á A

    2014-03-01

    Dry eye syndrome in the workplace is associated with new ways of working, with increasing use of screens and electronic devices and environmental conditions encountered in modern office designs and other environments. Also affect occupational exposure to ionizing radiation, chemicals or atmospheric dust with increased ocular dryness. The study of pathophysiological aspects and laboral causality of the dry eye, must be to develop joint task in Occupational Health, Public Health in coordination with and responsible for the national health system, which would involve primary and secondary preventive measures more effective and proper diagnosis, control and monitoring of the disease, A better knowledge of occupational hazards and actions agreed and coordinated between occupational physicians, preventers, primary care physicians and specialist physicians, such as ophthalmology, will get results much more effective when earlier and optimize available resources. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  15. Contact lens wear and dry eyes: challenges and solutions

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    Markoulli M

    2017-02-01

    Full Text Available Maria Markoulli, Sailesh Kolanu School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia Abstract: The number of contact lens wearers worldwide has remained relatively stable over the past decade, despite the investment that has gone into contact lens technology. This is largely because 10%–50% of wearers dropout of contact lens wear within 3 years of commencement; the most common reason cited being contact lens discomfort (CLD. Of the symptoms reported, sensation of dry eye is the most common. Given the outcome of reduced wearing time, increased chair time, and ultimate contact lens discontinuation, the challenge is to identify the warning signs of CLD early on. Clinically detectable changes such as conjunctival staining, conjunctival indentation, conjunctival epithelial flap formation, lid wiper epitheliopathy, Demodex blepharitis, and meibomian gland dysfunction have been linked to CLD, highlighting the need to perform regular aftercare visits to identify these changes. At a cellular level, conjunctival metaplasia and reduced goblet cell density have been linked to CLD, leading to a downstream effect on the tear film breakup time of contact lens wearers. These factors suggest a strong link between CLD and friction, raising the need to target this as a means of minimizing CLD. The purpose of this review is to identify the clinical signs that relate to CLD as a means of earlier detection and management in order to combat contact lens dropout. Keywords: contact lens discomfort, dry eye disease, lid wiper epitheliopathy, tear film biomarkers, meibomian gland dysfunction

  16. A review on recent advances in dry eye: Pathogenesis and management

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    Ankita S Bhavsar

    2011-01-01

    Full Text Available Keratoconjunctivitis sicca, more commonly known as dry eye, is an extremely common and often unrecognized disease. It is the condition in ophthalmology that in its mild grade of severity will affect most of the population at one time or other. Due to a wide variety of presentations and symptoms, it often frustrates the ophthalmologists as well as patients. Due to multifactorial and elusive etiology, it is often challenging to treat dry eye. Ocular surface disorders are also clinically important to treat especially in terms of visual acuity. Xero-dacryology is therefore becoming a very important branch of ophthalmology. Recent studies have given insight into the inflammatory etiology of dry eye. The conventional and main approach to the treatment of dry eye is providing lubricating eye drops or tear substitutes. However, the newer treatment approach is to target the underlying cause of dry eye instead of conventional symptomatic relief. In light of the above knowledge, the present article focuses on newer theories on pathogenesis of dry eye and their impact on dry eye management. Method of Literature Search: A systematic literature review was performed using PubMed databases in two steps. The first step was oriented to articles published for dry eye. The second step was focused on the role of inflammation and anti-inflammatory therapy for dry eye. The search strategy was not limited by year of publication. A manual literature search was also undertaken from authentic reference books on ocular surface disease.

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

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    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.

  18. Passive Smoking as a Risk Factor of Dry Eye in Children

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    Amany Abdel-Fattah El-Shazly

    2012-01-01

    Full Text Available Purpose. Adult active smoking is a risk factor for dry eye. We hypothesize that passive smoking in children can also produce the same effects. Methods. We included 112 school children presenting with eye discomfort. Assessment of eye dryness and its severity levels depending on symptoms of dry eye, visual symptoms, tear breakup time (TBUT, Schirmer-1 test, and corneal fluorescein staining were done for all of them. Exposure to cigarette smoking was assessed by history-taking and urinary cotinine levels. Results. Dry eye was found in 80/112 children. Passive smoking was documented in 76/112 children. Number of cigarettes to which the child was exposed per day and the duration of exposure to passive smoking were significantly higher in children with dry eye compared to those without. Urinary cotinine, and cotinine/creatinine ratio (CCR was significantly higher in children with dry eye compared to those without dry eye. Multiregression analysis showed that the most important determinants of dry eye were CCR and number of cigarettes/day. Conclusion. Passive smoking represents a significant risk factor of dry eye in children comparable to that shown with active adult smoking. Male children are more prone to this effect.

  19. High incidence of dry eye in young children with allergic conjunctivitis in Southwest China.

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    Chen, Lin; Pi, Lianhong; Fang, Jing; Chen, Xinke; Ke, Ning; Liu, Qing

    2016-12-01

    To identify the prevalence of dry eye in pediatric population with allergic conjunctivitis in Southwest China. A single-centre, prospective, case-control study conducted between May 2015 and December 2015 included 40 children, 3-6 years of age, with seasonal allergic conjunctivitis (SAC) or perennial allergic conjunctivitis (PAC) and 40 age- and gender-matched children undergoing medical healthy examination without history of allergy or dry eye as a control. A dry eye score system (DESS) was administered to both groups. Slit-lamp examinations including tear film break-up time (TFBUT) and fluorescent corneal staining (FCS) were performed. Correlation analyses were performed to evaluate associations between measures of dry eye and signs and symptoms of AC. The prevalence of dry eye was 97.5% (78/80 eyes) in cases and 27.50% (22/80 eyes) in controls. Mean DESS score was 4.75 ± 2.22 in the case group and 0.80 ± 1.22 in the control group (p conjunctivitis. The incidence of dry eye assessed by TFBUT was higher in young children with SAC and PAC than in controls. However, subjective symptoms of dry eye (DESS) were inconsistent with objective signs, indicating that close attention should be paid to the evaluation and treatment of dry eye in pediatric population with AC. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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

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    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.

  1. 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

  2. A murine model of dry eye induced by topical administration of erlotinib eye drops.

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    Yang, Qi-Chen; Bao, Jing; Li, Cheng; Tan, Gang; Wu, An-Hua; Ye, Lei; Ye, Lin-Hong; Zhou, Qiong; Shao, Yi

    2018-03-01

    In the present study, the effects of erlotinib on mouse tear function and corneal epithelial tissue structure were investigated. Throughout the 3 weeks of treatment, no notable differences were observed in the body, eye or lacrimal gland weights of the control and experimental mice. However, in the experimental group, the tear volume and break‑up times of tear film were significantly lower following treatment with erlotinib compared with the control group. Corneal fluorescein staining in the experimental group revealed patchy staining, and the Lissamine green staining and inflammatory index were significantly higher in the experimental group at 3 weeks than in the control group. In the experimental group, the number of corneal epithelium layers increased significantly following treatment with erlotinib for 3 weeks and a significant increase in the number of vacuoles was observed compared with the control group. Treatment with erlotinib significantly increased the corneal epithelial cell apoptosis, and led to a significantly increased number of epithelial cell layers and increased keratin 10 expression. It also significantly reduced the number of conjunctival goblet cells. Transmission electron microscopy and scanning electron microscopy revealed that the corneal epithelial surface was irregular and there was a substantial reduction and partial loss of the microvilli in the experimental group. Mice treated with erlotinib also exhibited an increased protein expression of tumor necrosis factor‑α and decreased protein expression of phosphorylated‑epidermal growth factor receptor in the corneal epithelial cells. The topical application of erlotinib eye drops was revealed to induce dry eyes in mice. This is a novel method of developing a model of dry eyes in mice.

  3. Semifluorinated Alkane Eye Drops for Treatment of Dry Eye Disease Due to Meibomian Gland Disease.

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    Steven, Philipp; Augustin, Albert J; Geerling, Gerd; Kaercher, Thomas; Kretz, Florian; Kunert, Kathleen; Menzel-Severing, Johannes; Schrage, Norbert; Schrems, Wolfgang; Krösser, Sonja; Beckert, Michael; Messmer, Elisabeth M

    2017-11-01

    Meibomian gland disease is generally accepted as the leading cause for evaporative dry eye disease (DED). In a previous study, perfluorohexyloctane, a semifluorinated alkane, has been demonstrated to significantly increase tear film breakup time and to reduce corneal fluorescein staining in patients with evaporative DED, thereby vastly reducing dry eye-related symptoms. This study was set up to evaluate perfluorohexyloctane in a larger population of patients with Meibomian gland dysfunction. Seventy-two patients with Meibomian gland disease and associated dry eye received 1 drop of perfluorohexyloctane 4 times daily during an observational, prospective, multicenter, 6-8-week study. Clinical assessment included best-corrected visual acuity, intraocular pressure, Schirmer test I, tear film breakup time, anterior and posterior blepharitis assessment, number of expressible Meibomian glands, meibum quality and quantity, ocular surface fluorescein staining, lid margin and symptom assessment, and Ocular Surface Disease Index (OSDI © ). From the 72 patients recruited, 61 completed the trial per protocol. Nine patients did not apply the medication as recommended and 2 patients were lost to follow-up. Tear film breakup time, corneal and conjunctival fluorescein staining, number of expressible Meibomian glands, and severity of anterior and posterior blepharitis significantly improved after 6-8 weeks of perfluorohexyloctane application. In addition, symptoms improved as demonstrated by a significant decrease of OSDI-values from 37 (±13) to 26 (±16). In concordance with previous findings, 6-8 weeks of topical application of perfluorohexyloctane significantly improves clinical signs of Meibomian gland disease and associated mild to moderate DED.

  4. Lifitegrast for the treatment of dry eye disease in adults.

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    Donnenfeld, Eric D; Perry, Henry D; Nattis, Alanna S; Rosenberg, Eric D

    2017-10-01

    Dry eye disease (DED) is a common ocular disorder that can have a substantial burden on quality of life and daily activities. Lifitegrast ophthalmic solution 5.0% is the first medication approved in the US for the treatment of the signs and symptoms of DED. The aim of this article is to summarize the preclinical and clinical data on lifitegrast and discuss how lifitegrast may fit into the current treatment landscape for DED. Areas covered: A literature search of published preclinical and clinical data was conducted to review the chemistry, pharmacodynamics, pharmacokinetics, and clinical efficacy/safety of lifitegrast. The impact that lifitegrast may have on DED treatment practices is also discussed. Expert opinion: The introduction of lifitegrast provides a potentially important additional option for eye care professionals treating DED. In clinical trials conducted in adults with DED, lifitegrast ophthalmic solution 5.0% improved both signs and symptoms of DED. Of note, in 2 phase 3 trials, symptom improvements were observed as early as 2 weeks, which may be explained by lifitegrast's unique mechanism of action of blocking a specific signaling pathway in inflammation. Future research should include evaluation of whether lifitegrast can be used in combination with other DED treatments.

  5. Dry eye syndrome: developments and lifitegrast in perspective

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    Lollett IV

    2018-01-01

    Full Text Available Ivonne V Lollett,1 Anat Galor2,3 1University of Miami, Miller School of Medicine, Miami, FL, 2Ophthalmology Department, Miami Veterans Administration Medical Center, Miami, FL, 3Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA Abstract: 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. Keywords: lifitegrast

  6. Semifluorinated Alkane Eye Drops for Treatment of Dry Eye Disease--A Prospective, Multicenter Noninterventional Study.

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    Steven, Philipp; Scherer, Dieter; Krösser, Sonja; Beckert, Michael; Cursiefen, Claus; Kaercher, Thomas

    2015-10-01

    Evaporation of the tear film is heavily discussed as one core reason for dry eye disease (DED). Subsequently, new artificial tear products are developed that specifically target this pathomechanism. Perfluorohexyloctane (F6H8, NovaTears(®)) from the family of semifluorinated alkanes is a novel substance that has been approved as a medical device, as a nonblurring wetting agent for the ocular surface. Thirty patients with hyperevaporative dry eye received F6H8 during a prospective, multicenter, observational 6-week study. Patients were advised to apply 1 drop 4 times daily in both eyes. Parameters assessed included best corrected visual acuity, intraocular pressure, Schirmer I test, tear fluid, tear film breakup time (TFBUT), corneal staining, meibum secretion, and Ocular Surface Disease Index (OSDI(©)). From the 30 patients recruited, 25 completed the trial per protocol. Four patients discontinued F6H8 and 1 patient did not present for follow-up. F6H8 treatment led to significant reduction of corneal staining and significant increase of Schirmer I and TFBUT. In addition, OSDI score dropped significantly from a mean of 55 (± 23.0) to 34 (± 22.4). Visual acuity and ocular pressure did not change. This prospective observational study shows significant beneficial effects in patients suffering from evaporative DED, using F6H8 in all the relevant parameters tested. The decrease of the OSDI by a mean of 21 points was particularly remarkable and clearly exceeds minimal, clinical important differences for mild or moderate and severe disease. Overall, F6H8 (NovaTears) seems to be safe and effective in treating mild to moderate hyperevaporative DED.

  7. Semifluorinated Alkane Eye Drops for Treatment of Dry Eye Disease—A Prospective, Multicenter Noninterventional Study

    Science.gov (United States)

    Scherer, Dieter; Krösser, Sonja; Beckert, Michael; Cursiefen, Claus; Kaercher, Thomas

    2015-01-01

    Abstract Purpose: Evaporation of the tear film is heavily discussed as one core reason for dry eye disease (DED). Subsequently, new artificial tear products are developed that specifically target this pathomechanism. Perfluorohexyloctane (F6H8, NovaTears®) from the family of semifluorinated alkanes is a novel substance that has been approved as a medical device, as a nonblurring wetting agent for the ocular surface. Methods: Thirty patients with hyperevaporative dry eye received F6H8 during a prospective, multicenter, observational 6-week study. Patients were advised to apply 1 drop 4 times daily in both eyes. Parameters assessed included best corrected visual acuity, intraocular pressure, Schirmer I test, tear fluid, tear film breakup time (TFBUT), corneal staining, meibum secretion, and Ocular Surface Disease Index (OSDI©). Results: From the 30 patients recruited, 25 completed the trial per protocol. Four patients discontinued F6H8 and 1 patient did not present for follow-up. F6H8 treatment led to significant reduction of corneal staining and significant increase of Schirmer I and TFBUT. In addition, OSDI score dropped significantly from a mean of 55 (±23.0) to 34 (±22.4). Visual acuity and ocular pressure did not change. Conclusions: This prospective observational study shows significant beneficial effects in patients suffering from evaporative DED, using F6H8 in all the relevant parameters tested. The decrease of the OSDI by a mean of 21 points was particularly remarkable and clearly exceeds minimal, clinical important differences for mild or moderate and severe disease. Overall, F6H8 (NovaTears) seems to be safe and effective in treating mild to moderate hyperevaporative DED. PMID:26296040

  8. The Core Mechanism of Dry Eye Disease (DED) Is Inflammation

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    Wei, Yi; Asbell, Penny A.

    2014-01-01

    Purpose The purpose of this article is to review the evidence for the hypothesis that the core mechanism of Dry Eye Disease (DED) is inflammation, including evidence from recent basic, clinical and translational research involving human patients, animal models, and cell cultures. Method Using the key words “dry eye + inflammation” , the authors conducted a comprehensive search of the PubMed and Web of Science databases for scientific articles published in English between January 1st 1900 and August 30th 2013 on the role of inflammation in DED in cell cultures, animal models and humans. The resulting articles were then categorized and reviewed. Results The literature search revealed a total of 458 publications, almost all published after 1992. The percentages of original studies and review articles are 77.29% (354) and 22.71% (104), respectively. Among the original studies, the number of reports on inflammation of human DED is 200 (43.7%); animal models, 115 (25.1 %); and cell cultures, 39 (8.5 %). The human DED studies reveal changes of numerous inflammatory cells and mediators in ocular surface and tear film and those changes can be attenuated or reversed by anti-inflammatory drug treatments. The animal DED studies demonstrate that DED is likely a dominant T-lymphocytes, especially T-helper 17-subset (Th17)-mediated autoimmune disease and that the autoimmune-driven inflammatory cycles are fundamentally linked with DED progression. These results are mirrored and confirmed by a number of corneal and conjunctival epithelial cell culture studies that clearly demonstrate an inflammatory immune response pattern when those cells are exposed to desiccation, inflammatory mediators or high osmolarity shock. A yearly distributing plot revealed that 76% were published from 2003 to 2011, 53% from 2008 to 2012, and 11% during the first 9 months of 2013. This distribution signifies a rapidly growing awareness of the importance of inflammation in DED pathogenesis. Conclusion

  9. The effect of antihypertensive therapy on dry eye disease.

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    Kalkan Akcay, Emine; Akcay, Murat; Can, Gamze Dereli; Aslan, Nabi; Uysal, Betul Seher; Ceran, Basak Bostanci; Koseahya, Pinar; Cagil, Nurullah

    2015-01-01

    There is a generalization that "antihypertensive (antiHT) therapy causes Dry Eye Syndrome", which has been claimed for years however most of the publications are epidemiological studies. We performed a clinical study to investigate the effects of antiHT agents on tear function. The aim of this article is to evaluate the effects of different classes of antiHT medications on tear osmolarity, ocular surface problems and dry eye symptoms. Prospective, non-randomized a clinical study. A total of 71 patients who would be initiated antiHT medication due to elevated systemic blood pressure were included in the study. Thirty of these patients were given antiHT drugs containing diuretic (diuretic +), and 41 of them were given diuretic-free drugs (diuretic -). While the number of the patients medicated in the group that received Angiotensin Converting Enzyme inhibitors (ACE inh)/Angiotensin receptor blockers (ARB) (ACE/ARB +) was 29, the number of those medicated in the ACE/ARB-free group (ACE/ARB -) was 42. Ocular surface disease index scores, tear osmolarity, Schirmer I test, tear film break-up time (TBUT), fluorescein (FL) and rose bengal corneal staining patterns of the patients were analyzed. The patients were examined through the repetition of all the tests in the 1st and the 3rd month. The participants (n = 71) comprised 38 males and 33 females with a mean age of 51.8 ± 10.4. When the first (0-1st month) and the third month (0-3rd months) control measurements between diuretics (+) and diuretics (-) groups before and after antiHT therapies were compared, a statistically significant difference was not found in any of the tests applied. When the 0-1st month measurements of ACE/ARB (+) and ACE/ARB (-) groups were compared, it was observed that staining with FL in ACE/ARB (+) group decreased in a statistically significant manner (p = 0.035) and there was a significant increase in TBUT values (p = 0.022). The use of antiHT drugs containing diuretic had no

  10. Associations of systemic diseases, smoking and contact lens wear with severity of dry eye.

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    Lee, Sze-Yee; Petznick, Andrea; Tong, Louis

    2012-11-01

    Systemic diseases, smoking, ocular surgeries and contact lens wear have been linked with dry eye but it is not known if these factors are also associated with severity of dry eye. A cross-sectional investigation was conducted on the effect of various systemic and ocular conditions with respect to the severity of dry eye in Asian patients. Prospective recruitment of consecutive new referral patients from a dry eye clinic was performed. Medical history, dry eye symptoms and clinical assessment were coded in a standardised form and analysed. Out of 510 patients (25% men), mean ± S.D. age 53.0 ± 14.1 years, 25 had previous diagnosis of rheumatoid arthritis, 30 had diabetic mellitus, 41 had thyroid disease, and 33 were current smokers; 23 and 41 patients had previous LASIK and cataract surgery respectively and 90 were current contact lenses wearers. A previous diagnosis of rheumatoid arthritis was associated with more severe superior corneal fluorescein staining (OR = 11.2, 95% CI 4.6-27.4). Generally, with the exception of rheumatoid arthritis, there were no associations between dry eye severity and systemic diseases, smoking, previous ocular surgeries and contact lens wear. Dry eye patients with rheumatoid arthritis tend to have more severe ocular surface damage in the superior cornea. Ophthalmic & Physiological Optics © 2012 Singapore Eye Research Institute.

  11. Review of hydroxypropyl cellulose ophthalmic inserts for treatment of dry eye

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    Nguyen T

    2011-05-01

    Full Text Available Theresa Nguyen, Robert LatkanyDry Center, Physician Eyecare of New York, New York, NY, USAAbstract: Dry eye syndrome is a prevalent disease that affects visual acuity, activities of daily living, and quality of life. A number of contributory factors affect the severity of dry eye syndrome, including autoimmune disease, environmental surroundings, contact lens use, hormonal changes, anatomical features, chronic inflammation, infections, and iatrogenic factors, such as medications or surgery. Symptoms may include intermittent or constant blurry vision, discomfort, burning, foreign body sensation, hyperemia, dryness, and photophobia. The severity of dry eye syndrome can range from very mild disease to extremely severe cases with vision-threatening consequences. A variety of dry eye treatment modalities exist to address the different causes, symptoms, and consequences of ocular surface disease, including artificial tears, lubricating gels, ophthalmic inserts, anti-inflammatory drops, and surgical procedures. In this paper, an assortment of literature pertaining to the treatment of dry eye syndrome, in particular hydroxypropyl cellulose ophthalmic inserts, is reviewed. These inserts can be used effectively as monotherapy, or in conjunction with other therapies, and should be considered in the treatment of dry eye syndrome.Keywords: hydroxypropyl cellulose ophthalmic inserts, dry eye, punctal occlusion, ocular surface disease

  12. A Clinic-based Survey of Clinical Characteristics and Practice Pattern of Dry Eye in Japan.

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    Kawashima, Motoko; Yamada, Masakazu; Suwaki, Kazuhisa; Shigeyasu, Chika; Uchino, Miki; Hiratsuka, Yoshimune; Yokoi, Norihiko; Tsubota, Kazuo

    2017-03-01

    The aim of this study was to investigate the clinical characteristics and practice pattern of patients with dry eye disease (DED) in eye clinics across Japan. A multi-center, cross-sectional study was conducted among patients with DED who visited eye clinics in Japan. Subjective symptoms, patient's background, ocular surface features, and tear function were evaluated. Main outcome measures were tear break-up time (TBUT), Schirmer I value, kerato-conjunctival staining score, and dry eye symptom questionnaire score. Initially, 463 subjects were enrolled, and 449 cases (63 male and 386 female; mean age, 62.6 ± 15.7 years) were included in the final analysis. Overall, 94.9% of patients had a shortened TBUT (≤5 s), and 54.6% had an aqueous tear deficiency (Schirmer I value ≤5 mm). The most prevalent subtype of dry eye was aqueous-deficient dry eye, which was present in 35.0% of all patients, followed by short-BUT-type dry eye, which was seen in 26.7%. The two most common DED subtypes were aqueous-deficient and short-BUT-type dry eye. Shortened TBUT is the most common feature of dry eye, regardless of subtype. The current treatment choice mainly consisted of hyaluronic acid, two novel mucin secretagogues, diquafosol and rebamipide, and steroidal eye drops. University Hospital Medical Information Network: UMIN (registries no. UMIN 000015890). Japan Dry Eye Society, Tokyo, Japan, and Santen Pharmaceutical Co., Ltd., Osaka, Japan.

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

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    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.

  14. 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.

  15. Noncontact detection of dry eye using a custom designed IR thermal image system

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    Su, Tai Yuan; Chen, Kerh Hwa; Liu, Po Hsuan; Wu, Ming Hong; Chang, David O.; Chiang, Huihua

    2011-03-01

    Dry eye syndrome is a common irritating eye disease. Current clinical diagnostic methods are invasive and uncomfortable to patients. A custom designed noncontact infrared (IR) thermal image system was developed to measure the spatial and temporal variation of the ocular surface temperature over a 6-second eye-opening period. We defined two parameters: the temperature difference value and the compactness value to represent the degree of the temperature change and irregularity of the temperature distribution on the tear film. By using these two parameters, in this study, a linear discrimination result for the dry eye and the normal eye groups; the sensitivity is 0.9, the specificity is 0.86 and the receiver operating characteristic (ROC) area is 0.91. The result suggests that the custom designed IR thermal image system may be used as an effective tool for noncontact detection of dry eye.

  16. Short break-up time type dry eye has potential ocular surface abnormalities.

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    Ichihashi, Yoshiyuki; Ide, Takeshi; Kaido, Minako; Ishida, Reiko; Hatou, Shin; Tsubota, Kazuo

    2015-01-01

    To describe a case series in which corneal fluorescein staining (CFS) development occurred in short break-up time (s-BUT) dry eyes after a short period during prolonged opening of the eye. The study was designed as a clinical case series. Ocular surface evaluations were performed on 13 individuals with s-BUT dry eye. Tear function examinations included Schirmer's test and BUT evaluation. In all 13 cases, the BUT was short, but the tear quantity was not so bad. In all cases, CFS developed following a single eye opening, and the staining was observed at sites that showed as dark spots. In several cases, the CFS disappeared later. In this study, we demonstrated that CFS could develop following a single eye opening. Based on our findings, CFS is a dynamic phenomenon rather than a stable indicator of ocular surface abnormalities. Moreover, s-BUT dry eye has the potential to show ocular surface abnormalities.

  17. Safety and efficacy of autologous serum eye drop for treatment of dry eyes in graft-versus-host disease.

    Science.gov (United States)

    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.

  18. Corneal Sensitivity and Dry Eye Symptoms in Patients with Keratoconus

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    Dienes, Lóránt; Kiss, Huba J.; Perényi, Kristóf; Nagy, Zoltán Z.; Acosta, M. Carmen; Gallar, Juana; Kovács, Illés

    2015-01-01

    Purpose To investigate corneal sensitivity to selective mechanical, chemical, and thermal stimulation and to evaluate their relation to dry eye symptoms in patients with keratoconus. Methods Corneal sensitivity to mechanical, chemical, and thermal thresholds were determined using a gas esthesiometer in 19 patients with keratoconus (KC group) and in 20 age-matched healthy subjects (control group). Tear film dynamics was assessed by Schirmer I test and by the non-invasive tear film breakup time (NI-BUT). All eyes were examined with a rotating Scheimpflug camera to assess keratoconus severity. Results KC patients had significatly decreased tear secretion and significantly higher ocular surface disease index (OSDI) scores compared to controls (5.3±2.2 vs. 13.2±2.0 mm and 26.8±15.8 vs. 8.1±2.3; p0.05). The mean threshold for selective mechanical (KC: 139.2±25.8 vs. control: 109.1±24.0 ml/min), chemical (KC: 39.4±3.9 vs. control: 35.2±1.9%CO2), heat (KC: 0.91±0.32 vs. control: 0.54±0.26 Δ°C) and cold (KC: 1.28±0.27 vs. control: 0.98±0.25 Δ°C) stimulation in the KC patients were significantly higher than in the control subjects (p0.05), whereas in the control subjects both mechanical (r = 0.52, p = 0.02), chemical (r = 0.47, p = 0.04), heat (r = 0.26, p = 0.04) and cold threshold (r = 0.40, p = 0.03) increased with age. In the KC group, neither corneal thickness nor tear flow, NI-BUT or OSDI correlated significantly with mechanical, chemical, heat or cold thresholds (p>0.05 for all variables). Conclusions Corneal sensitivity to different types of stimuli is decreased in patients with keratoconus independently of age and disease severity. The reduction of the sensory input from corneal nerves may contribute to the onset of unpleasant sensations in these patients and might lead to the impaired tear film dynamics. PMID:26495846

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

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    Niu, Liangliang; Zhang, Shujie; Wu, Jihong; Chen, Ling; Wang, Yan

    2015-01-01

    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, ptear IL-18 concentrations were also significantly increased in the SSDE (p<0.001) and NSSDE (p<0.05) groups. In the current study, we found that mRNA and protein expressions of NLRP3 inflammasome were upregulated in human dry eyes, especially in SSDE; the downstream inflammatory factors caspase-1, IL-1β, and IL-18 were also elevated in dry eye patients. These observations suggest the involvement of NLRP3 inflammasome in the onset and development of the inflammation in dry eye.

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

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    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.

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

    Science.gov (United States)

    ... pads or washcloths over the eyes and using artificial tears or lubricating eye drops. There are other ... eye. If the problem persists and makes good vision difficult, punctual plugs can be considered. Ultimately, the ...

  2. Dry eye syndrome: developments and lifitegrast in perspective.

    Science.gov (United States)

    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.

  3. Dry eye symptoms align more closely to non-ocular conditions than to tear film parameters.

    Science.gov (United States)

    Galor, Anat; Felix, Elizabeth R; Feuer, William; Shalabi, Nabeel; Martin, Eden R; Margolis, Todd P; Sarantopoulos, Constantine D; Levitt, Roy C

    2015-08-01

    To evaluate the relationship between dry eye symptoms, non-ocular conditions and tear film parameters. Cross-sectional study. The study population consisted of patients who were seen in the Miami Veterans Affairs eye clinic. Patients filled out standardised questionnaires assessing dry eye symptoms (dry eye questionnaire 5 (DEQ5) and ocular surface disease index (OSDI)), non-ocular pain, depression and post-traumatic stress disorder (PTSD), and also underwent measurement of tear film parameters. Correlations between dry eye symptoms and non-ocular conditions as compared with tear film parameters. 136 patients with a mean age of 65 (SD 11) years participated in the study. All correlations between the dry eye questionnaire scores (DEQ5 and OSDI) and (A) self-reported non-ocular pain measures (numerical rating scale and pain history), (B) depression and (C) PTSD were significant and moderate in strength (Pearson's coefficient 0.24 to 0.60, ptear film measures were weak (Pearson's coefficient -0.10 to 0.18) and most were not significant. Multivariable linear regression analyses revealed that PTSD and non-ocular pain more closely associated with dry eye symptoms than did tear film parameters. Specifically, non-ocular pain and PTSD accounted for approximately 36% of the variability in DEQ5 scores (R=0.60) and approximately 40% of variability in OSDI scores (R=0.64). Of note, none of the tear parameters remained significantly associated with dry eye symptoms in either model. Dry eye symptoms more closely align to non-ocular pain, depression and PTSD than to tear film parameters. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. PREVALENCE OF DRY EYE SYNDROME IN PATIENTS WITH TYPE 1 AND TYPE 2 DIABETESA COMPARATIVE STUDY

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    Somnath Das

    2017-08-01

    Full Text Available BACKGROUND Diabetes mellitus (DM is a major cause of various ocular complications including Keratoconjunctivitis sicca resulting in tear film deficiency, significantly hindering the performance of daily life and may lead to blindness in severe cases. The objective of our study was to understand the association between Type 1 and Type 2 diabetes mellitus (DM and development of dry eye syndrome. MATERIALS AND METHODS A pair of eyes of 40 patients with Type 1 DM and 60 patients with Type 2 DM was tested for dry eye syndrome using standard scores from Schirmer test 1, 2, tear film break-up time and Rose Bengal staining. Results were statistically analysed to understand significant association. RESULTS Patients with both types of DM belonged to middle or older age groups. Dry eye syndrome was present in nearly half of the patients, as assessed by different techniques. Dry eye syndrome was significantly increased with progressing age and duration of DM of both types in patients. There was, however, no significant difference in prevalence of dry eyes between patients with Type 1 and Type 2 DM. CONCLUSION Dry eye syndrome is an important comorbidity of DM and progresses with age and duration of the disease, and needs early detection and therapeutic management.

  5. Impact of Dry Eye Symptoms and Daily Activities in a Modern Office.

    Science.gov (United States)

    van Tilborg, Mirjam M; Murphy, Paul J; Evans, Katharine S

    2017-06-01

    Modern offices and the use of electronic devices are increasing factors in work-related eye symptoms. However, symptoms of eye fatigue or dry eye sensation can be mixed and confusing. This study surveys the eye symptoms reported during a working day at modern offices to investigate the possible inhibition on daily work activities. Two online digital surveys were sent to three different work locations, by direct e-mail. Survey A consisted of 14 questions that investigated eye symptoms experienced during daily activities at work and the impact on daily activities. Survey B consisted of four general questions, the Dutch Ocular Surface Disease Index, the Work Productivity and Activity Index, and the Illness Perception Questionnaire. A total of 505 participants completed survey A, and 213 completed survey B. The participants reported that a high proportion of their day was spent working on a computer (60%). The majority experienced an air draft (79.1%) and had no adjustable light (81.5%) at their workspace. Dry eye-related symptoms were reported at a significantly higher frequency at work than at home (P work due to eye symptoms, with more than 5% experiencing symptoms most or all of the time. Indoor environment, work environment, and general health were perceived as the main reasons for developing dry eye. Compared with males, females showed a statistically significant higher Ocular Surface Disease Index score (P work productivity. This investigation shows that dry eye symptoms have a negative impact on daily activities at work. These findings suggest that multidisciplinary understanding of the negative impact of dry eye by a range of specialists will be of help in managing work-related dry eye.

  6. Efficacy of punctum plug treatment in short break-up time dry eye.

    Science.gov (United States)

    Kaido, Minako; Ishida, Reiko; Dogru, Murat; Tamaoki, Tomoko; Tsubota, Kazuo

    2008-08-01

    To evaluate the efficacy of punctum plug insertion on tear and dynamic visual function in dry eye patients with short break-up time (s-BUT) of the tears. A prospective comparative case series design was used. Twenty-seven eyes of 27 dry eye patients with a s-BUT seen at Keio University School of Medicine, Department of Ophthalmology, were studied. Functional visual acuity (FVA) measurements, tear function examinations and ocular surface evaluations including Schirmer test, tear break-up time, fluorescein and Rose Bengal vital staining scores were performed before and 1 month after insertion of punctum plugs (PP) in dry eye patients with s-BUT. Degree of satisfaction with the PP treatment was also graded. Nineteen out of 27 eyes (70.4%) showed a satisfactory outcome with the PP treatment because of decreased subjective dry eye symptoms. On the other hand, six out of eight eyes with an unsatisfactory outcome had epiphora. The visual maintenance ratio value was observed to significantly increase from 0.87 +/- 0.09 to 0.91 +/- 0.07 in eyes with no epiphora, whereas the visual maintenance ratio value significantly decreased from 0.98 +/- 0.10 to 0.86 +/- 0.13 in the group of eyes with epiphora after PP treatment. (p < 0.05) Likewise, FVA significantly improved after PP insertion in the group with no epiphora and decreased in eyes with epiphora. Visual acuity in the conventional Landolt visual testing remained significantly unchanged in both group of eyes with or without epiphora. FVA was useful in assessing and quantifying vision related symptomatology in s-BUT type of dry eye treated with PP occlusion.

  7. Analysis on therapy efficacy of different drugs for dry eyes after cataract surgery

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    Li-Ping Yang

    2017-02-01

    Full Text Available AIM: To explore the therapy efficacy of different drugs for dry eyes after cataract surgery.METHODS: Collected from June 2014 to June 2016 in patients with dry eyes in our departments of cataract surgery, a total of 60 cases with 120 eyes, according to the doctor order divided into pure sodium hyaluronate eye drops group 20 cases(40 eyes, sodium hyaluronate eye drops combined pranoprofen eye drops group 20 cases(40 eyes, sodium hyaluronate eye drops combined pranoprofen eye drops and Qiju Dihuang pill group of 20 cases(40 eyes. All patients were treated for 1mo. Observation of break up time(BUT, Shimmer Ⅰ test(SItand fluorescein corneal staining(FIwere recorded before the treatment and 1, 2wk, 1, 3mo after treatment. RESULTS: Difference of efficient rates of three groups 1mo after treatment were statistically significant(PP>0.05; at 1, 3mo after treatment compared with before treatment, the differences of the three groups were statistically significant(PPP>0.05; but sodium hyaluronate eye drops combined pranoprofen eye drops and Qiju Dihuang pill group(12.14±1.97swas superior to pure sodium hyaluronate eye drops group(10.54±1.88sand sodium hyaluronate eye drops combined pranoprofen eye drops group(12.05±1.63s.SIt: there was no statistically significant difference among three groups before treatment(P>0.05; at 1, 3mo after treatment compared with before treatment, the differences of the three groups were statistically significant(PPP>0.05; at 1, 3mo after treatment compared with before treatment, the differences of the three groups were statistically significant(PPP>0.05.CONCLUSION:Sodium hyaluronate eye drops combined pranoprofen eye drops and Qiju Dihuang pill in the treatment of dry eye after cataract surgery is better than that of sodium hyaluronate eye drops combined pranoprofen eye drops group and simple application of sodium hyaluronate eye drops, which can better improve the visual function, improve tear film stability, get better

  8. Restoration of Tear Secretion in a Murine Dry Eye Model by Oral Administration of Palmitoleic Acid

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    Shigeru Nakamura

    2017-04-01

    Full Text Available Sea buckthorn (Hippophae rhamnoides–derived products have traditionally been used as food and medicinal ingredients in Eastern countries. The purpose of this study was to investigate the effect of oral intake of sea buckthorn oil products on tear secretion using a murine dry eye model. Orally administered sea buckthorn pulp oil (not seed oil restored aqueous tear secretion to its normal value under a dry eye condition. Palmitoleate (C16:1, a fatty acid present in sea buckthorn pulp oil, preserved tear secretion and suppressed inflammatory cytokines in the lacrimal gland to the same extent as that by pulp oil. These results suggest that an oral intake of sea buckthorn pulp oil has a potency to preserve tear secretion capacity in the dry eye state and palmitoleate, its main constituent fatty acid, is an active component of the oil. This effect may enable a potent diet-based treatment for the prevention of dry eye.

  9. Prediction of risk and incidence of dry eye in critical patients

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    Diego Dias de Araújo

    2016-01-01

    Full Text Available Objectives: to estimate the incidence of dry eye, to identify risk factors and to establish a risk prediction model for its development in adult patients admitted to the intensive care unit of a public hospital. Method: concurrent cohort, conducted between March and June, 2014, with 230 patients admitted to an intensive care unit. Data were analyzed by bivariate descriptive statistics, with multivariate survival analysis and Cox regression. Results: 53% out of 230 patients have developed dry eye, with onset mean time of 3.5 days. Independent variables that significantly and concurrently impacted the time for dry eye to occur were: O2 in room air, blinking more than five times per minute (lower risk factors and presence of vascular disease (higher risk factor. Conclusion: dry eye is a common finding in patients admitted to adults intensive care units, and care for its prevention should be established.

  10. Dry Eye in Vernal Keratoconjunctivitis: A Cross-Sectional Comparative Study

    National Research Council Canada - National Science Library

    Villani, Edoardo; Strologo, Marika Dello; Pichi, Francesco; Luccarelli, Saverio V; De Cillà, Stefano; Serafino, Massimiliano; Nucci, Paolo

    2015-01-01

    The purpose of this comparative cross-sectional study was to investigate the use of standardized clinical tests for dry eye in pediatric patients with active and quiet vernal keratoconjunctivitis (VKC...

  11. 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.

  12. 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.

  13. Effects of Lycium barbarum (goji berry) on dry eye disease in rats.

    Science.gov (United States)

    Chien, Kaung-Jen; Horng, Chi-Ting; Huang, Yu-Syuan; Hsieh, Yi-Hsien; Wang, Chau-Jong; Yang, Jai-Sing; Lu, Chi-Cheng; Chen, Fu-An

    2018-01-01

    Lycium barbarum (goji berry) has long been used as a food and traditional herbal medicine. This study aimed to investigate the beneficial effect of the goji berry on dry eye disease in rats. Male Sprague‑Dawley rats with induced dry eye disease were randomly assigned to four groups: Vehicle (control), low‑dose goji berry extract [GBE; 250 mg/kg/body weight (bw)], median‑dose GBE (350 mg/kg/bw), and high‑dose GBE (500 mg/kg/bw). Three methods, Schirmer's test, tear break‑up time (BUT) measurement and keratoconjunctival fluorescein staining, were used to evaluate the effect of GBE on symptoms of dry eye disease experienced by the rats. The results of the present study revealed that both the Schirmer's test score and tear BUT significantly increased following 1 week of GBE administration. Furthermore, the severity of the keratoconjunctival staining decreased significantly. In addition, the results suggested that administration of GBE may ameliorate dry eye disease symptoms in a dose‑dependent manner. There were no mortalities and no apparent abnormal histopathology changes in the liver or kidney tissues of rats administered GBE for 21 consecutive days. Polysaccharides and betaine present in GBE may have important effects in alleviating dry eye disease induced by oxidative stress and inflammation. In conclusion, the goji berry is a safe, functional food with beneficial effects in alleviating dry eye disease.

  14. Investigation of extended blinks and interblink intervals in subjects with and without dry eye

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    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

  15. Predictors of Discordance between Symptoms and Signs in Dry Eye Disease.

    Science.gov (United States)

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

    2017-03-01

    To investigate predictors of discordance between symptoms and signs in dry eye disease (DED). Cross-sectional association study. A total of 648 patients with dry eye from the Groningen LOngitudinal Sicca StudY (GLOSSY), a tertiary dry eye clinic patient cohort from the Netherlands. Patient symptoms were assessed using the Ocular Surface Disease Index (OSDI) questionnaire. Dry eye signs were assessed by tear osmolarity, Schirmer test, tear breakup time, corneal and conjunctival staining, and meibomian gland dysfunction, all in both eyes, and a composite dry eye signs severity score was calculated from these 6 tests for each patient. Linear regression analysis was used to test the association of discordance between symptoms and signs with a wide range of independent variables (demographic and environmental variables, systemic diseases, ocular traits, and medications). Predictors of discordance between symptoms and signs in DED, defined by the difference between the rank score of the OSDI and the rank score of the dry eye signs severity score. Of the 648 subjects in this cohort, 536 (82.7%) were female and the mean age was 55.8 years (standard deviation, 15.6 years). Significant predictors of greater symptoms than signs were the presence of a chronic pain syndrome, atopic diseases, a known allergy, the use of antihistamines (all P signs were increased age (P signs were highly associated with lower self-perceived health (P signs in DED is an indicator of self-perceived health. The study found important predictors of greater symptoms to signs but also predictors of lesser symptoms to signs. Awareness of these predictors is helpful in assessing patients with dry eye in clinical practice. Copyright © 2016 American Academy of Ophthalmology. All rights reserved.

  16. 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.

  17. Effects of eye drops of Buddleja officinalis Maxim. extract on lacrimal gland cell apoptosis in castrated rats with dry eye.

    Science.gov (United States)

    Peng, Qing-hua; Yao, Xiao-lei; Wu, Quan-long; Tan, Han-yu; Zhang, Jing-rong

    2010-03-01

    To explore the possible mechanism of eye drops of Buddleja officinalis extract in treating dry eye of castrated rats by analyzing the expressions of Bax and Bcl-2 proteins. Forty-five Wistar male rats were randomly divided into sham-operated group, untreated group and eye drops of Buddleja officinalis Maxim. extract (treatment) group. The dry eye model was established with orchiectomy in the untreated group and treatment group. Rats in the treatment group were treated with eye drops of Buddleja officinalis Maxim. extract, one drop once, three times daily. Eyes of rats in the sham-operated group and untreated group were instilled with normal saline. After one-, two-, or three-month treatment, five rats in each group were scarified respectively. Then samples were taken to detect related indices. Expressions of Bax and Bcl-2 of lacrimal gland were checked by immunohistochemical method and quantity of apoptotic cells was counted. After one-, two- or three-month treatment, the quantities of expressions of Bax in acinar epithelial cells and glandular tube cells were significantly lower, and those of Bcl-2 were significantly higher in the treatment group than in the untreated group, and the quantities of apoptotic cells of the treatment group were significantly lower than those of the untreated group (PBuddleja officinalis Maxim. are flavonoids, which can significantly inhibit cell apoptosis in lacrimal gland.

  18. Evaluation of clinical outcomes in patients with dry eye disease using lubricant eye drops containing polyethylene glycol or carboxymethylcellulose

    Directory of Open Access Journals (Sweden)

    Cohen S

    2013-12-01

    Full Text Available Stephen Cohen,1 Anna Martin,2 Kenneth Sall31Cohen Optometry, Scottsdale, AZ, USA; 2Alcon Laboratories Inc, Fort Worth, TX, USA; 3Sall Research Medical Center Inc, Artesia, CA, USABackground: The purpose of this study was to compare changes in corneal staining in patients with dry eye after 6 weeks of treatment with Systane® Gel Drops or Refresh Liquigel® lubricant eye drops.Methods: Patients aged ≥18 years with a sodium fluorescein corneal staining sum score of ≥3 in either eye and best-corrected visual acuity of 0.6 logarithm of the minimum angle of resolution or better in each eye who were using a lubricant eye gel or ointment for dry eye were included in this randomized, parallel-group, multicenter, double-blind trial. Patients were randomized to four times daily Systane® Gel Drops (polyethylene glycol 400 0.4% and propylene glycol 0.3% or Refresh LiquiGel® Drops (carboxymethylcellulose sodium 1% for 6 weeks. The primary efficacy outcome was mean change from baseline to week 6 in sodium fluorescein corneal staining. Supportive efficacy outcomes included conjunctival staining, tear film break-up time, Patient Global Assessment of Improvement, Impact of Dry Eye on Everyday Life (IDEEL Treatment Satisfaction/Treatment Bother Questionnaire, Single Symptom Comfort Scale, and Ocular Symptoms Questionnaire. The safety analysis comprised recording of adverse events.Results: In total, 147 patients (Systane group, n=73; Refresh group, n=74; mean ± standard deviation age, 57±16 years were enrolled and included in the safety and efficacy analyses. Corneal staining was significantly reduced from baseline to week 6 for Systane and Refresh (−3.4±2.5 and −2.5±2.6 units, respectively; P<0.0001, t-test, with a significantly greater improvement with Systane versus Refresh (P=0.0294. Results for conjunctival staining, tear film break-up time, and patient-reported outcome questionnaires were not statistically different between groups. No safety

  19. 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.

  20. 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 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

  1. Effect of soft contact lens curvature on dry eye of flight attendants

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    Chang-Liang Meng

    2014-10-01

    Full Text Available AIM: To discuss the effect of wearing customized curvature soft corneal contact lens to dry eye degree of flight attendants.METHODS: Eighty cases(160 eyesof flight attendants from China Southern were divided into two groups: control group 40 cases(80 eyeswearing ready-made Bausch soft corneal contact lens(curvature 8.4; the experiment group 40 cases(80 eyes, wearing Bausch soft corneal contact lens with customized curvature. Tear break-up time(BUT, Schirmer Ⅰ test(SⅠtand fluorescein(FLstaining were as dry eye evaluation index. The results was statistically analyzed.RESULTS: BUT, SⅠt average shortening value of the experimental group were less than that of the control group, there was statistical significance(PPCONCLUSION: Wearing customized curvature soft corneal contact lens can prevent the flight dry eye more effectively than fixed curvature product.

  2. Prospective, randomized, controlled comparison of SYSTANE UD eye drops versus VISINE INTENSIV 1% EDO eye drops for the treatment of moderate dry eye.

    Science.gov (United States)

    Jacobi, Christina; Kruse, Friedrich E; Cursiefen, Claus

    2012-12-01

    The aim of this prospective, randomized, clinical, single-center study was to compare the safety and efficacy of 2 ocular surface lubricant eye drops: preservative-free hydroxypropyl (HP)-Guar (SYSTANE UD(®)) eye drops versus preservative-free Tamarindus indica seed polysaccharide (TSP) 1% (VISINE INTENSIV 1% EDO(®)) eye drops. Fifty-six eyes of 28 patients with moderate keratoconjunctivitis sicca (DEWS severity level 2) were enrolled in the trial. Patients were randomized for 2 treatment groups (SYSTANE UD eye drops vs. VISINE INTENSIV 1% EDO eye drops). The eye drops in both groups were applied 5 times per day for 3 months. Statistical analyses were performed using Statistica™ software (Mann-Whitney U-test and Wilcoxon test). P-Values<0.05 were considered significant. After 3 months of treatment the patients of both groups had subjective benefit in the relief of symptoms of dry eye disease evaluated by the Ocular Surface Disease Index (OSDI) questionnaire score. Patients treated with HP-Guar and TSP showed improvements in tear film stability measured by tear break-up time (TBUT), which are statistically significant in the HP-Guar group (P=0.02). The results of this clinical trial show improvements of symptoms and signs in patients with moderate dry eye after the consistent use of preservative-free HP-Guar and TSP lubricant eye drops. Both artificial tear formulations produce amelioration in tear film stability improving eye conditions and patient quality of life. HP-Guar seems to be slightly more effective in improving ocular surface protection by decreasing tear film evaporation.

  3. A review of quality of life measures in dry eye questionnaires.

    Science.gov (United States)

    Grubbs, Joseph R; Tolleson-Rinehart, Sue; Huynh, Kyle; Davis, Richard M

    2014-02-01

    Dry eye disease (DED) is an ocular disease that affects 5% to 17% of the US population. Because of the negative effects of DED on patients' quality of life (QOL), disease-specific questionnaires that assess QOL in patients with dry eyes are essential in the monitoring and management of this chronic ocular condition. This review provides clinicians and researchers with a summary of the current questionnaires available for assessing QOL in patients with dry eyes. A systematic review of the literature was performed in March 2013. There are only 2 validated, reliable dry eye questionnaires with QOL measures currently available for clinic use: the Ocular Surface Disease Index (OSDI) and the Impact of Dry Eye on Everyday Life questionnaire (IDEEL). Multiple other dry eye questionnaires assess some degree of QOL, but they have either not been tested for validity and reliability or are limited in QOL measures they assess. The OSDI and IDEEL are validated, reliable disease-specific questionnaires that assess QOL measures in patients with DED. Because of its extensive development process and multiple QOL measures, the IDEEL offers a more thorough assessment of the effect of DED on QOL for clinical trials, whereas the OSDI may be the more convenient option for clinical use as a result of its shorter completion time. Other questionnaires used to assess QOL in DED (eg, 25-item National Eye Institute Visual Function Questionnaire and Texas Eye Research and Technology Center DEQ) are fairly limited in this assessment. Finally, because of the negative effects of DED on QOL, this review emphasizes the importance of including QOL measures in future questionnaires for the monitoring and management of DED.

  4. The Prospective Health Assessment of Cataract Patients’ Ocular Surface (PHACO study: the effect of dry eye

    Directory of Open Access Journals (Sweden)

    Trattler WB

    2017-08-01

    Full Text Available William B Trattler,1 Parag A Majmudar,2 Eric D Donnenfeld,3 Marguerite B McDonald,4 Karl G Stonecipher,5 Damien F Goldberg6 On behalf of the PHACO Study Group 1Center for Excellence in Eye Care, Miami, FL, USA; 2Chicago Cornea Consultants, Chicago, IL, USA; 3Ophthalmic Consultants of Long Island, Garden City, NY, USA; 4Ophthalmic Consultants of Long Island, Lynbrook, NY, USA; 5University North Carolina School of Medicine, Chapel Hill, NC, USA; 6Wolstan & Goldberg Eye Associates, Torrance, CA, USA Purpose: To determine the incidence and severity of dry eye as determined by the International Task Force (ITF scale in patients being screened for cataract surgery.Patients and methods: This was a prospective, multi-center, observational study of 136 patients, at least 55 years of age, who were scheduled to undergo cataract surgery. The primary outcome measure was the incidence of dry eye as evaluated by grade on the ITF scale and secondary outcome measures include tear break-up time (TBUT, ocular surface disease index score, corneal staining with fluorescein, conjunctival staining with lissamine green, and a patient questionnaire to evaluate symptoms of dry eye.Results: Mean patient age was 70.7 years. A total of 73.5% of patients were Caucasian and 50% were female. Almost 60% had never complained of a foreign body sensation; only 13% complained of a foreign body sensation half or most of the time. The majority of patients (62.9% had a TBUT ≤5 seconds, 77% of eyes had positive corneal staining and 50% of the eyes had positive central corneal staining. Eighteen percent had Schirmer’s score with anesthesia ≤5 mm.Conclusion: The incidence of dry eye in patients scheduled to undergo cataract surgery in a real-world setting is higher than anticipated. Keywords: cataract surgery screening, dry eye, International Task Force scale, observational study

  5. 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.

  6. Effect of lipid-based dry eye supplements on the tear film in wearers of eye cosmetics.

    Science.gov (United States)

    Wang, Michael T M; Cho, Irene Sung Hee; Jung, Soo Hee; Craig, Jennifer P

    2017-08-01

    To compare the effects on tear film parameters and contamination in cosmetic eyeliner wearers, after single application of two lipid-based dry eye treatments: a lipid-containing lubricant eye drop and a phospholipid liposomal spray. Fifty participants were enrolled in a prospective, randomised, paired-eye, investigator-masked trial. Pencil eyeliner (Body Shop ® Crayon Eye Definer) was applied to the upper eyelid periocular skin of both eyes, anterior to the lash line. Baseline tear film quality was assessed fifteen minutes after eyeliner application. A lubricant drop (Systane ® Balance) was then applied to one eye (randomised), and liposomal spray (Tears Again ® ) to the contralateral eye. Tear film contamination, lipid layer grade, non-invasive tear film break-up time and tear evaporation rate were evaluated fifteen minutes post-treatment and compared to pre-treatment values. Pre-treatment measurements did not differ between eyes assigned to lubricant drop and liposomal spray. Tear film contamination was observed in a greater proportion of eyes following both treatments (both pfilm break-up time or tear evaporation rate (all p>0.05). Changes in tear film parameters did not differ between treatments (all p>0.05). Both the lipid-containing lubricant eye drop and phospholipid liposomal spray result in clinically apparent tear film contamination in eyeliner cosmetic wearers. Although both treatments effected an increase in lipid layer thickness, neither displayed clinical efficacy in improving tear film stability. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  7. Dry Eye Disease Incidence Associated with Chronic Graft-Host Disease: Nonconcurrent Cohort Study (An American Ophthalmological Society Thesis).

    Science.gov (United States)

    Mian, Shahzad I; De la Parra-Colín, Paola; De Melo-Franco, Rafael; Johnson, Christopher; Barrientos-Gutierrez, Tonatiuh

    2015-09-01

    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. 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. 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. 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.

  8. The Prospective Health Assessment of Cataract Patients’ Ocular Surface (PHACO) study: the effect of dry eye

    Science.gov (United States)

    Trattler, William B; Majmudar, Parag A; Donnenfeld, Eric D; McDonald, Marguerite B; Stonecipher, Karl G; Goldberg, Damien F

    2017-01-01

    Purpose To determine the incidence and severity of dry eye as determined by the International Task Force (ITF) scale in patients being screened for cataract surgery. Patients and methods This was a prospective, multi-center, observational study of 136 patients, at least 55 years of age, who were scheduled to undergo cataract surgery. The primary outcome measure was the incidence of dry eye as evaluated by grade on the ITF scale and secondary outcome measures include tear break-up time (TBUT), ocular surface disease index score, corneal staining with fluorescein, conjunctival staining with lissamine green, and a patient questionnaire to evaluate symptoms of dry eye. Results Mean patient age was 70.7 years. A total of 73.5% of patients were Caucasian and 50% were female. Almost 60% had never complained of a foreign body sensation; only 13% complained of a foreign body sensation half or most of the time. The majority of patients (62.9%) had a TBUT ≤5 seconds, 77% of eyes had positive corneal staining and 50% of the eyes had positive central corneal staining. Eighteen percent had Schirmer’s score with anesthesia ≤5 mm. Conclusion The incidence of dry eye in patients scheduled to undergo cataract surgery in a real-world setting is higher than anticipated. PMID:28848324

  9. The Prospective Health Assessment of Cataract Patients' Ocular Surface (PHACO) study: the effect of dry eye.

    Science.gov (United States)

    Trattler, William B; Majmudar, Parag A; Donnenfeld, Eric D; McDonald, Marguerite B; Stonecipher, Karl G; Goldberg, Damien F

    2017-01-01

    To determine the incidence and severity of dry eye as determined by the International Task Force (ITF) scale in patients being screened for cataract surgery. This was a prospective, multi-center, observational study of 136 patients, at least 55 years of age, who were scheduled to undergo cataract surgery. The primary outcome measure was the incidence of dry eye as evaluated by grade on the ITF scale and secondary outcome measures include tear break-up time (TBUT), ocular surface disease index score, corneal staining with fluorescein, conjunctival staining with lissamine green, and a patient questionnaire to evaluate symptoms of dry eye. Mean patient age was 70.7 years. A total of 73.5% of patients were Caucasian and 50% were female. Almost 60% had never complained of a foreign body sensation; only 13% complained of a foreign body sensation half or most of the time. The majority of patients (62.9%) had a TBUT ≤5 seconds, 77% of eyes had positive corneal staining and 50% of the eyes had positive central corneal staining. Eighteen percent had Schirmer's score with anesthesia ≤5 mm. The incidence of dry eye in patients scheduled to undergo cataract surgery in a real-world setting is higher than anticipated.

  10. Presence or absence of ocular surface inflammation directs clinical and therapeutic management of dry eye

    Directory of Open Access Journals (Sweden)

    Sambursky R

    2016-11-01

    Full Text Available Robert Sambursky Coastal Eye Institute, Cornea and Comprehensive Ophthalmology, Bradenton, FL, USA Background: The presence of clinically significant inflammation has been confirmed in the tears of 40%–65% of patients with symptoms of dry eye. Ocular surface inflammation may lead to tear film instability, epithelial cell irregularities, and permeability, resulting in chronic symptomatic pain and fluctuating vision as well as negative surgical outcomes.Patients and methods: A retrospective single center medical chart review of 100 patients was conducted. All patients were tested with the InflammaDry test to determine if patients exhibited elevated levels of matrix metalloproteinase 9 (MMP-9. InflammaDry-positive patients were started on a combination of cyclosporine 0.05% twice daily, 2,000–4,000 mg oral omega-3 fatty acids, and frequent artificial tear replacement. InflammaDry-negative patients were started on 2,000–4,000 mg of oral omega-3 fatty acids and frequent artificial tear replacement. Each patient was retested at ~90 days. A symptom questionnaire was performed at the initial visit and at 90 days.Results: 60% of the patients with dry eye symptoms tested positive for elevated MMP-9 at the initial visit. 78% of all patients returned for follow-up at ~90 days including 80% (48/60 of the previously InflammaDry-positive patients and 75% (30/40 of the previously InflammaDry-negative patients. A follow-up symptom questionnaire reported at least 75% symptomatic improvement in 65% (31/48 of the originally InflammaDry-positive patients and in 70% (21/30 of the initially InflammaDry-negative patients. Symptomatic improvement of at least 50% was reported in 85% (41/48 of previously InflammaDry-positive patients and 86% (26/30 of previously InflammaDry-negative patients. Following treatment, 54% (26/48 of previously InflammaDry-positive patients converted to a negative InflammaDry result.Conclusion: Identifying which symptomatic dry eye

  11. Diurnal Tracking of Blink and Relationship to Signs and Symptoms of Dry Eye.

    Science.gov (United States)

    Rodriguez, John D; Lane, Keith J; Ousler, George W; Angjeli, Endri; Smith, Lisa M; Bateman, Kirk M; Abelson, Mark B

    2016-08-01

    To assess diurnal changes in the signs and symptoms of dry eyes and their relationship to diurnal interblink interval (IBI) in normal subjects and in subjects with dry eye. Blink data were collected from 9:00 AM to 8:00 PM during 2 days of normal activity using an electrocardiogram monitoring device. All subjects recorded ocular discomfort (0-5 scale) and primary activity hourly each day in a diary. Inferior and central fluorescein staining was graded by slit lamp (0-4) at the start and end of each day. Blink activity was detected using an algorithm based on recognition of the waveform corresponding to the kinematic properties of the blink signal. Normal subjects (N = 12) reported negligible symptoms, and results did not show a diurnal change in group hourly IBI. Mean daily IBI for the group with dry eye (N = 15) (4.63 ± 1.63 s) was shorter than that for the normal group (5.28 ± 1.48 s) (P = 0.0483). Correlation of diurnal symptoms and mean hourly IBI was relatively weak (r = -0.248). A repeated-measures model found IBI to be significantly associated with the time of day (P = 0.0028). Inferior corneal staining showed a small but significant diurnal increase for both normal group and group with dry eyes. Diurnal blink tracking reveals significant trending with symptoms. Diurnal change in IBI may be an appropriate surrogate for symptoms in the study of dry eye.

  12. Research progress on the prevalence and pathogen of dry eye syndrome after corneal refractive surgery

    Directory of Open Access Journals (Sweden)

    Zhi-Meng Zhang

    2016-03-01

    Full Text Available Because of the rapid improving of corneal refractive surgery with laser, its characteristics such as safety, stability, availability and predictability have already been proved by clinical practice. Laser in situ keratomileusis(LASIK, epipolis laser in situ keratomileusis(Epi-LASIK, femtosecond laser in situ keratomileusis(FS-LASIKand small incision lenticule extraction(SMILEare the main operational methods. SMILE has gradually been being accepted by young and middle-aged with its minimal invasive and little post-surgery complications. Dry eye syndrome is one of the most common complications that may affect the visual effect of the surgery. Specialists and patients have paid more attention to dry eye disease after corneal refractive surgery. According to clinical and experimental researches, the basic condition of ocular surface before surgery, the application of drugs in or after the surgery, the type of refractive surgery that operator choose, as well as the damage and reinnervation of corneal nerve all play important roles in post-surgery dry eye. This article reviews the pathogen of dry eye disease after surgery and the prevalence of dry eye after surgery.

  13. Dry eye-induced conjunctival epithelial squamous metaplasia is modulated by interferon-gamma.

    Science.gov (United States)

    De Paiva, Cintia S; Villarreal, Arturo L; Corrales, Rosa M; Rahman, Hassan T; Chang, Victor Y; Farley, William J; Stern, Michael E; Niederkorn, Jerry Y; Li, De-Quan; Pflugfelder, Stephen C

    2007-06-01

    To investigate the role of interferon (IFN)-gamma in the pathogenesis of conjunctival squamous metaplasia in dry eye. Experimental dry eye was created by subjecting C57BL/6 and IFN-gamma-knockout mice to desiccating environmental stress for 5 or 10 days. T-cell antigens and IFN-gamma were detected by immunohistochemistry. Goblet cells were counted in periodic acid Schiff (PAS)-stained sections. Expression of small, proline-rich protein (SPRR)-2 was evaluated by confocal microscopy. Tear IFN-gamma was measured by immunobead assay. Dry eye promoted migration of CD4+ T cells and IFN-gamma+ cells into goblet cell zones of the conjunctiva and increased the concentration of IFN-gamma in tears. This migration was accompanied by progressive goblet cell loss and an increase in SPRR-2 expression in the conjunctival epithelium. A significant inverse correlation was observed between the density of infiltrating CD4+ T cells and goblet cells. Dry eye had no effect on conjunctival goblet cell density in IFN-gamma-knockout mice; however, exogenous administration of IFN-gamma significantly decreased goblet cell density after 5 days. Conjunctival epithelial response to experimental dryness is related to the degree of CD4+ T-cell infiltration and the level of IFN-gamma production. These findings suggest that IFN-gamma plays a pivotal role in promoting conjunctival squamous metaplasia in dry eye, and they provide insight into the immune pathogenesis of keratoconjunctivitis sicca.

  14. 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.

  15. SELDI-TOF-MS ProteinChip array profiling of tears from patients with dry eye.

    Science.gov (United States)

    Grus, Franz H; Podust, Vladimir N; Bruns, Kai; Lackner, Karl; Fu, Siyu; Dalmasso, Enrique A; Wirthlin, Anton; Pfeiffer, Norbert

    2005-03-01

    Protein and peptides in tears play an important role in ocular surface diseases. In previous studies, changes have been demonstrated in the electrophoretic protein profiles of patients with dry eye. The purpose of this work was to determine the usefulness of surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS) ProteinChip Array (Ciphergen Biosystems, Inc., Fremont, CA) technology for the automated analysis of proteins and peptides in tear fluid. Patients with dry eye (DRY, n = 88) and healthy subjects (CTRL, n = 71) were examined. Their tear proteins were analyzed using SELDI-TOF-MS ProteinChip Arrays with three different chromatographic surfaces (CM10 cation exchange, Q10 anion exchange, and H50 reversed-phase) prepared by means of a laboratory liquid-handling robotic workstation. The data were analyzed by multivariate statistical techniques and artificial neural networks, and the most important biomarkers were purified and identified by tandem MS. Complex patterns of tear proteins and peptides were detected. The different chromatographic surfaces revealed the selective enrichment of proteins such as lipocalin and lysozyme. Discriminant analysis demonstrated highly significant changes in the protein profiles in patients with dry eye (P < 0.001). With a seven-peptide multimarker panel, an artificial neural network could differentiate between patients with dry eye and healthy individuals with a specificity and sensitivity of 90%. The identification of biomarkers revealed an increase of inflammatory markers in patients with dry eye and a decrease of some proteins that may have protective functions. The SELDI-TOF-MS technology seems to be ideally suitable for the mass screening of peptides and proteins in tears. This highly sensitive approach dramatically reduces the analysis time and provides protein profiles with great mass accuracy. Thus, it may become a very useful tool in the search for potential biomarkers for diagnosis

  16. Long term treatment with sodium hyaluronate-containing artificial tears reduces ocular surface damage in patients with dry eye

    National Research Council Canada - National Science Library

    Aragona, Pasquale; Papa, Vincenzo; Micali, Antonio; Santocono, Marcello; Milazzo, Giovanni

    2002-01-01

    ... abnormalities of the ocular surface. The aim of this study was to explore the effect of sodium hyaluronate-containing eye drops on the ocular surface of patients with dry eye during long term treatment...

  17. 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

  18. Comparison of 0.3% Hypotonic and Isotonic Sodium Hyaluronate Eye Drops in the Treatment of Experimental Dry Eye.

    Science.gov (United States)

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

    2017-08-01

    To compare the efficacy of 0.3% hypotonic and isotonic sodium hyaluronate (SH) eye drops in the treatment of experimental dry eye. Experimental dry eye was established in female C57BL/6 mice by subcutaneous scopolamine injection and an air draft. The mice were divided into three groups (n = 15): control, preservative-free 0.3% isotonic SH, and preservative-free 0.3% hypotonic SH. The tear volume, tear film break-up time, and corneal fluorescein staining scores were measured 5 and 10 days after treatment. After conjunctival tissues were excised at 10 days, the levels of interleukin (IL)-6, IL-17, interferon (IFN)-γ, and IFN-γ inducible protein-10 were determined using the multiplex immunobead assay. In addition, PAS staining and flow cytometry were performed to evaluate the counts of conjunctival goblet cells and CD4+ IFN-γ+ T cells. Mice treated with 0.3% hypotonic SH showed a significant decrease in corneal staining scores (P = 0.04) and the levels of IL-6 (16.7 ± 1.4 pg/mL, P = 0.02) and IFN-γ (46.5 ± 11.5 pg/mL, P = 0.02) compared to mice treated with 0.3% isotonic SH (IL-6; 32.5 ± 8.8 pg/mL, IFN-γ; 92.0 ± 16.0 pg/mL) at day 10. Although no significant difference in CD4+ IFN-γ+ T cell numbers was observed, goblet cell counts were higher in the hyopotonic SH group than in the isotonic SH group (P = 0.02). When compared to 0.3% isotonic SH eye drops, 0.3% hypotonic SH eye drops can be more effective by improving corneal staining scores, decreasing inflammatory molecules, and increasing goblet cell counts for experimental dry eye. These data suggest that hypotonic artificial tears may be useful as an adjunctive treatment for inflammatory dry eye.

  19. 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

  20. Oral sea buckthorn oil attenuates tear film osmolarity and symptoms in individuals with dry eye.

    Science.gov (United States)

    Larmo, Petra S; Järvinen, Riikka L; Setälä, Niko L; Yang, Baoru; Viitanen, Matti H; Engblom, Janne R K; Tahvonen, Raija L; Kallio, Heikki P

    2010-08-01

    Dry eye is a common condition that can severely impair the quality of life. We aimed to find out whether oral sea buckthorn (SB) oil, containing (n-3) and (n-6) fatty acids and antioxidants, affects dry eye. In this double-blind, randomized, parallel trial, 20- to 75-y-old women and men experiencing dry eye symptoms consumed 2 g of SB or placebo oil daily for 3 mo from fall to winter. One hundred participants were recruited and 86 completed the study. Clinical dry eye tests and symptom follow-ups were performed. Tear film hyperosmolarity is a focal factor in dry eye. There was a general increase in the osmolarity from baseline to the end of the intervention. Compared with the placebo group, the increase was significantly less in the SB group when all participants were included [intention to treat (ITT), P = 0.04] and when only participants consuming the study products for at least 80% of the intervention days were included [per protocol (PP), P = 0.02]. The maximum intensities of redness and burning tended to be lower in the SB group. In the ITT participants, the group difference was significant for redness (P = 0.04) but not for burning (P = 0.05). In the PP participants, the group difference was significant for burning (P = 0.04) but not for redness (P = 0.11). In conclusion, SB oil attenuated the increase in tear film osmolarity during the cold season and positively affected the dry eye symptoms.

  1. Dry eye after small incision lenticule extraction and LASIK for myopia.

    Science.gov (United States)

    Xu, Yesheng; Yang, Yabo

    2014-03-01

    To compare the effects of small incision lenticule extraction (SMILE) and LASIK with either femtosecond laser or mechanical microkeratome on dry eye. A total of 176 patients (338 eyes) who underwent refractive procedures for myopia were observed in this nonrandomized, interventional, prospective study. To evaluate dry eye, the Schirmer secretion test without anesthesia, tear break-up time, and the McMonnies questionnaire were used preoperatively and at 1, 3, and 6 months postoperatively. In all groups, there was no significant decrease in the results from the Schirmer secretion test without anesthesia after surgery. The value in the LASIK group was significantly lower than any other group at 3 and 6 months postoperatively. In all groups, the tear break-up time decreased significantly after surgery and did not return to preoperative levels within 6 months; the SMILE group time lasted significantly longer than the LASIK group at 1 month. The McMonnies score increased significantly in all groups after surgery. The preoperative levels returned within 6 months in all groups except the LASIK group. The mean McMonnies score in the SMILE group was better than other groups. Dry eye after corneal refractive surgery usually occurs transiently. The SMILE procedure had better dry eye parameters and relatively fewer subjective symptoms than LASIK. Copyright 2014, SLACK Incorporated.

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

    OpenAIRE

    S. Srinivasan; P. Santhi; G. Dhamodaran

    2017-01-01

    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 distu...

  3. Effect of mistletoe combined with carboxymethyl cellulose on dry eye in postmenopausal women

    Directory of Open Access Journals (Sweden)

    Nan Jiang

    2017-11-01

    Full Text Available AIM: To investigate the protective effect of mistletoe combined with carboxymethyl cellulose eye drops on dry eye in postmenopausal women. METHODS: Sixty postmenopause female patients diagnosed of dry eye were assigned randomly to mistletoe combined with carboxymethyl cellulose eye drops treatment group (n=30 and control group treated with normal saline eye drops (n=30. The subjective symptoms of ocular surface, Ocular Surface Disease Index (OSDI, tear film function tests, tear protein and corneal morphology by confocal scanning microscopy were analyzed before treatment and at 1, 2, 4 and 8wk after treatment respectively. To ensure the safety of the trial, all patients were examined with systolic pressure, diastolic pressure, glutamic-pyruvic transaminase, glutamic oxaloacetic transaminase, urine creatinine, and blood urea nitrogen at 8wk after treatment. RESULTS: There were no obvious differences between two groups before the treatment (P>0.05. In two months after the treatment, the symptoms of ocular surface, OSDI, tear protein, and tear film function were only slightly changed in normal saline eye drops group. However, all indices were improved after the treatment of mistletoe combined with carboxymethyl cellulose eye drops group (P<0.05. In addition, the average amount of corneal epithelium basal cells and inflammatory cells of mistletoe treated group were 3174±379 and 38±25 cells/mm2, significantly decreased as compared to the control group with 4309±612 and 158± 61 cells/mm2, respectively. In the control group, although nerves still maintained straight under corneal epithelium, the number of nerves were significantly decreased, as compared with normal female. In the mistletoe treated group, the number of nerves was only slightly reduced, compared with normal female. CONCLUSION: Mistletoe combined with carboxymethyl cellulose eye drops can alleviate the symptoms and signs of dry eye symptoms.

  4. High prevalence of sleep and mood disorders in dry eye patients: survey of 1,000 eye clinic visitors

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    Ayaki M

    2015-03-01

    Full Text Available Masahiko Ayaki, Motoko Kawashima, Kazuno Negishi, Kazuo Tsubota Department of Ophthalmology, Keio University School of Medicine, Tokyo, JapanPurpose: We aimed to explore the prevalence of probable sleep and mood disorders in eye clinic visitors.Methods: This was a cross-sectional study. The participants were outpatients at six eye clinics from January through March, 2014. Outpatients were invited to complete a questionnaire containing the Pittsburgh Sleep Quality Index (PSQI and Hospital Anxiety and Depression Scale (HADS. A final diagnosis was made, and patients were classified into six diagnostic groups. The main outcome measures were the scores of the PSQI and HADS among the diagnostic groups. Results: A total 1,000 outpatients participated, and 730 patients (mean age 59.5±19.0 years; 487 females were analyzed after exclusion of children and patients diagnosed with healthy eyes, acute injury, or unilateral pseudophakia. The mean PSQI and HADS scores across all patients were 5.3±3.1 and 9.2±6.2, respectively. For the diagnostic groups, the mean PSQI and HADS scores, respectively, were 5.7±3.3 and 10.2±6.0 for dry eye (n=247, 5.4±3.2 and 9.2±5.7 for bilateral cataracts (n=159, 5.3±3.3 and 8.0±5.3 for bilateral pseudophakia (n=99, and, 5.0±3.1 and 9.8±6.6 for glaucoma (n=109. Overall, 37.3% of patients were poor sleepers (PSQI ≥6, and 45.5% had possible mood disorders (HADS ≥10. Stepwise regression analysis revealed that the PSQI and HADS scores were significantly correlated with both age (P<0.05 and the presence of dry eye (P<0.05. Conclusion: The prevalence of sleep and mood disorders was significantly higher in patients with dry eye. The present results suggest consultation-liaison psychiatry services may be beneficial among eye disease patients.Keywords: depression, anxiety, cataract, liaison psychiatry, glaucoma

  5. 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.

  6. A Novel Fluorescent Lipid Probe for Dry Eye: Retrieval by Tear Lipocalin in Humans

    Science.gov (United States)

    Yeh, Po-Ting; Casey, Richard; Glasgow, Ben J.

    2013-01-01

    Purpose. A fluorescent probe was used to identify mucin-depleted areas on the ocular surface and to test the hypothesis that tear lipocalin retrieves lipids from the eyes of normal and dry eye subjects. Methods. Fluorescein-labeled octadecyl ester, FODE, was characterized by mass spectrometry and absorbance spectrophotometry. The use of FODE to define mucin defects was studied with impression membranes under conditions that selectively deplete mucin. The kinetics of FODE removal from the ocular surface were analyzed by sampling tears from control and dry eye patients at various times. The tear protein–FODE complexes were isolated by gel filtration and ion exchange chromatographies, monitored with absorption and fluorescent spectroscopies, and analyzed by gel electrophoresis. Immunoprecipitation verified FODE complexed to tear lipocalin in tears. Results. FODE exhibits an isosbestic point at 473 nm, pKa of 7.5, and red shift relative to fluorescein. The low solubility of FODE in buffer is enhanced with 1% Tween 80 and ethanol. FODE adheres to the ocular surface of dry eye patients. FODE produces visible staining at the contact sites of membranes, which correlates with removal of mucin. Despite the fact that tear lipocalin is reduced in dry eye patients, FODE removal follows similar rapid exponential decay functions for all subjects. FODE is bound to tear lipocalin in tears. Conclusions. Tear lipocalin retrieves lipid rapidly from the human ocular surface in mild to moderate dry eye disease and controls. With improvements in solubility, FODE may have potential as a fluorescent probe to identify mucin-depleted areas. PMID:23361507

  7. Dry eye syndrome, posttraumatic stress disorder, and depression in an older male veteran population.

    Science.gov (United States)

    Fernandez, Cristina A; Galor, Anat; Arheart, Kristopher L; Musselman, Dominique L; Venincasa, Vincent D; Florez, Hermes J; Lee, David J

    2013-05-01

    To evaluate whether veterans with posttraumatic stress disorder (PTSD) or depression have differences in dry eye symptoms and signs compared to a population without these conditions. Male patients aged ≥50 years with normal eyelid, conjunctival, and corneal anatomy were recruited from the Miami Veterans Affairs Eye Clinic (N = 248). We compared dry eye symptoms (determined by the Dry Eye Questionnaire 5 [DEQ5] score) to tear film indicators obtained by clinical examination (i.e., tear osmolarity, corneal staining, tear breakup time, Schirmer's, meibomian gland quality, orifice plugging, lid vascularity) between patients with PTSD or depression and those without these conditions. Student's t-tests, χ(2) analyses, and linear and logistic regressions were used to assess differences between the groups. DEQ5 scores were higher in the PTSD (mean = 13.4; standard error [SE] = 1.1; n = 22) and depression (mean = 12.0; SE = 0.8; n = 40) groups compared to the group without these conditions (mean = 9.8; SE = 0.4; n = 186; P depression groups had severe dry eye symptoms, defined as a DEQ5 score ≥ 12 (77% and 63% vs. 41%; P < 0.01 and P = 0.02, respectively). No significant differences in tear film indicators were found among the three groups. Multivariable logistic regression indicated that a PTSD diagnosis (odds ratio [OR] = 4.08; 95% confidence interval [CI] = 1.10-15.14) and use of selective serotonin reuptake inhibitors (OR = 2.66; 95% CI = 1.01-7.00) were significantly associated with severe symptoms. Patients with PTSD have ocular surface symptoms that are not solely explained by tear indicators. Identifying underlying conditions associated with ocular discomfort is essential to better understand the mechanisms behind ocular pain in dry eye syndrome.

  8. 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.

  9. 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

  10. The Heritability of Dry Eye Disease in a Female Twin Cohort

    NARCIS (Netherlands)

    Vehof, Jelle; Wang, Bin; Kozareva, Diana; Hysi, Pirro G.; Snieder, Harold; Hammond, Christopher J.

    2014-01-01

    PURPOSE. We estimated the relative importance of genes and environment in dry eye disease (DED) using a classic twin study. METHODS. A large sample of 3930 female monozygotic and dizygotic twins from the UK Adult Twin Registry (TwinsUK) was questioned about the presence of a DED diagnosis and about

  11. 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

  12. 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.

  13. Correlation Analysis of Ocular Symptoms and Signs in Patients with Dry Eye

    Science.gov (United States)

    Zhang, Mingzhou; Li, Kaixiu; Liu, Yan; Lv, Huibin

    2017-01-01

    Purpose. To analyze the correlations between the ocular surface signs and symptoms in patients with dry eye. Methods. In this observational study, 176 dry eye patients, including 60 males and 116 females, were enrolled and their dry eye symptoms and ocular signs were observed. Partial correlation analysis was conducted between OSDI score and each ocular surface sign, and the correlations were further discussed in different age groups. Then multiple linear regression analysis was used to further explore the influence of these signs on OSDI score. Results. Our correlation analyses showed that rounding of lid margins, notching of lid margins, vascularity of lid margins, hyperkeratinization, plugging of orifices, main duct dropout, and conjunctival congestion all had a positive correlation with OSDI score, while main duct number (central 1 cm) and BUT had a negative one. Further analysis suggested that these correlations varied in different age groups. Multiple linear regression analysis indicated that main duct number (central 1 cm), rounding of lid margins, and hyperkeratinization significantly affected OSDI score. Conclusions. Close attention should be paid to the morphology and structure of the eyelid margin and the function of meibomian gland in the diagnosis, treatment, and follow-up of dry eye diseases. PMID:28321333

  14. Effect of mild conjunctivitis complication on tear balance in dry eye.

    Science.gov (United States)

    Uchida, Hiroko; Imanaga, Yoshichika

    2012-10-01

    Inflammation of the ocular surface influences the stability of tear fluid. Mild conjunctivitis is often associated with dry-eye patients. The effect of mild conjunctivitis complication on tear break-up time (BUT) in patients with dry eyes was investigated. A total of 93 patients with dry eyes, excluding those having moderate to severe conjunctivitis, atopic keratoconjunctivitis, vernal conjunctivitis, previous ocular surgery, or who use contact lenses, were divided into those with and without mild conjunctivitis, and the BUT was compared. Fifty-four cases were complicated by mild conjunctivitis, conjunctival papilla formation was observed in 40 of these, and the mean BUT was 3.54±1.02 s. The mean BUT in 39 patients without conjunctivitis was 3.41±1.04 s, showing no significant difference between the groups (p=0.56). Allergic conjunctivitis was frequently observed in patients with dry eyes, but the complication of mild conjunctivitis had no influence on BUT. Copyright © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  15. Efficacy of Carboxymethylcellulose and Hyaluronate in Dry Eye Disease: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Song, Jae Kyeong; Lee, Kiheon; Park, Hwa Yeon; Hyon, Joon Young; Oh, Seung-Won; Bae, Woo Kyung; Han, Jong-Soo; Jung, Se Young; Um, Yoo Jin; Lee, Ga-Hye; Yang, Ji Hye

    2017-01-01

    The efficacy of two artificial tears, carboxymethylcellulose (CMC) and hyaluronate (HA), was compared in the treatment of patients with dry eye disease. We conducted a systematic review and meta-analysis on randomized controlled trials in the PubMed, Embase, Cochrane Library, and ClinicalTrials.gov databases. The efficacy was compared in terms of the mean change from baseline in tear break-up time. The meta-analysis was conducted using both random and fixed effect models. The quality of the selected studies was assessed for risk of bias. Five studies were included involving 251 participants. Random effect model meta-analysis showed no significant difference between CMC and HA in treating dry eye disease (pooled standardized mean difference [SMD]=-0.452; 95% confidence interval [CI], -0.911 to 0.007; P=0.053). In contrast, fixed effect model meta-analysis revealed significant improvements in the CMC group when compared to the HA group (pooled SMD=-0.334; 95% CI, -0.588 to -0.081; P=0.010). The efficacy of CMC appeared to be better than that of HA in treating dry eye disease, although meta-analysis results were not statistically significant. Further research is needed to better elucidate the difference in efficacy between CMC and HA in treating dry eye disease.

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

    Science.gov (United States)

    Kashima, Tomoyuki; Itakura, Hirotaka; Akiyama, Hideo; Kishi, Shoji

    2014-01-01

    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.

  17. Pro-inflammatory cytokines associated with clinical severity of dry eye disease of patients with depression.

    Science.gov (United States)

    Mrugacz, Małgorzata; Ostrowska, Lucyna; Bryl, Anna; Szulc, Agata; Zelazowska-Rutkowska, Beata; Mrugacz, Grzegorz

    2017-09-01

    The aim of this study was to assess the correlation of inflammatory cytokines levels in tears with severity of dry eye disease in a cohort of patients with depression. Tear fluid samples were collected from 32 patients with depression treated with antidepressants, and 34 healthy subjects. Cytokines were assessed by ELISA. All the subjects completed the Beck Depression Inventory and performed the ophthalmic examination, including dry eye tests. The tear fluid levels of IL-6, IL-17 and TNF-α in depressive patients were higher than in controls. The clinical severity of dry eye disease correlated significantly with the IL-17 and TNF-α levels. Our results suggest a crucial role of inflammatory cytokines, especially IL-17 and TNF-α, in the development of severe dry eye disease in patients with depression. Clarification of the role pro-inflammatory cytokines in the pathogenesis of ocular findings in depressive patients may be useful in establishing immunotherapeutic strategies for this disease. Copyright © 2017 Medical University of Bialystok. Published by Elsevier B.V. All rights reserved.

  18. DEBS – a unification theory for dry eye and blepharitis

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    Rynerson JM

    2016-12-01

    Full Text Available James M Rynerson,1 Henry D Perry2 1BlephEx, LLC, Alvaton, KY, 2Department of Ophthalmology, Nassau University Medical Center, Hofstra University School of Medicine, East Meadow, NY, USA Abstract: For many years, blepharitis and dry eye disease have been thought to be two distinct diseases, and evaporative dry eye distinct from aqueous insufficiency. In this treatise, we propose a new way of looking at dry eye, both evaporative and insufficiency, as the natural sequelae of decades of chronic blepharitis. Dry eye is simply the late form and late manifestation of one disease, blepharitis. We suggest the use of a new term in describing this one chronic disease, namely dry eye blepharitis syndrome (DEBS. Bacteria colonize the lid margin within a structure known as a biofilm. The biofilm allows for population densities that initiate quorum-sensing gene activation. These newly activated gene products consist of inflammatory virulence factors, such as exotoxins, cytolytic toxins, and super-antigens, which are then present for the rest of the patient’s life. The biofilm never goes away; it only thickens with age, producing increasing quantities of bacterial virulence factors, and thus, increasing inflammation. These virulence factors are likely the culprits that first cause follicular inflammation, then meibomian gland dysfunction, aqueous insufficiency, and finally, after many decades, lid destruction. We suggest that there are four stages of DEBS which correlate with the clinical manifestations of folliculitis, meibomitis, lacrimalitis, and finally lid structure damage evidenced by entropion, ectropion, and floppy eyelid syndrome. When one fully understands the structure and location of the glands within the lid, it becomes easy to understand this staged disease process. The longer a gland can resist the relentless encroachment of the invading biofilm, the longer it can maintain normal function. The stages depend purely on anatomy and years of

  19. Investigation on risk factors of dry eye in type 2 diabetes patients

    Directory of Open Access Journals (Sweden)

    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.

  20. Validity of subjective assessment as screening tool for dry eye disease and its association with clinical tests

    Directory of Open Access Journals (Sweden)

    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.

  1. Local synthesis of sex hormones: are there consequences for the ocular surface and dry eye?

    Science.gov (United States)

    Gibson, Emma J; Stapleton, Fiona; Wolffsohn, James S; Golebiowski, Blanka

    2017-12-01

    Sex hormones are associated with the physiology and pathophysiology of almost all organs in the body, as well as most diseases. Interest in the associations between sex hormones and ocular tissues has increased in recent years. Androgens may have a positive effect on dry eye, whereas the effects of oestrogen on ocular conditions remain unclear. Intracrinology, the local synthesis and metabolism of hormones that is unique to humans, is of relevance to the eye and may help to explain why studies of the relationship between oestrogens and dry eye signs and symptoms are inconclusive. Knowledge of the pathways of hormone formation and metabolism is crucial to understanding the pathogenesis of ocular disease including dry eye. This review examines the mechanisms of steroidal sex hormone biosynthesis and reviews the significance of locally produced sex hormones, with a focus on ocular surface tissues. Much of the current literature is based on animal studies, which may not be transferable to humans due to the absence of intracrine production in animals. A large proportion of the human studies investigate systemic hormone levels rather than local levels. There is subsequently a need for additional studies to provide a better understanding of the local production of sex hormones within the human eye and ocular surface and to clarify the relationships between ocular levels of sex hormones and conditions including dry eye. © 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.

  2. Effects of oral sea buckthorn oil on tear film Fatty acids in individuals with dry eye.

    Science.gov (United States)

    Järvinen, Riikka L; Larmo, Petra S; Setälä, Niko L; Yang, Baoru; Engblom, Janne Rk; Viitanen, Matti H; Kallio, Heikki P

    2011-09-01

    Evaporative dry eye is associated with meibomian gland dysfunction and abnormalities of the tear film lipids. Dry eye is known to be affected positively by intake of linoleic and γ-linolenic acids and n-3 fatty acids. Oral sea buckthorn (Hippophaë rhamnoides) (SB) oil, which contains linoleic and α-linolenic acids and antioxidants, has shown beneficial effects on dry eye. The objective was to investigate whether supplementation with SB oil affects the composition of the tear film fatty acids in individuals reporting dry eye. One hundred participants were randomized to this parallel, double-blind, placebo-controlled study, which 86 of them completed. The participants daily consumed 2 g of SB or placebo oil for 3 months. Tear film samples were collected at the beginning, during, and at the end of the intervention and 1 to 2 months later. Tear film fatty acids were analyzed as methyl esters by gas chromatography. There were no group differences in the changes in fatty acid proportions during the intervention (branched-chain fatty acids: P = 0.49, saturated fatty acids: P = 0.59, monounsaturated fatty acids: P = 0.53, and polyunsaturated fatty acids: P = 0.16). The results indicate that the positive effects of SB oil on dry eye are not mediated through direct effects on the tear film fatty acids. Carotenoids and tocopherols in the oil or eicosanoids produced from the fatty acids of the oil may have a positive effect on inflammation and differentiation of the meibomian gland cells.

  3. Determining the frequency of dry eye in computer users and comparing with control group

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    Mohammad Hossein Davari

    2017-08-01

    Full Text Available AIM: To determine the frequency of dry eye in computer users and to compare them with control group. METHODS: This study was a case control research conducted in 2015 in the city of Birjand. Sample size of study was estimated to be 304 subjects(152 subjects in each group, computer user group and control group. Non-randomized method of sampling was used in both groups. Schirmer test was used to evaluate dry eye of subjects. Then, subjects completed questionnaire. This questionnaire was developed based on objectives and reviewing the literature. After collecting the data, they were entered to SPSS Software and they were analyzed using Chi-square test or Fisher's test at the alpha level of 0.05.RESULTS: In total, 304 subjects(152 subjects in each groupwere included in the study. Frequency of dry eyes in the control group was 3.3%(5 subjectsand it was 61.8% in computer users group(94 subjects. Significant difference was observed between two groups in this regard(Pn=12, and it was 34.2% in computer users group(n=52, which significant difference was observed between two groups in this regard(PP=0.8. The mean working hour with computer per day in patients with dry eye was 6.65±3.52h, while it was 1.62±2.54h in healthy group(T=13.25, PCONCLUSION: This study showed a significant relationship between using computer and dry eye and ocular symptoms. Thus, it is necessary that officials need to pay particular attention to working hours with computer by employees. They should also develop appropriate plans to divide the working hours with computer among computer users. However, due to various confounding factors, it is recommended that these factors to be controlled in future studies.

  4. Sensitivity and specificity of a point-of-care matrix metalloproteinase 9 immunoassay for diagnosing inflammation related to dry eye.

    Science.gov (United States)

    Sambursky, Robert; Davitt, William F; Latkany, Robert; Tauber, Shachar; Starr, Christopher; Friedberg, Murray; Dirks, Monte S; McDonald, Marguerite

    2013-01-01

    To determine the clinical sensitivity, specificity, negative predictive value, and positive predictive value of a rapid point-of-care diagnostic test to detect elevated matrix metalloproteinase 9 levels (InflammaDry). In a prospective, sequential, masked, multicenter clinical trial, InflammaDry was performed on 206 patients: 143 patients with clinical signs and symptoms of dysfunctional tear syndrome (dry eyes) and 63 healthy individuals serving as controls. Participants were assessed as healthy controls or for a clinical diagnosis of dry eye using the Ocular Surface Disease Index, Schirmer tear test, tear breakup time, and keratoconjunctival staining. The sensitivity and specificity of InflammaDry were compared with clinical assessment. InflammaDry showed sensitivity of 85% (in 121 of 143 patients), specificity of 94% (59 of 63), negative predictive value of 73% (59 of 81), and positive predictive value of 97% (121 of 125). Compared with clinical assessment, InflammaDry is sensitive and specific in diagnosing dry eye. Dry eye is often underdiagnosed resulting from poor communication between the clinical assessment of dry eye severity between clinicians and patients. This often leads to a lack of effective treatment. Matrix metalloproteinase 9 is an inflammatory biomarker that has been shown to be elevated in the tears of patients with dry eyes. The ability to accurately detect elevated matrix metalloproteinase 9 levels may lead to earlier diagnosis, more appropriate treatment, and better management of ocular surface disease. Preoperative and perioperative management of inflammation related to dry eyes may reduce dry eyes that develop after laser in situ keratomileusis, improve wound healing, and reduce flap complications. Recognition of inflammation may allow for targeted perioperative therapeutic management of care for patients who undergo cataract and refractive surgery and improve outcomes. clinicaltrials.gov Identifier: NCT01313351.

  5. Resolution of pinguecula-related dry eye disease after argon laser photocoagulation

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    Napoli PE

    2017-07-01

    Full Text Available Pietro Emanuele Napoli,1 Raffaele Sanna,1 Claudio Iovino,1 Maurizio Fossarello,1,2 1Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy; 2Clinica Oculistica, San Giovanni di Dio hospital, Azienda Ospedaliera Universitaria di Cagliari, Cagliari, Italy Purpose: To describe an unusual case of unilateral, chronic symptoms and signs of dry eye, and recurrent episodes of ocular irritation related to pinguecula, which were refractory to prior medical treatments, successfully treated with argon laser photocoagulation.Methods: A 36-year-old man presented with an elevated yellowish mass on his conjunctiva in his left eye, which was associated with dry eye symptoms and general discomfort, such as “tightening sensation” and “stiffness”. On clinical assessment, the left eye revealed a mild conjunctival injection, a fluorescein break-up time (FBUT of 3.5 s, an abnormal fluorescein staining, and a Schirmer I test of 5 mm. Optical coherence tomography (OCT imaging ­evidenced a height at the most elevated point of the pinguecula of 740 µm. The patient underwent ­argon-laser photocoagulation. Results: After 2 weeks postoperatively, no residual of pinguecula or focal injection of the conjunctiva was detected by slit-lamp biomicroscopy and there was a significant improvement of clinical symptoms and signs: Schirmer I test and FBUT increased to 12 mm and >10 s, respectively, and fluorescein staining was absent. OCT imaging revealed a smooth structure of conjunctival contour, with a height of 404 µm. According to an ex juvantibus line of reasoning, definitive diagnosis was pinguecula-related dry eye disease.Conclusion: Based on the concept that tear film instability and inflammation are two key components of the pathogenesis of dry eye, we coined the term “pinguecula-related dry eye disease,” which can be successfully treated by a complete, accurate removal of the lesion with argon laser photocoagulation. Keywords

  6. 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 hyaluronate 0.1% was more effective than diquafosol 3% monotherapy or treatment with preserved sodium hyaluronate 0.1% in dry eye syndrome. Preservative-free sodium hyaluronate 0.1% eye drops can increase the effect of diquafosol 3% in dry eye syndrome.

  7. Lifitegrast ophthalmic solution in the treatment of signs and symptoms of dry eye disease: design, development, and place in therapy

    OpenAIRE

    Godin, Morgan R; Gupta, Preeya K

    2017-01-01

    Morgan R Godin, Preeya K Gupta Department of Ophthalmology, Division of Cornea and Refractive Surgery, Duke University Eye Center, Durham, NC, USA Abstract: A new topical ophthalmic medication, lifitegrast 5%, was recently approved by the US Food and Drug Administration for use in dry eye patients. Lifitegrast is an integrin antagonist that decreases inflammation on the ocular surface, thereby improving dry eye disease (DED). Through a series of prospective, multicenter, randomized, masked,...

  8. Assessment of dry eye in a GVHD murine model: Approximation through tear osmolarity measurement.

    Science.gov (United States)

    Martínez-Carrasco, Rafael; Sánchez-Abarca, Luis Ignacio; Nieto-Gómez, Cristina; García, Elisabet Martín; Ramos, Teresa L; Velasco, Almudena; Sánchez-Guijo, Fermín; Aijón, José; Hernández-Galilea, Emiliano

    2017-01-01

    Dry eye disease is one of the most frequent pathological events that take place in the course of the graft versus host disease (GVHD), and is the main cause of deterioration in quality of life for patients. Thus, demonstration of dry eye signs in murine models of oGVHD is crucial for the validation of these models for the study of the disease. Given the increasing evidence that tear osmolarity is an important player of dry eye disease, our purpose in this study was to validate the use of a reliable method to assess tear osmolarity in mice: the electrical impedance method. Then, we wanted to test its utility with an oGVHD model. Tear volume assessment was also performed, using the phenol red thread test. We found differences in tear osmolarity in mice that received a transplant with cells from bone marrow and spleen (the GVHD group) when compared with mice that only received bone marrow cells (the BM group) at day 7 (362 ± 8 mOsm/l and 345 ± 9 mOsm/l respectively; P eye disease, what contributes to give relevance to this model for the study of GVHD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Long-Term Results of Punctal Plug Applied to Dry Eye Patients

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    ismet Doğru

    2011-08-01

    Full Text Available Purpose: The evaluation of long-term results of punctal plugs applied to dry eye patients and the potential problems they may bring about. Material and Method: In this study, we retrospectively assessed 30 eyes of 15 patients with moderate to advanced dry eyes who were applied punctal plug (5 mm for treatment purpose and were observed for 12 months. The patients’ Ocular Surface Disease Index (OSDI scoring, Schimer-1 test (without topical anesthesia, tear film break-up time (TBUT and ocular surface staining with fluorescein results were evaluated and compared before and after 6- and 12-month use of punctal plug. The patients were started on topical antiinflammatory treatment and artificial tears two months before the application of the punctum plug. Results: The patients’ average age was 56.4±2.3 (range: 36-70 years, and the average follow-up period was 15 (12-30 months. The average OSDI score was statistically significantly decreased at 6 and 12 months when compared to the initial value (p<0.05. The average Schirmer-1 test values measured at 6 and 12 months were also statistically significantly increased compared with the initial value (p<0.05. The average Schirmer-1 test value at 12 months was considerably increased when compared with the 6th month’s value (p<0.05. The average TBUT was statistically significantly increased when compared to the values at 6 and 12 months (p<0.05. When the outcomes of ocular surface staining with fluorescein were evaluated, a significant decrease was seen at 6 and 12 months when compared to the initial value (p<0.05. Discussion: The punctal plug treatment associated with topical anti-inflammatory treatment for moderate and advanced dry eye patients is a reliable method. It decreases the dry eye symptoms and findings in the long term. (Turk J Ophthalmol 2011; 41: 225-9

  10. Botulinum neurotoxin type A versus punctal plug insertion in the management of dry eye disease

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    Amal A Bukhari

    2014-01-01

    Full Text Available Purpose: To compare the efficacies of punctal plug insertion and Botulinum toxin injection in dry eye disease not responding to topical medications. Materials and Methods: A non-controlled randomized clinical trial of two parallel groups of 60 dry eye patients seen in the clinic not responding to topical medications were divided into two groups. One group received punctal plugs and the other group received Botulinum toxin injections to prevent lacrimal tear drainage. Results: Of a total of 36 patients with a mean age of 44.5 years who received punctal plugs, 50% of them experienced improvements in the clinical manifestations of their disease. 12/36 (33.3% developed plug extrusion, and 6/36 (16.7% patients developed conjunctival erosions with irritation that necessitated plug removal within one week of insertion. A total of 24 patients with a mean age of 47.5 years received injections of Botulinum toxin. Of these, 83.3% had improvement in all of the clinical manifestations of dry eye. 4/24 (16.7% had no improvement in the degrees to which they experienced foreign body sensations, 33.3% reported shampoo entering the eye while showering. All of the patients who received Botulinum toxin injections were satisfied with the results of their treatment, whereas only 72.3% of the patients who received punctal plugs were satisfied with their results. Conclusion: Botulinum neurotoxin A injections can be a very good alternative to punctal plugs in improving the clinical manifestations of dry eye disease They are associated with the development of fewer and milder complications and with higher levels of patient satisfaction.

  11. Topical Application of Apricot Kernel Extract Improves Dry Eye Symptoms in a Unilateral Exorbital Lacrimal Gland Excision Mouse.

    Science.gov (United States)

    Kim, Chan-Sik; Jo, Kyuhyung; Lee, Ik-Soo; Kim, Junghyun

    2016-11-23

    The purpose of this study was to investigate the therapeutic effects of topical application of apricot kernel extract (AKE) in a unilateral exorbital lacrimal gland excision mouse model of experimental dry eye. Dry eye was induced by surgical removal of the lacrimal gland. Eye drops containing 0.5 or 1 mg/mL AKE were administered twice a day from day 3 to day 7 after surgery. Tear fluid volume and corneal irregularity scores were determined. In addition, we examined the immunohistochemical expression level of Muc4. The topical administration of AKE dose-dependently improved all clinical dry eye symptoms by promoting the secretion of tear fluid and mucin. Thus, the results of this study indicate that AKE may be an efficacious topical agent for treating dry eye disease.

  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 tears in the preservative-free group at 1, 2, and 3 months compared to initial values, respectively (P 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. Comparison of dry-eye disease after the femtosecond laser and mechanical microkeratome for laser in situ keratomileusis

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    Meng-Jun Fu

    2015-02-01

    Full Text Available AIM: To analyze dryeye disease after the femtosecond laser and mechanical microkeratome for laser in situ keratomileusis(LASIKby Oculus dry eye analyzer examination.METHODS: The people who had femtosecond LASIK(FS-LASIKand mechanical microkeratome LASIK in Weifang Eye Hospital from January 2014 to April 2014 were observed. Sixty patients(120 eyeswho had corneal refractive surgery were collected. The average age of patients was 27.46±6.65 years old. The LASIK group had 28 patients(56 eyesand the FS-LASIK group had 32 patients(64 eyes. The tears river altitude, first tear break up time(BUT, and average BUT at preoperative, 1wk and 1mo after operation were observed by Oculus dry eye analyzer.RESULTS: By Oculus dry eye analyzer examination, the preoperative tears river altitude of patients was 0.25±0.10mm. First BUT was 6.70±3.86s. Average BUT time was 10.14±4.51s. At 1wk after operation, the tears river altitude of patients was 0.19±0.04mm. The first BUT time was 4.87±1.71s. The average BUT time was 7.77±2.30s. There was significant difference between preoperative and 1wk after operation(PPPCONCLUSION: LASIK and FS-LASIK patients have different degree of dry eye symptom after operation. Dry eye symptoms mainly display in the decrease of tear production and the stability of tear film. It will be better after giving artificial tears. Oculus dry eye analyzer is a non-invasive examination equipment. It can reflect the amount of tears and the stability of tear film. It is usefull in rapid diagnosis of dry eye and judgment of the degree of dry eye symptom after LASIK operation.

  14. 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

  15. The Effect of Artificial Tears on Corneal Higher Order Aberrations in Dry Eye Patients

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    Hasan Ali Bayhan

    2014-03-01

    Full Text Available Purpose: To assess the effects of artificial tears on corneal higher order aberrations in dry eye patients. Materials and Methods: 30 right eyes of 30 newly diagnosed dry eye patients were evaluated in this prospective study. After routine ophthalmological examination, Schirmer test and tear break-up time (TBUT test were performed in all patients. Anterior corneal aberrations were derived from conversion of the corneal elevation profile into corneal wavefront data with 6.0 mm pupil diameter using Zernike polynomails by corneal topography before and 5 minutes after instillation of artificial tear (Eyestil®. Corneal optical aberrations were compared before and after instillation of eyedrop. Results: The study included 17 women and 13 men; the average age of the patients was 44.36±13.22 years. Mean TBUT was 4.78±2.78 seconds and mean Schirmer value was 3.58±2.45 mm/5 minutes. After instillation of artificial tear, significant reductions in corneal total aberration from 1.120±0.35 µm to 0.960±0.34 µm, higher order aberration from 0.674±0.26 µm to 0.464±0.18 µm, coma-like aberration from 0.283±0.10 µm to 0.238±0.09 µm, and spherical-like aberration from 0.254±0.11 µm to 0.221±0.08 µm were detected (all, p<0.001. After eyedrop instillation, statistically significant increment was observed in Strehl ratio (p<0.001. Conclusion: As well as reducing the dry eye symptoms, artificial tears also cause increment in optical quality of the eye. Benefits of artificial tears on visual quality can be evaluated objectively via corneal wavefront aberrations. (Turk J Ophthalmol 2014; 44: 119-22

  16. Folded bandage contact lens retention in a patient with bilateral dry eye symptoms: a case report

    OpenAIRE

    Ho, Derek K.-H.; Mathews, John P.

    2017-01-01

    Background Bandage contact lenses are commonly used by ophthalmic practitioners to protect the patient?s cornea. We report a case of folded bandage contact lens retained for six and a half years in the upper subtarsal space. To our knowledge, no other cases of retained bandage contact lens have previously been reported in the literature. Case presentation A patient was applied a pair of bandage contact lenses due to persistent ocular pain secondary to dry eye symptoms. At her subsequent visit...

  17. Development of lifitegrast: a novel T-cell inhibitor for the treatment of dry eye disease

    OpenAIRE

    Semba, Charles; Gadek,Thomas

    2016-01-01

    Charles P Semba,1 Thomas R Gadek2 1Vascular and Interventional Radiology, Stanford University School of Medicine, Stanford, CA, USA; 2Ophthalma Logic Consulting, Park City, UT, USA Abstract: Dry eye disease (DED) is a multifactorial disorder of the ocular surface characterized by symptoms of discomfort, decreased tear quality, and chronic inflammation that affects an estimated 20 million patients in the US alone. DED is associated with localized inflammation of the ocular surface and perioc...

  18. 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.

  19. Comparison of Development of Dry Eye in Conventional Hydrogel and Silicone Hydrogel Contact Lens Users

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    Rukiye Aydın

    2013-01-01

    Full Text Available Pur po se: To compare the level and severity of dry eye between conventional hydrogel and silicone hydrogel contact lens users by using dry eye questionnaires and clinical tests. Ma te ri al and Met hod: Forty-two contact lens users who attended the Cornea and Contact Lens Unit, Department of Ophthalmology at Dokuz Eylül University, were included in this study. The first group consisted of subjects who have used conventional hydrogel (CHL contact lens for minimum one year and maximum five years. The second group consisted of subjects who have used silicone hydrogel (SHL contact lens for minimum one year and maximum 5 years. Twenty healthy individuals with no history of contact lens use were included in the control group. OSDI (Ocular Surface Disease Index questionnaire was performed to all patients. The tear function was determined by Schirmer’s test and tear break-up time in all three groups. Re sults: There was no statistically significant OSDI score differences between CHL and SHL users. Nevertheless, it was noted that OSDI score in both groups was statistically higher than in the control group. There was no statistically significant difference in tear break-up time between CHL and SHL users. On the other hand, tear break-up time was significantly lower in both groups when compared to the control group. There was no significant difference among the groups for Schirmer scoring. Dis cus si on: The use of conventional hydrogel and silicone hydrogel lenses causes a decline in tear break-up time leading to dry eye symptoms. However, no differences were determined between CHL and SHL users with regard to the severity of dry eye symptoms. (Turk J Ophthalmol 2013; 43: 7-14

  20. Keratopathy, cataract, and dry eye in a survey of aniridia subjects

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    Shiple D

    2015-02-01

    Full Text Available David Shiple,1 Brenton Finklea,1 James D Lauderdale,2 Peter A Netland1 1Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville, VA, USA; 2Department of Cellular Biology, University of Georgia, Athens, GA, USA Purpose: To determine the prevalence of keratopathy, cataract, and dry eye in a group of individuals with aniridia. Methods: We reviewed survey data from the Aniridia Foundation International (AFI registry, which included 99 subjects who self-reported on corneal disease, cataract, and dry eye disease. Results: The average age of respondents was 25.3±18.6 years, with a range of 0 to 67. Of 99 subjects, 46% stated they have corneal disease, 32% stated they did not, and 22% were unsure. The average age of diagnosis of keratopathy was 20.0±12.2 years. Keratolimbal allograft was reported in 20% and penetrating keratoplasty in 9%. Cataract was reported in 65%, with an average age of 9.4±14.0 years at time of diagnosis, and cataract surgery was reported in 32%. The average age of subjects at the time of cataract and corneal surgery was 28.4±13.7 and 33.5±11.4 years, respectively. Symptomatic dry eye was reported in 56% of subjects, with an average age at diagnosis of 23.8±13.3 years. Conclusion: There is a high prevalence of corneal disease in aniridia, with diagnosis in late childhood or early adulthood in nearly one-half of subjects, often requiring corneal surgery. Cataract and dry eye are commonly associated with aniridia. Although aniridia subjects may have been aware of the diagnosis of cataract at an early age, they usually were treated for cataract and keratopathy as adults. Keywords: aniridic keratopathy, ocular surface disease, corneal disease, keratolimbal allograft

  1. Air exposure induced characteristics of dry eye in conjunctival tissue culture.

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    Hui Lin

    Full Text Available There are several animal models illustrating dry eye pathophysiology. Current study would like to establish an ex vivo tissue culture model for characterizing dry eye. Human conjunctival explants were cultured under airlift or submerged conditions for up to 2 weeks, and only airlifted conjunctival cultures underwent increased epithelial stratification. Starting on day 4, the suprabasal cells displayed decreased K19 expression whereas K10 keratin became evident in airlift group. Pax6 nuclear expression attenuated already at 2 days, while its perinuclear and cytoplasmic expression gradually increased. MUC5AC and MUC19 expression dramatically decreased whereas the full thickness MUC4 and MUC16 expression pattern disappeared soon after initiating the airlift condition. Real time PCR showed K16, K10 and MUC16 gene up-regulated while K19, MUC5AC, MUC19 and MUC4 down-regulated on day 8 and day 14. On day 2 was the appearance of apoptotic epithelial and stromal cells appeared. The Wnt signaling pathway was transiently activated from day 2 to day 10. The inflammatory mediators IL-1β, TNF-α, and MMP-9 were detected in the conditioned media after 6 to 8 days. In conclusion, airlifted conjunctival tissue cultures demonstrated Wnt signaling pathway activation, coupled with squamous metaplasia, mucin pattern alteration, apoptosis and upregulation of proinflammatory cytokine expression. These changes mimic the pathohistological alterations described in dry eye. This correspondence suggests that insight into the pathophysiology of dry eye may be aided through the use of airlifted conjunctival tissue cultures.

  2. Characteristics of symptoms experienced by persons with dry eye disease while driving in China.

    Science.gov (United States)

    Wang, Y; Lv, H; Liu, Y; Jiang, X; Zhang, M; Li, X; Wang, W

    2017-11-01

    PurposeTo assess the vision-related quality of life and self-reported driving performance of patients with dry eye disease (DED).Patients and methodsThe study was performed in the eye centre of Peking University Third Hospital, China. In total, 87 dry eye patients and 42 controls were enroled, including 49 patients without any treatment (group A), 38 patients treated with artificial tears (group B) and 42 controls without DED (group C). The participants had no eye disease other than DED. Scores of a vision-related quality-of-life questionnaire (Ocular Surface Disease Index (OSDI)), a daily life-related visual function questionnaire and a questionnaire about performance during driving were collected. Data were compared among the groups and analysed.ResultsSignificant differences in all clinical characteristics and OSDI scores were found between DED patients and normal controls (Pdriving habits and performance, which may increase the risk of dangerous driving (Pdriving. The frequencies of unsafe driving habits and performance were increased in patients with DED.

  3. Effect of Moisture Chamber Spectacles on Tear Functions in Dry Eye Disease.

    Science.gov (United States)

    Shen, Guanglin; Qi, Qiaoran; Ma, Xiaoping

    2016-02-01

    To evaluate the effect of moisture chamber spectacles (MCS) on tear functions in dry eye subjects. In this short-term study, 30 subjects with dry eye were recruited and randomly divided into two groups. Fifteen subjects (MCS group) were instructed to wear the appropriately sized MCS for a total of 90 min. Another 15 subjects (control group) received a drop of sterile nonpreserved 0.9% sodium chloride solution immediately after baseline measurement. Ocular comfort, tear meniscus height (TMH), noninvasive tear film break-up time (NIBUT), tear film lipid layer, and conjunctival hyperemia were evaluated in both groups at 15-min intervals for a period of 90 min (baseline and 15, 30, 45, 60, 75, and 90 min). There were significant improvements in ocular comfort, TMH, NIBUT, and lipid layer in the MCS group compared with those in the control group (p 0.05). Wearing MCS provided improvement in ocular comfort and tear film stability. Moisture chamber spectacles seem to be a safe and promising alternative treatment for dry eye, especially for patients who work in adverse environmental conditions.

  4. Randomized Trial of Desktop Humidifier for Dry Eye Relief in Computer Users.

    Science.gov (United States)

    Wang, Michael T M; Chan, Evon; Ea, Linda; Kam, Clifford; Lu, Yvonne; Misra, Stuti L; Craig, Jennifer P

    2017-11-01

    Dry eye is a frequently reported problem among computer users. Low relative humidity environments are recognized to exacerbate signs and symptoms of dry eye, yet are common in offices of computer operators. Desktop USB-powered humidifiers are available commercially, but their efficacy for dry eye relief has not been established. This study aims to evaluate the potential for a desktop USB-powered humidifier to improve tear-film parameters, ocular surface characteristics, and subjective comfort of computer users. Forty-four computer users were enrolled in a prospective, masked, randomized crossover study. On separate days, participants were randomized to 1 hour of continuous computer use, with and without exposure to a desktop humidifier. Lipid-layer grade, noninvasive tear-film breakup time, and tear meniscus height were measured before and after computer use. Following the 1-hour period, participants reported whether ocular comfort was greater, equal, or lesser than that at baseline. The desktop humidifier effected a relative difference in humidity between the two environments of +5.4 ± 5.0% (P .05). However, a relative increase in the median noninvasive tear-film breakup time of +4.0 seconds was observed in the humidified environment (P computer use.Trial registration no: ACTRN12617000326392.

  5. Lifitegrast: First LFA-1/ICAM-1 antagonist for treatment of dry eye disease.

    Science.gov (United States)

    Paton, D M

    2016-09-01

    Dry eye disease is an extremely common condition affecting millions worldwide. The underlying pathophysiological mechanism is thought to be localized inflammation of the ocular surface resulting in the localization of T cells at this surface followed by their activation and subsequent liberation of cytokines. This effect on T cells results from the binding of lymphocyte function-associated antigen-1 (LFA-1) located on T cells to intercellular adhesion molecule 1 (ICAM-1) expressed on inflamed epithelium and endothelium, and on T cells. Lifitegrast is a T-cell integrin antagonist designed to mimic ICAM-1, thus blocking the interaction of LFA-1 and ICAM-1. Lifitegrast enters the systemic circulation to a limited extent thus reducing the likelihood of unwanted systemic reactions. Clinical trials in over 2,500 subjects with dry eye disease have shown that 5.0% lifitegrast given by ocular instillation causes a significant reduction in objective and subjective signs and symptoms of the disease. These beneficial effects are associated with a relatively low incidence of unwanted effects, almost all local in nature. In light of these findings, lifitegrast was approved by the Food and Drug Administration (FDA) in 2016 for the treatment of dry eye disease, the first drug with this mechanism of action to be so approved. Copyright 2016 Prous Science, S.A.U. or its licensors. All rights reserved.

  6. [Effects of extract of Buddleja officinalis on prevention of dry eye in castrated rabbits].

    Science.gov (United States)

    Peng, Qing-Hua; Yao, Xiao-lei; Wu, Quan-long; Chen, Mei

    2008-11-01

    To assess the preventive effects of extract of Buddleja officinalis on dry eye in castrated rabbits and to discuss the mechanism of these effects. It was a experimental study. Thirty male rabbits were divided equally into normal group (A), disease group (B) and treatment group (C, D, and E). The dry eye model was established with orchiectomy (ORX) in Group B, C, D and E. Group C, D and E were gastrically perfused with single-dose or double-does of Buddleja officinalis extract or genistein for 30 days. All rabbits were examined with Schirmer I test (SIT). TGF-beta1, IL-1beta, TNF-alpha, Fas, FasL, Bax and bcl-2 were detected by immunohistochemistry. Morphological and ultrastructure changes were observed by electron microscopy. The SIT value of group C, D, E was significantly greater than that of group B (P Buddleja officinalis has a significant effect on the prevention of experimental dry eye in castrated male rabbits. The main components of extract of Buddleja officinalis are the flavonoids. The flavonoids display androgen-like activity. Therefore, it can adjust gonadal hormone level in vivo. As a result, it can inhibit local inflammation in lacrimal gland and reduce apoptosis of lacrimal gland cells.

  7. Dry Eye

    Science.gov (United States)

    ... treated with over-the-counter medications such as artificial tears, gels, and ointments. Environmental and lifestyle changes. ... and is the Federal government’s lead agency for vision research that leads to sight-saving treatments and ...

  8. Effects of extract of Buddleja officinalis eye drops on androgen receptors of lacrimal gland cells of castrated rats with dry eye.

    Science.gov (United States)

    Peng, Qing-Hua; Yao, Xiao-Lei; Wu, Quan-Long; Tan, Han-Yu; Zhang, Jing-Rong

    2010-01-01

    To evaluate the effects of the extract of Buddleja officinalis eye drops in basic tears secretory volume, tear film stability, expression of androgen receptors (AR) in castrated rats with dry eye, and to investigate the therapeutic effects of the extract of Buddleja officinalis on dry eye caused by gonadal hormones level imbalance. Forty-five Wistar masculinity rats were divided at random into nine groups, including normal groups (A1, A2 and A3); model groups (B1, B2 and B3); therapy groups with extract of Buddleja officinalis eye drops (C1, C2 and C3). The "1" stood for being fed for 1 month, and "2" for 2 months, and "3" for 3 months. The dry eye model was established with orchiectomy on groups B and C. Group C was treated with Buddleja officinalis extract eye drops for one month. All rats were checked with Schirmer I test (SIT) and tear film break-up time (BUT). Expression of AR was analyzed by flow cytometer (FCM). The SIT value of group C was significantly higher than that of group B (PBuddleja officinalis is the flavonoids that can significantly inhibit happening of dry eye of rat after androgen level lowered. Its mechanism is like androgen's and it can display androgen-like activity to keep basic tears secretory volume and tear film stability.

  9. Effects of a warm compress containing menthol on the tear film in healthy subjects and dry eye patients

    Science.gov (United States)

    Arita, Reiko; Morishige, Naoyuki; Sakamoto, Ichiro; Imai, Natsuko; Shimada, Yuko; Igaki, Michihito; Suzuki, Atsushi; Itoh, Kouzo; Tsubota, Kazuo

    2017-04-01

    Menthol is thought to stimulate lacrimation via activation of cold-sensitive primary afferent neurons in the cornea. We evaluated a warm compress containing menthol as a potential treatment for dry eye by examining its effects on the tear film in healthy subjects (n = 20) and dry eye patients (n = 35). Disposable eyelid-warming steamers that either did (MH) or did not (HO) contain menthol were applied to one eye of each subject either once only for 10 min or repeatedly over 2 weeks. Single application of MH significantly increased tear meniscus volume (P = 8.6 × 10-5, P = 1.3 × 10-5) and tear film breakup time (P = 0.006, P = 0.002) as well as improved meibum condition in healthy subjects and dry eye patients, respectively. Repeated application of MH significantly increased tear meniscus volume (P = 0.004, P = 1.7 × 10-4) and tear film breakup time (P = 0.037, P = 0.010) in healthy subjects and dry eye patients, respectively. Repeated application of MH thus induced persistent increases in tear fluid volume and tear film stability in dry eye patients, suggesting that repeated use of a warm compress containing menthol is a potential novel treatment for dry eye disease.

  10. The Effect of Tear Supplementation on Ocular Surface Sensations during the Interblink Interval in Patients with Dry Eye.

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    Lóránt Dienes

    Full Text Available To investigate the characteristics of ocular surface sensations and corneal sensitivity during the interblink interval before and after tear supplementation in dry eye patients.Twenty subjects (41.88±14.37 years with dry eye symptoms were included in the dry eye group. Fourteen subjects (39.13±11.27 years without any clinical signs and/or symptoms of dry eye were included in the control group. Tear film dynamics was assessed by non-invasive tear film breakup time (NI-BUT in parallel with continuous recordings of ocular sensations during forced blinking. Corneal sensitivity to selective stimulation of corneal mechano-, cold and chemical receptors was assessed using a gas esthesiometer. All the measurements were made before and 5 min after saline and hydroxypropyl-guar (HP-guar drops.In dry eye patients the intensity of irritation increased rapidly after the last blink during forced blinking, while in controls there was no alteration in the intensity during the first 10 sec followed by an exponential increase. Irritation scores were significantly higher in dry eye patients throughout the entire interblink interval compared to controls (p0.05.Ocular surface irritation responses due to tear film drying are considerably increased in dry eye patients compared to normal subjects. Although tear supplementation improves the protective tear film layer, and thus reduce unpleasant sensory responses, the rapid rise in discomfort is still maintained and might be responsible for the remaining complaints of dry eye patients despite the treatment.

  11. The Effect of Tear Supplementation on Ocular Surface Sensations during the Interblink Interval in Patients with Dry Eye

    Science.gov (United States)

    Dienes, Lóránt; Kiss, Huba J.; Perényi, Kristóf; Szepessy, Zsuzsanna; Nagy, Zoltán Z.; Barsi, Árpád; Acosta, M. Carmen; Gallar, Juana; Kovács, Illés

    2015-01-01

    Purpose To investigate the characteristics of ocular surface sensations and corneal sensitivity during the interblink interval before and after tear supplementation in dry eye patients. Methods Twenty subjects (41.88±14.37 years) with dry eye symptoms were included in the dry eye group. Fourteen subjects (39.13±11.27 years) without any clinical signs and/or symptoms of dry eye were included in the control group. Tear film dynamics was assessed by non-invasive tear film breakup time (NI-BUT) in parallel with continuous recordings of ocular sensations during forced blinking. Corneal sensitivity to selective stimulation of corneal mechano-, cold and chemical receptors was assessed using a gas esthesiometer. All the measurements were made before and 5 min after saline and hydroxypropyl-guar (HP-guar) drops. Results In dry eye patients the intensity of irritation increased rapidly after the last blink during forced blinking, while in controls there was no alteration in the intensity during the first 10 sec followed by an exponential increase. Irritation scores were significantly higher in dry eye patients throughout the entire interblink interval compared to controls (p0.05). Conclusion Ocular surface irritation responses due to tear film drying are considerably increased in dry eye patients compared to normal subjects. Although tear supplementation improves the protective tear film layer, and thus reduce unpleasant sensory responses, the rapid rise in discomfort is still maintained and might be responsible for the remaining complaints of dry eye patients despite the treatment. PMID:26302222

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

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    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

  13. Automated grading system for evaluation of ocular redness associated with dry eye

    Directory of Open Access Journals (Sweden)

    Rodriguez JD

    2013-06-01

    Full Text Available John D Rodriguez,1 Patrick R Johnston,1 George W Ousler III,1 Lisa M Smith,1 Mark B Abelson1,21Ora, Inc, Andover, MA, USA; 2Department of Ophthalmology, Harvard Medical School, Boston, MA, USABackground: We have observed that dry eye redness is characterized by a prominence of fine horizontal conjunctival vessels in the exposed ocular surface of the interpalpebral fissure, and have incorporated this feature into the grading of redness in clinical studies of dry eye.Aim: To develop an automated method of grading dry eye-associated ocular redness in order to expand on the clinical grading system currently used.Methods: Ninety nine images from 26 dry eye subjects were evaluated by five graders using a 0–4 (in 0.5 increments dry eye redness (Ora CalibraTM Dry Eye Redness Scale [OCDER] scale. For the automated method, the Opencv computer vision library was used to develop software for calculating redness and horizontal conjunctival vessels (noted as "horizontality". From original photograph, the region of interest (ROI was selected manually using the open source ImageJ software. Total average redness intensity (Com-Red was calculated as a single channel 8-bit image as R − 0.83G − 0.17B, where R, G and B were the respective intensities of the red, green and blue channels. The location of vessels was detected by normalizing the blue channel and selecting pixels with an intensity of less than 97% of the mean. The horizontal component (Com-Hor was calculated by the first order Sobel derivative in the vertical direction and the score was calculated as the average blue channel image intensity of this vertical derivative. Pearson correlation coefficients, accuracy and concordance correlation coefficients (CCC were calculated after regression and standardized regression of the dataset.Results: The agreement (both Pearson's and CCC among investigators using the OCDER scale was 0.67, while the agreement of investigator to computer was 0.76. A multiple

  14. Automated grading system for evaluation of ocular redness associated with dry eye.

    Science.gov (United States)

    Rodriguez, John D; Johnston, Patrick R; Ousler, George W; Smith, Lisa M; Abelson, Mark B

    2013-01-01

    We have observed that dry eye redness is characterized by a prominence of fine horizontal conjunctival vessels in the exposed ocular surface of the interpalpebral fissure, and have incorporated this feature into the grading of redness in clinical studies of dry eye. To develop an automated method of grading dry eye-associated ocular redness in order to expand on the clinical grading system currently used. Ninety nine images from 26 dry eye subjects were evaluated by five graders using a 0-4 (in 0.5 increments) dry eye redness (Ora Calibra™ Dry Eye Redness Scale [OCDER]) scale. For the automated method, the Opencv computer vision library was used to develop software for calculating redness and horizontal conjunctival vessels (noted as "horizontality"). From original photograph, the region of interest (ROI) was selected manually using the open source ImageJ software. Total average redness intensity (Com-Red) was calculated as a single channel 8-bit image as R - 0.83G - 0.17B, where R, G and B were the respective intensities of the red, green and blue channels. The location of vessels was detected by normalizing the blue channel and selecting pixels with an intensity of less than 97% of the mean. The horizontal component (Com-Hor) was calculated by the first order Sobel derivative in the vertical direction and the score was calculated as the average blue channel image intensity of this vertical derivative. Pearson correlation coefficients, accuracy and concordance correlation coefficients (CCC) were calculated after regression and standardized regression of the dataset. The agreement (both Pearson's and CCC) among investigators using the OCDER scale was 0.67, while the agreement of investigator to computer was 0.76. A multiple regression using both redness and horizontality improved the agreement CCC from 0.66 and 0.69 to 0.76, demonstrating the contribution of vessel geometry to the overall grade. Computer analysis of a given image has 100% repeatability and zero

  15. Diagnosis of response and non-response to dry eye treatment using infrared thermography images

    Science.gov (United States)

    Acharya, U. Rajendra; Tan, Jen Hong; Vidya, S.; Yeo, Sharon; Too, Cheah Loon; Lim, Wei Jie Eugene; Chua, Kuang Chua; Tong, Louis

    2014-11-01

    The dry eye treatment outcome depends on the assessment of clinical relevance of the treatment effect. The potential approach to assess the clinical relevance of the treatment is to identify the symptoms responders and non-responders to the given treatments using the responder analysis. In our work, we have performed the responder analysis to assess the clinical relevance effect of the dry eye treatments namely, hot towel, EyeGiene®, and Blephasteam® twice daily and 12 min session of Lipiflow®. Thermography is performed at week 0 (baseline), at weeks 4 and 12 after treatment. The clinical parameters such as, change in the clinical irritations scores, tear break up time (TBUT), corneal staining and Schirmer's symptoms tests values are used to obtain the responders and non-responders groups. We have obtained the infrared thermography images of dry eye symptoms responders and non-responders to the three types of warming treatments. The energy, kurtosis, skewness, mean, standard deviation, and various entropies namely Shannon, Renyi and Kapoor are extracted from responders and non-responders thermograms. The extracted features are ranked based on t-values. These ranked features are fed to the various classifiers to get the highest performance using minimum features. We have used decision tree (DT), K nearest neighbour (KNN), Naves Bayesian (NB) and support vector machine (SVM) to classify the features into responder and non-responder classes. We have obtained an average accuracy of 99.88%, sensitivity of 99.7% and specificity of 100% using KNN classifier using ten-fold cross validation.

  16. 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.

  17. Impact of oral vitamin D supplementation on the ocular surface in people with dry eye and/or low serum vitamin D.

    Science.gov (United States)

    Yang, Chih-Huang; Albietz, Julie; Harkin, Damien G; Kimlin, Michael G; Schmid, Katrina L

    2017-09-11

    To determine the possible association between serum vitamin D levels and dry eye symptoms, and the impact of an oral vitamin D supplement. Three linked studies were performed. (i) 29 older adult participants, (ii) 29 dry eyed participants, and (iii) 2-month vitamin D supplementation for 32 dry eyed/low serum vitamin D levelled participants. All participants were assessed by the Ocular Surface Diseases Index (OSDI) to determine dry eye symptoms, and the phenol red thread test (PRT) and/or Schirmer's tear test, tear meniscus height, non-invasive tear break up time, grading ocular surface redness and fluorescein staining of the cornea to detect the tear quality and ocular surface conditions. Blood samples were collected for serum vitamin D analysis and interleukin-6 (IL-6) levels. Among older adult participants, vitamin D levels were negatively correlated with dry eye symptoms, the severity of dry eye, and associated with tired eye symptom. Vitamin D levels of people with dry eye diagnosis were not correlated with OSDI scores and IL-6 levels; while IL-6 levels showed correlation with tear production. In supplement study, vitamin D levels increased by 29mol/l, while dry eye symptoms and grading of corneal staining appeared significant reductions. No significant changes in IL-6 levels. Low vitamin D levels (eye symptoms in older individuals but not those diagnosed with dry eye. Vitamin D supplement increased the vitamin D levels, and improved dry eye symptoms, the tear quality and ocular surface conditions. Copyright © 2017. Published by Elsevier Ltd.

  18. In Vivo and Impression Cytology Study on the Effect of Compatible Solutes Eye Drops on the Ocular Surface Epithelial Cell Quality in Dry Eye Patients

    Directory of Open Access Journals (Sweden)

    Manuela Lanzini

    2015-01-01

    Full Text Available The aim of this study is to investigate in vivo and ex vivo ocular surface alterations induced by dry eye disease and modification after osmoprotective therapy. Forty-eight eyes of 24 patients suffering from dry eye have been recruited. All patients received Optive (compatible solutes eye drops in one randomly selected eye and Hylogel (sodium hyaluronate 0,2% in the other. Follow-up included a baseline visit and further examination 30-, 60-, and 90-day intervals (which comprises clinical evaluation, in vivo confocal microscopy—IVCM—of the ocular surface, and conjunctival impression cytology. No significant difference in Schirmer I Test, TBUT, and vital staining results was observed during the follow-up period in both groups. IVCM showed in all patients an improvement of ocular surface epithelial morphology and signs of inflammation (oedema and keratocyte activation. However, these modifications were more evident in patients treated with Optive therapy. A significant reduction of the expression of MMP9 and IL6 in Optive group was observed during the follow-up period in comparison to Hylogel treatment. Our results show that in dry eye disease therapy based on osmoprotective eye drops determines a reduction of inflammatory activation of ocular surface, with consequent improvement of the quality of corneal and conjunctival epithelium.

  19. P2Y2 receptor agonists for the treatment of dry eye disease: a review

    Directory of Open Access Journals (Sweden)

    Lau OCF

    2014-01-01

    Full Text Available Oliver C F Lau,1 Chameen Samarawickrama,1,2 Simon E Skalicky1–31Sydney Eye Hospital, Sydney, NSW, Australia; 2Save Sight Institute, University of Sydney, Sydney, NSW, Australia; 3Ophthalmology Department, Addenbrooke's Hospital, Cambridge, United KingdomAbstract: Recent advances in the understanding of dry eye disease (DED have revealed previously unexplored targets for drug therapy. One of these drugs is diquafosol, a uridine nucleotide analog that is an agonist of the P2Y2 receptor. Several randomized controlled trials have demonstrated that the application of topical diquafosol significantly improves objective markers of DED such as corneal and conjunctival fluorescein staining and, in some studies, tear film break-up time and Schirmer test scores. However, this has been accompanied by only partial improvement in patient symptoms. Although evidence from the literature is still relatively limited, early studies have suggested that diquafosol has a role in the management of DED. Additional studies would be helpful to delineate how different subgroups of DED respond to diquafosol. The therapeutic combination of diquafosol with other topical agents also warrants further investigation.Keywords: dry eye disease, meibomian gland disease, aqueous tear deficiency, diquafosol, P2Y2 agonists

  20. Dry Eye in Vernal Keratoconjunctivitis: A Cross-Sectional Comparative Study.

    Science.gov (United States)

    Villani, Edoardo; Strologo, Marika Dello; Pichi, Francesco; Luccarelli, Saverio V; De Cillà, Stefano; Serafino, Massimiliano; Nucci, Paolo

    2015-10-01

    The purpose of this comparative cross-sectional study was to investigate the use of standardized clinical tests for dry eye in pediatric patients with active and quiet vernal keratoconjunctivitis (VKC) and to compare them with healthy children.We recruited 35 active VKC, 35 inactive VKC, and 70 age-matched control healthy subjects. Each child underwent a complete eye examination, including visual analog scale symptoms assessment, biomicroscopy, fluorescein break-up time (BUT), corneal fluorescein and conjunctival lissamine green staining, corneal esthesiometry, Schirmer test with anesthetic, and meibomian glands inspection and expression.Active VKC patients showed significantly increased symptoms and signs of ocular surface disease, compared with the other 2 groups. Inactive VKC patients, compared with control subjects, showed increased photophobia (P < 0.05; Mann-Whitney U test), conjunctival lissamine green staining and Schirmer test values, and reduced BUT and corneal sensitivity [P < 0.05 by analysis of variance (ANOVA) least significant difference posthoc test for BUT and Schirmer; P < 0.001 by Mann-Whitney U test for lissamine green staining and corneal sensitivity].Our results confirm the association between VKC and short-BUT dry eye. This syndrome seems to affect the ocular surface in quiescent phases too, determining abnormalities in tear film stability, epithelial cells integrity, and corneal nerves function. The very long-term consequences of this perennial mechanism of ocular surface damage have not been fully understood yet.

  1. Repeatability of infrared ocular thermography in assessing healthy and dry eyes.

    Science.gov (United States)

    Tan, Li Li; Sanjay, Srinivasan; Morgan, Philip B

    2016-08-01

    To investigate the inter-image, inter-occasion and inter-examiner repeatability of NEC infrared thermo-tracer TH 9260 in assessing healthy and dry eyes. Ocular surface temperature (OST) was recorded using NEC infrared thermo-tracer TH 9260 on 21 healthy and 15 dry eyes. Data from the right eyes were analyzed. Marking of the ocular surface and OST acquisition was performed using a new 'diamond' demarcation method. Twelve OST indices were obtained at three different time points following a blink: 0s, 5s and 10s. Inter-image, inter-occasion and inter-examiner repeatability of the infrared ocular thermography was evaluated by calculating coefficients of repeatability (COR). Ten out of the twelve tested OST indices had good repeatability with small inter-image variability (%COR: 0.2-0.9), inter-occasion variability (%COR: 2.1-3.7) and inter-examiner variability (%COR: 1.5-3.7) for the three studied time points. Two of the OST indices (temperature standard deviation of the region of interest and radial temperature difference) had poor repeatability with much larger inter-image variability (%COR: 8.9-140.7), inter-occasion variability (%COR: 47.5-153.5) and inter-examiner variability (%COR: 54.7-142.0) for the three studied time points. Most of the metrics adopted in this assessment can be considered to be highly repeatable. Copyright © 2016 British Contact Lens Association. All rights reserved.

  2. Diagnostic Performance of McMonnies Questionnaire as a Screening Survey for Dry Eye: A Multicenter Analysis

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    Yuxin Guo

    2016-01-01

    Full Text Available Purpose. To evaluate the diagnostic performance of the McMonnies questionnaire as a screening survey for dry eye in Chinese outpatients. Methods. The questionnaire was self-administered by 27,999 patients with dry eye symptoms. A thorough ophthalmic examination including tear break-up time (TBUT, fluorescein staining, and Schirmer I test was completed to make a clinical diagnosis of dry eye. Reliability, validity, and accuracy of the McMonnies questionnaire were assessed. Results. The McMonnies questionnaire showed poor internal consistency (Cronbach α=0.37, but excellent validity as the scores correlated with TBUT (Spearman test, r=-0.322, P<0.001 and Schirmer I test (Spearman’s test, r=-0.370, P<0.001, and significantly differed between the dry eye and control groups (2-sample t-test, t=69.51, P<0.001. The area under the receiver-operating characteristics (ROC curve (AUC was 0.729, suggesting moderate accuracy in identifying dry eye and non-dry eye patients. However, the AUCs varied significantly in different gender and age subgroups (z test, P<0.001, as the discriminating ability declined with age. Analysis of the ROC curves also revealed that different cut-off points should be employed for each subgroup to achieve the same level of accuracy. Conclusions. The McMonnies questionnaire demonstrates moderate diagnostic value, and different cut-off points should be selected for various study populations.

  3. Cationic amino acid transporters and beta-defensins in dry eye syndrome.

    Science.gov (United States)

    Jäger, Kristin; Garreis, Fabian; Dunse, Matthias; Paulsen, Friedrich P

    2010-01-01

    Several diseases concomitant with L-arginine deficiency (diabetes, chronic kidney failure, psoriasis) are significantly associated with dry eye syndrome. One important factor that has so far been neglected is the y(+) transporter. In humans, y(+) accounts for nearly 80% of arginine transport, exclusively carrying the cationic amino acids L-arginine, L-lysine and L-ornithine. y(+) is represented by CAT(cationic amino acid transporter) proteins. L-arginine is a precursor of the moisturizer urea, which has been used in the treatment of dry skin diseases. Although urea has also been shown to be part of the tear film, little attention has been paid to it in this role. Moreover, L-arginine and L-lysine are major components contributing to synthesis of the antimicrobially active beta-defensins induced under dry eye conditions. The first results have demonstrated that transport of L-arginine and L-lysine into epithelial cells is limited by the y(+) transporter at the ocular surface. Copyright 2010 S. Karger AG, Basel.

  4. Folded bandage contact lens retention in a patient with bilateral dry eye symptoms: a case report.

    Science.gov (United States)

    Ho, Derek K-H; Mathews, John P

    2017-07-04

    Bandage contact lenses are commonly used by ophthalmic practitioners to protect the patient's cornea. We report a case of folded bandage contact lens retained for six and a half years in the upper subtarsal space. To our knowledge, no other cases of retained bandage contact lens have previously been reported in the literature. A patient was applied a pair of bandage contact lenses due to persistent ocular pain secondary to dry eye symptoms. At her subsequent visit, bandage contact lens was removed from her left eye, but none was found in the right eye. Documentation from further visit stated that the bandage contact lenses were no longer in situ. 6.5 years since the lens insertion, lid eversion revealed a 'foreign body' retained beneath her right upper eyelid, which was noted to be a folded, discoloured bandage contact lens. The 'upper fornix trap', where the contact lens may be retained by the upper tarsal edge, presents an anatomical hazard for contact lens users. Moreover, soft contact lenses may be more likely to retain asymptomatically and to fold onto itself compared to hard lenses. Our case report highlights the importance of performing a thorough eye examination, which includes double eversion of the upper eyelids and sweeping of the fornices with cotton buds, and maintaining clinical suspicion of contact lens retention.

  5. Analysis of correlation between the clinical feature of dry eye and the disease condition in type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Yu-Mei Zhou

    2017-08-01

    Full Text Available AIM: To investigate the clinical features of dry eye with type 2 diabetic patients, and to analyze the correlation between the clinical features of dry eye and the disease condition. METHODS: Retrospective case series study. Dry eye cases with type 2 diabetic were analyzed from March to December in 2016. And the clinical features of patients were summarized. Dry eye examination including tear break-up time(BUTand Schirmer test(schirmer Ⅰ test, SⅠt. Patients were divided into RESULTS: There were 178 cases collected. All cases were diagnosed as dry eye both eyes. The patient's age ranged from 32 to 85 years, with an average 58.41±13.06 years. There were 110(61.8%male cases, and 68(38.2%female cases. In all cases, the mean value of BUT was 4.52±2.31s, and the mean value of SⅠt was 4.25±1.99mm/5min. The value of women were more than men, but the differences were not significant statistically. Patients of ≥60 group were less than the age group of t=4.153, 4.021; PF=68.884, 60.204; Pt=-6.615, -5.918; PCONCLUSION:There were two types dry eye in 2 diabetic patients: the instability of tear-film and the reduction of tear secretion. The clinic features of dry eye were related to age, the course of the disease, and the level of blood glucose.

  6. Lacrimal hypofunction as a new mechanism of dry eye in visual display terminal users.

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    Shigeru Nakamura

    Full Text Available BACKGROUND: Dry eye has shown a marked increase due to visual display terminal (VDT use. It remains unclear whether reduced blinking while focusing can have a direct deleterious impact on the lacrimal gland function. To address this issue that potentially affects the life quality, we conducted a large-scale epidemiological study of VDT users and an animal study. METHODOLOGY/PRINCIPAL FINDINGS: Cross sectional survey carried out in Japan. A total of 1025 office workers who use VDT were enrolled. The association between VDT work duration and changes in tear film status, precorneal tear stability, lipid layer status and tear secretion were analyzed. For the animal model study, the rat VDT user model, placing rats onto a balance swing in combination with exposure to an evaporative environment was used to analyze lacrimal gland function. There was no positive relationship between VDT working duration and change in tear film stability and lipid layer status. The odds ratio for decrease in Schirmer score, index of tear secretion, were significantly increased with VDT working year (P = 0.012 and time (P = 0.005. The rat VDT user model, showed chronic reduction of tear secretion and was accompanied by an impairment of the lacrimal gland function and morphology. This dysfunction was recovered when rats were moved to resting conditions without the swing. CONCLUSIONS/SIGNIFICANCE: These data suggest that lacrimal gland hypofunction is associated with VDT use and may be a critical mechanism for VDT-associated dry eye. We believe this to be the first mechanistic link to the pathogenesis of dry eye in office workers.

  7. Tear film osmolarity measurements in dry eye disease using electrical impedance technology.

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    Jacobi, Christina; Jacobi, Arnd; Kruse, Friedrich E; Cursiefen, Claus

    2011-12-01

    Tear film hyperosmolarity is recognized as an important pathogenetic factor in dry eye syndrome, but difficulties in its measurement have limited its utility in the recent past. This prospective, nonrandomized, clinical single-center study investigates the osmolarity in tear samples of patients with keratoconjunctivitis sicca compared with healthy controls. One hundred thirty-three patients [aged 58 years (51-64 years), 86 women and 47 men] with moderate to severe keratoconjunctivitis sicca and 95 controls [aged 52 years (48-61 years), 55 women and 40 men] were enrolled in the trial. Tear samples were collected directly from the inferior lateral tear meniscus. Inclusion criteria were a tear breakup time of less than 5 seconds, a Schirmer test with anesthesia less than 5 mm, and positive symptoms (Ocular Surface Disease Index score > 83). Tear film osmolarity was analyzed by the TearLab osmometer. In our study, patients with moderate to severe keratoconjunctivitis sicca showed a tear film osmolarity of 320 mOsmol/L (301-324 mOsmol/L). The results of the control group were 301 mOsmol/L (298-304 mOsmol/L). Our results revealed a significantly higher tear film osmolarity in patients with moderate to severe keratoconjunctivitis sicca compared with the control group. The sensitivity was 87%, and the specificity was 81%. Our results approved the referent value in moderate to severe dry eye of approximately 316 mOsmol/L, as described in the literature. The results showed a significantly higher tear film osmolarity in patients with severe keratoconjunctivitis sicca compared with the healthy controls. Testing tear film osmolarity can be a very effective objective diagnostic tool in the diagnosis of dry eye disease.

  8. Measurement of Symptoms Pre- and Post-treatment of Dry Eye Syndromes.

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    McMonnies, Charles W

    2016-11-01

    : Valid assessment of dry eye syndrome symptoms is essential for diagnosis and for making treatment decisions and monitoring responses to treatment. Notwithstanding the desirability of being able to measure across several assessment domains to gauge the influence of symptom burden on the quality of life, the time-consuming nature of such assessments may make them unsuitable for routine clinical use. This review of symptom assessment methods examines the relative merits of visual analogue and Likert scales. Also examined are ways in which symptoms can be influenced by comorbid diseases and associated medications, and how the validity of assessing treatment efficacy could be compounded by natural progression of a dry eye syndrome apart from either favorable, neutral, or adverse responses to treatment. Follow-up assessments may also be biased by patient expectations. How validity of responses could be improved by the instructional use of a demonstration scale is described and illustrated. Personal instruction is suggested for patients anticipated to have age- or language-related difficulties but for some patients instruction could be successfully self-directed. A comparison of methods used to monitor dry eye syndrome treatment has allowed recommendations to be made for a method of using visual analogue scales which incorporates features which have been demonstrated to be advantageous in previous studies. The continuous nature of a visual analogue scale allows for smaller changes to be recorded with associated better discriminating capacity. More powerful statistical analysis of findings is possible when using visual analogue scales. Reference to previous assessment scores and exactly the same scale anchors improve the reliability of measurements of change in symptoms over time.

  9. [Comparison of local acetylcysteine and artificial tears in the management of dry eye syndrome].

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    Pokupec, Rajko; Petricek, Igor; Sikić, Jakov; Bradić, Mirna; Popović-Suić, Smiljka; Petricek, Goranka

    2005-01-01

    Dry eye syndrome is a common clinical entity causing difficulties to many people, especially the elderly. Standard substitution therapy with artificial tears may frequently prove inadequate, thus any new treatment modality is highly welcome. The syndrome implies lacrimal hyperosmolality, which in turn results in mucus accumulation in the conjunctival sac causing additional irritation. Locally applied acetylcysteine, a mucolytic, regulates mucus secretion and reduces mucus accumulation. The aim of the study was to compare the efficacy of artificial tear therapy and therapy with local acetylcysteine. The study included 32 patients with the symptoms and signs of dry eye attending our department between March 20 and May 9, 2003. All study patients were on long-term substitution therapy with artificial tears. Upon evaluation of subjective discomforts and objective signs, the patients were switched from artificial tear therapy (Isopto-Tears, Alcon, with polyvinyl alcohol as active ingredient) to therapy with locally applied acetylcysteine (Brunac, Bruschettini). All parameters were re-evaluated at 2-week control visit. Thirty of 32 patients (94%) completed the study with control visit. Of these, 18 (60%) patients reported reduction of subjective discomforts, ten (33%) patients observed no change, and two (7%) patients experienced more discomforts with acetylcysteine than with artificial tear therapy. On objective sign evaluation, 12 (40%) patients showed less discomforts, unchanged condition was recorded in 13 (43%) patients, and five (17%) patients had more discomforts as compared with artificial tear therapy. A statistically significant difference (p=0.05) between artificial tear therapy and acetylcysteine therapy was found for the subjective symptom score but not for the objective sign score. Therapy with acetylcysteine proved more efficient than artificial tears in reducing subjective symptoms but had no effect on the objective signs of dry eye syndrome. The

  10. A PROSPECTIVE OBSERVATIONAL STUDY REGARDING PREVALENCE OF DRY EYE DISEASE IN POST-OPERATIVE CATARACT SURGERY PATIENTS OF 140 CASES.

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    S. Srinivasan

    2017-02-01

    Full Text Available BACKGROUND Dry eye disease is one of the most common ocular surface disorder with large number of studies carried out in various countries estimate the prevalence of dry eye disease to be between 5-34%. The prevalence of dry eye increases with age. As per Breaver Dam study regarding dry eye the prevalence of DED 13.3%. Dry eye was apparently higher in women than men. Studies have shown that cataract surgery worsen dry eye symptoms in patients with preexisting dry eye symptoms as well as without preexisting DES, mostly dry eye symptoms last for two months of post cataract surgery period. MATERIALS AND METHODS The prospective observational study was conducted in Department of Ophthalmology, Government Vellore Medical College and Hospital, Vellore. The total number of cataract surgery performed cases were 140 in number. The study period was four months, conducted in tertiary eye center. The Cataract patients were preoperatively at normal tear secretions. Post cataract surgery period from first POD, one week POD, four weeks, six weeks, two months and three months POD examined by slit lamp, Schirmer's test I, TBUT and corneal sensitivity test were performed. RESULTS Our study revealed that increased prevalence in female sex with increased age group range from 51-70 years showed post cataract surgery period dryness of eye. The ratio of Post cataract surgery DED in male and female is 13:29. This shows increased female sex prevalence of postoperative DED. In our study, the prevalence of post cataract surgery dry eye disease was 30%. CONCLUSION 73% cataract surgeries is now clear corneal cataract surgery and this procedure cuts a large part of corneal nerves. The nerve essential for tear production gets disturbed leading to dryness and hence decreased visual function. The corneal nerves are important in self-regulation of tears since they provide the sensation in the feedback loop that signals tear production. When the functions of the nerves get blocked

  11. Combination Therapy of Intense Pulsed Light Therapy and Meibomian Gland Expression (IPL/MGX) Can Improve Dry Eye Symptoms and Meibomian Gland Function in Patients With Refractory Dry Eye: A Retrospective Analysis.

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    Vegunta, Sravanthi; Patel, Dharmendra; Shen, Joanne F

    2016-03-01

    To assess the improvement in meibomian gland function and dry eye symptoms in patients with refractory dry eye treated with a combination therapy of intense pulsed light (IPL) and meibomian gland expression (MGX). Medical records of 81 consecutive patients with dry eye treated with serial IPL/MGX were retrospectively examined to determine the outcome. All patients had a minimum of 6 months of follow-up after the first IPL/MGX treatment. Patients typically received 1 to 4 IPL treatments spaced 4 to 6 weeks apart. Each IPL session included MGX. Thirty-five charts had complete data for inclusion in analysis. We reviewed demographics, ocular histories, Standard Patient Evaluation of Eye Dryness 2 (SPEED2) symptom survey scores, slit-lamp examinations, and meibomian gland evaluations (MGE) at baseline and at each visit before IPL/MGX treatments. The paired t test showed a significant (P IPL/MGX therapy. Of the 35 patients, 8 (23%) had a ≥50% decrease in SPEED2, 23 (66%) had a 1% to 49% decrease in SPEED2, 1 (3%) had no change in SPEED2, and 3 (9%) had an increase in SPEED2. The Paired t test showed a significant increase in MGE in the left eye but not in the right eye (OD P = 0.163 and OS P = 0.0002). Thirteen patients (37%) had improved MGE bilaterally. Eight patients (23%) had either a decrease in MGE bilaterally or a decrease in 1 eye with no change in the other eye. This retrospective analysis shows that the combination of IPL and MGX can significantly improve dry eye symptoms (in 89% of patients) and meibomian gland function (in 77% of patients in at least 1 eye).

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

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    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. [Prevalence of dry eye in Hansen's disease patients from a colony hospital in Goiânia, Brazil].

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    Frazão, Karys Carvalho; Picolo, Naira Bernardes; Hanouche, Rosana Zacarias; Santos, Procópio Miguel dos; Santos, Regina Cândido Ribeiro dos

    2005-01-01

    To determine the prevalence of dry eye in Hansen's disease patients from the "Hospital de Dermatologia Sanitária de Goiânia". The sample of the present study included 70 patients with Hansen's disease, from the "Hospital de Dermatologia Sanitária de Goiânia", and 30 controls, from the "Fundação Banco de Olhos de Goiás", both located in Goiânia-GO, Brazil. Ophthalmologic examination and Schirmer I, break-up time (BUT) and rose Bengal staining tests were carried out for all patients in a single evaluation. For the diagnosis of dry eye the Schirmer I equal or less than 5 mm and rose Bengal grade II or III, in at least one eye were considered. Forty-four (63.0%) patients with Hansen's disease were male and 22 (73.3%) controls were female (p=0.001). The mean age of the patients with Hansen's disease was 61.1+/-12.5 years and in the control group, it was 55.7+/-9.6 years. Fifteen (21.4%) patients with Hansen's disease and four (13.3%) controls presented with dry eye diagnosis (p=0.429). The lepromatous type (74.2%) of Hansen's disease was the most prevalent and dry eye (66.7%) was more frequent in this clinical form of the disease. The dry eye disease was more prevalent in patients with Hansen's disease, although the difference was not statistically significant.

  14. 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

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

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    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

  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. Signs and Symptoms of Dry Eye in Keratoconus Patients Before and After Intrastromal Corneal Rings Surgery.

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    Carracedo, Gonzalo; Recchioni, Alberto; Alejandre-Alba, Nicolás; Martin-Gil, Alba; Batres, Laura; Morote, Ignacio Jimenez-Alfaro; Pintor, Jesús

    2017-04-01

    Based on the relationship between keratoconus and dry eye, the aim of this study was to evaluate changes in signs and symptoms of dry eye in keratoconus patients before and after intrastromal corneal ring surgery. Fifteen keratoconus patients were enrolled in Fundación Jiménez-Díaz of Madrid and University Clinic of Optometry of the Universidad Complutense de Madrid (Madrid, Spain). Tear break up time (TBUT), Schirmer test without anesthesia, corneal staining, diadenosine tetraphosphate (Ap4A) concentration, and ocular surface disease index (OSDI) were evaluated. Impression cytology combined with laser confocal microscopy was performed to evaluate goblet cell density, mucin cloud height (MCH), and cell layer thickness (CLT). All measurements were performed before (pre) surgery, 1 month (post) and 6 months after surgery (post6m). We found no statistical differences in time in Schirmer test, TBUT, and corneal staining. OSDI scores were 44.96  ±  8.65, 26.30 ± 6.79, and 19.31 ± 4.28 for (pre), (post), and (post6m) surgery, respectively (p keratoconus patients except for the MCH that increases drastically. More studies are needed to clarify the reason of its improvement.

  18. The Relationship Between Ocular Itch, Ocular Pain, and Dry Eye Symptoms (An American Ophthalmological Society Thesis).

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    Galor, Anat; Small, Leslie; Feuer, William; Levitt, Roy C; Sarantopoulos, Konstantinos D; Yosipovitch, Gil

    2017-08-01

    To evaluate associations between sensations of ocular itch and dry eye (DE) symptoms, including ocular pain, and DE signs. A cross-sectional study of 324 patients seen in the Miami Veterans Affairs eye clinic was performed. The evaluation consisted of questionnaires regarding ocular itch, DE symptoms, descriptors of neuropathic-like ocular pain (NOP), and evoked pain sensitivity testing on the forehead and forearm, followed by a comprehensive ocular surface examination including corneal mechanical sensitivity testing. Analyses were performed to examine for differences between those with and without subjective complaints of ocular itch. The mean age was 62 years with 92% being male. Symptoms of DE and NOP were more frequent in patients with moderate-severe ocular itch compared to those with no or mild ocular itch symptoms. With the exception of ocular surface inflammation (abnormal matrix metalloproteinase 9 testing) which was less common in those with moderate-severe ocular itch symptoms, DE signs were not related to ocular itch. Individuals with moderate-severe ocular itch also demonstrated greater sensitivity to evoked pain on the forearm and had higher non-ocular pain, depression, and post-traumatic stress disorders scores, compared to those with no or mild itch symptoms. Subjects with moderate-severe ocular itch symptoms have more severe symptoms of DE, NOP, non-ocular pain and demonstrate abnormal somatosensory testing in the form of increased sensitivity to evoked pain at a site remote from the eye, consistent with generalized hypersensitivity.

  19. 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.

  20. Effects of diquafosol tetrasodium administration on visual function in short break-up time dry eye.

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    Kaido, Minako; Uchino, Miki; Kojima, Takashi; Dogru, Murat; Tsubota, Kazuo

    2013-01-01

    To investigate the effect of diquafosol tetrasodium on tear and visual function in short break-up time (sBUT) dry eye (DE). This interventional nonrandomized comparative study involved 11 eyes in 11 patients with sBUT DE (symptom-positive sBUT group) and 13 eyes in 13 volunteers with BUT values ≤5 s without DE symptoms (symptom-negative sBUT group). Tear function was assessed by measuring BUT and Schirmer values. Serial measurements were made of visual acuities (using a functional visual acuity measurement system) and higher-order aberrations (using a wavefront sensor). The parameters were compared before and 1 month after diquafosol tetrasodium instillation. Any changes in symptomatology after administration were also recorded. After diquafosol tetrasodium administration, BUT values tended to increase in the symptom-positive sBUT group (P=0.07) and significantly increased in the symptom-negative sBUT group (P0.05). Diquafosol tetrasodium administration provided relief of DE symptoms in 75% of patients in the symptom-positive sBUT group. Diquafosol tetrasodium appeared to improve tear film stability and visual function in sBUT DE.

  1. Efficacy of Rebamipide Instillation for Contact Lens Discomfort With Dry Eye.

    Science.gov (United States)

    Igarashi, Tsutomu; Kobayashi, Maika; Yaguchi, Chiemi; Fujimoto, Chiaki; Suzuki, Hisaharu; Takahashi, Hiroshi

    2017-11-10

    To examine the effects of rebamipide ophthalmic solution on the symptoms, signs, and cytokine concentrations in tear fluid among soft contact lens (SCL) wearers with Dry eye disease (DED). From November 2015 to June 2017, this open-label, single-arm study examined 40 eyes of 20 SCL wearers with DED who had been using daily disposable SCLs for >3 months (mean age, 30.0±8.33 years; range, 20-47 years). Signs, symptoms, and cytokine concentrations were assessed before and 4 weeks after starting 2% rebamipide ophthalmic solution 4 times/day. Dry eye disease was diagnosed according to: compromised tear dynamics (Schirmer test ≤5 mm or tear break-up time (TBUT) ≤5 sec); ocular surface abnormalities (positive vital staining with fluorescein or lissamine green); and presence of symptoms. Touch thresholds using a Cochet-Bonnet anesthesiometer were also determined for the cornea and conjunctivae. Symptoms were assessed using the 12-item Ocular Surface Disease Index questionnaire. Concentrations of cytokines in tear fluid were measured. Significant improvements in signs were seen for TBUT, surface abnormalities, and touch thresholds. Ocular Surface Disease Index scores likewise improved significantly in all the 12 items. Of the cytokines measured, only interleukin-1β, interleukin-8, and monocyte chemotactic protein-1 were found in ≥60% of tear samples, with no significant differences in concentrations before and after rebamipide use. Rebamipide significantly improved all signs and symptoms in patients with DED who wore daily disposable SCLs. Rebamipide is effective for DED treatment with SCL wear.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  2. Possible association between subtypes of dry eye disease and seasonal variation

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    Ayaki M

    2017-09-01

    Full Text Available Masahiko Ayaki, Motoko Kawashima, Miki Uchino, Kazuo Tsubota, Kazuno Negishi Department of Ophthalmology, Keio University, Shinjuku, Tokyo, Japan Purpose: The purpose of this study was to evaluate the influence of seasons on the signs and symptoms of dry eye disease (DED. Methods: This is a cross-sectional, case-control study, and participants were non-DED subjects (n=1,916, mean age 54.4±14.4 years and DED patients (n=684, 54.2±12.1 years visiting six eye clinics at various practices and locations in Japan. We evaluated the signs and symptoms of DED and the seasons with the most severe results were compared to those with the least severe results in both groups. Main outcome measures were differences in the severity of the signs and symptoms of DED between the most and least severe seasons. Results: The majority of DED symptoms were most severe during spring and least severe in summer. Significant differences between these two seasons were found for irritation (P=0.001, pain (P=0.007, blurring (P=0.000, and photophobia (P=0.007 in the DED group. Superficial punctate keratopathy (P=0.001 and tear break-up time (BUT; P=0.000 results also indicated that DED was most severe in spring. In contrast, fewer patients had low Schirmer test results in spring, although this was not statistically significant (P=0.061. Conclusion: Our results demonstrated that the severity of DED is seasonal, which may explain the increase of short BUT-type DED cases observed in spring when air pollen counts are highest. Keywords: dry eye disease, seasonality, tear break-up time, cornea, ocular surface, tear production, hay fever, air pollen, allergic conjunctivitis

  3. Effectiveness of an Eyelid Thermal Pulsation Procedure to Treat Recalcitrant Dry Eye Symptoms After Laser Vision Correction.

    Science.gov (United States)

    Schallhorn, Craig S; Schallhorn, Julie M; Hannan, Stephen; Schallhorn, Steven C

    2017-01-01

    To provide an initial retrospective evaluation of the effectiveness of a thermal pulsation system to treat intractable patient-reported dye eye symptoms following laser vision correction. A total of 109 eyes of 57 patients underwent thermal pulsation therapy (LipiFlow; TearScience, Morrisville, NC) for the treatment of dry eye symptoms following laser vision correction. A standardized dry eye questionnaire, the Standard Patient Evaluation of Eye Dryness (SPEED II), was administered to all patients before and after thermal pulsation therapy. The primary outcome was patient-reported dry eye symptoms as measured by this questionnaire. The mean patient age was 49 years (interquartile range [IQR]: 38 to 60), 70% were female, and the primary refractive procedure was LASIK (n = 91, 83%) or photorefractive keratectomy (PRK) (n = 18, 17%). Patients underwent thermal pulsation therapy at a mean of 40.5 months (IQR: 27.6 to 55.0) after the primary procedure. The mean pre-therapy SPEED II questionnaire score was 17.5 (IQR: 14 to 21), with a reduced mean post-therapy score of 10.2 (IQR: 6 to 14; 95% confidence interval [CI]: 8.8 to 11.5, P < .001). Patients with PRK tended to report more improvement. At the follow-up clinical evaluation, objective improvements were noted in tear break-up time (+1.9 sec; 95% CI: 1.3 to 2.5), reduction in grade of meibomian gland dysfunction (-0.69; 95% CI: -0.54 to -0.84), and corneal staining (-0.74; 95% CI: -0.57 to -0.91). In this initial retrospective evaluation, a significant improvement in patient-reported dry eye symptoms was observed following thermal pulsation therapy. This treatment modality may have utility in the management of dry eye symptoms following laser vision correction, but further study is needed to define its role. [J Refract Surg. 2017;33(1):30-36.]. Copyright 2017, SLACK Incorporated.

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

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    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.

  5. Study on the epidemic trend and risk factors of dry eye among special crowd in Dezhou from 2011 to 2014

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    Jing Wang

    2016-05-01

    Full Text Available AIM:To analyze epidemiological characteristics of dry eye and the difference of prevalence in groups with different profession and ages to investigate the relevant risk factors so as to lay a scientific foundation for the diagnostics and treatment of dry eye. METHODS:Dry eye questionnaire and ocular examination were conducted to 8 145 common persons participating in social physical examinations in Dezhou Center for Disease Control and Prevention from February 2011 to November 2014. RESULTS:In the target population, 1 803 persons were suffering dry eye, accounting for 22.14%,the prevalence in female was higher than that in male,there was significant difference between genders(χ2=45.12,Pχ2=95.76,Pχ2=59.80,PCONCLUSION:Dry eye prevention and treatment are badly in need in Dezhou city; and the major clinical characteristics of the disease should be grasped to make a timely and accurate diagnosis and to conduct specific health education and behavior interventional measures to people with different occupations.

  6. Targeted delivery of hyaluronic acid to the ocular surface by a polymer-peptide conjugate system for dry eye disease.

    Science.gov (United States)

    Lee, David; Lu, Qiaozhi; Sommerfeld, Sven D; Chan, Amanda; Menon, Nikhil G; Schmidt, Tannin A; Elisseeff, Jennifer H; Singh, Anirudha

    2017-06-01

    Hyaluronic acid (HA) solutions effectively lubricate the ocular surface and are used for the relief of dry eye related symptoms. However, HA undergoes rapid clearance due to limited adhesion, which necessitates frequent instillation. Conversely, highly viscous artificial tear formulations with HA blur vision and interfere with blinking. Here, we developed an HA-eye drop formulation that selectively binds and retains HA for extended periods of time on the ocular surface. We synthesized a heterobifunctional polymer-peptide system with one end binding HA while the other end binding either sialic acid-containing glycosylated transmembrane molecules on the ocular surface epithelium, or type I collagen molecule within the tissue matrix. HA solution was mixed with the polymer-peptide system and tested on both ex vivo and in vivo models to determine its ability to prolong HA retention. Furthermore, rabbit ocular surface tissues treated with binding peptides and HA solutions demonstrated superior lubrication with reduced kinetic friction coefficients compared to tissues treated with conventional HA solution. The results suggest that binding peptide-based solution can keep the ocular surface enriched with HA for prolonged times as well as keep it lubricated. Therefore, this system can be further developed into a more effective treatment for dry eye patients than a standard HA eye drop. Eye drop formulations containing HA are widely used to lubricate the ocular surface and relieve dry eye related symptoms, however its low residence time remains a challenge. We designed a polymer-peptide system for the targeted delivery of HA to the ocular surface using sialic acid or type I collagen as anchors for HA immobilization. The addition of the polymer-peptide system to HA eye drop exhibited a reduced friction coefficient, and it can keep the ocular surface enriched with HA for prolonged time. This system can be further developed into a more effective treatment for dry eye than a

  7. Effect of different concentrations of sodium hyaluronate on the ocular surface change of dry eye in New Zealand rabbits

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    Shuang-Yong Wang

    2015-10-01

    Full Text Available AIM:To observe the effect of different concentrations of sodium hyaluronate on ocular surface change of dry eye. METHODS: New Zealand rabbits with dry eye was prepared and treated with 0.1% and 0.3% sodium hyaluronate drops fluid respectively, which were regarded as low concentration treatment group(group Band high concentration treatment group(group Crespectively. However, the rabbits treated with saline were regarded as control group(group A. And then, corneal fluorescein staining, Schirmer test, conjunctival goblet cells, mucin expression and histological changes were observed.RESULTS: On D7 and D14 after treatment, corneal fluorescein staining scores were lower in group B and group C than that in group A(PP PCONCLUSION: The sodium hyaluronate can improve ocular surface damage of dry eye in New Zealand rabbits. The high concentration of sodium hyaluronate has better effect than low concentration.

  8. Effect of rebamipide ophthalmic suspension on optical quality in the short break-up time type of dry eye.

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    Koh, Shizuka; Inoue, Yasushi; Sugmimoto, Toshiki; Maeda, Naoyuki; Nishida, Kohji

    2013-09-01

    To determine the effect of rebamipide ophthalmic suspension on optical quality in patients with dry eye with short break-up time (BUT) of the tear film. Twenty-six eyes of 16 patients with the short BUT type of dry eye were enrolled and treated with 2% rebamipide ophthalmic suspension. At baseline and at 2 and 4 weeks after initiating the treatment, the serial corneal higher-order aberrations (HOAs), BUT, fluorescein staining, and Schirmer test were measured. Patients were asked to complete questionnaires about the changes in dry eye-related ocular symptoms after the treatment. Before the treatment, the pattern of postblink corneal HOAs for 10 seconds showed a sawtooth pattern, with a marked upward curve that increased after blinking. Treatment with rebamipide for 4 weeks significantly (P < 0.05) improved the postblink corneal HOAs and stabilized the pattern of the corneal HOAs. Significant increases in the tear film BUT were seen 2 and 4 weeks after the treatment (P < 0.001 for both comparisons). Rebamipide administered to treat the short BUT type of dry eye significantly improved optical quality because of the improvement in tear stability.

  9. Combination therapy with diquafosol tetrasodium and sodium hyaluronate in patients with dry eye after laser in situ keratomileusis.

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    Toda, Ikuko; Ide, Takeshi; Fukumoto, Teruki; Ichihashi, Yoshiyuki; Tsubota, Kazuo

    2014-03-01

    To evaluate the possible advantages of combination therapy with diquafosol tetrasodium and sodium hyaluronate for dry eye after laser in situ keratomileusis (LASIK). Prospective randomized comparative trial. A total of 206 eyes of 105 patients who underwent LASIK were enrolled in this study. Patients were randomly assigned to 1 of 4 treatment groups according to the postoperative treatment: artificial tears, sodium hyaluronate, diquafosol tetrasodium, and a combination of hyaluronate and diquafosol. Questionnaire responses reflecting subjective dry eye symptoms, uncorrected and corrected visual acuity, functional visual acuity, manifest refraction, tear break-up time, fluorescein corneal staining, Schirmer test, and corneal sensitivity were examined before and 1 week and 1 month after LASIK. Distance uncorrected visual acuity was significantly better in the combination group than in the hyaluronate group 1 week and 1 month after LASIK. Near uncorrected visual acuity was significantly better in the combination group than in the artificial tear and diquafosol groups 1 week and 1 month after LASIK. Distance functional visual acuity improved significantly only in the combination group 1 month after LASIK. The Schirmer value in the combination group was significantly higher than that in the hyaluronate group at 1 month after LASIK. Subjective dry eye symptoms in the combination group improved significantly compared with those in the other groups 1 week after surgery. Our results suggest that hyaluronate and diquafosol combination therapy is beneficial for early stabilization of visual performance and improvement of subjective dry eye symptoms in patients after LASIK. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Lifitegrast ophthalmic solution in the treatment of signs and symptoms of dry eye disease: design, development, and place in therapy.

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    Godin, Morgan R; Gupta, Preeya K

    2017-01-01

    A new topical ophthalmic medication, lifitegrast 5%, was recently approved by the US Food and Drug Administration for use in dry eye patients. Lifitegrast is an integrin antagonist that decreases inflammation on the ocular surface, thereby improving dry eye disease (DED). Through a series of prospective, multicenter, randomized, masked, placebo-controlled studies in >2,000 patients total, lifitegrast was shown to be effective for improvement in both the signs and symptoms of DED. A subsequent study focused on the safety profile of lifitegrast and demonstrated that the majority of adverse events were mild and resolved over time. Lifitegrast is now available for use in clinical practice.

  11. Change in Prostaglandin Expression Levels and Synthesizing Activities in Dry Eye Disease

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    Shim, Jongwoo; Park, Changhun; Lee, Hyun Soo; Park, Min Soo; Lim, Hyung Taek; Chauhan, Sunil; Dana, Reza; Lee, Hyon; Lee, Hyung Keun

    2013-01-01

    Objective To investigate the expression level of prostaglandins (PGs) and their de novo synthesis in dry eye (DE) disease. Design Cross-sectional case-control study and in vivo mouse experimental study. Participants Forty-six eyes from 23 DE patients and 33 eyes from 17 age- and sex-matched controls were studied. Also, DE-induced murine eyes were compared with control eyes. Methods Patients completed a symptom questionnaire using a 100-mm visual analog scale (VAS). Nanoliquid chromatography tandem mass spectrometry was used for the quantification of PGE2 and PGD2. A DE disease environmental chamber was used to induce DE in mice. One week after induction, enzyme expressions of cyclooxygenase-1, cyclooxygenase-2 (COX-2), PG E synthase (PGES), and PG D synthase (PGDS) in the lacrimal glands, meibomian glands, and corneas were examined using immunohistochemistry and quantitative real-time polymerase chain reaction (qRT-PCR). Main Outcome Measures The mean PGE2 and PGD2 levels in the tears of DE patients were measured and compared with symptom severity scores. Immunohistochemistry staining patterns and qRT-PCR data of DE mice were quantified. Results The mean PGE2 level in the tears of DE patients (2.72±3.42 ng/ml) was significantly higher than that in the control group (0.88±0.83 ng/ml; P = 0.003). However, the mean PGD2 level in the tears of DE patients (0.11 ±0.22 ng/ml) was significantly lower (0.91 ±3.28 ng/ml; P = 0.028). The mean PGE2-to-PGD2 ratio correlated strongly with VAS scoring (P = 0.008). In DE mice, COX-2 mRNA was significantly higher in ocular surface tissue and lacrimal glands. Furthermore, PGES mRNA was significantly higher in ocular surface tissue, whereas PGDS mRNA was decreased. Immunohistochemistry staining showed elevated COX-2 expression in the lacrimal glands, meibomian glands, corneas, and conjunctivas. Furthermore, PGES expression was found in periductal infiltrated cells of the lacrimal glands and conjunctival epithelium. Also, PGDS

  12. Lifitegrast, a Novel Integrin Antagonist for Treatment of Dry Eye Disease.

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    Perez, Victor L; Pflugfelder, Stephen C; Zhang, Steven; Shojaei, Amir; Haque, Reza

    2016-04-01

    The etiology of dry eye disease (DED) is complex and not yet fully understood, but the disease is now recognized as being associated with ocular surface inflammation. The latest advances in the understanding of the pathophysiology of DED have directed the focus of recent drug development to target the inflammatory pathways involved in the disease. Lifitegrast is a novel small molecule integrin antagonist that inhibits T cell-mediated inflammation by blocking the binding of two important cell surface proteins (lymphocyte function-associated antigen 1 and intercellular adhesion molecule 1), thus lessening overall inflammatory responses. This review highlights the role of T cells and integrins in the inflammatory process involved in the pathophysiology of DED and outlines the scientific rationale for the role of lifitegrast. In addition, the preclinical development, pharmacological properties, clinical efficacy, and safety of lifitegrast are described. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  13. Cold-Sensitive Corneal Afferents Respond to a Variety of Ocular Stimuli Central to Tear Production: Implications for Dry Eye Disease

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    Hirata, Harumitsu; Meng, Ian D.

    2010-01-01

    Innocuous “cold” cornea afferents were excited by the ocular stimuli (drying, cooling, evaporation, and hyperosmolar stress of the cornea) that normally produce tears. Dysfunction of these corneal afferents may be responsible for some forms of dry eye.

  14. Morphological Alterations of the Palpebral Conjunctival Epithelium in a Dry Eye Model

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    Henriksson, Johanna Tukler; De Paiva, Cintia S.; Farley, William; Pflugfelder, Stephen C.; Burns, Alan R.; Bergmanson, Jan P.G.

    2012-01-01

    Purpose To investigate the normal palpebral conjunctival histology in C57BL/6 mice, and the structural changes that occur in a dry eye model. Methods 24 male and female C57BL/6 mice, 8 untreated (UT) and 16 exposed to experimental ocular surface desiccating stress (DS). Ocular dryness was induced by administration of scopolamine hydrobromide (0.5 mg/0.2 ml) QID for 5 (DS5) or 10 (DS10) days. Counts and measurements were obtained using anatomical reference points and goblet cell density was investigated with a variety of stains. Results Near the junction between the lid margin and the normal palpebral conjunctiva, the epithelium had an average thickness of 45.6±10.5μm, 8.8±2.0 cell layers, versus 37.7±5.6μm, 7.4±1.3 layers in DS10 (P<0.05). In the goblet cell populated palpebral region the normal epithelium was thicker (P<0.05) than in DS5 and DS10. In the control, 43% of the goblet cells were covered by squamous epithelium, compared to 58% (DS5) and 63% (DS10) (P<0.05). A decreased number of Periodic Acid Schiff (PAS) and Alcian blue stained goblet cells was observed in the dry eye. Not all goblet cells stained with PAS and Alcian blue. Conclusions The mouse palpebral conjunctival epithelium was structurally similar to the human. After DS the palpebral conjunctival epithelium decreased in thickness and goblet cell access to the surface appeared to be inhibited by surrounding epithelial cells, potentially slowing down their migration to the surface. Differential staining with PAS and Alcian blue suggests there may be different subtypes of conjunctival goblet cells. PMID:23146932

  15. The Pathophysiology of Dry Eye Disease: What We Know and Future Directions for Research.

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    Pflugfelder, Stephen C; de Paiva, Cintia S

    2017-11-01

    Clinical and laboratory studies performed over the past few decades have discovered that dry eye is a chronic inflammatory disease that can be initiated by numerous extrinsic or intrinsic factors that promote an unstable and hyperosmolar tear film. These changes in tear composition, in some cases combined with systemic factors, lead to an inflammatory cycle that causes ocular surface epithelial disease and neural stimulation. Acute desiccation activates stress signaling pathways in the ocular surface epithelium and resident immune cells. This triggers production of innate inflammatory mediators that stimulate the production of matrix metalloprotease, inflammatory cell recruitment, and dendritic cell maturation. These mediators, combined with exposure of autoantigens, can lead to an adaptive T cell-mediated response. Cornea barrier disruption develops by protease-mediated lysis of epithelial tight junctions, leading to accelerated cell death; desquamation; an irregular, poorly lubricated cornea surface; and exposure and sensitization of epithelial nociceptors. Conjunctival goblet cell dysfunction and death are promoted by the T helper 1 cytokine interferon gamma. These epithelial changes further destabilize the tear film, amplify inflammation, and create a vicious cycle. Cyclosporine and lifitegrast, the 2 US Food and Drug Administration-approved therapies, inhibit T-cell activation and cytokine production. Although these therapies represent a major advance in dry eye therapy, they are not effective in improving discomfort and corneal epithelial disease in all patients. Preclinical studies have identified other potential therapeutic targets, biomarkers, and strategies to bolster endogenous immunoregulatory pathways. These discoveries will, it is hoped, lead to further advances in diagnostic classification and treatment. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  16. 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.

  17. Expression Profiling of Nonpolar Lipids in Meibum From Patients With Dry Eye: A Pilot Study.

    Science.gov (United States)

    Chen, Jianzhong; Keirsey, Jeremy K; Green, Kari B; Nichols, Kelly K

    2017-04-01

    The purpose of this investigation was to characterize differentially expressed lipids in meibum samples from patients with dry eye disease (DED) in order to better understand the underlying pathologic mechanisms. Meibum samples were collected from postmenopausal women with DED (PW-DED; n = 5) and a control group of postmenopausal women without DED (n = 4). Lipid profiles were analyzed by direct infusion full-scan electrospray ionization mass spectrometry (ESI-MS). An initial analysis of 145 representative peaks from four classes of lipids in PW-DED samples revealed that additional manual corrections for peak overlap and isotopes only slightly affected the statistical analysis. Therefore, analysis of uncorrected data, which can be applied to a greater number of peaks, was used to compare more than 500 lipid peaks common to PW-DED and control samples. Statistical analysis of peak intensities identified several lipid species that differed significantly between the two groups. Data from contact lens wearers with DED (CL-DED; n = 5) were also analyzed. Many species of the two types of diesters (DE) and very long chain wax esters (WE) were decreased by ∼20% in PW-DED, whereas levels of triacylglycerols were increased by an average of 39% ± 3% in meibum from PW-DED compared to that in the control group. Approximately the same reduction (20%) of similar DE and WE was observed for CL-DED. Statistical analysis of peak intensities from direct infusion ESI-MS results identified differentially expressed lipids in meibum from dry eye patients. Further studies are warranted to support these findings.

  18. Extraorbital lacrimal gland excision: a reproducible model of severe aqueous tear-deficient dry eye disease.

    Science.gov (United States)

    Stevenson, William; Chen, Yihe; Lee, Sang-Mok; Lee, Hyun Soo; Hua, Jing; Dohlman, Thomas; Shiang, Tina; Dana, Reza

    2014-12-01

    The aim of this study was to establish and characterize extraorbital lacrimal gland excision (LGE) as a model of aqueous tear-deficient dry eye disease in mice. Female C57BL/6 mice at 6 to 8 weeks of age were randomized to extraorbital LGE, sham surgery, or scopolamine groups. Mice that underwent extraorbital LGE or sham surgery were housed in the standard vivarium. Scopolamine-treated mice were housed in a controlled environment chamber that allowed for the continuous regulation of airflow (15 L/min), relative humidity (30%), and temperature (21-23°C). Clinical disease severity was assessed over the course of 14 days using the phenol red thread test and corneal fluorescein staining. Real-time polymerase chain reaction was performed to assess corneal mRNA expression of interleukin 1β, tumor necrosis factor α, and matrix metalloproteinase 9. Flow cytometry was used to assess T helper cell frequencies in the conjunctivae and draining lymph nodes. Extraorbital LGE markedly reduced aqueous tear secretion as compared with the sham procedure and induced a more consistent decrease in aqueous tear secretion than was observed in mice that received scopolamine while housed in the controlled environment chamber. Extraorbital LGE significantly increased corneal fluorescein staining scores as compared with those of both the sham surgery and scopolamine-treated groups. Extraorbital LGE significantly increased the corneal expression of interleukin 1β, tumor necrosis factor α, and matrix metalloproteinase 9. Further, extraorbital LGE increased T helper 17-cell frequencies in the conjunctivae and draining lymph nodes. Extraorbital LGE induces aqueous tear-deficient dry eye disease in mice as evidenced by decreased aqueous tear secretion, increased corneal epitheliopathy, and induced ocular surface inflammation and immunity.

  19. The Effect of Dry Eye Disease on Scar Formation in Rabbit Glaucoma Filtration Surgery

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    Hong Ji

    2017-05-01

    Full Text Available The success rate of glaucoma filtration surgery is closely related to conjunctival inflammation, and the main mechanism of dry eye disease (DED is inflammation. The aim of this study was to evaluate the effect of DED on bleb scar formation after rabbit glaucoma filtration surgery. Sixteen New Zealand white rabbits were randomly divided into control and DED groups. A DED model was induced by twice-daily topical administration of 0.1% benzalkonium chloride (BAC drops for three weeks. Ocular examinations were performed to verify the DED model. Surgical effects were assessed, and histologic assessments were performed on the 28th postoperative day. Higher fluorescein staining scores, lower basal tear secretion levels and goblet cell counts, and increased interleukin 1β (IL-1β levels were observed in the DED group. The DED eyes displayed significantly higher intraocular pressure (IOP% on the 14th postoperative day; a smaller bleb area on days 14, 21 and 28; and a shorter bleb survival time. Moreover, proliferating cell nuclear antigen (PCNA and alpha-smooth muscle actin (α-SMA levels were significantly increased in the DED group. These results demonstrate that DED promotes filtering bleb scar formation and shortens bleb survival time; these effects may be mediated via IL-1β.

  20. Sleep and mood disorders in dry eye disease and allied irritating ocular diseases.

    Science.gov (United States)

    Ayaki, Masahiko; Kawashima, Motoko; Negishi, Kazuno; Kishimoto, Taishiro; Mimura, Masaru; Tsubota, Kazuo

    2016-03-01

    The aim of the present study was to evaluate sleep and mood disorders in patients with irritating ocular diseases. The study design was a cross-sectional/case-control study conducted in six eye clinics. Out of 715 outpatients diagnosed with irritating ocular surface diseases and initially enrolled, 301 patients with dry eye disease (DED) and 202 age-matched control participants with other ocular surface diseases were analyzed. The mean Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) scores were 6.4 ± 3.2 and 11.1 ± 5.7 for severe DED (n = 146), 5.5 ± 3.3 and 9.8 ± 4.0 for mild DED (n = 155), 5.5 ± 3.1 and 9.5 ± 6.6 for chronic conjunctivitis (n = 124), and 5.0 ± 3.3 and 8.9 ± 5.3 for allergic conjunctivitis (n = 78). There were significant differences among these diagnostic groups for PSQI (P sleep quality in patients with DED is significantly worse than in patients with other irritating ocular surface diseases and it is correlated with the severity of DED.

  1. Effects of dry eye therapies on environmentally induced ocular surface disease

    Science.gov (United States)

    Moore, Quianta L.; De Paiva, Cintia S.; Pflugfelder, Stephen C.

    2015-01-01

    PURPOSE To evaluate the effectiveness of artificial tears and corticosteroids on mitigating the acute ocular surface response to low humidity environments. DESIGN Single-group, crossover clinical trial. METHODS Twenty subjects with aqueous deficient dry eye were enrolled. Subjects meeting inclusion criteria at visit 1 and were exposed to a baseline 90-minute low humidity environment at visit 2. They then used artificial tears for 2 weeks prior to low humidity exposure at visit 3, followed by 0.1% dexamethasone for two weeks prior to the final low humidity exposure at visit 4. Outcome measures included corneal and conjunctival staining, blink rate and irritation symptoms before and after each low humidity exposure. Digital polymerase chain reaction (PCR) was performed to measure HLA-DR RNA transcripts in conjunctival cells taken by impression cytology at each visit. RESULTS There was significantly less corneal and conjunctival epitheliopathy after the low humidity exposure at visit 4 compared to after the low humidity exposure at visit 3 (p= 0.003). Subjects reported significantly less eye irritation during the low humidity exposure after using the dexamethasone (visit 4) compared to artificial tears (visit 3) (p=0.01). HLA-DR transcripts significantly decreased after the stress at visit 4 (post dexamethasone) compared to visit 2. CONCLUSION Our study demonstrates corticosteroid eye drops mitigate the acute adverse effects of an experimental low humidity challenge, likely due to suppression of stress-activated inflammatory pathways. While extended use of corticosteroids is not indicated, other anti-inflammatory therapies with activity against stress-activated pathways may prove as effective. PMID:25868759

  2. 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.

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

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    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

  4. Dry eye disease and uveitis: A closer look at immune mechanisms in animal models of two ocular autoimmune diseases.

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    Bose, Tanima; Diedrichs-Möhring, Maria; Wildner, Gerhild

    2016-12-01

    Understanding the immunopathogenesis of autoimmune and inflammatory diseases is a prerequisite for specific and effective therapeutical intervention. This review focuses on animal models of two common ocular inflammatory diseases, dry eye disease (DED), affecting the ocular surface, and uveitis with inflammation of the inner eye. In both diseases autoimmunity plays an important role, in idiopathic uveitis immune reactivity to intraocular autoantigens is pivotal, while in dry eye disease autoimmunity seems to play a role in one subtype of disease, Sjögren' syndrome (SjS). Comparing the immune mechanisms underlying both eye diseases reveals similarities, and significant differences. Studies have shown genetic predispositions, T and B cell involvement, cytokine and chemokine signatures and signaling pathways as well as environmental influences in both DED and uveitis. Uveitis and DED are heterogeneous diseases and there is no single animal model, which adequately represents both diseases. However, there is evidence to suggest that certain T cell-targeting therapies can be used to treat both, dry eye disease and uveitis. Animal models are essential to autoimmunity research, from the basic understanding of immune mechanisms to the pre-clinical testing of potential new therapies. Copyright © 2016 Elsevier B.V. All rights reserved.

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

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    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 tear film characteristics, reverse ocular surface features, and alleviate the subjective symptoms associated with dry eye syndrome in patients with type 2 diabetes.

  6. Lifitegrast ophthalmic solution in the treatment of signs and symptoms of dry eye disease: design, development, and place in therapy

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    Godin MR

    2017-05-01

    Full Text Available Morgan R Godin, Preeya K Gupta Department of Ophthalmology, Division of Cornea and Refractive Surgery, Duke University Eye Center, Durham, NC, USA Abstract: A new topical ophthalmic medication, lifitegrast 5%, was recently approved by the US Food and Drug Administration for use in dry eye patients. Lifitegrast is an integrin antagonist that decreases inflammation on the ocular surface, thereby improving dry eye disease (DED. Through a series of prospective, multicenter, randomized, masked, placebo-controlled studies in >2,000 patients total, lifitegrast was shown to be effective for improvement in both the signs and symptoms of DED. A subsequent study focused on the safety profile of lifitegrast and demonstrated that the majority of adverse events were mild and resolved over time. Lifitegrast is now available for use in clinical practice. Keywords: OPUS-1, OPUS-2, OPUS-3, SONATA, LFA-1, ICAM-1, OSDI, ocular surface

  7. Predictive factors for the placebo effect in clinical trials for dry eye: a pooled analysis of three clinical trials.

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    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 panalysis 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.

  8. Corneal sensitivity, ocular surface health and tear film stability after punctal plug therapy of aqueous deficient dry eye

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    Azza Mohamed Ahmed Said

    2016-11-01

    Full Text Available AIM: To evaluate the effect of punctal occlusion using thermosensitive (smart plug versus silicone plug for management of aqueous deficient dry eye on corneal sensitivity, ocular surface health and tear film stability. METHODS: A comparative prospective interventional case study included 45 patients with bilateral severe form of aqueous deficient dry eye. In each patient, the smart plug was inserted in the lower punctum of the right eye which was considered as study group 1 and silicone plug was inserted in the lower punctum of the left eye of the same patient which was considered as study group 2. All patients were subjected to careful history taking and questionnaire for subjective assessment of severity of symptoms. Corneal sensitivity, corneal fluorescein, rose bengal staining, Schirmer’s I test, tear film break up time and conjunctival impression cytology were performed pre and 1, 3 and 6mo post plug insertion. RESULTS: A statistically significant improvement in subjective and objective manifestations occurred following treatment with both types of plugs (P<0.01. The thermosensitive plug caused significant overall improvement, decrease in frequency of application of tear substitutes and improvement of conjunctival impression cytology parameters in the inserted side (P<0.01. Canaliculitis was reported in two eyes (4.4% following punctal occlusion using thermosensitive plug (study group 1. Spontaneous plug loss occurred in 21 eyes (46.6% in the silicone plug group (study group 2. CONCLUSION: Improvement of subjective and objective manifestations of aqueous deficient dry eye occurs following punctal plug occlusion. Thermosensitive plug has good patient's compliance with fewer complications and lower rates of loss compared to the silicone plug.

  9. The tear substitutive therapy for prophylaxis and treatment of dry eye after cataract surgery

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    V. N. Trubilin

    2013-01-01

    Full Text Available Purpose: To study the efficiency of tear substitutes based on hyaluronic acid at the patients after phacoemulsification for prophylaxis and postoperative therapy of dry eye syndrome.Methods: 168 patients (168 eyes were examined before cataract surgery. The average age was 69.2±5.7 years old. Patients were divided into four groups according to the presence of eye dry syndrome and following tear substitutive therapy. 55 patients with a mild case of DES (the first group were treated with Vismed® eye drops 1 drop given 3 times a day for 1 week before surgery and postoperatively. 10 patients with a moderate case of DES (second group were treated with Vismed gel® to use with the same periodicity. Patients without DES were divided into two groups: 50 of them (third group were treated to use Vismed® 1 drop 3 times a day postoperatively, the rest 53 didn’t undergo the course of treatment — «checkout group». The observation period was 45 days after operation. The study of tear secretion and osmolarity of tear fluid was performed before and after operative period.Results: 65 patients were first diagnosed a mild or moderate case of DES. On the third day after operation every group showed the increase of tear osmolarity, it was especially noticable among the patients of «checkout group» from 294 to 314 mOsm / l at the average. On the seventh day after operation all groups showed further negative dynamics, and in the «checkout» group comparing to initial indices was registered noticable worsening of the studied parameters (р≤0.05. By the 14th day after phacoemulsification patients from the 1st and the 3rd groups displayed the tendency to restoration of indices to the preoperative values. Indices of osmolarity and tear secretion restored among the patients from the 1st and the 2nd groups by the 21st day and even improved in comparison to the preoperative values of group 3. Meanwhile, «checkout» group’s indices fell to a level

  10. Oral administration of royal jelly restores tear secretion capacity in rat blink-suppressed dry eye model by modulating lacrimal gland function.

    Science.gov (United States)

    Imada, Toshihiro; Nakamura, Shigeru; Kitamura, Naoki; Shibuya, Izumi; Tsubota, Kazuo

    2014-01-01

    Tears are secreted from the lacrimal gland (LG), a dysfunction in which induces dry eye, resulting in ocular discomfort and visual impairment. Honey bee products are used as a nutritional source in daily life and medicine; however, little is known about their effects on dry eye. The aim of the present study was to investigate the effects of honey bee products on tear secretion capacity in dry eye. We selected raw honey, propolis, royal jelly (RJ), pollen, or larva from commercially available honey bee products. Tear secretion capacity was evaluated following the oral administration of each honey bee product in a rat blink-suppressed dry eye model. Changes in tear secretion, LG ATP content, and LG mitochondrial levels were measured. RJ restored the tear secretion capacity and decrease in LG ATP content and mitochondrial levels to the largest extent. Royal jelly can be used as a preventative intervention for dry eye by managing tear secretion capacity in the LG.

  11. Oral administration of royal jelly restores tear secretion capacity in rat blink-suppressed dry eye model by modulating lacrimal gland function.

    Directory of Open Access Journals (Sweden)

    Toshihiro Imada

    Full Text Available Tears are secreted from the lacrimal gland (LG, a dysfunction in which induces dry eye, resulting in ocular discomfort and visual impairment. Honey bee products are used as a nutritional source in daily life and medicine; however, little is known about their effects on dry eye. The aim of the present study was to investigate the effects of honey bee products on tear secretion capacity in dry eye. We selected raw honey, propolis, royal jelly (RJ, pollen, or larva from commercially available honey bee products. Tear secretion capacity was evaluated following the oral administration of each honey bee product in a rat blink-suppressed dry eye model. Changes in tear secretion, LG ATP content, and LG mitochondrial levels were measured. RJ restored the tear secretion capacity and decrease in LG ATP content and mitochondrial levels to the largest extent. Royal jelly can be used as a preventative intervention for dry eye by managing tear secretion capacity in the LG.

  12. Risk of dry eye syndrome in patients treated with whole-brain radiotherapy.

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    Nanda, Tavish; Wu, Cheng-Chia; Campbell, Ashley A; Bathras, Ryan M; Jani, Ashish; Kazim, Michael; Wang, Tony J C

    2017-08-04

    With improvements in systemic therapy, patients with cancer treated with whole-brain radiotherapy (WBRT) are living long enough to develop late toxicities, including dry eye syndrome. In general practice, dose to the lacrimal gland (LG) is not constrained (maximum constraint <40 Gy) in WBRT. The purpose of this study was to measure dose to the LG in WBRT and determine methods for reducing radiation exposure. We conducted a retrospective review of 70 3-dimensional (3D) conformal plans; thirty-six plans with a radiation prescription of 30 Gy in 10 fractions and 34 plans with a prescription of 37.5 Gy in 15 fractions. LGs were contoured in accordance with Freedman and Sidani (2015). Biological effective dose (BED)3 maximum constraints were calculated from 40 Gy and 20 Gy to be 32.17 Gy (30 Gy) and 36.70 Gy (37.5 Gy). Both regimens demonstrated supraorbital blocking by 3 methods: T1, bordering the supraorbital ridge; T2, no contact with supraorbital ridge; and T3, coverage of the supraorbital ridge. Mean dose for the plans with a 30-Gy prescription and the plans with a 37.5-Gy prescription was 27.5 Gy and 35.2 Gy, respectively (p ≤ 0.0001). BED3 maximum constraint (Dmax) was violated 16 of 26 (61.5%) in T1 (average Dmax: 32.2 Gy), 13 of 28 (46.4%) in T2 (average Dmax: 32.1 Gy), and 5 of 18 (27.8%) in T3 (average Dmax: 31.8 Gy) for the 30-Gy prescription. Dmax was violated in 32 of 32 (100%) in T1 (average Dmax: 40.1 Gy), 22 of 22 (100%) in T2 (average Dmax: 40.3 Gy), and 14 of 14 (100%) in T3 (average Dmax: 39.4) for the 37.5 Gy prescription. Average Dmax for the 37.5-Gy prescription was highly significant in favor of T3 (p = 0.0098). Patients who receive WBRT may develop dry eye syndrome as a late toxicity. Constraints are commonly violated with a prescription of 37.5 Gy. Methods to reduce dose include T3 supraorbital blocking, an easily implementable change that may dramatically improve patient quality of life. Copyright © 2017

  13. Sex differences in the effect of aging on dry eye disease

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    Ahn JH

    2017-08-01

    Full Text Available Jong Ho Ahn,1 Yoon-Hyeong Choi,2 Hae Jung Paik,1 Mee Kum Kim,3 Won Ryang Wee,3 Dong Hyun Kim1 1Department of Ophthalmology, Gachon University Gil Medical Center, 2Department of Preventive Medicine, Gachon University College of Medicine, Incheon, 3Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea Purpose: Aging is a major risk factor in dry eye disease (DED, and understanding sexual differences is very important in biomedical research. However, there is little information about sex differences in the effect of aging on DED. We investigated sex differences in the effect of aging and other risk factors for DED.Methods: This study included data of 16,824 adults from the Korea National Health and Nutrition Examination Survey (2010–2012, which is a population-based cross-sectional survey. DED was defined as the presence of frequent ocular dryness or a previous diagnosis by an ophthalmologist. Basic sociodemographic factors and previously known risk factors for DED were included in the analyses. Linear regression modeling and multivariate logistic regression modeling were used to compare the sex differences in the effect of risk factors for DED; we additionally performed tests for interactions between sex and other risk factors for DED in logistic regression models.Results: In our linear regression models, the prevalence of DED symptoms in men increased with age (R=0.311, P=0.012; however, there was no association between aging and DED in women (P>0.05. Multivariate logistic regression analyses showed that aging in men was not associated with DED (DED symptoms/diagnosis: odds ratio [OR] =1.01/1.04, each P>0.05, while aging in women was protectively associated with DED (DED symptoms/diagnosis: OR =0.94/0.91, P=0.011/0.003. Previous ocular surgery was significantly associated with DED in both men and women (men/women: OR =2.45/1.77 [DED symptoms] and 3.17/2.05 [DED diagnosis], each P<0.001. Tests for

  14. Regarding the influence of sex and aging on dry eye disease

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    Han SB

    2017-09-01

    Full Text Available Sang Beom HanDepartment of Ophthalmology, Kangwon National University Hospital, Kangwon National University Graduate School of Medicine, Chuncheon, Republic of KoreaI read with great interest the article by Ahn et al1 entitled “Sex differences in the effect of aging on dry eye disease”, in which the authors revealed the sex differences in the effect of aging on dry eye disease (DED in Korean adult population. They also showed the differences in patterns of DED following ocular surgery according to sex.1 The large population-based cross-sectional study was undoubtfully well designed and conducted, and suggests that matching of age and sex is recommended in further researches on DED.1However, I would like to point out that there exist controversies regarding the effect of aging and sex on DED. Our previous study showed that age had no significant association with the prevalence of DED in adults of 65 years or older, while female sex was significantly related to increased prevalence of DED.2 By contrast, studies in the US demonstrated that prevalence of DED increased with aging both in male and female populations.3,4 Moreover, there are differences in pathophysiology of DED according to age. Although dysfunction of lacrimal and meibomian glands may play an important role in the pathogenesis of DED in the elderly, DED associated with visual display terminal use or contact lens wear is more common in young and middle-aged patients.5 Therefore, I believe these differences in the pathogenesis should be considered in the evaluation of the effects of sex and aging on DED.Authors' replyJong Ho Ahn,1 Yoon-Hyeong Choi,2 Hae Jung Paik,1 Mee Kum Kim,3 Won Ryang Wee,3 Dong Hyun Kim11Department of Ophthalmology, Gachon University Gil Medical Center, 2Department of Preventive Medicine, Gachon University College of Medicine, Incheon, 3Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South KoreaWe thank the author for taking a

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

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    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

  16. Development of lifitegrast: a novel T-cell inhibitor for the treatment of dry eye disease

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    Semba CP

    2016-06-01

    Full Text Available Charles P Semba,1 Thomas R Gadek2 1Vascular and Interventional Radiology, Stanford University School of Medicine, Stanford, CA, USA; 2Ophthalma Logic Consulting, Park City, UT, USA Abstract: Dry eye disease (DED is a multifactorial disorder of the ocular surface characterized by symptoms of discomfort, decreased tear quality, and chronic inflammation that affects an estimated 20 million patients in the US alone. DED is associated with localized inflammation of the ocular surface and periocular tissues leading to homing and activation of T cells, cytokine release, and development of hyperosmolar tears. This inflammatory milieu results in symptoms of eye dryness and discomfort. Homing of T cells to the ocular surface is influenced by the binding of lymphocyte function-associated antigen-1 (LFA-1; CD11a/CD18; αLβ2, a cell surface adhesion protein, to its cognate ligand, intercellular adhesion molecule-1 (ICAM-1; CD54, which is expressed on inflamed ocular/periocular epithelium and vascular endothelium. LFA-1/ICAM-1 binding within the immunologic synapse enables both T-cell activation and cytokine release. Lifitegrast is a novel T-cell integrin antagonist that is designed to mimic the binding epitope of ICAM-1. It serves as a molecular decoy to block the binding of LFA-1/ICAM-1 and inhibits the downstream inflammatory process. In vitro studies have demonstrated that lifitegrast inhibits T-cell adhesion to ICAM-1-expressing cells and inhibits secretion of pro-inflammatory cytokines including interferon gamma, tumor necrosis factor alpha, macrophage inflammatory protein 1 alpha, interleukin (IL-1α, IL-1β, IL-2, IL-4, and IL-6, all of which are known to be associated with DED. Lifitegrast has the potential to be the first pharmaceutical product approved in the US indicated for the treatment of both symptoms and signs of DED. Clinical trials involving over 2,500 adult DED patients have demonstrated that topically administered lifitegrast 5

  17. Development of lifitegrast: a novel T-cell inhibitor for the treatment of dry eye disease.

    Science.gov (United States)

    Semba, Charles P; Gadek, Thomas R

    2016-01-01

    Dry eye disease (DED) is a multifactorial disorder of the ocular surface characterized by symptoms of discomfort, decreased tear quality, and chronic inflammation that affects an estimated 20 million patients in the US alone. DED is associated with localized inflammation of the ocular surface and periocular tissues leading to homing and activation of T cells, cytokine release, and development of hyperosmolar tears. This inflammatory milieu results in symptoms of eye dryness and discomfort. Homing of T cells to the ocular surface is influenced by the binding of lymphocyte function-associated antigen-1 (LFA-1; CD11a/CD18; αLβ2), a cell surface adhesion protein, to its cognate ligand, intercellular adhesion molecule-1 (ICAM-1; CD54), which is expressed on inflamed ocular/periocular epithelium and vascular endothelium. LFA-1/ICAM-1 binding within the immunologic synapse enables both T-cell activation and cytokine release. Lifitegrast is a novel T-cell integrin antagonist that is designed to mimic the binding epitope of ICAM-1. It serves as a molecular decoy to block the binding of LFA-1/ICAM-1 and inhibits the downstream inflammatory process. In vitro studies have demonstrated that lifitegrast inhibits T-cell adhesion to ICAM-1-expressing cells and inhibits secretion of pro-inflammatory cytokines including interferon gamma, tumor necrosis factor alpha, macrophage inflammatory protein 1 alpha, interleukin (IL)-1α, IL-1β, IL-2, IL-4, and IL-6, all of which are known to be associated with DED. Lifitegrast has the potential to be the first pharmaceutical product approved in the US indicated for the treatment of both symptoms and signs of DED. Clinical trials involving over 2,500 adult DED patients have demonstrated that topically administered lifitegrast 5.0% ophthalmic solution can rapidly reduce the symptoms of eye dryness and decrease ocular surface staining with an acceptable long-term safety profile. The purpose of this review is to highlight the developmental

  18. Severe symptoms of short tear break-up time dry eye are associated with accommodative microfluctuations.

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    Kaido, Minako; Kawashima, Motoko; Ishida, Reiko; Tsubota, Kazuo

    2017-01-01

    Validating the hypothesis that accommodative microfluctuations (AMFs) may be associated with severe symptoms in short tear break-up time (BUT) dry eye (DE). This study included 12 subjects with short BUT DE (age: 49.6±18.3 years). Diagnoses were performed based on the presence of DE symptoms, BUT ≤5 s, Schirmer score >5 mm, and negative keratoconjunctival epithelial damage. Tear evaluation, AMF, and functional visual acuity (VA) examinations were conducted before and after DE treatment. The AMF parameters evaluated were: total high-frequency component (HFC), HFC with low accommodation for the task of staring into the distance (HFC1), HFC with high accommodation for deskwork (HFC2). A subjective questionnaire of DE symptoms was also performed. Mean BUT increased from 1.9±2.0 to 6.4±2.5 s after treatment (P0.05). Subjective DE symptoms were reduced in nine patients. Along with the improvement of BUT after treatment, DE symptoms diminished and HFC1 and functional VA improved, suggesting that tear film instability is associated with deterioration of functional VA, AMF, and DE symptoms.

  19. Evaluation of an automatic dry eye test using MCDM methods and rank correlation.

    Science.gov (United States)

    Peteiro-Barral, Diego; Remeseiro, Beatriz; Méndez, Rebeca; Penedo, Manuel G

    2017-04-01

    Dry eye is an increasingly common disease in modern society which affects a wide range of population and has a negative impact on their daily activities, such as working with computers or driving. It can be diagnosed through an automatic clinical test for tear film lipid layer classification based on color and texture analysis. Up to now, researchers have mainly focused on the improvement of the image analysis step. However, there is still large room for improvement on the machine learning side. This paper presents a methodology to optimize this problem by means of class binarization, feature selection, and classification. The methodology can be used as a baseline in other classification problems to provide several solutions and evaluate their performance using a set of representative metrics and decision-making methods. When several decision-making methods are used, they may offer disagreeing rankings that will be solved by conflict handling in which rankings are merged into a single one. The experimental results prove the effectiveness of the proposed methodology in this domain. Also, its general purpose allows to adapt it to other classification problems in different fields such as medicine and biology.

  20. Association Between Migraine and Dry Eye Disease: A Nationwide Population-Based Study.

    Science.gov (United States)

    Yang, Soonwon; Kim, Woojun; Kim, Hyun Seung; Na, Kyung-Sun

    2017-06-01

    Despite the possible association between migraine and dry eye disease (DED), there are only a few studies investigating this link in a relatively limited number of patients. Therefore, we have analyzed the relationship between migraine and DED in the Korean population. This population-based cross-sectional study included 14 329 adults participating in the fifth annual Korea National Health and Nutrition Examination Survey from 2010 to 2012. Migraine, DED diagnosis, and DED symptoms were assessed using questionnaires and surveys. Data were analyzed using logistic regression to determine the association of migraine with DED while controlling for demographic, lifestyle, and medical factors. Individuals with migraine were more likely to report a DED diagnosis (14.4% vs. 8.2%, p migraine and DED diagnosis was significant after adjustments (OR, 1.577; 95% CI, 1.340-1.855). The association between migraine and DED symptoms showed a similar pattern (OR, 1.304; 95%CI, 1.151-1.502). Although a causal relationship was not revealed, we found that patients who had a lifetime history of migraine were more likely to suffer from DED than individuals who did not present with headaches; this association may require confirmation. Large prospective cohort studies are required to evaluate the association between migraine and DED, as well as the influence of DED treatment on the frequency and severity of migraine attacks.

  1. Mitochondria-Targeted Antioxidant SkQ1 Prevents Anesthesia-Induced Dry Eye Syndrome

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    Evgeni Yu. Zernii

    2017-01-01

    Full Text Available Dry eye syndrome (DES is an age-related condition increasingly detected in younger people of risk groups, including patients who underwent ocular surgery or long-term general anesthesia. Being a multifactorial disease, it is characterized by oxidative stress in the cornea and commonly complicated by ocular surface inflammation. Polyetiologic DES is responsive to SkQ1, a mitochondria-targeted antioxidant suppressing age-related changes in the ocular tissues. Here, we demonstrate safety and efficacy of topical administration of SkQ1 at a dosage of 7.5 μM for the prevention of general anesthesia-induced DES in rabbits. The protective action of SkQ1 improves clinical state of the ocular surface by inhibiting apoptotic and prenecrotic changes in the corneal epithelium. The underlying mechanism involves the suppression of the oxidative stress supported by the stimulation of intrinsic antioxidant activity and the activity of antioxidant enzymes, foremost glutathione peroxidase and glutathione reductase, in the cornea. Furthermore, SkQ1 increases antioxidant activity and stability of the tear film and produces anti-inflammatory effect exhibited as downregulation of TNF-α and IL-6 and pronounced upregulation of IL-10 in tears. Our data suggest novel features of SkQ1 and point to its feasibility in patients with DES and individuals at risk for the disease including those subjected to general anesthesia.

  2. A standardized extract of Rhynchosia volubilis Lour. exerts a protective effect on benzalkonium chloride-induced mouse dry eye model.

    Science.gov (United States)

    Kang, Suk Woo; Kim, Kyung-A; Lee, Chung Hyun; Yang, Sung Jae; Kang, Tae Kyeom; Jung, Je Hyeong; Kim, Tae-Jin; Oh, Sang-Rok; Jung, Sang Hoon

    2017-12-27

    In contrast to other leguminous plants generally used as food, Rhynchosia volubilis Loureiro, a small soybean with a black seed coat, has been used as a traditional oriental remedy for various human diseases in Eastern Asia. In this study, we demonstrated the protective effect of R. volubilis against dry eye disease. We aimed to investigate whether a standardized ethanol extract of R. volubilis (EERV) can protect the cornea in a benzalkonium chloride (BAC)-induced mouse dry eye model. Experimental dry eye was induced by the instillation of 0.2% BAC on mouse cornea. A standardized ethanol extract of R. volubilis (EERV) was orally administered following BAC treatment. The positive control group was treated with commercial eye drops. Fluorescein staining, tear break-up time (BUT), and hematoxylin and eosin staining were evaluated on the ocular surface. Squamous metaplasia and apoptosis in the corneal epithelial layer were detected by immunostaining. Furthermore, the protein expression of cytochrome c, Bcl-2, and Bax was determined. EERV treatment significantly improved fluorescein scoring, BUT, and smoothness in the cornea compared to the vehicle group. In addition, EERV inhibited squamous metaplasia and apoptosis in the cornea. The expression of cytochrome c and Bax was upregulated, while that of Bcl-2 was downregulated in the vehicle group compared with that in the control group. However, EERV treatment inhibited the expression of cytochrome c and Bax, while that of Bcl-2 was improved. Standardized EERV could be a beneficial candidate for the treatment of dry eye disease. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Improvement of Outcome Measures of Dry Eye by a Novel Integrin Antagonist in the Murine Desiccating Stress Model

    Science.gov (United States)

    Krauss, Achim H.; Corrales, Rosa M.; Pelegrino, Flavia S. A.; Tukler-Henriksson, Johanna; Pflugfelder, Stephen C.; de Paiva, Cintia S.

    2015-01-01

    Purpose We investigated the effects of GW559090, a novel, competitive, and high-affinity α4 integrin antagonist, in a murine model of dry eye. Through interaction with vascular cell adhesion molecule 1 (VCAM-1) and fibronectin α4β1 integrin is involved in leukocyte trafficking and activation. Methods Female C57BL/6 mice, aged 6 to 8 weeks, were subjected to desiccating stress (DS). Bilateral topical twice daily treatment with GW559090 was compared to vehicle-treated controls. Treatment was initiated at the time of DS induction. Treatment effects were assessed on corneal staining with Oregon Green Dextran (OGD) and expression of inflammatory markers in ocular surface tissues by real time PCR. Dendritic cell activation was measured in draining cervical lymph nodes (CLN) by flow cytometry. Separate groups of mice received GW559090 subcutaneously to evaluate the effects of systemic administration on corneal staining and cells in CLN. Results Topical GW559090 significantly reduced corneal uptake of OGD compared to vehicle-treated disease controls in a dose-dependent manner (1, 3, 10, and 30 mg/mL) with 30 mg/mL showing the greatest reduction in OGD staining. When administered topically, corneal expression of IL-1α, matrix metalloproteinase (MMP)–9, chemokine ligand 9 (CXCL9), and TGF-β1 was reduced in GW559090-treated eyes. Topical treatment with GW559090 decreased dendritic cell activation in lymph nodes. The effects on corneal staining and cellular composition in CLN were not reproduced by systemic administration of GW559090, suggestive of a local role for integrin antagonism in the treatment of dry eye. Conclusion. The novel α4 integrin antagonist, GW559090, improved outcome measures of corneal staining and ocular surface inflammation in this murine model of dry eye. These results indicate the potential of this novel agent for the treatment of dry eye disease. PMID:26348638

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

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    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.

  5. Safety and efficacy of a hydroxypropyl guar/polyethylene glycol/propylene glycol-based lubricant eye-drop in patients with dry eye.

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    Labetoulle, Marc; Messmer, Elisabeth M; Pisella, Pierre-Jean; Ogundele, Abayomi; Baudouin, Christophe

    2017-04-01

    To demonstrate non-inferiority of a hydroxypropyl guar/polyethylene glycol/propylene glycol lubricating eye-drop (HPG/PEG/PG) compared with an osmoprotective carboxymethylcellulose/glycerine eye-drop (O/CMC) for ocular surface staining. This was a multicentre, randomised, observer-masked, parallel-group study. Adults with dry eye instilled HPG/PEG/PG/ or O/CMC 4 times daily for 35 days and then as needed through day 90. Total ocular surface staining (TOSS) score changes from baseline and Impact of Dry Eye on Everyday Life (IDEEL) treatment satisfaction module scores were assessed. Non-inferiority, based on TOSS score change from baseline, was concluded if the upper limit of the 2-sided CI was <2 units. Mean±SD patient age was 64.4±13.7 years; 94 patients were randomised to treatment (HPG/PEG/PG, n=46; O/CMC, n=48). Mean±SE TOSS score change from baseline to day 35 was -2.2±0.33 with HPG/PEG/PG and -1.7±0.47 with O/CMC (treatment difference, -0.47±0.47; p=0.38), and the non-inferiority criterion was met. IDEEL treatment satisfaction scores were similar between groups at day 35 and day 90. The most frequently reported adverse event was eye irritation (HPG/PEG/PG, n=2; O/CMC, n=3). HPG/PEG/PG and O/CMC reduced ocular surface damage, and HPG/PEG/PG was non-inferior to O/CMC. Both treatments were effective, convenient and well tolerated. NCT01863368, Results. 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/.

  6. The Effect of Low-Dose Aspirin on Dry Eye Parameters and Ocular Surface Disease Index Questionnaire.

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    Yazıcı, Alper; Sarı, Esin; Ayhan, Erkan; Şahin, Gözde; Tıskaoğlu, Nesime Setge; Gürbüzer, Taha; Kurt, Hüseyin; Ermiş, Sıtkı Samet

    2018-02-01

    To evaluate the effects of acetylsalicylic acid (aspirin) on tear film parameters and dry eye disease. Fifty-seven patients using low-dose aspirin regularly for antiaggregant purposes as well as 49 controls, who required antiaggregant treatment but who had not yet started, were included in the study. Tear osmolarity, tear break-up time (TBUT), Schirmer and Oxford grading of ocular surface staining were performed on all patients and dry eye symptomatology was assessed using the ocular surface disease index questionnaire (OSDI). The mean osmolarity was 302.11 ± 16.22 mOsm/L in the aspirin group and 313.88 ± 19.57 mOsm/L in the control group (P < 0.01). The mean Schirmer's score was 24.16 ± 10.52 mm and 21.94 ± 10.11 mm (P = 0.232), TBUT was 13.61 ± 3.31 s and 10.39 ± 4.46 s (P < 0.01), OSDI score was 5.15 ± 5.98 and 16.94 ± 14.17 (P < 0.01), and Oxford score was 0.12 ± 0.33 and 0.12 ± 0.44 in aspirin and control groups, respectively (P = 0.99). Dry eye diagnosis was lower in the aspirin group, but statistical significance was present only in TBUT and osmolarity-based dry eye diagnosis (P ≤ 0.01). In terms of symptom-based dry eye diagnosis with the threshold of OSDI ≥23, none of the aspirin group had dry eye diagnosis, whereas 32.6% of the control group had the diagnosis (P < 0.01). The use of low-dose aspirin might be great option for treatment of ocular surface inflammatory disease through increasing TBUT and decreasing tear osmolarity with a resultant symptomatic satisfaction.

  7. [Effects of extract of Buddleja officinalis eye drops on androgen receptors of lacrimal gland cells of castrated rats with dry eye].

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    Peng, Qing-Hua; Yao, Xiao-Lei; Wu, Quan-Long

    2012-01-01

    To observe the effects of the extract of Buddleja officinalis eye drops (EBOED) on basic tears secretory volume, tear film stability, and expressions of androgen receptors (AR) in castrated rats with dry eye, and to investigate the mechanism of EBOED on dry eye caused by decreased anti-androgen levels. Forty-five male Wistar rats were randomly divided into the blank group, the model group, and the treatment group (treated by EBOED), respectively. Rats in each group were further divided into three sub-groups (fed for one month, two months, and three months, respectively). There were totally nine groups, with five in each. The dry eye model was established with orchiectomy of rats in the model group and the treatment group. EBOED was given to rats in the treatment group for one successive month. Schirmer I test (SIT) and breakup time of tear film (BUT) were determined in all experimental rats. Expressions of AR was analyzed by flow cytometer. Ths SIT value, BUT, and AR positive rate in the model group at the 1st, 2nd, 3rd month were lower than those in the blank group of the same time points (P < 0.01). There was statistical difference in SIT value, BUT, and AR positive rate between the model group and the treatment group at the three time points (P < 0.01). Take the three-month subgroup as an example, the SIT value in the treatment group was (12.667 +/- 5.221) mm, obviously higher than that in the model group (2.676 +/- 1.987) mm. The BUT in the treatment group was (11.758 +/- 4.415) s, obviously longer than that of the model group (4.667 +/- 2.108) s. The AR positive rate in the treatment group was 49.33% +/- 3.44%, obviously higher than that of the model group (33.32% +/- 7.12%, all P < 0.01). The main components of EBOED was the flavonoids which could significantly inhibit the occurrence of dry eye in rats with decreased androgen levels. Its mechanism might possibly be similar to androgen.

  8. Frequency and risk factors associated with dry eye in patients attending a tertiary care ophthalmology center in Mexico City

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    Martinez JD

    2016-07-01

    Full Text Available Jaime D Martinez,1 Anat Galor,2,3 Nallely Ramos-Betancourt,1 Andrés Lisker-Cervantes,1 Francisco Beltrán,1 Jorge Ozorno-Zárate,1 Valeria Sánchez-Huerta,1 Marco-Antonio Torres-Vera,1 Everardo Hernández-Quintela1 1Cornea and External Diseases Service, Asociación Para Evitar la Ceguera en Mexico (Association to prevent blindness in Mexico, Universidad Nacional Autónoma de México, Mexico City, Mexico; 2Department of Ophthalmology, Miami Veterans Affairs Medical Center, 3Cornea and External Diseases Division, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA Purpose: The purpose of this study was to ascertain the frequency and risk factors of dry eye (DE among patients attending a tertiary care ophthalmology center in Mexico.Methods: Approximately 338 consecutive new patients attending a tertiary care ophthalmology center in Mexico City underwent an ocular surface examination, which included tear film break-up time, fluorescein corneal staining, Schirmer’s test, and evaluation of meibum quality. Symptoms of DE were evaluated by the Ocular Surface Disease Index and Dry Eye Questionnaire-5. Information on demographics, exposures, past medical and ocular history, and medications was also collected.Results: The frequency of severe DE symptoms was found to be 43% based on the Ocular Surface Disease Index and 30% based on Dry Eye Questionnaire-5. Risk factors significantly associated with increased DE symptoms included dry mouth and gastrointestinal ulcer medications. With regard to signs, aqueous tear deficiency was a less-frequent finding (22% in our population than evaporative deficiency (94%. Risk factors associated with aqueous tear deficiency were dry mouth and diuretic use. No risk factors were associated with evaporative deficiency. Risk factors associated with meibomian gland dysfunction included old age, male sex, arthritis, and use of an antihypertensive. The only risk factor associated with corneal staining was dry

  9. Vitamin B12 deficiency evaluation and treatment in severe dry eye disease with neuropathic ocular pain.

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    Ozen, Serkan; Ozer, Murat Atabey; Akdemir, Mehmet Orçun

    2017-06-01

    This study aims to understand the effect of vitamin B12 deficiency on neuropathic ocular pain (NOP) and symptoms in patients with dry eye disease (DED). Patients with severe DED (without receiving topical artificial tears treatment) and ocular pain were enrolled (n = 90). Patients with severe DED and vitamin B12 deficiency (group 1, n = 45) received parenteral vitamin B12 supplement + topical treatment (artificial tears treatment + cyclosporine), and patients with severe DED and normal serum vitamin B12 level (group 2, n = 45) received only topical treatment (artificial tears treatment + cyclosporine). Patients were evaluated by the ocular surface disease index (OSDI) questionnaire, 3rd question (have you experienced painful or sore eyes during last week?) score of OSDI as a pain determiner and pain frequency measure), tear break up time (TBUT), and Schirmer's type 1 test. We compared the groups' OSDI, TBUT, and Schirmer's test recordings at the first visit and after 12 weeks retrospectively. The OSDI score, 3rd OSDI question score, TBUT, and Schirmer's test results improved after 12 weeks (p B12 level at enrollment was 144.24 ±43.36 pg/ml in group 1 and 417.53 ±87.22 pg/ml in group 2. The mean vitamin B12 level in group 1 reached to 450 ±60.563 pg/ml after 12 weeks of treatment. The mean score changes between the groups were not statistically significant; however, the decrease in the OSDI questionnaire score (-30.80 ±5.24) and 3rd OSDI question score (-2.82 ±0.53) were remarkable in group 1 (Table 2). The mean TBUT increase was +7.98 ±2.90 s and Schirmer's test result increase was +12.16 ±2.01 mm in group 1. The mean TBUT increase was +6.18 ±1.49 s and Schirmer's test result increase was +6.71 ±1.47 mm in group 2. These findings indicate that vitamin B12 deficiency is related with NOP. It may be important to consider measuring the serum vitamin B12 level in patients with severe DED presenting with resistant ocular pain despite taking topical treatment.

  10. Effect of Qijudihuang pill assisting sodium hyaluronate on visual function and tear film stability in patients with dry eye

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    Wei-Fang Chen

    2016-03-01

    Full Text Available AIM:To study the effect of Qijudihuang pills assisting sodium hyaluronate on visual function and tear film stability in patients with dry eye. METHODS:Seventy-eight patients(156 eyeswith dry eye from October 2013 to July 2015 were chosen for this study and randomly divided into observation group and control group, 39 patients(78 eyesin each group. The patients in observation group received Qijudihuang pills combined with sodium hyaluronate. The patients in control group received sodium hyaluronate only. The visual function, tear film stability, Chinese and Western medicine clinical integration and clinical curative effect were compared between the two groups. RESULTS:Clinical curative effect:effective rate of observation group was 92% and was significantly higher than that of the control group as 74%(χ2=4.532, PPPPCONCLUSION:Qijudihuang pills combined with sodium hyaluronate can improve visual function, tear film stability and Chinese and Western medical clinic symptoms, then improve the efficacy.

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

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    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

  12. Omega-3 supplementation is neuroprotective to corneal nerves in dry eye disease: a pilot study.

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    Chinnery, Holly R; Naranjo Golborne, Cecilia; Downie, Laura E

    2017-07-01

    To investigate whether oral, long-chain omega-3 (ω-3) essential fatty acid (EFA) supplementation, for 3 months, induces changes to the central corneal sub-basal nerve plexus in dry eye disease and whether nerve alterations correlate with clinical findings. This prospective, comparative study involved the final 12 participants enrolled in a randomised, double-masked, placebo-controlled clinical trial of 60 participants with moderate dry eye disease. Participants received either placebo (olive oil 1500 mg/day; n = 4) or ω-3 EFA supplements (~1000 mg/day eicosapentaenoic acid + ~500 mg/day docosahexaenoic acid; n = 8) for 90 days. The main outcome measure was the mean change in central corneal sub-basal plexus nerve parameters between days one and 90, quantified using in vivo confocal microscopy. Secondary outcomes included mean change in tear osmolarity, corneal dendritic cell density and basal epithelial cell density. Compared with baseline, the reduction in OSDI score and tear osmolarity at day 90 were greater in the ω-3 EFA group than the placebo group (OSDI: ω-3 EFA, mean ± SEM: -15.6 ± 2.8 vs placebo: -2.8 ± 4.1 units, t5 = 2.6, p = 0.04; tearosmolarity: ω-3 EFA: -22.63 ± 5.7 vs placebo: -8 ± 2.7 mOsmol/L, t9 = 2.3, p = 0.04). At day 90, corneal total nerve branch density (CTBD: 91.1 ± 8.6 vs 45.1 ± 13.4 branches/mm2 , F1,10 = 14, p = 0.004) and corneal nerve branch density on the main fibre (CNBD: 63.4 ± 6.5 vs 27.9 ± 11.5 branches/mm2 , F1,10 = 6, p = 0.03) were higher in the ω-3 EFA group compared with placebo. Relative to day 1, CNBD (branches/mm2 ) increased at day 90 in the ω-3 EFA group (+20.0 ± 9.2, t8 = 3.2 p = 0.01) compared with placebo (-10.8 ± 3.2). Similar changes were evident for corneal nerve fibre length (CNFL, mm/mm2 ), which increased from baseline at day 90 in the omega-3 EFA group (+2.9 ± 1.6, t8 = 3.4 p = 0.01) compared with placebo (-2.7 ± 0.5). There was a negative correlation between CTBD and tear osmolarity (r10 = -0

  13. Corneal Tissue From Dry Eye Donors Leads to Enhanced Graft Rejection.

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    Inomata, Takenori; Hua, Jing; Nakao, Takeshi; Shiang, Tina; Chiang, Homer; Amouzegar, Afsaneh; Dana, Reza

    2018-01-01

    To assess the effect of dry eye disease (DED) in graft donors on dendritic cell (DC) maturation, host T-cell sensitization, and corneal allograft rejection. Corneas of control (healthy donor) and DED mice (C57BL/6) were transplanted onto fully allogeneic naive BALB/c recipients (n = 10 mice/group). Long-term allograft survival was evaluated for 8 weeks. Corneas and draining lymph nodes (dLNs) were harvested at posttransplantation day 14 (n = 5 mice/group). The frequencies of MHCII CD11c DCs in the donor corneas and host dLNs and the frequencies of interferon (IFN)-γ and IL-17 CD4 T cells and Foxp3 expression by Tregs in host dLNs were investigated using flow cytometry. The enzyme-linked immunospot assay was used to assess host T-cell allosensitization through direct and indirect pathways (n = 3/group). Recipients of DED donor corneas showed significantly reduced graft survival (10%) compared with control mice (50% survival, P = 0.022), and had significantly increased frequencies of mature DCs in the grafted cornea (DED donor 44.0% ± 0.36% vs. healthy donor 35.4 ± 0.5%; P donor 25.1% ± 0.66% vs. healthy donor 13.7% ± 1.6%; P = 0.005). Frequencies of IFN-γ and IL-17 T cells were increased in the dLNs of recipients of DED corneas, whereas the expression (mean fluorescence intensity) of Foxp3 in Tregs was decreased significantly in these mice (DED donor 6004 ± 193 vs. healthy donor 6806 ± 81; P = 0.0002). Enzyme-linked immunospot analysis showed that the direct pathway of allosensitization was significantly amplified in recipients of grafts with DED (P = 0.0146). Our results indicate that DED in the donor is a significant risk factor for subsequent corneal allograft rejection.

  14. LFA-1/ICAM-1 Interaction as a Therapeutic Target in Dry Eye Disease.

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    Pflugfelder, Stephen C; Stern, Michael; Zhang, Steven; Shojaei, Amir

    Dry eye disease (DED) is a common ocular disorder associated with inflammation of the lacrimal gland and ocular surface. The interaction of the integrin lymphocyte function-associated antigen-1 (LFA-1) with its cognate ligand intercellular adhesion molecule-1 (ICAM-1) is known to have important roles in the interaction of a variety of cells involved in immune responses and inflammation, including those prominent in ocular surface inflammation. Lifitegrast, an LFA-1 antagonist that blocks binding of ICAM-1 to LFA-1, has recently been approved in the United States for the treatment of signs and symptoms of DED. In this review, we evaluate research findings to explore the potential role of LFA-1/ICAM-1 interaction in the pathophysiology of DED, and the evidence supporting LFA-1/ICAM-1 interaction as a rational therapeutic target in DED. The results of our review suggest that LFA-1/ICAM-1 interaction may play important roles in the cell-mediated immune response and inflammation associated with DED, including facilitating the homing of dendritic cells to the lymph nodes, interaction of dendritic cells with T cells and subsequent T cell activation/differentiation, migration of activated CD4 + T cells from the lymph nodes to the ocular surface, reactivation of T cells by resident antigen-presenting cells at the ocular surface, and recruitment and retention of LFA-1-expressing T cells in the conjunctival epithelium. Based on the available evidence, inhibition of LFA-1/ICAM-1 interaction represents a rational targeted approach in treating DED. Notably, inhibition of LFA-1/ICAM-1 binding with lifitegrast offers a novel approach to reducing ocular surface inflammation in this condition.

  15. Corneal confocal microscopy and dry eye findings in contact lens discomfort patients.

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    Dogan, Aysun Sanal; Gurdal, Canan; Arslan, Nese

    2017-08-16

    To evaluate the corneal confocal microscopy and dry eye findings in patients with contact lens discomfort. The study included 3 groups of participants: Contact lens wearers using silicone hydrogel soft contact lenses who are symptomatic (CLD, n=15) or asymptomatic (ACL, n=11) and non-wearers as controls (n=14). Duration of contact lens wear, Ocular Surface Disease Index (OSDI) questionnaire responses, fluorescein tear break-uptime (FBUT), and corneal confocal microscopy findings were recorded. Mean age was 25.7±8.2 years and male/female ratio was 7/33. Demographic findings were similar regarding the groups. CLD patients had a longer lens use history than ACL (median 5 vs 2 years, p<0.001). OSDI scores were higher in CLD group than ACL or controls (p<0.001, p=0.002). FBUT was significantly lowest in CLD group, compared to controls and ACL (p<0.001, p=0.039). FBUT was also lower in ACL patients compared to controls (p=0.036). There was no difference between basal epithelium cell counts between all 3 groups. Anterior stromal activated keratocyte numbers were similar between contact lens using groups but was lower in controls (p=0.005). However, dendritiform cells in the sub-basal nerve layer were higher in CLD group compared to controls but similar to ACL (p<0.001, p=0.058). Graded sub-basal nerve tortuosity was more prominent in CLD group than the ACL (p=0.014). Patients with CLD had been wearing contact lenses for longer than those without symptoms. OSDI and FBUT scores were worse in CLD patients. In contact lens discomfort patients, there were increased dendritiform cells, indicating intensified inflammatory status of the cornea. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  16. Influence of a controlled environment simulating an in-flight airplane cabin on dry eye disease.

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

    2013-03-01

    To evaluate symptoms, signs, and the levels of 16 tears inflammatory mediators of dry eye (DE) patients exposed to an environment simulating an in-flight air cabin in an environmental chamber. Twenty DE patients were exposed to controlled environment simulating an in-flight airplane cabin (simulated in-flight condition [SIC]) of 23°C, 5% relative humidity, localized air flow, and 750 millibars (mb) of barometric pressure. As controls, 15 DE patients were subjected to a simulated standard condition (SSC) of 23°C, 45% relative humidity, and 930 mb. A DE symptoms questionnaire, diagnostic tests, and determination of 16 tear molecules by multiplex bead array were performed before and 2 hours after exposure. After SIC exposure, DE patients became more symptomatic, suffered a significant (P ≤ 0.05) decrease in tear stability (tear break up time) (from 2.18 ± 0.28 to 1.53 ± 0.20), and tear volume (phenol red thread test), and a significant (P ≤ 0.05) increase in corneal staining, both globally (0.50 ± 0.14 before and 1.25 ± 0.19 after) and in each area (Baylor scale). After SSC, DE patients only showed a mild, but significant (P ≤ 0.05), increase in central and inferior corneal staining. Consistently, tear levels of IL-6 and matrix metalloproteinase (MMP)-9 significantly increased and tear epidermal growth factor (EGF) significantly decreased (P ≤ 0.05) only after SIC. The controlled adverse environment conditions in this environmental chamber can simulate the conditions in which DE patients might be exposed during flight. As this clearly impaired their lacrimal functional unit, it would be advisable that DE patients use therapeutic strategies capable of ameliorating these adverse episodes.

  17. Rasch analysis of three dry eye questionnaires and correlates with objective clinical tests.

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    McAlinden, Colm; Gao, Rongrong; Wang, Qinmei; Zhu, Senmiao; Yang, Jing; Yu, Ayong; Bron, Anthony J; Huang, Jinhai

    2017-04-01

    To assess the psychometric properties of Chinese versions of the Ocular Comfort Index (OCI), Ocular Surface Disease Index (OSDI) and McMonnies questionnaires. Further, to assess the correlation between questionnaire scores and objective dry eye disease (DED) clinical tests. Translated versions of the OCI, OSDI and McMonnies questionnaires were completed in a random order by 238 participants with DED. Objective clinical tests included visual acuity (VA), fluorescein tear film break-up time (TBUT), corneal fluorescein staining, Schirmer I testing and meibomian gland grading. Rasch analysis was used to assess questionnaire psychometrics and spearman rank for correlations. For the OCI, the person separation was 2.31, item infit and outfit statistics ranged from 0.74-1.14 and 0.75-1.32, respectively, and targeting 1.54 logits. For the OSDI, person separation was 0.94. None of the three subscales provided valid measurements based on Rasch analysis. For the McMonnies questionnaire, person separation was 1.17, item infit and outfit statistics ranged from 0.7 to 1.21 and 0.51-3.49, respectively. There were weak correlations between questionnaire scores and clinical tests. There were weak correlations between OSDI scores and VA, fluorescein TBUT, Schirmer I testing and corneal fluorescein staining. There were weak correlations between McMonnies scores and VA, fluorescein TBUT, Schirmer I testing, and corneal fluorescein staining and meibomian gland grading. The OCI questionnaire was the only questionnaire that provided valid measurement on the basis of Rasch analysis, although slight multidimensionality was found. There were weak correlations between OCI scores and fluorescein TBUT, Schirmer I testing, and corneal fluorescein staining. Due to this paradoxical disconnect between symptoms and signs and the repeatability of tests, the use of both subjective and objective markers in the clinical management of patients or as endpoints in clinical trials would appear prudent

  18. Evaluation of reading speed and contrast sensitivity in dry eye disease.

    Science.gov (United States)

    Ridder, William H; Zhang, Yi; Huang, Jing-Feng

    2013-01-01

    Visual disturbance is a common symptom reported by patients with dry eye disease (DED). The purpose of this study was to evaluate visual performance, including reading speed and contrast sensitivity, in control and DED subjects. Fifty-two DED patients (mild, n = 17; moderate, n = 22; severe, n = 13; based on corneal staining and the Ocular Surface Disease Index ≥ 20) and 20 control subjects (Ocular Surface Disease Index reading speed was determined using the Wilkins Rate of Reading Test. Analysis of covariance was conducted to compare clinical characteristics among subject groups while adjusting for age, sex, and study site. Partial correlation coefficients from linear regression were used to measure the linear relationship between contrast sensitivity and reading speed with DED parameters. The log of the minimum angle of resolution visual acuities and contrast sensitivity were not significantly different across subject groups. The DED patients (134.9 ± 4.95 words per minute) exhibited slower reading speeds than the control subjects (158.3 ± 8.40 words per minute, p = 0.046). As DED severity increased, the reading speed decreased (141.0 ± 7.96 words per minute, 136.8 ± 7.15 words per minute, and 127.0 ± 9.63 words per minute in mild, moderate, and severe groups, respectively). Reading rate was found to correlate weakly with corneal staining based on a partial correlation coefficient (-0.345, p reading rate was lower in DED subjects than that in control subjects. As the DED severity increased, the reading rate decreased. This finding is consistent with patient-reported symptoms and provides direct evidence for the impact of DED on reading performance. These findings suggest that reading speed may be used to monitor treatment benefit in DED.

  19. Automated Grading System for Evaluation of Corneal Superficial Punctate Keratitis Associated with Dry Eye.

    Science.gov (United States)

    Rodriguez, John D; Lane, Keith; Ousler, George W; Angjeli, Endri; Smith, Lisa; Abelson, Mark

    2015-03-03

    Purpose. To develop an automated method of grading fluorescein staining that accurately reproduces the clinical grading system currently in use. Methods. From the slit lamp photograph of the fluorescein-stained cornea, the region of interest was selected and punctate dot number calculated using software developed with the Opencv computer vision library. Images (N=229) were then divided into six incremental severity categories based on computed scores. The final selection of fifty-four photographs represented the full range of scores: nine images from each of six categories. These were then evaluated by three investigators using a clinical 0-4 corneal staining scale. Pearson correlations were calculated to compare investigator scores, and mean investigator and automated scores. Lin's Concordance Correlations (CCC) and Bland Altman plots were used to assess agreement between methods and between investigators. Results. Pearson's correlation between investigators was 0.914; mean CCC between investigators was 0.882. Bland-Altman analysis indicated that scores assessed by Investigator 3 were significantly higher than those of Investigators 1 and 2 (paired t-test). The predicted grade was calculated to be: G pred =1.48log(N dots ) - 0.206. The two-point Pearson's correlation coefficient between the methods was 0.927 (p<0.0001). CCC between predicted automated score G pred and mean investigator score was 0.929, 95% C.I. (0.884, 0.957). Bland-Altman analysis did not indicate bias. The difference in standard deviation between clinical and automated methods was 0.398. Conclusion. An objective, automated analysis of corneal staining provides a quality assurance tool to be used to substantiate clinical grading of key corneal staining endpoints in multi-centered clinical trials of dry eye. Copyright © 2015 by Association for Research in Vision and Ophthalmology.

  20. Automated Grading System for Evaluation of Superficial Punctate Keratitis Associated With Dry Eye.

    Science.gov (United States)

    Rodriguez, John D; Lane, Keith J; Ousler, George W; Angjeli, Endri; Smith, Lisa M; Abelson, Mark B

    2015-04-01

    To develop an automated method of grading fluorescein staining that accurately reproduces the clinical grading system currently in use. From the slit lamp photograph of the fluorescein-stained cornea, the region of interest was selected and punctate dot number calculated using software developed with the OpenCV computer vision library. Images (n = 229) were then divided into six incremental severity categories based on computed scores. The final selection of 54 photographs represented the full range of scores: nine images from each of six categories. These were then evaluated by three investigators using a clinical 0 to 4 corneal staining scale. Pearson correlations were calculated to compare investigator scores, and mean investigator and automated scores. Lin's Concordance Correlation Coefficients (CCC) and Bland-Altman plots were used to assess agreement between methods and between investigators. Pearson's correlation between investigators was 0.914; mean CCC between investigators was 0.882. Bland-Altman analysis indicated that scores assessed by investigator 3 were significantly higher than those of investigators 1 and 2 (paired t-test). The predicted grade was calculated to be: Gpred = 1.48log(Ndots) - 0.206. The two-point Pearson's correlation coefficient between the methods was 0.927 (P < 0.0001). The CCC between predicted automated score Gpred and mean investigator score was 0.929, 95% confidence interval (0.884-0.957). Bland-Altman analysis did not indicate bias. The difference in SD between clinical and automated methods was 0.398. An objective, automated analysis of corneal staining provides a quality assurance tool to be used to substantiate clinical grading of key corneal staining endpoints in multicentered clinical trials of dry eye.

  1. Corneal Nerve Regeneration after Self-Retained Cryopreserved Amniotic Membrane in Dry Eye Disease.

    Science.gov (United States)

    John, Thomas; Tighe, Sean; Sheha, Hosam; Hamrah, Pedram; Salem, Zeina M; Cheng, Anny M S; Wang, Ming X; Rock, Nathan D

    2017-01-01

    To evaluate the efficacy of self-retained cryopreserved amniotic membrane (CAM) in promoting corneal nerve regeneration and improving corneal sensitivity in dry eye disease (DED). In this prospective randomized clinical trial, subjects with DED were randomized to receive CAM (study group) or conventional maximum treatment (control). Changes in signs and symptoms, corneal sensitivity, topography, and in vivo confocal microscopy (IVCM) were evaluated at baseline, 1 month, and 3 months. Twenty subjects (age 66.9 ± 8.9) were enrolled and 17 completed all follow-up visits. Signs and symptoms were significantly improved in the study group yet remained constant in the control. IVCM showed a significant increase in corneal nerve density in the study group (12,241 ± 5083 μm/mm2 at baseline, 16,364 ± 3734 μm/mm2 at 1 month, and 18,827 ± 5453 μm/mm2 at 3 months, p = 0.015) but was unchanged in the control. This improvement was accompanied with a significant increase in corneal sensitivity (3.25 ± 0.6 cm at baseline, 5.2 ± 0.5 cm at 1 month, and 5.6 ± 0.4 cm at 3 months, p < 0.001) and corneal topography only in the study group. Self-retained CAM is a promising therapy for corneal nerve regeneration and accelerated recovery of the ocular surface health in patients with DED. The study is registered at clinicaltrials.gov with trial identifier: NCT02764814.

  2. Corneal Nerve Regeneration after Self-Retained Cryopreserved Amniotic Membrane in Dry Eye Disease

    Directory of Open Access Journals (Sweden)

    Thomas John

    2017-01-01

    Full Text Available Purpose. To evaluate the efficacy of self-retained cryopreserved amniotic membrane (CAM in promoting corneal nerve regeneration and improving corneal sensitivity in dry eye disease (DED. Methods. In this prospective randomized clinical trial, subjects with DED were randomized to receive CAM (study group or conventional maximum treatment (control. Changes in signs and symptoms, corneal sensitivity, topography, and in vivo confocal microscopy (IVCM were evaluated at baseline, 1 month, and 3 months. Results. Twenty subjects (age 66.9 ± 8.9 were enrolled and 17 completed all follow-up visits. Signs and symptoms were significantly improved in the study group yet remained constant in the control. IVCM showed a significant increase in corneal nerve density in the study group (12,241 ± 5083 μm/mm2 at baseline, 16,364 ± 3734 μm/mm2 at 1 month, and 18,827 ± 5453 μm/mm2 at 3 months, p=0.015 but was unchanged in the control. This improvement was accompanied with a significant increase in corneal sensitivity (3.25 ± 0.6 cm at baseline, 5.2 ± 0.5 cm at 1 month, and 5.6 ± 0.4 cm at 3 months, p<0.001 and corneal topography only in the study group. Conclusions. Self-retained CAM is a promising therapy for corneal nerve regeneration and accelerated recovery of the ocular surface health in patients with DED. The study is registered at clinicaltrials.gov with trial identifier: NCT02764814.

  3. Effect of desiccating environmental stress versus systemic muscarinic AChR blockade on dry eye immunopathogenesis.

    Science.gov (United States)

    Chen, Yihe; Chauhan, Sunil K; Lee, Hyun Soo; Stevenson, William; Schaumburg, Chris S; Sadrai, Zahra; Saban, Daniel R; Kodati, Shilpa; Stern, Michael E; Dana, Reza

    2013-04-03

    A majority of experimental data on dry eye disease (DED) immunopathogenesis have been derived from a murine model of DED that combines desiccating environmental stress with systemic muscarinic acetylcholine receptor (mAChR) inhibition. However, to our knowledge the effects of pharmacologic mAChR blockade on the pathogenesis of experimental DED have not been evaluated systemically. The purpose of our study was to investigate the differential effects of desiccating environmental stress and mAChR inhibition on the pathogenesis of DED. DED was induced in female C57BL/6 mice by exposure to a desiccating environment in the controlled-environment chamber or to systemic scopolamine, or by performing extraorbital lacrimal gland excision. Clinical disease was assessed using corneal fluorescein staining (CFS) and the cotton thread test (CTT). Corneal CD11b(+) and conjunctival CD3(+) T-cell infiltration were evaluated by flow cytometry. T-cells from draining cervical lymph nodes (CLN) and distant inguinal lymph nodes (ILN) were analyzed for Th1, Th2, Th17, and Treg responses by flow cytometry and ELISA. Desiccating environmental stress and systemic mAChR blockade induced similar clinical signs of DED. However, desiccating environmental stress imparted higher conjunctival CD3(+) T-cell infiltration, and greater Th17-cell activity and Treg dysfunction than mAChR blockade, while mAChR blockade decreased tear secretion to a greater extent than desiccating environmental stress. Systemic mAChR blockade attenuated Th17 activity and enhanced Th2 and Treg responses without affecting Th1 activity. In vivo inhibition of mAChRs variably affects CD4(+) T-cell subsets, and desiccating environmental stress and systemic mAChR blockade induce DED through different primary pathogenic mechanisms.

  4. Effect of hypotonic 0.4% hyaluronic acid drops in dry eye patients: a cross-over study.

    Science.gov (United States)

    Troiano, Pasquale; Monaco, Gaspare

    2008-12-01

    The aim of the study is to evaluate the short-term effects of 2 kinds of artificial tears, both containing 0.4% hyaluronic acid in an aqueous solution yet having different osmolarity, on the typical symptoms of patients suffering from dry eye and on the vitality of corneal and conjunctival epithelial cells. A cross-over, randomized, balanced, single-blind study involving 28 patients was divided into 2 treatment groups: group A (unpreserved 0.4% hyaluronic acid eye drops 300 mOsm/L) and group B (unpreserved 0.4% hyaluronic acid eye drops 150 mOsm/L). Both treatments were administered for 7 days, being dosed as a 1 solution drop 4 times daily. After a 1-day wash-out period, the patients in group A passed over to group B and vice versa. Treatment with hypotonic solution gave better results in relieving symptoms, along with a statistically significant improvement (P < 0.001) in the state of the corneoconjunctival epithelium, than the isotonic solution. At the end of the study, 60.7% of the patients declared that they preferred hypotonic solution and only 10.7% preferred isotonic solution; the remaining 28.6% did not notice any difference between the 2 treatments. By reducing the osmolarity of tear film, the hypotonic solution not only improves the characteristics of tear film and the vitality of the epithelial cells of the cornea and conjunctiva but also proves to be effective in reducing dry eye symptoms.

  5. Effects of topical fucosyl-lactose, a milk oligosaccharide, on dry eye model: an example of nutraceutical candidate

    Directory of Open Access Journals (Sweden)

    Claudio eBucolo

    2015-11-01

    Full Text Available Purpose: Colostrum has been proposed to treat severe dryness and problematic eye lesions showing a beneficial effect. The aim of the study was to investigate the effect of 2-fucosyl-lactose, a natural sugar present in the human colostrum, in an experimental dry eye. Methods: Dry eye was induced in adult male New Zealand albino rabbits by topical administration of 1% atropine. Tear volume (Schirmer’s test, tear film breakup time (TBUT, corneal staining and tear osmolarity were assessed. Fucosyl-lactose eye drops was instilled at different concentrations (0.01%, 0.1%, 1%. Results: After 24 hours from first atropine administration, tear volume and TBUT values were significantly improved in groups treated with 2-flucosyl-lactose in a dose-dependent manner. Tear volume increased from 5.25 to 10.75 mm and TBUT values from 8.75 to 34.5 seconds with 0.01% or 1% 2-flucosyl-lactose treatment, respectively. No changes were observed in terms of corneal staining among the all groups treated with 2-fucosyl-lactose. Atropine instillation caused an increase of tear osmolarity (428 mOsm/L, which was reversed by topical treatment with 2-fucosyl-lactose at all doses.Conclusions: The present study demonstrated that 2-fucosyl-lactose, a human milk oligosaccharide, has protective effect on tear film stability.

  6. Boston scleral lens prosthetic device for treatment of severe dry eye in chronic graft-versus-host disease.

    Science.gov (United States)

    Jacobs, Deborah S; Rosenthal, Perry

    2007-12-01

    To determine if the Boston Scleral Lens Prosthetic Device (BSLPD) reduces symptoms and improves quality of life in patients with severe dry eye from chronic graft-versus-host disease (cGvHD). This is a noncomparative interventional case series reporting 33 consecutive patients with severe dry eye from cGvHD, unresponsive to conventional therapy, who were fitted with the BSLPD. A patient survey was undertaken after lenses were dispensed and worn regarding the effect of scleral lens wear on their symptoms, quality of life, and activities of daily living. The patient population was characterized from a retrospective chart review. Survey data were tabulated. BSLPD wear resulted in improvement in pain, photophobia, and general quality of life in nearly all patients, with more than half reporting the highest improvement level for pain (52%) and photophobia (63%), and more than two thirds (73%) reporting the highest improvement level for quality of life. There was improvement in reading and driving in >90% of those who reported previous compromise, with >60% reporting the highest improvement level for each of these activities. The BSLPD mitigates symptoms and improves quality of life in patients with severe dry eye from cGHvD.

  7. A randomised, double-masked comparison study of diquafosol versus sodium hyaluronate ophthalmic solutions in dry eye patients

    Science.gov (United States)

    Takamura, Etsuko; Tsubota, Kazuo; Watanabe, Hitoshi; Ohashi, Yuichi

    2012-01-01

    Aims To compare the efficacy and safety of 3% diquafosol ophthalmic solution with those of 0.1% sodium hyaluronate ophthalmic solution in dry eye patients, using mean changes in fluorescein and rose bengal staining scores as endpoints. Trial design and methods In this multicenter, randomised, double-masked, parallel study of 286 dry eye patients with fluorescein and rose bengal staining scores of ≥3 were randomised to the treatment groups in a 1 : 1 ratio. Efficacy and safety were evaluated after drop-wise instillation of the study drug, six times daily for 4 weeks. Results After 4 weeks, the intergroup difference in the mean change from baseline in fluorescein staining score was −0.03; this verified the non-inferiority of diquafosol. The mean change from baseline in rose bengal staining score was significantly lower in the diquafosol group (p=0.010), thus verifying its superiority. The incidence of adverse events was 26.4% and 18.9% in the diquafosol and sodium hyaluronate groups, respectively, with no significant difference. Conclusions Diquafosol (3%) and sodium hyaluronate (0.1%) exhibit similar efficacy in improving fluorescein staining scores of dry eye patients, whereas, diquafosol exhibits superior efficacy in improving rose bengal staining scores. Diquafosol has high clinical efficacy and is well tolerated with a good safety profile. PMID:22914501

  8. Effects of extract of Buddleja officinalis on partial inflammation of lacrimal gland in castrated rabbits with dry eye.

    Science.gov (United States)

    Yao, Xiao-Lei; Peng, Qing-Hua; Peng, Jun; Tan, Han-Yu; Wu, Quan-Long; Wu, Da-Li; Chen, Mei; Li, Chuan-Ke; Li, Dian; Zhu, Hui-An

    2010-01-01

    To assess the effects of extract of Buddleja officinalis on tear secretion volume, tear film stability, expressions of TGF-β1, IL-1β, TNF-α in lacrimal gland of castrated rabbits with dry eye. A total of 30 victory rabbits were divided averagely into normal group(A), model group(B), therapy group with low dose extract of Buddleja officinalis (C), therapy group with high dose extract of Buddleja officinalis (D) and therapy group with genistein (E). The dry eye model was established with orchiectomy on Group B, C, D, E. Group C, D, E were administered intragastrically with corresponding dose extract of Buddleja officinalis or genistein for 30 days. All rabbits were detected with SIT. TGF-β1, IL-1β, TNF-α were detected with immunohistochemistry and the ultrastructure of lacrimal gland was observed under transmission electron microscope. The SIT value of group C, D, E were respectively 13.167±4.957, 14.667±5.279, 8.667±0.516, obviously higher than that of group B 5.667±2.338 (PBuddleja officinalis can adjust lacrimal gland partial inflammation of dry eye.

  9. Serial measurement of tear meniscus by FD-OCT after instillation of artificial tears in patients with dry eyes.

    Science.gov (United States)

    Bujak, Matthew C; Yiu, Samuel; Zhang, Xinbo; Li, Yan; Huang, David

    2011-01-01

    To use Fourier-domain optical coherence tomography (FD-OCT) to study the effect of artificial tears on the tear meniscus in patients with dry eyes. The lower tear meniscus of 16 consecutive patients with dry eyes was imaged by an FD-OCT system (RTVue; Optovue, Inc., Fremont, CA). Baseline and five serial pairs of measurements were taken after the instillation of artificial tears (Optive; Allergan, Irvine, CA) at 1, 2, 5, 10, and 15 minutes. The lower meniscus height, depth, and area were measured with a computer caliper. Baseline meniscus measurements were 235.5 ± 150.0 μm, 138.1 ± 78.7 μm, and 0.020 ± 0.022 mm(2) for height, depth, and area, respectively. After instillation of artificial tears, all lower tear meniscus parameters remained significantly elevated for 5 minutes and returned to baseline by 10 minutes. FD-OCT is able to quantify a dramatic initial increase in tear meniscus, followed by a decay back to baseline values after approximately 5 minutes. FD-OCT may be useful in objectively quantifying the dynamic efficacy of dry eye treatments. Copyright 2011, SLACK Incorporated.

  10. Preliminary report of improved sleep quality in patients with dry eye disease after initiation of topical therapy

    Directory of Open Access Journals (Sweden)

    Ayaki M

    2016-02-01

    Full Text Available Masahiko Ayaki,1 Ikuko Toda,2 Naoko Tachi,3 Kazuno Negishi,1 Kazuo Tsubota11Department of Ophthalmology, Keio University School of Medicine, 2Department of Ophthalmology, Mimamiaoyama Eye Clinic, Tokyo, 3Eye Center, Shinseikai Toyama Hospital, Imizu, JapanPurpose: Dry eye disease (DED is potentially associated with sleep and mood disorders. This study evaluated sleep quality in patients with DED using a questionnaire-based survey before and after topical eyedrop treatment. The effectiveness of sleep and ophthalmic services in assisting with sleep problems in patients with eye disease was also assessed.Methods: Seventy-one consecutive patients with DED visiting eight general eye clinics in various locations answered a questionnaire containing the Pittsburgh Sleep Quality Index and Hospital Anxiety and Depression Scale. Photophobia and chronotype (morningness/­eveningness were also evaluated with two representative questions from established questionnaires (National Eye Institute Visual Function Questionnaire-25 and Morningness/Eveningness questionnaire. Follow-up evaluation was conducted by interview or mail 3–10 months after the initial evaluation. A sleep service was established in two eye clinics to identify possible ocular diseases related to sleep and mood disorders; it comprised a questionnaire, sleep diary, actigram, medical interviews, visual field testing, retinal ganglion cell layer thickness measurement, and DED examination.Results: Patients with newly diagnosed DED exhibited a greater improvement in sleep after DED treatment compared with patients with established DED. Improvement in Pittsburgh Sleep Quality Index was significant (P<0.05 and strongly correlated with improvement in Hospital Anxiety and Depression Scale (P<0.05 for new patients, but not for patients with established DED. Ten eye clinic patients visited the sleep service and nine of them had DED. They were successfully treated with eyedrops and sleep services, which

  11. A single LipiFlow® Thermal Pulsation System treatment improves meibomian gland function and reduces dry eye symptoms for 9 months.

    Science.gov (United States)

    Greiner, Jack V

    2012-04-01

    To evaluate the effect of a single treatment with the LipiFlow(®) Thermal Pulsation System on signs of meibomian gland dysfunction (MGD) and dry eye symptoms over a 9-month period. Patients (n = 42 eyes, 21 subjects) diagnosed with MGD and dry eye symptoms were recruited for a non-significant risk, prospective, open-label, 1-month clinical trial. Patients received a single 12-minute treatment using the LipiFlow(®) Thermal Pulsation System on each eye. The LipiFlow(®) device applies heat to the conjunctival surfaces of the upper and lower inner eyelids while simultaneously applying pulsatile pressure to the outer eyelid surfaces to express the meibomian glands. Patient symptoms were evaluated using the Ocular Surface Disease Index (OSDI) and Standard Patient Evaluation for Eye Dryness (SPEED) dry eye questionnaires; tear break-up time was measured with the dry eye test (DET™); and meibomian gland function was evaluated using a standardized diagnostic expression technique. Data are presented for patient's pre-treatment (baseline) and at 1-month and 9-month post-treatment. Meibomian gland secretion scores improved significantly from baseline (4.4 ± 4.0) to 1-month post-treatment (11.3 ± 6.2; p LipiFlow(®) Thermal Pulsation System offers a technological advancement for the treatment of dry eye disease secondary to meibomian gland dysfunction. A single 12-minute LipiFlow(®) treatment results in up to 9 months of sustained improvement of meibomian gland function, tear break-up time and dry eye symptoms that are unparalleled with current dry eye treatments.

  12. Effect of Korean Red Ginseng supplementation on dry eye syndrome in glaucoma patients - A randomized, double-blind, placebo-controlled study.

    Science.gov (United States)

    Bae, Hyoung Won; Kim, Ji Hyun; Kim, Sangah; Kim, Minkyo; Lee, Naeun; Hong, Samin; Seong, Gong Je; Kim, Chan Yun

    2015-01-01

    Many patients with glaucoma have difficulty using antiglaucoma eye drops because of dry eye symptom. In this prospective, randomized, double-blind, placebo-controlled study, we evaluated the effect of Korean Red Ginseng on dry eye syndrome in patients with glaucoma treated with antiglaucoma eye drops. Forty-nine participants were allocated to the Korean Red Ginseng (3 g/day; n = 24) or placebo (n = 25) groups for 8 weeks. Tear film stability, fluorescein corneal staining, conjunctival hyperemia, tear production, grade of meibomian gland dysfunction, and dry eye questionnaire (Ocular Surface Disease Index) were evaluated at baseline and on completion of the treatment. Almost all patients displayed dry eye symptoms and signs at baseline. After the 8-week intervention, Korean Red Ginseng supplementation significantly improved the tear film stability and total Ocular Surface Disease Index score, as compared to placebo (p Red Ginseng supplementation may provide an additional treatment option for dry eye and patients with glaucoma using antiglaucoma eye drops.

  13. Influence on ocular surface after cataract surgery and effect of topical diquafosol on postoperative dry eye: a multicenter prospective randomized study

    Directory of Open Access Journals (Sweden)

    Miyake K

    2017-03-01

    Full Text Available Kensaku Miyake,1 Norihiko Yokoi2 On behalf of Dry Eye After Cataract Surgery Investigational Study Group (DASIS group 1Miyake Eye Hospital, Nagoya, 2Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan Purpose: To investigate influences of 3% diquafosol sodium ophthalmic solution (DQS on ocular surface after cataract surgery and effects on postoperative dry eye. Design: This study had two consecutive prospective study phases. The former was an observational study from before cataract surgery to 4 weeks after surgery and the latter was a randomized open-label study from 4 to 8 weeks after surgery. Methods: Subjects were 433 eyes of 433 patients undergoing cataract surgery with intraocular lens implantation. Dry eye examination of tear breakup time (BUT, corneal and conjunctival fluorescein staining scores, total subjective symptom score (12 symptoms, and Schirmer I test were conducted before surgery and 4 weeks after surgery. Patient demographics and these examination results were used to analyze risk factors to predict postoperative dry eye. In a randomized study, 154 eyes diagnosed with dry eye postoperatively were applied either DQS or artificial tears (AT six times daily for 4 weeks. The data of the examinations were compared. Results: At 4 weeks after surgery, BUT was shortened significantly (P=0.036, fluorescein staining score increased significantly (P=0.012, but total subjective symptom score was significantly improved (P<0.001. The majority of postoperative dry eye was shortened BUT type (53.1%. The dry eye prevalence after surgery decreased (55.7% compared with before surgery (69.7%. Females and the patient with dry eye symptoms before surgery had significant risk factors for postoperative dry eye. In a randomized study, BUT was significantly prolonged in the DQS group (P=0.015, but not in the AT group. Fluorescein staining score was significantly improved in both groups (P<0.001. Total subjective symptom

  14. A mass and solute balance model for tear volume and osmolarity in the normal and the dry eye

    KAUST Repository

    Gaffney, E.A.

    2010-01-01

    Tear hyperosmolarity is thought to play a key role in the mechanism of dry eye, a common symptomatic condition accompanied by visual disturbance, tear film instability, inflammation and damage to the ocular surface. We have constructed a model for the mass and solute balance of the tears, with parameter estimation based on extensive data from the literature which permits the influence of tear evaporation, lacrimal flux and blink rate on tear osmolarity to be explored. In particular the nature of compensatory events has been estimated in aqueous-deficient (ADDE) and evaporative (EDE) dry eye. The model reproduces observed osmolarities of the tear meniscus for the healthy eye and predicts a higher concentration in the tear film than meniscus in normal and dry eye states. The differential is small in the normal eye, but is significantly increased in dry eye, especially for the simultaneous presence of high meniscus concentration and low meniscus radius. This may influence the interpretation of osmolarity values obtained from meniscus samples since they need not fully reflect potential damage to the ocular surface caused by tear film hyperosmolarity. Interrogation of the model suggests that increases in blink rate may play a limited role in compensating for a rise in tear osmolarity in ADDE but that an increase in lacrimal flux, together with an increase in blink rate, may delay the development of hyperosmolarity in EDE. Nonetheless, it is predicted that tear osmolarity may rise to much higher levels in EDE than ADDE before the onset of tear film breakup, in the absence of events at the ocular surface which would independently compromise tear film stability. Differences in the predicted responses of the pre-ocular tears in ADDE compared to EDE or hybrid disease to defined conditions suggest that no single, empirically-accessible variable can act as a surrogate for tear film concentration and the potential for ocular surface damage. This emphasises the need to measure

  15. Influence on ocular surface after cataract surgery and effect of topical diquafosol on postoperative dry eye: a multicenter prospective randomized study

    Science.gov (United States)

    Miyake, Kensaku; Yokoi, Norihiko

    2017-01-01

    Purpose To investigate influences of 3% diquafosol sodium ophthalmic solution (DQS) on ocular surface after cataract surgery and effects on postoperative dry eye. Design This study had two consecutive prospective study phases. The former was an observational study from before cataract surgery to 4 weeks after surgery and the latter was a randomized open-label study from 4 to 8 weeks after surgery. Methods Subjects were 433 eyes of 433 patients undergoing cataract surgery with intraocular lens implantation. Dry eye examination of tear breakup time (BUT), corneal and conjunctival fluorescein staining scores, total subjective symptom score (12 symptoms), and Schirmer I test were conducted before surgery and 4 weeks after surgery. Patient demographics and these examination results were used to analyze risk factors to predict postoperative dry eye. In a randomized study, 154 eyes diagnosed with dry eye postoperatively were applied either DQS or artificial tears (AT) six times daily for 4 weeks. The data of the examinations were compared. Results At 4 weeks after surgery, BUT was shortened significantly (P=0.036), fluorescein staining score increased significantly (P=0.012), but total subjective symptom score was significantly improved (Peye was shortened BUT type (53.1%). The dry eye prevalence after surgery decreased (55.7%) compared with before surgery (69.7%). Females and the patient with dry eye symptoms before surgery had significant risk factors for postoperative dry eye. In a randomized study, BUT was significantly prolonged in the DQS group (P=0.015), but not in the AT group. Fluorescein staining score was significantly improved in both groups (P<0.001). Total subjective symptom score was significantly decreased in the AT group (P<0.001), but not in the DQS group. Conclusion Our study suggests that cataract surgery has harmful effects on tear film stability and ocular surface, and DQS has a capability to improve them. PMID:28360509

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

    Directory of Open Access Journals (Sweden)

    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

  17. Effect of Oral Re-esterified Omega-3 Nutritional Supplementation on Dry Eyes

    Science.gov (United States)

    Donnenfeld, Eric D.; Shah, Zubin A.; Holland, Edward J.; Gross, Michael; Faulkner, William J.; Matossian, Cynthia; Lane, Stephen S.; Toyos, Melissa; Bucci, Frank A.; Perry, Henry D.

    2016-01-01

    Purpose: To assess the effect of oral re-esterified omega-3 fatty acids on tear osmolarity, matrix metalloproteinase-9 (MMP-9), tear break-up time (TBUT), Ocular Surface Disease Index (OSDI), fluorescein corneal staining, Schirmer score, meibomian gland dysfunction (MGD) stage and omega-3 index in subjects with dry eyes and confirmed MGD. Methods: This was a multicenter, prospective, interventional, placebo-controlled, double-masked study. Subjects were randomized to receive 4 softgels containing a total of 1680 mg of eicosapentaenoic acid/560 mg of docosahexaenoic acid or a control of 3136 mg of linoleic acid, daily for 12 weeks. Subjects were measured at baseline, week 6, and week 12 for tear osmolarity, TBUT, OSDI, fluorescein corneal staining, and Schirmer test with anesthesia. MMP-9 testing and omega-3 index were done at baseline and at 12 weeks. Results: One hundred five subjects completed the study. They were randomized to omega-3 (n = 54) and control group (n = 51). Statistically significant reduction in tear osmolarity was observed in the omega-3 group versus control group at week 6 (−16.8 ± 2.6 vs. −9.0 ± 2.7 mOsm/L, P = 0.042) and week 12 (−19.4 ± 2.7 vs. −8.3 ± 2.8 mOsm/L, P = 0.004). At 12 weeks, a statistically significant increase in omega-3 index levels (P < 0.001) and TBUT (3.5 ± 0.5 s vs. 1.2 ± 0.5 s, P = 0.002) was also observed. Omega-3 group experienced a significant reduction in MMP-9 positivity versus control group (67.9% vs. 35.0%, P = 0.024) and OSDI scores decreased significantly in omega-3 (−17.0 ± 2.6) versus control group (−5.0 ± 2.7, P = 0.002). Conclusions: Oral consumption of re-esterified omega-3 fatty acids is associated with statistically significant improvement in tear osmolarity, omega-3 index levels, TBUT, MMP-9, and OSDI symptom scores. PMID:27442314

  18. Determination of Risk Factors and Treatment of Dry Eye Disease in Type 1 Diabetes Before Corneal Complications at Sindh Institute of Ophthalmology And Visual Sciences.

    Science.gov (United States)

    Shujaat, Shehnilla; Jawed, Muhammad; Memon, Shahzad; Talpur, Khalid Iqbal

    2017-01-01

    The objective of this study was to assess and determine the risk factors and treatment of dry eye disease in type 1 diabetes before any ocular surface or corneal complication occurs. This study was conducted at Sindh Institute of Ophthalmology And Visual Sciences, Hyderabad, Pakistan. Subjects and methods for observational study were undertaken at the Department of Ophthalmology Sindh Institute Of Ophthalmology And Visual Sciences, Hyderabad, Pakistan. Hundred confirmed cases of type 1 diabetes were included in the study by non probability convenience sampling. Tear film breakup time and schrimer test were carried out to determine dry eye disease. Data was collected by self-prepared questionnaire and entered and analyzed by using Statistical Program for Social Sciences (SPSS, version 20.0). The frequencies and percentage were recorded and any associations with predisposing factors were statistically analyzed by t test. Out of hundred patients, 71 (71%) were found to have dry eyes (P<0.001). The mean age of the subject in this study was 50.97 years (range 30-70 years). Old age was related to high risk of dry eye disease (P<0.001). There was no big difference in the incidence of dry eyes in males and females. Long duration was found to be related with increased occurrence of dry eyes (P<0.001). We found higher values for abnormal tear film break up time than schirmer test values leading to increased occurrence of evaporative dry eyes. There is marked increase in frequency/ risk of developing dry eye disease in type 1 diabetes patients. Therefore, it is recommended to have periodic ophthalmic examination for type 1 diabetic patients.

  19. Prevalence and associated factors of dry eye: Our experience in patients above 40 years of age at a Tertiary Care Center

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    Suchi Shah

    2015-01-01

    Conclusions: Dry eye is a very common condition with a high prevalence among the elderly. We recommend the screening of all out-patients by TBUT, which is a simple test to perform and examination of lids for meibomian gland disease, which if present can be treated. Further studies are needed to establish uniform diagnostic criteria for dry eye, which will help to get more concrete prevalence data, as well as its etiological factors.

  20. Evaluation of the Effect of Moist Chamber Spectacles in Patients With Dry Eye Exposed to Adverse Environment Conditions.

    Science.gov (United States)

    Ogawa, Mamoru; Dogru, Murat; Toriyama, Naoki; Yamaguchi, Takefumi; Shimazaki, Jun; Tsubota, Kazuo

    2017-10-31

    To evaluate the effect of moist chamber spectacle wear on the ocular surface and tear functions in a controlled wind exposure environment. Twenty-eight eyes of 14 probable dry eye subjects (4 men, 10 women; mean age: 34.5 years) underwent constant wind exposure for 10 min without spectacle, with conventional spectacle wear, and with moist chamber spectacle wear. Dryness Visual Analog Scale (VAS) scores, tear evaporation, blink rate, tear film breakup testing, and fluorescein staining were performed before and after wind exposure. The mean dryness VAS score after wind exposure was significantly higher when no spectacles were worn or when conventional spectacles with no moist chambers were worn compared with after exposure scores when moist chamber spectacles were worn (P=0.02). The mean of tear evaporation rate from the ocular surface and blink rate increased significantly with wind exposure when no spectacles were worn or when conventional spectacles with no moist chambers were worn (P=0.04). There were no significant changes before and after wind exposure when the moist chamber spectacles were worn (P=0.1). Moist chamber spectacles appear to have favorable effects on dry eye symptomatology, tear stability, and blink rates in adverse environment conditions such as wind exposure.

  1. Dry eye evaluation and correlation analysis between tear film stability and corneal surface regularity after small incision lenticule extraction.

    Science.gov (United States)

    Zhang, Hui; Wang, Yan

    2017-09-22

    To investigate the dry eye after small incision lenticule extraction (SMILE) and explore the correlations between changes in the tear film stability, the tear secretion and the corneal surface regularity. Sixty-two eyes of 22 men and 13 women who underwent SMILE were included in this study. Corneal topography was measured to assess the index of surface variance (ISV) and the index of vertical asymmetry (IVA). Dry eye tests including subjective symptom questionnaire, tear breakup time (TBUT), corneal fluorescein staining and Schirmer's test (ST) were evaluated before and at 1 and 6 months postoperatively. TBUT was found to be significantly decreased from 9.8 ± 3.4 s preoperatively to 7.4 ± 3.8 s at 1 month and 6.5 ± 3.6 s at 6 months (both P film stability following SMILE procedure.

  2. Randomised controlled trial of topical antibacterial Manuka (Leptospermum species) honey for evaporative dry eye due to meibomian gland dysfunction.

    Science.gov (United States)

    Albietz, Julie M; Schmid, Katrina L

    2017-11-01

    The aim was to evaluate the efficacy of standardised Manuka (Leptospermum species) antibacterial honey as adjunctive twice daily treatment to conventional therapy (warm compresses, lid massage and preservative-free lubricant), in participants with evaporative dry eye due to moderate to advanced meibomian gland dysfunction. This prospective, open-label study involved 114 participants. After two weeks of conventional therapy participants were randomised to one of three treatment groups: Optimel Antibacterial Manuka Eye Gel (98 per cent Leptospermum species honey) plus conventional therapy (n = 37), Optimel Manuka plus Lubricant Eye Drops (16 per cent Leptospermum species honey) plus conventional therapy (n = 37) and a control (conventional therapy) (n = 40). Clinical evaluations performed at baseline and Week 8 included: symptom scores (Ocular Surface Disease Index, Ocular Comfort Index), daily lubricant use, tear assessments (break-up time, secretion, osmolarity and InflammaDry), corneal sensation, ocular surface staining, meibomian gland secretion quality and expressibility, bulbar conjunctival, limbal and lid marginal redness and eyelid marginal bacterial cultures and colony counts. Significant improvements (p ≤ 0.05) occurred at Week 8 in symptoms, tear break-up time, staining, tear osmolarity, meibum quality and bulbar, limbal and lid margin redness for all treatments. Improvement in staining was significantly greater with Optimel 16 per cent drops (p = 0.035). Significant improvements (p honey treatments are effective as adjunctive therapies for meibomian gland dysfunction. © 2017 Optometry Australia.

  3. 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.

  4. In vivo imaging of palisades of Vogt in dry eye versus normal subjects using en-face spectral-domain optical coherence tomography.

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    Wajdene Ghouali

    Full Text Available To evaluate a possible clinical application of spectral-domain optical coherence tomography (SD-OCT using en-face module for the imaging of the corneoscleral limbus in normal subjects and dry eye patients.Seventy-six subjects were included in this study. Seventy eyes of 35 consecutive patients with dry eye disease and 82 eyes of 41 healthy control subjects were investigated. All subjects were examined with the Avanti RTVue® anterior segment OCT. En-face OCT images of the corneoscleral limbus were acquired in four quadrants (inferior, superior, nasal and temporal and then were analyzed semi-quantitatively according to whether or not palisades of Vogt (POV were visible. En-face OCT images were then compared to in vivo confocal microscopy (IVCM in eleven eyes of 7 healthy and dry eye patients.En-face SD-OCT showed POV as a radially oriented network, located in superficial corneoscleral limbus, with a good correlation with IVCM features. It provided an easy and reproducible identification of POV without any special preparation or any direct contact, with a grading scale from 0 (no visualization to 3 (high visualization. The POV were found predominantly in superior (P<0.001 and inferior (P<0.001 quadrants when compared to the nasal and temporal quadrants for all subjects examined. The visibility score decreased with age (P<0.001 and was lower in dry eye patients (P<0.01. In addition, the score decreased in accordance with the severity of dry eye disease (P<0.001.En-face SD-OCT is a non-contact imaging technique that can be used to evaluate the POV, thus providing valuable information about differences in the limbal anatomy of dry eye patients as compared to healthy patients.

  5. A randomized, multicenter phase 3 study comparing 2% rebamipide (OPC-12759) with 0.1% sodium hyaluronate in the treatment of dry eye.

    Science.gov (United States)

    Kinoshita, Shigeru; Oshiden, Kazuhide; Awamura, Saki; Suzuki, Hiroyuki; Nakamichi, Norihiro; Yokoi, Norihiko

    2013-06-01

    To investigate the efficacy of 2% rebamipide ophthalmic suspension compared with 0.1% sodium hyaluronate ophthalmic solution for the treatment of patients with dry eye. Randomized, multicenter, active-controlled parallel-group study. One hundred eighty-eight patients with dry eye. Following a 2-week screening period, patients were allocated randomly to receive 2% rebamipide or 0.1% sodium hyaluronate, administered as 1 drop in each eye 4 or 6 times daily, respectively, for 4 weeks. There were 2 primary end points: changes in the fluorescein corneal staining (FCS) score to determine noninferiority of 2% rebamipide and changes in the lissamine green conjunctival staining (LGCS) score to determine superiority. Secondary objective end points were Schirmer's test results and tear film breakup time (TBUT). Secondary subjective end points were dry eye-related ocular symptoms (foreign body sensation, dryness, photophobia, eye pain, and blurred vision) score and the patients' overall treatment impression score. In the primary analysis, the mean change from baseline in FCS scores verified noninferiority, indicated significant improvement, and, in LGCS scores, verified the superiority of 2% rebamipide to 0.1% sodium hyaluronate. Values for the Schirmer's test and TBUT were comparable between the 2 groups. For 2 dry eye-related ocular symptoms--foreign body sensation and eye pain--2% rebamipide showed significant improvements over 0.1% sodium hyaluronate. Patients had a significantly more favorable impression of 2% rebamipide than of 0.1% sodium hyaluronate; 64.5% rated treatment as improved or markedly improved versus 34.7%, respectively. No serious adverse events were observed. Administration of 2% rebamipide was effective in improving both the objective signs and subjective symptoms of dry eye. Those findings, in addition to the well-tolerated profile of 2% rebamipide, clearly show that it is an effective therapeutic method for dry eye. Proprietary or commercial disclosure

  6. The sustained effect (12 months) of a single-dose vectored thermal pulsation procedure for meibomian gland dysfunction and evaporative dry eye

    OpenAIRE

    Blackie CA; Coleman CA; Holl; EJ

    2016-01-01

    Caroline A Blackie,1 Christy A Coleman,1 Edward J Holland,2  On behalf of the LipiFlow Study Group 1TearScience Inc., Morrisville, NC, 2Cincinnati Eye Institute, Edgewood, KY, USA Purpose: To evaluate the sustained effect (up to 1 year) of a single, 12-minute vectored thermal pulsation (VTP) treatment in improving meibomian gland function and dry eye symptoms in patients with meibomian gland dysfunction and evaporative dry eye.Methods: The prospective, multicenter, open-label clin...

  7. The sustained effect (12 months) of a single-dose vectored thermal pulsation procedure for meibomian gland dysfunction and evaporative dry eye

    OpenAIRE

    Blackie, Caroline; Coleman,Christy; Holland, Edward

    2016-01-01

    Caroline A Blackie,1 Christy A Coleman,1 Edward J Holland,2  On behalf of the LipiFlow Study Group 1TearScience Inc., Morrisville, NC, 2Cincinnati Eye Institute, Edgewood, KY, USA Purpose: To evaluate the sustained effect (up to 1 year) of a single, 12-minute vectored thermal pulsation (VTP) treatment in improving meibomian gland function and dry eye symptoms in patients with meibomian gland dysfunction and evaporative dry eye.Methods: The prospective, multicenter, open-la...

  8. The sustained effect (12 months of a single-dose vectored thermal pulsation procedure for meibomian gland dysfunction and evaporative dry eye

    Directory of Open Access Journals (Sweden)

    Blackie CA

    2016-07-01

    Full Text Available Caroline A Blackie,1 Christy A Coleman,1 Edward J Holland,2  On behalf of the LipiFlow Study Group 1TearScience Inc., Morrisville, NC, 2Cincinnati Eye Institute, Edgewood, KY, USA Purpose: To evaluate the sustained effect (up to 1 year of a single, 12-minute vectored thermal pulsation (VTP treatment in improving meibomian gland function and dry eye symptoms in patients with meibomian gland dysfunction and evaporative dry eye.Methods: The prospective, multicenter, open-label clinical trial included 200 subjects (400 eyes who were randomized to a single VTP treatment (treatment group or twice-daily, 3-month, conventional warm compress and eyelid hygiene therapy (control group. Control group subjects received crossover VTP treatment at 3 months (crossover group. Effectiveness measures of meibomian gland secretion (MGS and dry eye symptoms were evaluated at baseline and 1, 3, 6, 9, and 12 months. Subjects with inadequate symptom relief could receive additional meibomian gland dysfunction therapy after 3 (treatment group and 6 months (crossover group.Results: At 3 months, the treatment group had greater mean improvement in MGS (P<0.0001 and dry eye symptoms (P=0.0068, compared to controls. At 12 months, 86% of the treatment group had received only one VTP treatment, and sustained a mean improvement in MGS from 6.4±3.7 (baseline to 17.3±9.1 (P<0.0001 and dry eye symptoms from 44.1±20.4 to 21.6±21.3 (P<0.0001; 89% of the crossover group had received only one VTP treatment with sustained mean improvement in MGS from 6.3±3.6 to 18.4±11.1 (P<0.0001 and dry eye symptoms from 49.1±21.0 to 24.0±23.2 (P<0.0001. Greater mean improvement in MGS was associated with less severe baseline MGS (P=0.0017 and shorter duration of time between diagnosis and treatment (P=0.0378.Conclusion: A single VTP treatment can deliver a sustained mean improvement in meibomian gland function and mean reduction in dry eye symptoms, over 12 months. A single VTP treatment

  9. The Effect of the Aqueous Extract of Bidens Pilosa L. on Androgen Deficiency Dry Eye in Rats.

    Science.gov (United States)

    Zhang, Chuanwei; Li, Kai; Yang, Zichao; Wang, Yuliang; Si, Haipeng

    2016-01-01

    Bidens pilosa L. (Bp) is widely distributed in China and has been widely used as a traditional Chinese medicine. The aim of this study was to examine the effect of the extract of Bp on androgen deficiency dry eye and determine its possible mechanisms. Twenty-four rats were randomly divided into four groups: Group Con (control), Group Sal (physiological saline), Group Fin (oral finasteride), and Group Bp (oral finasteride and Bp). The dry eye model was established in group Fin and group Bp. Aqueous tear quantity was measured with phenol red-impregnated cotton threads with anesthesia. Tear film breakup time (BUT) and corneal epithelial damage were evaluated by fluorescein staining. Animals were sacrificed at 28 days, and ocular tissues (lacrimal gland and cornea) were evaluated with light microscopy; gene microarray analysis for inflammatory cytokines and Western blot were also performed. Finasteride administration effectively induced dry eye in rats by 14 days after administration. Group Fin rats had significantly higher fluorescein staining scores and lower aqueous tear quantity and BUT than the group Con rats, and notable inflammatory cell infiltrates were observed in the lacrimal gland of group Fin rats. The fluorescein staining score, aqueous tear quantity and BUT significantly improved with Bp treatment in the group Bp rats, and the structures of the lacrimal gland were well maintained without significant lymphocyte infiltration. Cytokine antibody array data identified the cytokines B7-2/Cd86, IL-1β, IL-4, IL-6, IL-10, MMP-8, FasL, TNF-α and TIMP-1 as candidates for validation by Western blot. Expression levels of pro-inflammatory cytokines, including IL-1β, IL-6, and TNF-α, in group Fin were upregulated compared with group Con. Levels of anti-inflammatory cytokines, such as IL-4 and IL-10, in group Fin were also upregulated compared with those in group Con. Compared with group Fin, IL-1β, FasL, and TNF-α were significantly decreased in group Bp. The

  10. The Effect of the Aqueous Extract of Bidens Pilosa L. on Androgen Deficiency Dry Eye in Rats

    Directory of Open Access Journals (Sweden)

    Chuanwei Zhang

    2016-06-01

    Full Text Available Background/Aims: Bidens pilosa L. (Bp is widely distributed in China and has been widely used as a traditional Chinese medicine. The aim of this study was to examine the effect of the extract of Bp on androgen deficiency dry eye and determine its possible mechanisms. Methods: Twenty-four rats were randomly divided into four groups: Group Con (control, Group Sal (physiological saline, Group Fin (oral finasteride, and Group Bp (oral finasteride and Bp. The dry eye model was established in group Fin and group Bp. Aqueous tear quantity was measured with phenol red-impregnated cotton threads with anesthesia. Tear film breakup time (BUT and corneal epithelial damage were evaluated by fluorescein staining. Animals were sacrificed at 28 days, and ocular tissues (lacrimal gland and cornea were evaluated with light microscopy; gene microarray analysis for inflammatory cytokines and Western blot were also performed. Results: Finasteride administration effectively induced dry eye in rats by 14 days after administration. Group Fin rats had significantly higher fluorescein staining scores and lower aqueous tear quantity and BUT than the group Con rats, and notable inflammatory cell infiltrates were observed in the lacrimal gland of group Fin rats. The fluorescein staining score, aqueous tear quantity and BUT significantly improved with Bp treatment in the group Bp rats, and the structures of the lacrimal gland were well maintained without significant lymphocyte infiltration. Cytokine antibody array data identified the cytokines B7-2/Cd86, IL-1β, IL-4, IL-6, IL-10, MMP-8, FasL, TNF-α and TIMP-1 as candidates for validation by Western blot. Expression levels of pro-inflammatory cytokines, including IL-1β, IL-6, and TNF-α, in group Fin were upregulated compared with group Con. Levels of anti-inflammatory cytokines, such as IL-4 and IL-10, in group Fin were also upregulated compared with those in group Con. Compared with group Fin, IL-1β, FasL, and TNF

  11. Dry Eye Disease following Refractive Surgery: A 12-Month Follow-Up of SMILE versus FS-LASIK in High Myopia

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    Bingjie Wang

    2015-01-01

    Full Text Available Purpose. To compare dry eye disease following SMILE versus FS-LASIK. Design. Prospective, nonrandomised, observational study. Patients. 90 patients undergoing refractive surgery for myopia were included. 47 eyes underwent SMILE and 43 eyes underwent FS-LASIK. Methods. Evaluation of dry eye disease was conducted preoperatively and at 1, 3, 6, and 12 months postoperatively, using the Salisbury Eye Evaluation Questionnaire (SEEQ and TBUT. Results. TBUT reduced following SMILE at 1 and 3 months (p<0.001 and at 1, 3, and 6 months following FS-LASIK (p<0.001. TBUT was greater following SMILE than FS-LASIK at 3, 6, and 12 months (p<0.001, p<0.001, and p=0.009, resp.. SEEQ scores increased (greater symptoms following SMILE at 1 month (p<0.001 and 3 months (p=0.003 and at 1, 3, and 6 months following FS-LASIK (p<0.001. SMILE produced lower SEEQ scores (fewer symptoms than FS-LASIK at 1, 3, and 6 months (p<0.001. Conclusion. SMILE produces less dry eye disease than FS-LASIK at 6 months postoperatively but demonstrates similar degrees of dry eye disease at 12 months.

  12. 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

  13. 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

  14. In vivo confocal microscopic characterisation of the cornea in chronic graft-versus-host disease related severe dry eye disease.

    Science.gov (United States)

    Steger, B; Speicher, L; Philipp, W; Bechrakis, N E

    2015-02-01

    To first describe in vivo confocal microscopic (IVCM) corneal findings in severe dry eye syndrome due to ocular chronic graft versus host disease (cGvHD) after allogeneic stem cell transplantation. IVCM of the central cornea was performed in 12 prospectively recruited patients with severe ocular cGvHD associated dry eye syndrome and in six control patients with haematological malignancies without cGvHD. Within each examined corneal layer, at least three non-overlapping areas were selected for representative analysis. The number of sub basal nerve branches was markedly reduced in patients with cGvHD. Sub basal nerve morphology was characterised by increased tortuosity and reduced reflectivity. Accumulation of hyper-reflective extracellular matrix, significantly increased haze and increased keratocyte density were found in the anterior stroma of the study group. IVCM findings of the cornea in patients with severe ocular cGvHD include a rarefaction of the sub basal corneal nerve plexus and dense accumulation of hyper-reflective extracellular matrix in the anterior stroma. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Transduced PEP-1-FK506BP ameliorates corneal injury in Botulinum toxin A-induced dry eye mouse model

    Science.gov (United States)

    Kim, Dae Won; Lee, Sung Ho; Ku, Sae Kwang; Cho, Soo Hyun; Cho, Sung-Woo; Yoon, Ga Hyeon; Hwang, Hyun Sook; Park, Jinseu; Eum, Won Sik; Kwon, Oh-Shin; Choi, Soo Young

    2013-01-01

    FK506 binding protein 12 (FK506BP) belongs to a family of immunophilins, and is involved in multiple biological processes. However, the function of FK506BP in corneal disease remains unclear. In this study, we examined the protective effects on dry eye disease in a Botulinum toxin A (BTX-A) induced mouse model, using a cell-permeable PEP-1-FK506BP protein. PEP-1-FK506BP efficiently transduced into human corneal epithelial cells in a time- and dose-dependent manner, and remained stable in the cells for 48 h. In addition, we demonstrated that topical application of PEP-1-FK506BP was transduced into mouse cornea and conjunctiva by immunohistochemistry. Furthermore, topical application of PEP-1-FK506BP to BTX-A-induced mouse model markedly inhibited expression levels of pro-inflammatory cytokines such as interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and macrophage inhibitory factor (MIF) in corneal and conjunctival epithelium. These results suggest PEP-1-FK506BP as a potential therapeutic agent for dry eye diseases. [BMB Reports 2013; 46(2): 124-129] PMID:23433117

  16. The Association between Dry Eye Disease and Physical Activity as well as Sedentary Behavior: Results from the Osaka Study

    Directory of Open Access Journals (Sweden)

    Motoko Kawashima

    2014-01-01

    Full Text Available Purpose. To assess the association of dry eye disease (DED with physical activity and sedentary behavior. Methods. The cross-sectional survey conducted included Japanese office workers who use visual display terminals (n=672. DED was assessed according to the Japanese Dry Eye Diagnostic Criteria, and participants were categorized into “definite DED,” “probable DED,” or “non-DED” groups based on the results of DED examinations. Physical activity and sedentary behavior of participants were assessed using the International Physical Activity Questionnaire (IPAQ, and physical activity level was calculated in metabolic equivalent units per week (MET, min/week. Participants were classified as having a high, moderate, or low level of physical activity. Results. Participants with abnormal tear break-up time (BUT (≤5 s were involved in sedentary behavior for significantly longer duration than those with normal BUT (P=0.035. Non-DED participants (14.5% tended to have higher levels of physical activity than definite DED participants (2.5%. Participants with definite DED had significantly lower MET scores than those with non-DED (P=0.025. Conclusions. Our findings suggest that a lower level of physical activity and sedentary behavior are associated with DED; however, longitudinal/intervention studies with large groups of participants are needed to validate these findings.

  17. Office characteristics and dry eye complaints in European workers : The OFFICAIR study

    NARCIS (Netherlands)

    de Kluizenaar, Y; Roda, C.; Dijkstra, NE; Fossati, S; Mandin, C; Mihucz, VG; Hänninen, O; de Oliveira Fernandes, E; Silva, GV; Carrer, P; Bartzis, J; Bluijssen, P.M.

    2016-01-01

    Objectives Ocular discomfort is a prevalent health complaint in offices. It is hypothesized that, in addition to individual and occupational factors, the buildings' indoor environment may affect eye complaints. However, insight in potential building-related causal factors, needed to allow

  18. 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

    2018-01-20

    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, Pvision measured by OQAS is an interesting parameter for evaluating the effectiveness of a lacrimal substitute. The purpose of artificial tears is, among other things, to provide comfort and a reduction

  19. Lifitegrast ophthalmic solution 5.0% for treatment of dry eye disease: results of the OPUS-1 phase 3 study.

    Science.gov (United States)

    Sheppard, John D; Torkildsen, Gail L; Lonsdale, John D; D'Ambrosio, Francis A; McLaurin, Eugene B; Eiferman, Richard A; Kennedy, Kathryn S; Semba, Charles P

    2014-02-01

    To assess the efficacy and safety of lifitegrast ophthalmic solution 5.0% compared with placebo in subjects with dry eye disease. Prospective, randomized, double-masked, placebo-controlled, parallel arm, multicenter clinical trial. A total of 588 adult subjects with dry eye disease. Eligible subjects were randomized 1:1 to receive topically administered lifitegrast (5.0%) or placebo (vehicle) twice daily for 84 days after a 14-day open-label placebo run-in period. After enrollment (day 0), subjects were evaluated at days 14, 42, and 84. Key objective (fluorescein and lissamine staining scores [Ora scales]) and subjective (Ocular Surface Disease Index [OSDI], 7-item visual analog scale, and ocular discomfort score [Ora scale]) measures were assessed at all visits. The primary objective efficacy measure (sign) was mean change from baseline inferior corneal staining score (ICSS) at day 84. The co-primary subjective efficacy measure (symptom) was the mean change from baseline in the visual-related function subscale score of the Ocular Surface Disease Index (VR-OSDI). Supportive measures included corneal fluorescein scores (superior, central, total region) and conjunctival lissamine scores (nasal, temporal, total region) and symptom scores at day 84. The study met the primary objective efficacy ICSS end point in demonstrating superiority of lifitegrast compared with placebo (P = 0.0007). Lifitegrast significantly reduced corneal fluorescein staining (superior, P = 0.0392; total cornea, P = 0.0148) and conjunctival lissamine staining (nasal, P = 0.0039; total conjunctiva, P = 0.0086) at day 84 versus placebo. Significant (P lifitegrast dose at day 0. Lifitegrast ophthalmic solution 5.0% significantly reduced corneal fluorescein and conjunctival lissamine staining and improved symptoms of ocular discomfort and eye dryness compared with placebo when administered twice daily over 84 days. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All

  20. A prospective, multicenter, noninterventional study of Optive Plus® in the treatment of patients with dry eye: the prolipid study

    Directory of Open Access Journals (Sweden)

    Kaercher T

    2014-06-01

    Full Text Available Thomas Kaercher,1 Ulrich Thelen,2 Gerrett Brief,3 Robert J Morgan-Warren,4 Richard Leaback41Augenarztpraxis, Heidelberg, Germany; 2University of Münster, Münster, Germany; 3Ruhr University, Bochum, Germany; 4Allergan Holdings Ltd, Marlow, UK  Objective: The aim was to evaluate the efficacy of Optive Plus®, an artificial tear containing castor oil, in patients with dry eye, in a routine clinical setting. Methods: This was a prospective, noninterventional study of patients with dry eye who switched from a prior therapy or who were naïve to treatment (n=1,209. Patients were issued Optive Plus® artificial tears. Dry eye severity, tear break-up time (TBUT, Schirmer score, Ocular Surface Disease Index (OSDI score, and patient assessment of symptoms were recorded at baseline and at the follow-up visit (4 weeks after starting Optive Plus®. Results: The cause of dry eye was determined to be aqueous deficiency, lipid deficiency, or a mixture of aqueous and lipid deficiency (in 19.5%, 20.1%, and 47.8%, respectively, of the total study population. The severity of dry eye decreased from baseline to the follow-up visit, showing a decrease of the more severe levels (2–4 and a concurrent increase in mild level (1 of the rating scale. Patients reported an improvement in dry eye symptoms over the duration of the study, specifically 74.2% (n=152, 85.4% (n=182, and 82.4% (n=417 of patients in the aqueous-deficient, lipid-deficient, and mixed-deficiency groups, respectively. TBUT was measured in 475 patients. Baseline measurements for mean and standard deviation were 9.0±3.5, 7.1±3.6, and 6.6±3.0 seconds for the aqueous-deficient, lipid-deficient, and mixed-deficiency groups, respectively. These increased to 10.5±3.5, 10.0±3.6, and 9.2±3.1 seconds at the final visit. Overall, 92.5% of all patients were satisfied with the use of Optive Plus®, and 86% said they would purchase Optive Plus®. Ten percent of patients reported adverse events, and 1.8% of

  1. Bowman Break and Subbasal Nerve Plexus Changes in a Patient With Dry Eye Presenting With Chronic Ocular Pain and Vitamin D Deficiency.

    Science.gov (United States)

    Shetty, Rohit; Deshpande, Kalyani; Deshmukh, Rashmi; Jayadev, Chaitra; Shroff, Rushad

    2016-05-01

    To report the case of a 40-year-old patient with persistent bilateral ocular pain and discomfort for 2 years in whom conventional management of dry eye had failed. Detailed ocular examination, meibography, and tear film evaluation were suggestive of bilateral meibomian gland dysfunction and evaporative dry eye. Topical medication failed to alleviate the patient's symptoms. To identify the cause of pain, imaging was performed with in vivo confocal microscopy and anterior segment spectral domain optical coherence tomography. Systemic evaluation revealed severe vitamin D deficiency with a value of 5.86 ng/mL. Case report. In vivo confocal microscopy showed abnormal subbasal nerve plexus morphology, increased dendritic cell density, and enlarged terminal nerve sprouts. A breach in the Bowman layer was detected in both eyes on spectral domain optical coherence tomography. Conventional management having failed, LipiFlow treatment (TearScience, Morrisville, NC) was performed and topical therapy with cyclosporine 0.05%, steroids, and lubricating eye drops was initiated with incomplete symptomatic relief. However, with parenteral therapy for vitamin D deficiency, there was a dramatic improvement in the patient's symptoms. Inflammation aggravated by vitamin D deficiency results in an altered epithelial profile, Bowman layer damage, recruitment of dendritic cells, and altered subbasal nerve plexus features in patients with chronic dry eye disease. These can serve as potential imaging markers for studying the underlying mechanisms in patients with dry eye disease with persisting symptoms despite aggressive conventional treatment.

  2. 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.

  3. High Levels of 17β-Estradiol Are Associated with Increased Matrix Metalloproteinase-2 and Metalloproteinase-9 Activity in Tears of Postmenopausal Women with Dry Eye

    Directory of Open Access Journals (Sweden)

    Guanglin Shen

    2016-01-01

    Full Text Available Purpose. To determine the serum levels of sex steroids and tear matrix metalloproteinases (MMP 2 and 9 concentrations in postmenopausal women with dry eye. Methods. Forty-four postmenopausal women with dry eye and 22 asymptomatic controls were enrolled. Blood was drawn and analyzed for serum levels of sex steroids and lipids. Then, the following tests were performed: tear collection, Ocular Surface Disease Index (OSDI questionnaire, fluorescein tear film break-up time (TBUT, corneal fluorescein staining, Schirmer test, and conjunctival impression cytology. The conjunctival mRNA expression and tear concentrations of MMP-2 and MMP-9 were measured. Results. Serum 17β-estradiol levels were significantly higher in the dry eye subjects than in the controls (P=0.03, whereas there were no significant differences in levels of testosterone, dehydroepiandrosterone sulfate (DHEA-S, and progesterone. Tear MMP-2 and MMP-9 concentrations (P<0.001, as well as the MMP-9 mRNA expression in conjunctival samples (P=0.02, were significantly higher in dry eye subjects than in controls. Serum 17β-estradiol levels were positively correlated with tear MMP-2 and MMP-9 concentrations and negatively correlated with Schirmer test values. Conclusions. High levels of 17β-estradiol are associated with increased matrix metalloproteinase-2 and metalloproteinase-9 activity in tears of postmenopausal women with dry eye.

  4. Electrophoresis of tear proteins as a new diagnostic tool for two high risk groups for dry eye: computer users and contact lens wearers.

    Science.gov (United States)

    Chiva, Andreea

    2011-08-15

    Dry eye is the most prevalent condition seen by the ophthalmologist, in particular in elderly. The identification of new common risk factors (computer use and contact lens wear) extends the disease among the young people. The early diagnosis of dry eye is essential, but difficult, because the biochemical changes in tear film usually occur before any detectable signs. Due its advantages, electrophoresis of tear proteins could be an important tool for diagnosis of tear film impairment in high risk groups for dry eye. The role of tear proteins electrophoresis in early diagnosis of dry eye related to computer use and contact lens wear, as well as the biochemical changes in these high risk groups are presented. This review will summarize the actual data concerning the electrophoretic changes of tear proteins in computer users and contact lens wearers, two common high risk groups for dry eye. Electrophoresis of tear proteins using automated system Hyrys-Hydrasys SEBIA France is an important tool for early diagnosis of tear film alterations and monitoring of therapy. The quantification of many proteins in a single analysis using a small quantity of unconcentrated reflex tears is the main advantage of this technique. Electrophoresis of tear proteins should became a prerequisite, in particular for computer users less than 3 h/day, as well as at prescribing contact lenses.

  5. Prevalence of dry eye disease in southern Egypt: a hospital-based outpatient clinic study

    Directory of Open Access Journals (Sweden)

    Engy M Mostafa

    2016-01-01

    This is the first observational study of DED in southern Egypt on a large sample population. The prevalence of DED among ophthalmic outpatients at Sohag University Hospital, Egypt, was 22.8% depending on both symptoms and signs. Older age patients and females were more susceptible to DED. DED is an existing entity that can compound any eye condition causing incomplete recovery, and therefore high index of suspicion is greatly advised.

  6. Long-term (12-month) improvement in meibomian gland function and reduced dry eye symptoms with a single thermal pulsation treatment.

    Science.gov (United States)

    Greiner, Jack V

    2013-08-01

    To determine the 1-year post-treatment dry eye status of subjects with meibomian gland dysfunction and dry eye symptoms after receiving a single LipiFlow Thermal Pulsation System treatment. Single-centre, prospective, observational, open-label, 1-month-registered clinical trial with a 1-year follow-up examination. Patients with evaporative dry eye disease with meibomian gland dysfunction and dry eye symptoms who had participated in the registered 1-month clinical trial. Eighteen of 30 subjects initially enrolled were able to return for a 1-year follow-up. Both eyes of all patients were treated with a single 12-min treatment using the LipiFlow Thermal Pulsation System. Meibomian gland function, tear break-up time and dry eye symptoms were measured. Data are presented for pretreatment (baseline), and 1-month and 1-year post-treatment. Meibomian gland secretion scores, and tear break-up time and dry eye symptoms. Significant improvement in meibomian gland secretion scores from baseline measurements (4.0 ± 3.4) to 1-month post-treatment (11.3 ± 4.7; P < 0.0005) was maintained at 1-year (7.3 ± 4.6; P < 0.05). Baseline tear break-up time (4.9 ± 3.0) was significantly increased at 1-month (9.5 ± 6.9; P < 0.05); however, this improvement was no longer evident at 1-year post-treatment (6.0 ± 4.4). The significant improvement in symptom scores on Ocular Surface Disease Index and Standard Patient Evaluation of Eye Dryness questionnaires observed at 1-month (P < 0.0005) was maintained at 1-year (Ocular Surface Disease Index [P < 0.05]; Standard Patient Evaluation of Eye Dryness [P < 0.0005]). A single 12-min treatment with the Lipi Flow Thermal Pulsation System offers an effective treatment for evaporative dry eye and meibomian gland dysfunction resulting in significant and sustained improvement in signs and symptoms for up to 1 year. © 2012 The Author. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

  7. The sustained effect (12 months) of a single-dose vectored thermal pulsation procedure for meibomian gland dysfunction and evaporative dry eye.

    Science.gov (United States)

    Blackie, Caroline A; Coleman, Christy A; Holland, Edward J

    2016-01-01

    To evaluate the sustained effect (up to 1 year) of a single, 12-minute vectored thermal pulsation (VTP) treatment in improving meibomian gland function and dry eye symptoms in patients with meibomian gland dysfunction and evaporative dry eye. The prospective, multicenter, open-label clinical trial included 200 subjects (400 eyes) who were randomized to a single VTP treatment (treatment group) or twice-daily, 3-month, conventional warm compress and eyelid hygiene therapy (control group). Control group subjects received crossover VTP treatment at 3 months (crossover group). Effectiveness measures of meibomian gland secretion (MGS) and dry eye symptoms were evaluated at baseline and 1, 3, 6, 9, and 12 months. Subjects with inadequate symptom relief could receive additional meibomian gland dysfunction therapy after 3 (treatment group) and 6 months (crossover group). At 3 months, the treatment group had greater mean improvement in MGS (P<0.0001) and dry eye symptoms (P=0.0068), compared to controls. At 12 months, 86% of the treatment group had received only one VTP treatment, and sustained a mean improvement in MGS from 6.4±3.7 (baseline) to 17.3±9.1 (P<0.0001) and dry eye symptoms from 44.1±20.4 to 21.6±21.3 (P<0.0001); 89% of the crossover group had received only one VTP treatment with sustained mean improvement in MGS from 6.3±3.6 to 18.4±11.1 (P<0.0001) and dry eye symptoms from 49.1±21.0 to 24.0±23.2 (P<0.0001). Greater mean improvement in MGS was associated with less severe baseline MGS (P=0.0017) and shorter duration of time between diagnosis and treatment (P=0.0378). A single VTP treatment can deliver a sustained mean improvement in meibomian gland function and mean reduction in dry eye symptoms, over 12 months. A single VTP treatment provides significantly greater mean improvement in meibomian gland function and dry eye symptoms as compared to a conventional, twice-daily, 3-month regimen. Early VTP intervention for meibomian gland dysfunction is

  8. Acupuncture for the treatment of dry eye: a multicenter randomised controlled trial with active comparison intervention (artificial teardrops.

    Directory of Open Access Journals (Sweden)

    Tae-Hun Kim

    Full Text Available To evaluate the effects of acupuncture compared to a control group using artificial tears.multicenter randomised controlled trial (three local research hospitals of South Korea.150 patients with moderate to severe dry eye.Participants were randomly allocated into four weeks of acupuncture treatment (bilateral BL2, GB14, TE 23, Ex1, ST1, GB20, LI4, LI11 and single GV23 or to the artificial tears group (sodium carboxymethylcellulose.The ocular surface disease index (OSDI, tear film break-up time (TFBUT, Schirmer Ι test, visual analogue scale (VAS for self-assessment of ocular discomfort, general assessment (by both acupuncture practitioners and participants and quality of life (QOL through the Measure Yourself Medical Outcome Profile-2 (MYMOP-2.There was no statistically significant difference between two groups for the improvement of dry eye symptoms as measured by OSDI (MD -16.11, 95% CI [-20.91, -11.32] with acupuncture and -15.37, 95% CI [-19.57, -11.16] with artificial tears; P = 0.419, VAS (acupuncture: -23.84 [-29.59, -18.09]; artificial tears: -22.2 [-27.24, -17.16], P = 0.530 or quality of life (acupuncture: -1.32 [-1.65, -0.99]; artificial tears: -0.96 [-1.32, -0.6], P = 0.42 immediately after treatment. However, compared with artificial tears group, the OSDI (acupuncture: -16.15 [-21.38, -10.92]; artificial tears: -10.76 [-15.25, -6.27], P = 0.030 and VAS (acupuncture: -23.88 [-30.9, -16.86]; artificial tears: -14.71 [-20.86, -8.55], P = 0.018 were significantly improved in the acupuncture group at 8 weeks after the end of acupuncture treatment. TFBUT measurements increased significantly in the acupuncture group after treatment.Acupuncture may have benefits on the mid-term outcomes related to dry eye syndrome compared with artificial tears.ClinicalTrials.gov NCT01105221.

  9. The Effect of Tear Supplementation with 0.15% Preservative-Free Zinc-Hyaluronate on Ocular Surface Sensations in Patients with Dry Eye.

    Science.gov (United States)

    Perényi, Kristóf; Dienes, Lóránt; Kornafeld, Anna; Kovács, Balázs; Kiss, Huba J; Szepessy, Zsuzsanna; Nagy, Zoltán Z; Barsi, Árpád; Acosta, M Carmen; Gallar, Juana; Kovács, Illés

    To evaluate the effect of tear supplementation with preservative free 0.15% zinc-hyaluronate on ocular surface sensations and corneal sensitivity in dry eye patients. Ocular surface sensations were assessed using the ocular surface disease index (OSDI) questionnaire and by recording ocular sensations during forced blinking in parallel with noninvasive tear film breakup time measurement in 20 eyes of 20 dry eye patients. Corneal sensitivity thresholds to selective stimulation of corneal mechano-, thermal- and chemical receptors were measured using the Belmonte gas esthesiometer. All baseline measurements were repeated after 1 month of treatment with 0.15% zinc-hyaluronate. After 1 month, a significant decrease in mean OSDI score (from 35.66 ± 12.36 to 15.03 ± 11.22; P tear film breakup time (from 3.83 ± 0.80 to 8.67 ± 4.50 s; P  0.05). Prolonged use of 0.15% zinc-hyaluronate results in an improvement of tear film stability and a decrease of dry eye complaints. The decrease in corneal mechano-and polymodal receptor excitability suggests that zinc-hyaluronate helps to recover normal corneal sensitivity, and thus might have a beneficial additional effect on reducing ocular surface complaints in dry eye patients.

  10. Comparative study of bacterial status from conjunctival sac of the elder Qiang minority and Han people with dry eye in Sichuan, China.

    Science.gov (United States)

    Zhang, Yue; Liu, Zhi-Rong; Chen, Hui; Dong, Wan-Jiang; Fan, Ying-Chuan; Yu, Hua; Wang, Guang-Jin; Li, Yu-Chan; Cao, Kui

    2012-01-01

    To compare the status of bacteria in the conjunctival sac from the elder Qiang minority and Han people with dry eyes in Sichuan, China. Total of 54 elder Qiang people with dry eyes (108 eyes) were examined by cluster sampling. In the similar habitation region of Han people, 80 (160 dry eyes) Han people were analyzed as the control group. The bacteria was separated from the inferior palpebral conjunctiva, then inoculated on blood plate for 48 hours and identified. Totally 24 strains of bacteria were cultured in either Qiang minority or Han c populations with 3 strains of them existed in both ethnic groups. The commonest bacteria in conjunctival sac in two ethnic groups were non-pathogenic bacterium. The composition of Corynebacterium in Han people (54.1%) was significantly higher than that in Qiang minority (27.4%) (χ(2)=11.6721, P=0.0006). The percentage of Sphingomonas Paucimobilis in Qiang people was higher than that in Han people (χ(2)=18.6442, P=0.0000). However, there was no significant difference between Qiang minority and Han people either in bacterial positive rate in conjunctival sac, or the composition of bacteria species and strains, or the composition of staphylococcus epidemids between two ethnic populations. There was no significant difference of bacterial positive rate in conjunctival sac from the elder of Qiang minority and Han people with dry eye, but the species of bacteria were different.

  11. [The clinical efficiency of calf blood extract gel on moderate to severe dry eye induced by chronic graft versus host diseases after bone marrow transplantation].

    Science.gov (United States)

    Liu, Jing; Liu, Zu-Guo; Shao, Yi; Chen, Jing-Yao; Li, Wei; Lin, Hui

    2013-01-01

    To investigate the clinical efficiency of calf blood extract gel on dry eye induced by chronic graft versus host diseases after bone marrow transplantation. It was a two-stage cross-over design double-blind controlled study. Twelve patients (twenty-four eyes) diagnosis dry eye induced by chronic graft versus diseases in Ocular Surface Out-patient Clinic of Xiamen University Affiliated Xiamen Eye Center 2009 from 2010 to were divide into two groups: group A accepted the treatment of autologous serum in the first stage and group B accepted the treatment of calf blood extract gel, after one month of elution, group A accepted calf blood extract gel and group B accepted autologous serum. The signs and symptoms with different therapies were recorded at the time of pre and post therapies, which were analyzed by Wilcoxon analysis and two-stage cross-over analysis. Ocular dry eye symptoms including visual tiredness, dry and unsmooth sensation, foreign body sensation, photophobia, pain, redness and visual acuity had been improved in both autologous serum therapy (U = 22.5, 43.2, 27.0, 17.4, 21.5, 38.5, 23.0, P extract gel therapy (U = 333.0, 24.5, 29.0, 40.5, 26.0, 36.0, 51.0, P dry eye signs and symptoms including visual tiredness, dry and unsmooth sensation, burning sensation, photophobia, pain, tearing, redness, visual acuity, corneal FL, TFBUT and S It hadn't significantly improved between two kinds of therapies (F = 1.45, 2.43, 2.14, 1.91, 1.63, 0.51, 1.19, 0.68, 2.75, 0.77, 1.23, P > 0.05) or between two kinds of offering drug orders (F = 3.17, 2.62, 0.91, 1.42, 0.89, 2.17, 0.95, 1.54, 3.21, 6.72, 1.37, P > 0.05) in the two-stage cross-over design. Only foreign body sensation had significantly statistical difference between two kinds of drug (F = 11.38, P 0.05). Calf blood extract gel can be consider as a alternative for the treatment of dry eye induced by cGVHDs, because of its functions on releasing ocular dry eye symptoms and promoting corneal epithelial cells

  12. Safety of Lifitegrast Ophthalmic Solution 5.0% in Patients With Dry Eye Disease: A 1-Year, Multicenter, Randomized, Placebo-Controlled Study

    OpenAIRE

    Donnenfeld, Eric D.; Karpecki, Paul M.; Majmudar, Parag A.; Nichols, Kelly K.; Raychaudhuri, Aparna; Roy, Monica; Semba, Charles P.

    2016-01-01

    Purpose: To evaluate the 1-year safety of lifitegrast ophthalmic solution 5.0% in patients with dry eye disease compared with placebo. Methods: SONATA (Safety Of a 5.0% coNcentrATion of lifitegrAst ophthalmic solution) was a multicenter, randomized, prospective, double-masked, placebo-controlled phase 3 study (NCT01636206). Adults (?18 years) with dry eye disease (Schirmer test score ?1 and ?10 mm; corneal staining score ?2.0) were randomized 2:1 to lifitegrast ophthalmic solution 5.0% or pla...

  13. A prospective, multicenter, noninterventional study of Optive Plus(®) in the treatment of patients with dry eye: the prolipid study.

    Science.gov (United States)

    Kaercher, Thomas; Thelen, Ulrich; Brief, Gerrett; Morgan-Warren, Robert J; Leaback, Richard

    2014-01-01

    The aim was to evaluate the efficacy of Optive Plus(®), an artificial tear containing castor oil, in patients with dry eye, in a routine clinical setting. This was a prospective, noninterventional study of patients with dry eye who switched from a prior therapy or who were naïve to treatment (n=1,209). Patients were issued Optive Plus(®) artificial tears. Dry eye severity, tear break-up time (TBUT), Schirmer score, Ocular Surface Disease Index (OSDI) score, and patient assessment of symptoms were recorded at baseline and at the follow-up visit (4 weeks after starting Optive Plus(®)). The cause of dry eye was determined to be aqueous deficiency, lipid deficiency, or a mixture of aqueous and lipid deficiency (in 19.5%, 20.1%, and 47.8%, respectively, of the total study population). The severity of dry eye decreased from baseline to the follow-up visit, showing a decrease of the more severe levels (2-4) and a concurrent increase in mild level (1) of the rating scale. Patients reported an improvement in dry eye symptoms over the duration of the study, specifically 74.2% (n=152), 85.4% (n=182), and 82.4% (n=417) of patients in the aqueous-deficient, lipid-deficient, and mixed-deficiency groups, respectively. TBUT was measured in 475 patients. Baseline measurements for mean and standard deviation were 9.0±3.5, 7.1±3.6, and 6.6±3.0 seconds for the aqueous-deficient, lipid-deficient, and mixed-deficiency groups, respectively. These increased to 10.5±3.5, 10.0±3.6, and 9.2±3.1 seconds at the final visit. Overall, 92.5% of all patients were satisfied with the use of Optive Plus(®), and 86% said they would purchase Optive Plus(®). Ten percent of patients reported adverse events, and 1.8% of all patients experienced treatment-related adverse events. Optive Plus(®) was well tolerated and effective in reducing the signs and symptoms of all types of dry eye but is recommended for lipid-deficient dry eye patients.

  14. A prospective, multicenter, noninterventional study of Optive Plus® in the treatment of patients with dry eye: the prolipid study

    Science.gov (United States)

    Kaercher, Thomas; Thelen, Ulrich; Brief, Gerrett; Morgan-Warren, Robert J; Leaback, Richard

    2014-01-01

    Objective The aim was to evaluate the efficacy of Optive Plus®, an artificial tear containing castor oil, in patients with dry eye, in a routine clinical setting. Methods This was a prospective, noninterventional study of patients with dry eye who switched from a prior therapy or who were naïve to treatment (n=1,209). Patients were issued Optive Plus® artificial tears. Dry eye severity, tear break-up time (TBUT), Schirmer score, Ocular Surface Disease Index (OSDI) score, and patient assessment of symptoms were recorded at baseline and at the follow-up visit (4 weeks after starting Optive Plus®). Results The cause of dry eye was determined to be aqueous deficiency, lipid deficiency, or a mixture of aqueous and lipid deficiency (in 19.5%, 20.1%, and 47.8%, respectively, of the total study population). The severity of dry eye decreased from baseline to the follow-up visit, showing a decrease of the more severe levels (2–4) and a concurrent increase in mild level (1) of the rating scale. Patients reported an improvement in dry eye symptoms over the duration of the study, specifically 74.2% (n=152), 85.4% (n=182), and 82.4% (n=417) of patients in the aqueous-deficient, lipid-deficient, and mixed-deficiency groups, respectively. TBUT was measured in 475 patients. Baseline measurements for mean and standard deviation were 9.0±3.5, 7.1±3.6, and 6.6±3.0 seconds for the aqueous-deficient, lipid-deficient, and mixed-deficiency groups, respectively. These increased to 10.5±3.5, 10.0±3.6, and 9.2±3.1 seconds at the final visit. Overall, 92.5% of all patients were satisfied with the use of Optive Plus®, and 86% said they would purchase Optive Plus®. Ten percent of patients reported adverse events, and 1.8% of all patients experienced treatment-related adverse events. Conclusion Optive Plus® was well tolerated and effective in reducing the signs and symptoms of all types of dry eye but is recommended for lipid-deficient dry eye patients. PMID:24970993

  15. 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 metabolic syndrome can influence tear osmolarity and tear film function. Patients with metabolic syndrome showed tear hyperosmolarity and tear film dysfunction.

  16. Absence of ACAT-1 attenuates atherosclerosis but causes dry eye and cutaneous xanthomatosis in mice with congenital hyperlipidemia.

    Science.gov (United States)

    Yagyu, H; Kitamine, T; Osuga, J; Tozawa, R; Chen, Z; Kaji, Y; Oka, T; Perrey, S; Tamura, Y; Ohashi, K; Okazaki, H; Yahagi, N; Shionoiri, F; Iizuka, Y; Harada, K; Shimano, H; Yamashita, H; Gotoda, T; Yamada, N; Ishibashi, S

    2000-07-14

    Acyl-CoA:cholesterol acyltransferase (ACAT) catalyzes esterification of cellular cholesterol. To investigate the role of ACAT-1 in atherosclerosis, we have generated ACAT-1 null (ACAT-1-/-) mice. ACAT activities were present in the liver and intestine but were completely absent in adrenal, testes, ovaries, and peritoneal macrophages in our ACAT-1-/- mice. The ACAT-1-/- mice had decreased openings of the eyes because of atrophy of the meibomian glands, a modified form of sebaceous glands normally expressing high ACAT activities. This phenotype is similar to dry eye syndrome in humans. To determine the role of ACAT-1 in atherogenesis, we crossed the ACAT-1-/- mice with mice lacking apolipoprotein (apo) E or the low density lipoprotein receptor (LDLR), hyperlipidemic models susceptible to atherosclerosis. High fat feeding resulted in extensive cutaneous xanthomatosis with loss of hair in both ACAT-1-/-:apo E-/- and ACAT-1-/-:LDLR-/- mice. Free cholesterol content was significantly increased in their skin. Aortic fatty streak lesion size as well as cholesteryl ester content were moderately reduced in both double mutant mice compared with their respective controls. These results indicate that the local inhibition of ACAT activity in tissue macrophages is protective against cholesteryl ester accumulation but causes cutaneous xanthomatosis in mice that lack apo E or LDLR.

  17. Therapeutic Efficacy of Topically Applied Antioxidant Medicinal Plant Extracts in a Mouse Model of Experimental Dry Eye

    Science.gov (United States)

    Lee, Jee Bum; Li, Ying; Choi, Ji Suk; Lee, Hyo Seok

    2016-01-01

    Purpose. To investigate the therapeutic effects of topical administration of antioxidant medicinal plant extracts in a mouse model of experimental dry eye (EDE). Methods. Eye drops containing balanced salt solution (BSS) or 0.001%, 0.01%, and 0.1% extracts were applied for the treatment of EDE. Tear volume, tear film break-up time (BUT), and corneal fluorescein staining scores were measured 10 days after desiccating stress. In addition, we evaluated the levels of interleukin- (IL-) 1β, tumor necrosis factor- (TNF-) α, IL-6, interferon- (IFN-) γ, and IFN-γ associated chemokines, percentage of CD4+C-X-C chemokine receptor type 3 positive (CXCR3+) T cells, goblet cell density, number of 4-hydroxy-2-nonenal (4-HNE) positive cells, and extracellular reactive oxygen species (ROS) production. Results. Compared to the EDE and BSS control groups, the mice treated with topical application of the 0.1% extract showed significant improvements in all clinical parameters, IL-1β, IL-6, TNF-α, and IFN-γ levels, percentage of CD4+CXCR3+ T cells, goblet cell density, number of 4-HNE-positive cells, and extracellular ROS production (P extracts improved clinical signs, decreased inflammation, and ameliorated oxidative stress marker and ROS production on the ocular surface of the EDE model mice. PMID:27313829

  18. Study design and baseline findings from the progression of ocular findings (PROOF) natural history study of dry eye.

    Science.gov (United States)

    McDonnell, Peter J; Pflugfelder, Stephen C; Stern, Michael E; Hardten, David R; Conway, Taryn; Villanueva, Linda; Hollander, David A

    2017-12-28

    The aim of this research is to initiate a 5-year natural history study of dry eye disease (DED) using objectively assessed and patient-reported outcomes, to explore the hypothesis that DED is a progressive condition that has substantive and measurable impacts not only on the ocular surface, but on quality of life and visual functioning. Our objective for this report is to examine the baseline data. A multicenter, prospective, controlled, observational study of Level 2 (mild-to-moderate) DED patients based on International Task Force Delphi Panel severity grading, and controls, documented baseline measures (including tear film biomarkers and quality of life). Tear cytokine concentrations were also measured in the tear film. Patients were using artificial tears as needed. Two hundred seventeen DED patients and 67 gender- and age-matched controls were enrolled. A majority were females and Caucasian and groups did not differ significantly in terms of gender, race, or age. Differences between DED and matched controls, at baseline, included mean scores for Ocular Surface Disease Index (31.7 vs 4.1, P vision was reported as moderate/severe/very severe at baseline in 57.6% of DED patients vs.10.5% of normal controls (P vision, productivity, and visits to eye care practitioners in mild to moderate DED patients compared to normal subjects of similar ages and genders. ClinicalTrials.gov NCT00833235 on January 30, 2009.

  19. PERSIST: Physician's Evaluation of Restasis® Satisfaction in Second Trial of topical cyclosporine ophthalmic emulsion 0.05% for dry eye: a retrospective review

    Directory of Open Access Journals (Sweden)

    Mah F

    2012-11-01

    Full Text Available Francis Mah,1 Mark Milner,2 Samuel Yiu,3 Eric Donnenfeld,4 Taryn M Conway,5 David A Hollander51University of Pittsburgh, Pittsburgh, PA, 2The Eye Center, Hamden, CT, 3University of Southern California, Los Angeles, CA, 4Ophthalmic Consultants of Long Island and Connecticut, Rockville Centre, New York, NY, 5Allergan Inc, Irvine, CA, USABackground: Chronic dry eye disease often requires long-term therapy. Tear film alterations in the setting of dry eye may include reduced tear volume as well as an increase in inflammatory cytokines and osmolarity. Topical cyclosporine ophthalmic emulsion 0.05% (Restasis®; Allergan Inc, Irvine, CA is indicated to increase tear production in patients with dry eye and reduced tear production presumed to be due to ocular inflammation. This study was designed to evaluate the efficacy of a second trial of topical cyclosporine in patients with dry eye who were previously considered treatment failures.Materials and methods: This multicenter (three cornea practices retrospective chart review evaluated clinical outcomes in patients with dry eye who received a second trial of cyclosporine after a prior treatment failure, defined as prior discontinuation of topical cyclosporine after less than 12 weeks.Results: Thirty-five patients, most of whom were female (71.4% and Caucasian (62.9%, were identified. Prior discontinuation was most commonly due to burning/stinging (60%. The median duration of second treatment was 10 months (range 1 week to 45 months. Physician education was provided in the second trial in 97.1% of cases. At initiation of the second trial of cyclosporine, 10 (28.6% patients received courses of topical corticosteroids. Physicians reported on a questionnaire that 80% of patients achieved clinical benefit with a second trial of cyclosporine.Conclusion: A repeat trial with topical cyclosporine can achieve clinical success. Direct patient education via the physician and staff may be key to success. Proper patient

  20. MaquiBright™ standardized maqui berry extract significantly increases tear fluid production and ameliorates dry eye-related symptoms in a clinical pilot trial.

    Science.gov (United States)

    Hitoe, S; Tanaka, J; Shimoda, H

    2014-09-01

    Dry eye symptoms, resulting from insufficient tear fluid generation, represent a considerable burden for a largely underestimated number of people. We concluded from earlier pre-clinical investigations that the etiology of dry eyes encompasses oxidative stress burden to lachrymal glands and that antioxidant MaquiBright™ Aristotelia chilensis berry extract helps restore glandular activity. In this pilot trial we investigated 13 healthy volunteers with moderately dry eyes using Schirmer test, as well as a questionnaire which allows for estimating the impact of dry eyes on daily routines. Study participants were assigned to one of two groups, receiving MaquiBright™ at daily dosage of either 30 mg (N.=7) or 60 mg (N.=6) over a period of 60 days. Both groups presented with significantly (PDry Eye-related Quality of life Score" (DEQS), with values spanning from zero (impact) to a maximum score of 60. Participants had comparable baseline values of 41.0±7.7 (30 mg) and 40.2±6.3 (60 mg). With 30 mg treatment the score significantly decreased to 21.8±3.9 and 18.9±3.9, after 30 and 60 days, respectively. With 60 mg treatment the DEQS significantly decreased to 26.9±5.3 and 11.1±2.7, after 30 and 60 days, respectively. Blood was drawn for safety analyses (complete blood rheology and -chemistry) at all three investigative time points without negative findings. In conclusion, while daily supplementation with 30 mg MaquiBright™ is effective, the dosage of 60 significantly increased tear fluid volume at all investigative time points and decreased dry eye symptoms to almost a quarter from initial values after two months treatment.

  1. Tear volume estimation using a modified Schirmer test: a randomized, multicenter, double-blind trial comparing 3% diquafosol ophthalmic solution and artificial tears in dry eye patients

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    Miyake H

    2016-05-01

    Full Text Available Hideki Miyake,1 Yuri Kawano,2 Hiroshi Tanaka,2 Akihiro Iwata,3 Takahiro Imanaka,1 Masatsugu Nakamura1 1Ophthalmic Disease Area Strategy Department, 2Clinical Operations Department, 3Data Science Department, R&D Division, Santen Pharmaceutical Co., Ltd. Osaka, Japan Purpose: We aimed to evaluate the feasibility of using a modified Schirmer test to determine the increase in tear volume after administration of 3% diquafosol ophthalmic solution (diquafosol 3% in dry eye patients. Patients and methods: A randomized, multicenter, prospective, double-blind clinical study recruited 50 qualified subjects. They received diquafosol 3% in one eye and artificial tears in the other eye. The study protocol comprised a screening and treatment procedure completed within 1 day. The Schirmer test was performed on closed eyes three times a day. The primary efficacy end points were the second Schirmer test scores 10 minutes after the single dose. Secondary end points were the third Schirmer test scores 3 hours and 40 minutes after the single dose and the symptom scores prior to the second and third Schirmer tests. Results: According to the Schirmer test, 10 minutes after administration, diquafosol 3% significantly increased tear volume compared to artificial tears. Diquafosol 3% and artificial tears both showed significant improvements in the symptom scores compared to baseline. However, there was no significant difference in the symptoms score between diquafosol 3% and artificial tears. Conclusion: The modified Schirmer test can detect a minute change in tear volume in dry eye patients. These findings will be useful in the diagnosis of dry eye, assessment of treatment benefits in daily clinical practice, and the development of possible tear-secreting compounds for dry eye. Keywords: P2Y2, efficacy, Diquas®

  2. Synergistic Effect of Artificial Tears Containing Epigallocatechin Gallate and Hyaluronic Acid for the Treatment of Rabbits with Dry Eye Syndrome.

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    Ching-Li Tseng

    Full Text Available Dry eye syndrome (DES is a common eye disease. Artificial tears (AT are used to treat DES, but they are not effective. In this study, we assessed the anti-inflammatory effect of AT containing epigallocatechin gallate (EGCG and hyaluronic acid (HA on DES. Human corneal epithelial cells (HCECs were used in the WST-8 assay to determine the safe dose of EGCG. Lipopolysaccharide-stimulated HCECs showing inflammation were treated with EGCG/HA. The expression of IL-1ß, IL-6, IL-8, and TNF-α was assessed by real-time PCR and AT physical properties such as the viscosity, osmolarity, and pH were examined. AT containing EGCG and HA were topically administered in a rabbit DES model established by treatment with 0.1% benzalkonium chloride (BAC. Tear secretion was assessed and fluorescein, H&E, and TUNEL staining were performed. Inflammatory cytokine levels in the corneas were also examined. The non-toxic optimal concentration of EGCG used for the treatment of HCECs in vitro was 10 μg/mL. The expression of several inflammatory genes, including IL-1ß, IL-6, IL-8, and TNF-α, was significantly inhibited in inflamed HCECs treated with 10 μg/mL EGCG and 0.1% (w/v HA (E10/HA compared to that in inflamed HCECs treated with either EGCG or HA alone. AT containing E10/HA mimic human tears, with similar osmolarity and viscosity and a neutral pH. Fluorescence examination of the ocular surface of mouse eyes showed that HA increased drug retention on the ocular surface. Topical treatment of DES rabbits with AT plus E10/HA increased tear secretion, reduced corneal epithelial damage, and maintained the epithelial layers and stromal structure. Moreover, the corneas of the E10/HA-treated rabbits showed fewer apoptotic cells, lower inflammation, and decreased IL-6, IL-8, and TNF-α levels. In conclusion, we showed that AT plus E10/HA had anti-inflammatory and mucoadhesive properties when used as topical eye drops and were effective for treating DES in rabbits.

  3. Effect assessment of subconjunctival injection of rapamycin-loaded microspheres in non-obese diabetic mice with dry eye caused by Sjögren's syndrome

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    Meng Wang

    2013-05-01

    Full Text Available AIM: To study the effect of rapamycin-loaded microspheres in non-obese diabetic(NODmice with dry eye caused by Sjögren's syndrome(SS. METHODS: Twenty 8-week-old female NOD mice with dry eye caused by SS were randomly divided into 4 groups. One week later, the mice were treated with subconjunctival injection. GroupⅠ and Ⅱ received 200μg/kg and 400μg/kg rapamycin-loaded microspheres, Group Ⅲ and Ⅳ received normal saline and empty microspheres. Five 8-week-old female healthy KM mice were used as untreated controls. Before and 5, 10, 15, 20 days after the experiment, the amount of secretion of tears, the score of corneal fluorescein staining and rose bengal staining were investigated. Conjunctival epithelial cells were observed and graded by conjunctival impression cytology. RESULTS: Compared with the group Ⅲ and Ⅳ, the amount of secretion of tears of the mice in groupⅠ and Ⅱ increased. The scores of corneal fluorescein staining and rose bengal staining were lower. The levels of conjunctival impression cytology reduced. CONCLUSION: Rapamycin-loaded microspheres can decrease dry eye signs by alleviating the ocular surface inflammation of NOD mice. It suggests rapamycin-loaded microsphere is valuable to dry eye caused by SS.

  4. 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 tear value, tear clearance rate, keratoepitheliopathy scores, conjunctival goblet cell density, and symptom score (p 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.

  5. Tear Production Rate in a Mouse Model of Dry Eye According to the Phenol Red Thread and Endodontic Absorbent Paper Point Tear Tests.

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    Kilic, Servet; Kulualp, Kadri

    2016-01-01

    This study compared the endodontic absorbent paper point test (EAPTT) and the phenol red thread test (PRTT) for the assessment of tear production rate in a mouse model of dry eye. Fourteen BALB/c breed female mice were allocated into experimental and control groups of equal number. For 6 wk, the experimental group was kept in dry-eye cabinets, whereas the control group was kept in normal cages under ambient conditions. In both groups, the tear production rate was measured by using EAPTT and PRTT before the study, at study baseline, and at weeks 2, 4, and 6. Tear production at weeks 2, 4, and 6 differed significantly between groups and tests. Evaluating the groups independently in terms of the test technique revealed significant differences in tear production rate between the 2 groups at the same measurement times. Due to their persistent exposure to evaporative stress factors, the tear production rate of the mice in the dry-eye cabinet was consistently lower than that of controls. Unlike PRTT, EAPTT can be readily applied to the small globes of laboratory animals without the need for forceps, thus saving time and effort. In addition, EAPTT was practical and imposed no undue stress on the mice, due to the test material's firmer structure. Therefore, compared with PRTT, EAPTT is safer and more reliable for the diagnosis of dry-eye syndrome in mice.

  6. Expression of CXCL9, -10, -11, and CXCR3 in the Tear Film and Ocular Surface of Patients with Dry Eye Syndrome

    Science.gov (United States)

    Park, Chang-Soo; You, In-Cheon; Choi, Hwan-Jun; Lee, Kwang-Hoon; Im, Seong-Kyu; Park, Hong-Yong; Pflugfelder, Stephen C.

    2010-01-01

    Purpose. To investigate the expression of CXCL9, -10, -11, and CXCR3 in the tear film and ocular surface of patients with dry eye syndrome. Methods. Thirty-three patients with dry eye (16 with and 17 without Sjögren's syndrome) and 15 control subjects were recruited. The concentrations of CXCL9, -10, and -11 in tears were measured with enzyme-linked immunosorbent assays. The correlation between chemokine levels and tear film and ocular surface parameters was analyzed. The expression of CXCL9, -10, -11, and CXCR3 in the conjunctiva was evaluated by using immunohistochemistry. Flow cytometry was performed to count CXCR3+ cells and CXCR3+CD4+ cells in the conjunctiva. Results. The concentrations of CXCL9, -10, and -11 were 1,148 ± 1,088, 24,338 ± 8,706, and 853 ± 334 pg/mL, in the patients with dry eye, and 272 ± 269 (P = 0.01), 18,149 ± 5,266 (P = 0.02), and 486 ± 175 (P tears of the patients with Sjögren's syndrome compared with those of the patients with non-Sjögren's dry eye (P tear secretion, and CXCL11 levels correlated significantly with basal tear secretion, tear clearance rate, keratoepitheliopathy score, and goblet cell density (P tear film and ocular surface of patients with dry eye syndrome, especially in those with Sjögren's syndrome. CXCL11 levels correlated significantly with various tear film and ocular surface parameters. (ClinicalTrials.gov number, NCT00991679.) PMID:19850844

  7. Lifitegrast clinical efficacy for treatment of signs and symptoms of dry eye disease across three randomized controlled trials.

    Science.gov (United States)

    Holland, Edward J; Whitley, Walter O; Sall, Kenneth; Lane, Stephen S; Raychaudhuri, Aparna; Zhang, Steven Y; Shojaei, Amir

    2016-07-22

    Report efficacy findings from three clinical trials (one phase 2 and two phase 3 [OPUS-1, OPUS-2]) of lifitegrast ophthalmic solution 5.0% for treatment of dry eye disease (DED). Three 84-day, randomized, double-masked, placebo-controlled trials. Adults (≥18 years) with DED were randomized (1:1) to lifitegrast 5.0% or matching placebo. Changes from baseline to day 84 in signs and symptoms of DED were analyzed. Phase 2, pre-specified endpoint: inferior corneal staining score (ICSS; 0-4); OPUS-1, coprimary endpoints: ICSS and visual-related function subscale (0-4 scale); OPUS-2, coprimary endpoints: ICSS and eye dryness score (EDS, VAS; 0-100). Fifty-eight participants were randomized to lifitegrast 5.0% and 58 to placebo in the phase 2 trial; 293 to lifitegrast and 295 to placebo in OPUS-1; 358 to lifitegrast and 360 to placebo in OPUS-2. In participants with mild-to-moderate baseline DED symptomatology, lifitegrast improved ICSS versus placebo in the phase 2 study (treatment effect, 0.35; 95% CI, 0.05-0.65; p = 0.0209) and OPUS-1 (effect, 0.24; 95% CI, 0.10-0.38; p = 0.0007). Among more symptomatic participants (baseline EDS ≥40, recent artificial tear use), lifitegrast improved EDS versus placebo in a post hoc analysis of OPUS-1 (effect, 13.34; 95% CI, 2.35-24.33; nominal p = 0.0178) and in OPUS-2 (effect, 12.61; 95% CI, 8.51-16.70; p lifitegrast improved ICSS in participants with mild-to-moderate baseline symptomatology in two studies, and EDS in participants with moderate-to-severe baseline symptomatology in two studies. Based on the overall findings from these trials, lifitegrast shows promise as a new treatment option for signs and symptoms of DED.

  8. Cutoff score and responsiveness of the 8-item Contact Lens Dry Eye Questionnaire (CLDEQ-8) in a Large daily disposable contact lens registry.

    Science.gov (United States)

    Chalmers, Robin L; Keay, Lisa; Hickson-Curran, Sheila B; Gleason, William J

    2016-10-01

    To report (1) results of the 8-item Contact Lens Dry Eye Questionnaire (CLDEQ-8) among a large sample of SCL wearers before and during 1 year after fitting with one of 2 daily disposable (DD) lenses (etafilcon A or narafilcon B) in the TEMPO Registry, (2) the cut-off score to identify highly symptomatic SCL wearers and (3) the clinically important difference (CID) in the CLDEQ-8 score. Demographics, CL history and patterns of SCL use were documented. Construct validity of the CLDEQ-8 was tested versus overall opinion (OO) of habitual SCLs, eye dryness and eye sensitivity at baseline. Responsiveness to change in OO was tested. Cutoff score, CID, and predictive accuracy were analyzed with general linear mixed models, adjusting for clustering by site with Bonferoni correction for multiple comparisons. Baseline CLDEQ-8 data from 977 habitual SCL wearers showed significant association with OO, eye dryness and sensitivity (pContact Lens Association. Published by Elsevier Ltd. All rights reserved.

  9. Evaluation of a new artificial tear formulation for the management of tear film stability and visual function in patients with dry eye

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    Torkildsen G

    2017-10-01

    Full Text Available Gail Torkildsen,1 Mile Brujic,2 Michael S Cooper,3 Paul Karpecki,4 Parag Majmudar,5 William Trattler,6 Meryl Reis,7 Joseph B Ciolino1,8 1Andover Eye Clinic, Andover MA, 2Premier Vision Group, Bowling Green, OH, 3Windam Eye Group, Willimantic, CT, 4Gaddie Eye Center, Louisville KY, 5Chicago Cornea Consultants, Chicago IL, 6Center For Excellence in Eye Care, Miami, FL, 7Rohto Mentholatum Research Laboratories, Horsham, PA, 8Massachusetts Eye and Ear Infirmary, Boston MA, USA Purpose: Artificial tears are the first line of therapy for dry eye disease (DED and are also the most frequently used treatment approach for this common condition. Despite this, there are few published studies that directly compare the effectiveness of different drop preparations, especially those formulated specifically for dry eye. In this study, we tested a new artificial tear product, Rohto® Dry-Aid™, for its ability to relieve the signs and symptoms of DED. The study used a second drop, Systane® Ultra, as a positive comparator.Materials and methods: This was a prospective, single-center, open-label, parallel-group study comparing the effects of the two products when used continuously over ~30 days (Clinical Trials registration number NCT03183089. Subjects were randomly assigned to one of the two test groups and were monitored 2 and 4 weeks after enrollment. Efficacy endpoints included ocular staining, visual function, and ocular discomfort.Results: Treatment groups had similar ocular staining and ocular comfort scores, and both showed statistically significant ocular discomfort score improvement. Subjects in the Rohto group reported significant improvements in visual tasking activities such as watching television and driving at night. There was also a tendency for diary symptom scores to worsen from morning to evening in the Systane group, but not in the Rohto group; this trend was not significant, but warrants further study.Conclusion: The two products, Rohto Dry

  10. 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 Pbiomechanical 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.

  11. A questionnaire-based survey of dry eye disease among leather tannery workers in Kanpur, India: a case-control study.

    Science.gov (United States)

    Gupta, Ramesh Chandra; Ranjan, Ratnesh; Kushwaha, Raj Nath; Khan, Perwez; Mohan, Shalini

    2014-12-01

    Kanpur is a major leather processing center in India, where a large number of tanneries are situated. During tanning process, workers are constantly exposed to heat, leather dust produced in buffering operations and a wide range of chemicals. All these factors are known to cause dry eye. Being ophthalmologists of a tertiary health care center in Kanpur, we used to notice over a period of time that a considerable number of patients with dry eye symptoms, attending our out-patient department, were related to leather tanning industries. But, no published data is available on the prevalence of and risk factors for dry eye disorders among tannery worker. To estimate the prevalence of dry eye problem and its severity among the workers of leather tanneries in the industrial belt of Kanpur and to evaluate various risk factors related to it. In this cross-sectional case-control study, Ocular Surface Disease Index (OSDI) Questionnaire was presented to randomly selected tannery workers and control group. OSDI score was calculated based on subjects' response, and was evaluated with OSDI chart to assess the magnitude of dry eye symptoms and to grade its severity. RESULTS were analyzed statistically to evaluate the significance level. A total of 800 workers were selected by simple random sampling, out of which 72 workers were excluded from the study. Thus the questionnaire was presented to a total of 728 workers, while control group included 260 individuals. All the workers as well as controls were male with age ranging from 20 to 59 years. The mean age for tannery workers was 34.05 ± 8.96 years and that for control group was 32.97 ± 10.59 years (p = 0.14). The tannery workers had mean duration of work at tanneries for 6.99 ± 4.86 years. The prevalence of dry eye symptoms among tannery workers was 33.79% (95% CI: 30.35-37.24), while that in control group was 15.77% (95% CI: 11.31-20.23) (p < 0.0001). Among symptomatic workers, 47.96% (95% CI: 41.68-54.26) workers had mild, 36

  12. Effectiveness of Combined Tear Film Therapy in Patients with Evaporative Dry Eye with Short Tear Film Breakup Time.

    Science.gov (United States)

    Kim, Yung Hui; Kang, Yeon Soo; Lee, Hyo Seok; Choi, Won; You, In Cheon; Yoon, Kyung Chul

    2017-10-01

    The aim of this study was to evaluate the effectiveness of combined tear film therapy targeted to aqueous, mucin, and lipid layers in patients with refractory evaporative dry eye (EDE) with short tear film breakup time (TBUT). The patients who had EDE with short TBUT and severe symptoms refractory to artificial tears were treated with hyaluronic acid (HA) 0.15% and diquafosol tetrasodium (DQS) 3% (Group 1), HA and carbomer-based lipid-containing eyedrops (Liposic EDO Gel, LPO) (Group 2), or HA, DQS, and LPO (Group 3). Ocular Surface Disease Index (OSDI) score, visual analog scale (VAS) symptom score, TBUT, Schirmer score, and corneal and conjunctival staining scores were evaluated, and noninvasive tear film breakup time (NIBUT) and tear meniscus height were measured using Keratograph ® 5 M before and 1 and 3 months after treatment. OSDI scores, VAS scores, TBUT, and NIBUT were improved at 1 and 3 months after treatment in all groups (all P film layers was most effective in improving ocular symptoms and tear film quality.

  13. Therapeutic effect of a new warm moist air device assisted with eyelid massage on office dry eye

    Directory of Open Access Journals (Sweden)

    Bing Zhao

    2017-08-01

    Full Text Available AIM: To investigate the therapeutic effect of a new warm moist air device assisted with eyelid massage in the treatment of office dry eye(ODE.METHODS: Sixty ODE patients were recruited, and these patients were randomly divided into two groups. One group received artificial tear treatment, and the other group received a new eyelid warm moist air device combined with eyelid massage treatment. Subjects completed the ocular surface disease index(OSDI, which was followed by fluorescein tear breakup time(BUT, corneal fluorescein staining(CFS, Schirmer I test(SⅠtand meibomian gland secretion function evaluation at baseline, and 2 and 4wk after treatment.RESULTS: In these 60 patients, 48 patients(23 in artificial tear treated group and 25 in the new warm moist air device assisted with eyelid massage treated groupwere positive for meibomian gland dysfunction(MGD. Compared to artificial tear treatment, the new warm moist air device assisted with eyelid massage treatment showed favorable therapeutic effect on OSDI(FGroup=41.63, PFGroup=60.47,PFGroup=12.12,PFGroup=0.17, P>0.05, CFS(FGroup=1.79, P>0.05and meibomian gland expressibility(FGroup=0.68, P>0.05between the two groups during 4wk treatment. CONCLUSION: This new eyelid warm moist air device assisted with eyelid massage has favorable therapeutic effect over artificial tear in ODE treatment.

  14. The Effect of Hormone Replacement Therapy on Dry Eye Syndrome Evaluated with Schirmer Test and Break-Up Time.

    Science.gov (United States)

    Feng, Yanhong; Feng, Gang; Peng, Shuli; Li, Hui

    2015-01-01

    Hormone replacement therapy (HRT) for dry eye syndrome (DES) is controversial in clinical practice. The goal of this study was to review relevant studies and analyze the pooled data to determine whether HRT is effective for DES. In this study, a literature search of PubMed, Embase, and Cochrane databases up to May 2015 was performed, with the search restricted to English language publications. The studies were screened after reading the abstract and full text. Only studies related to the effect of HRT on DES were included in the meta-analysis. Results of Schirmer tests with and without anesthetics and tear break-up time (BUT) values data were extracted and entered into RevMan software to meta-analyze the overall effect of HRT on DES. A total of 43 studies were identified, and 21 of these studies were found to be related to the effect of HRT on DES. Ultimately, 5 studies were included in the final meta-analysis. The pooled results revealed that HRT can affect Schirmer test results without anesthetics but does not affect Schirmer test results with anesthetics and BUT. The results indicate that HRT might improve DES symptoms when measuring basal tear production without anesthesia.

  15. Depressive Symptoms in Patients With Dry Eye Disease: A Case-Control Study Using the Beck Depression Inventory.

    Science.gov (United States)

    Hallak, Joelle A; Tibrewal, Sapna; Jain, Sandeep

    2015-12-01

    To measure depressive symptoms in patients with dry eye disease (DED) and controls using the Beck Depression Inventory (BDI) and to determine the association between depressive and DED symptoms. Fifty-three patients with DED and 41 controls were recruited to the study. DED symptoms were assessed using the Symptom Burden Tool and Ocular Surface Disease Index tool. Depressive symptoms were assessed using the BDI. Regression diagnostics were performed to detect outliers. Linear statistical models and polynomial regression were used to determine the relationship between depressive symptoms and DED symptoms. An independent t test was performed to determine differences in BDI scores between cases and controls. Scatter plots were generated and linear regression was used to estimate the association between scores. Logistic regression was used for the DED dichotomous outcome and depression status as exposure. Regression models revealed that the association is linear more than quadratic or cubic. After adjusting for age, sex, race, and psychiatric medication, the regression coefficient between DED symptoms and depressive symptoms among DED cases was 1.22 (95% confidence interval, 0.27-2.18). DED symptom scores and depression scores were statistically significantly different between DED cases and controls. Adjusted logistic regression revealed an odds ratio of 2.79 (95% confidence interval, 0.96-8.12). This study provides further evidence regarding the association between DED and depression and their symptoms. Prospective studies are needed to understand the mechanisms underlying the association between symptoms of depression and symptoms of DED.

  16. Effect of hypotonic 0.18% sodium hyaluronate eyedrops on inflammation of the ocular surface in experimental dry eye.

    Science.gov (United States)

    Oh, Han Jin; Li, Zhengri; Park, Soo-Hyun; Yoon, Kyung Chul

    2014-09-01

    To investigate the efficacy of hypotonic 0.18% sodium hyaluronate (SH) eyedrops in a mouse model of experimental dry eye (EDE). EDE was induced in C57BL/6 mice by a subcutaneous scopolamine injection and an air draft. The mice were divided into 4 groups according to topical treatment regimens: EDE control, isotonic 0.5% carboxymethycellulose (CMC), isotonic 0.1% SH, and hypotonic 0.18% SH. Tear volume, corneal smoothness, and corneal staining scores were measured at 5 and 10 days of EDE. Multiplex immunobead assay, immunohistochemistry, and flow cytometry for proinflammatory cytokines, chemokines, and inflammatory molecules were performed at 10 days of EDE. The 0.18% SH group had a significantly lower corneal smoothness and staining scores than the 0.5% CMC and 0.1% SH groups at 10 days of EDE (PHypotonic 0.18% SH eyedrops are more effective in improving ocular surface irregularity and staining and decreasing inflammatory cytokines, chemokines, and cells on the ocular surface compared with isotonic 0.5% CMC or 0.1% SH eyedrops in the treatment of EDE.

  17. Improved signs, symptoms, and quality of life associated with dry eye syndrome: hydroxypropyl cellulose ophthalmic insert patient registry.

    Science.gov (United States)

    Koffler, Bruce H; McDonald, Marguerite; Nelinson, Donald S

    2010-05-01

    To evaluate the acceptability, ease of use, and efficacy of hydroxypropyl cellulose ophthalmic inserts in reducing signs and symptoms of moderate-to-severe dry eye syndrome (DES), and improving quality of life (QoL) and activities of daily living (ADL). The multicenter, prospective, open-label, 4-week registry comprised 520 patients with bilateral DES and a history of artificial tear use, or a desire to use artificial tears within the previous week. Visit 1 encompassed a clinical evaluation and symptom and QoL questionnaires, including the Ocular Surface Disease Index. Patients were trained to use inserts, which were used once daily, thereafter, as monotherapy or with existing therapy. At visit 2, clinical evaluation and questionnaires evaluated changes in signs, symptoms, ADL, and QoL. Adverse events were monitored throughout the registry. There were 418 (80.4%) completers. Statistically significant improvements in discomfort, burning, dryness, grittiness, stinging, and light sensitivity, as well as clinical signs of keratitis, conjunctival staining, and tear volume were seen (PIndex total scores improved by 21.3% (P<0.05). Blurred vision, affecting 8.7% of patients, was the most commonly reported adverse event leading to discontinuation. Hydroxypropyl cellulose ophthalmic inserts significantly improved signs and symptoms of moderate-to-severe DES, as well as ADL and QoL. Benefits were additive to those seen with patients' existing care.

  18. Correlation Between the Inflammatory Marker HLA-DR and Signs and Symptoms in Moderate to Severe Dry Eye Disease.

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    Brignole-Baudouin, Françoise; Riancho, Luisa; Ismail, Dahlia; Deniaud, Maëva; Amrane, Mourad; Baudouin, Christophe

    2017-04-01

    To investigate correlations of the inflammatory HLA-DR marker with clinical signs and symptoms commonly used to assess dry eye disease (DED) severity. Baseline data were collected from three clinical studies conducted on moderate to severe DED patients. Characteristics of DED were analyzed and correlations were performed in 311 patients. Data were analyzed after treatment with 1 mg/mL cyclosporine (CsA) and vehicle. We quantified HLA-DR by flow cytometry in impression cytology specimens. We found HLA-DR significantly increased with diagnosis of Sjögren syndrome (P DR arbitrary units of fluorescence were statistically reduced after CsA treatment compared to vehicle (P = 0.022 and P = 0.021 in two studies). In clinical research on DED, discrepancy is often observed between symptoms and signs. We found HLA-DR correlated significantly with CFS clinical signs and to a lower extent Schirmer's test and weakly with TBUT and symptom reporting questionnaires. HLA-DR was reported to be useful for monitoring anti-inflammatory efficacy treatments in DED, which was confirmed with the reduction of HLA-DR while on CsA treatment. Its expression by conjunctival cells has the potential to serve as a biomarker, bridging signs and symptoms in clinical research in DED, but there is still a need for additional validation studies.

  19. The Effect of Hormone Replacement Therapy on Dry Eye Syndrome Evaluated with Schirmer Test and Break-Up Time

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    Yanhong Feng

    2015-01-01

    Full Text Available Hormone replacement therapy (HRT for dry eye syndrome (DES is controversial in clinical practice. The goal of this study was to review relevant studies and analyze the pooled data to determine whether HRT is effective for DES. In this study, a literature search of PubMed, Embase, and Cochrane databases up to May 2015 was performed, with the search restricted to English language publications. The studies were screened after reading the abstract and full text. Only studies related to the effect of HRT on DES were included in the meta-analysis. Results of Schirmer tests with and without anesthetics and tear break-up time (BUT values data were extracted and entered into RevMan software to meta-analyze the overall effect of HRT on DES. A total of 43 studies were identified, and 21 of these studies were found to be related to the effect of HRT on DES. Ultimately, 5 studies were included in the final meta-analysis. The pooled results revealed that HRT can affect Schirmer test results without anesthetics but does not affect Schirmer test results with anesthetics and BUT. The results indicate that HRT might improve DES symptoms when measuring basal tear production without anesthesia.

  20. An evaluation of Retaine™ ophthalmic emulsion in the management of tear film stability and ocular surface staining in patients diagnosed with dry eye

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    Ousler III G

    2015-02-01

    Full Text Available George Ousler III,1 Douglas K Devries,2 Paul M Karpecki,3 Joseph B Ciolino41Ora, Inc, Andover, MA, USA; 2Eye Care Associates of Nevada, Sparks, NV, USA; 3Koffler Vision Group, Lexington, KY, USA; 4Massachusetts Eye and Ear, Boston, MA, USAAbstract: A single-center, open-label study consisting of two visits over the course of approximately 2 weeks was conducted to evaluate the efficacy of Retaine™ ophthalmic emulsion in improving the signs and symptoms of dry eye. Forty-two subjects were enrolled and received 1–2 drops twice daily of Retaine™ beginning at the first visit (day 1 and ending at the second visit. Subjects were instructed to complete a symptomatology diary twice daily prior to drop instillation through the morning of the second visit. Ocular sign and symptom assessments, visual acuity procedures, and comfort assessments were conducted during both visits. A statistically significant reduction was observed in mean breakup area on the second visit between the predose time and the postdose time (P=0.026. On the second visit, subjects had significantly less corneal fluorescein staining in the superior (P=0.002, central (P=0.017, corneal sum (P=0.011, and all ocular regions combined (P=0.038 than on the first visit. On the second visit, statistically significant reductions in dryness (P<0.001, grittiness (P=0.0217, ocular discomfort (P=0.0017, and all symptoms (P<0.001 were also seen as measured by the Ora Calibra™ Ocular Discomfort and 4-Symptom Questionnaire (0–5 scale. Subjects reported a statistically significant improvement in their abilities to work with a computer at night (P=0.044. Mean drop comfort scores ranged from 1.29–1.81 on the Ora Calibra™ 0–10 Drop Comfort Scale, on which 0 is very comfortable and 10 is very uncomfortable. Retaine™ demonstrates promising results as a novel artificial tear option for individuals suffering from dry eye. The unique mechanism of action of Retaine™ provides enhanced comfort

  1. 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

  2. Enhancing the cross-cultural adaptation and validation process: linguistic and psychometric testing of the Brazilian-Portuguese version of a self-report measure for dry eye.

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    Santo, Ruth Miyuki; Ribeiro-Ferreira, Felipe; Alves, Milton Ruiz; Epstein, Jonathan; Novaes, Priscila

    2015-04-01

    To provide a reliable, validated, and culturally adapted instrument that may be used in monitoring dry eye in Brazilian patients and to discuss the strategies for the enhancement of the cross-cultural adaptation and validation process of a self-report measure for dry eye. The cross-cultural adaptation process (CCAP) of the original Ocular Surface Disease Index (OSDI) into Brazilian-Portuguese was conducted using a 9-step guideline. The synthesis of translations was tested twice, for face and content validity, by different subjects (focus groups and cognitive interviews). The expert committee contributed on several steps, and back translations were based on the final rather than the prefinal version. For validation, the adapted version was applied in a prospective longitudinal study to 101 patients from the Dry Eye Clinic at the General Hospital of the University of São Paulo, Brazil. Simultaneously to the OSDI, patients answered the short form-36 health survey (SF-36) and the 25-item visual function questionnaire (VFQ-25) and underwent clinical evaluation. Internal consistency, test-retest reliability, and measure validity were assessed. Cronbach's alpha value of the cross-culturally adapted Brazilian-Portuguese version of the OSDI was 0.905, and the intraclass correlation coefficient was 0.801. There was a statistically significant difference between OSDI scores in patients with dry eye (41.15 ± 27.40) and without dry eye (17.88 ± 17.09). There was a negative association between OSDI and VFQ-25 total score (P adaptation process requires skill, knowledge, experience, and a considerable investment of time to maximize the attainment of semantic, idiomatic, experiential, and conceptual equivalence between the source and target questionnaires. A well-established guideline resulted in a culturally adapted Brazilian-Portuguese version of the OSDI, tested and validated on a sample of Brazilian population, and proved to be a valid and reliable instrument for assessing

  3. Blue light induced A2E oxidation in rat eyes--experimental animal model of dry AMD.

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    Wielgus, A R; Collier, R J; Martin, E; Lih, F B; Tomer, K B; Chignell, C F; Roberts, J E

    2010-11-01

    Previous studies have shown that short-wavelength blue visible light induces retinal injury and may be a risk factor for age related macular degeneration. A2E is a blue light absorbing retinal chromophore that accumulates with age. Our previous in vitro studies have determined that, although A2E itself has a low phototoxic efficiency, the oxidation products of A2E that are formed in the presence of visible light can contribute to observed retinal pigment epithelial photodamage. The purpose of this study was to investigate the effects of blue light on retinal phototoxicity and its relationship to A2E, oxidized A2E and its isomers. Sprague-Dawley albino rats were dark adapted for 24 h. Control rats remained in the dark while experimental rats were exposed to blue light (λ = 450 nm, 3.1 mW cm(-2)) for 6 h. Isolated retinas were homogenized in Folch extraction mixture and then in chloroform. The dried extracts were reconstituted and divided for determination of organic soluble compound. Esters of fatty acids were determined with GC-MS, A2E and other chromophores using HPLC, and A2E oxidation products with LC-MS. Exposure of rat eyes to blue light did not significantly change the fatty acid composition of the retina. The A2E concentration (normalized to fatty acid content) in blue light exposed animals was found to be lower than the A2E concentration in control rats. The concentrations of all-trans-retinal-ethanolamine adduct and iso-A2E a precursor and an isomer of A2E respectively, were also lower after blue-light exposure than in the retinas of rats housed in the dark. On the other hand, the amount of oxidized forms of A2E was higher in the animals exposed to blue light. We conclude that in the rat eye, blue-light exposure promotes oxidation of A2E and iso-A2E to the products that are toxic to retinal tissue. Although high concentrations of A2E may be cytotoxic to the retina, the phototoxicity associated with blue light damage to the retina is in part a result of

  4. Dry eye, sleep quality, and mood status in glaucoma patients receiving prostaglandin monotherapy were comparable with those in non-glaucoma subjects.

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    Shugyoku Ra

    Full Text Available Prior studies suggested that glaucoma patients suffer worse dry eye and mood and sleep disorders than non-glaucoma subjects. Prostaglandin analogues are first-line therapy for glaucoma, inducing few instillation problems and sufficient pressure-reduction effects. This study compared dry eye, sleep quality, and mood status between glaucoma patients receiving prostaglandin monotherapy and non-glaucoma subjects.This cross-sectional study evaluated 1520 patients (579 males and 941 females for glaucoma status and dry eye-related symptoms (dryness, eye fatigue, photophobia, pain, blurring and signs (Schirmer test, tear break-up time, corneal staining scores. Of the total cohort, 93 patients were also evaluated by Pittsburgh sleep quality index (PSQI and hospital anxiety and depression score (HADS. Inclusion criteria were consecutive patients ≥ 51 years of age and best-corrected visual acuity ≥ 20/25. Glaucoma patients included those treated with prostaglandin or a fixed combination including prostaglandin. Exclusion criteria were history of ocular surgery within one month. Data were analyzed using the chi-square or Mann-Whitney U tests, at 5% significance.There were no significant differences in dry eye-related signs and symptoms between the control (n = 1431, mean age of 66.9 years and glaucoma groups (n = 89, 67.9 years. The psychiatric sub-analysis of the control (n = 61, 66.2 years and glaucoma groups (n = 32, 67.3 years revealed mean scores of 5.02 ± 3.10 and 5.16 ± 3.46 for PSQI (normal range ≤ 5, 9.47 ± 5.61 and 9.42 ± 7.36 for HADS (normal range ≤ 10, 4.84 ± 3.22 and 4.71 ± 3.45 for anxiety (normal range ≤ 5, and 4.63 ± 3.05 and 4.71 ± 4.40 for depression (normal range ≤ 5, respectively, without statistical significance.Our results were comparable between glaucoma patients on prostaglandin monotherapy and non-glaucoma subjects for dry eye-related clinical manifestations, sleep quality, and mood status.

  5. Anti-Inflammatory and Antioxidative Effects of Camellia japonica on Human Corneal Epithelial Cells and Experimental Dry Eye: In Vivo and In Vitro Study.

    Science.gov (United States)

    Lee, Hyo Seok; Choi, Joo-Hee; Cui, Lian; Li, Ying; Yang, Jee Myung; Yun, Je-Jung; Jung, Ji Eun; Choi, Won; Yoon, Kyung Chul

    2017-02-01

    To analyze the anti-inflammatory and antioxidative effects of Camellia japonica (CJ) on human corneal epithelial (HCE) cells and its therapeutic effects in a mouse model of experimental dry eye (EDE). Camellia japonica extracts of varying concentrations (0.001%, 0.01%, and 0.1%) were used to treat HCE cells. Dichlorofluorescein diacetate (DCF-DA) and dihydroethidium (DHE) assays were performed. The production of peroxiredoxin (PRX) 1-6 and manganese-dependent superoxide dismutase (MnSOD) in HCE cells was assessed using Western blot analysis. Furthermore, eye drops containing 0.001%, 0.01%, or 0.1% CJ extract or a balanced salt solution (BSS) were applied to the EDE. Clinical parameters were measured 7 days after treatment. The levels of inflammatory markers and intracellular reactive oxygen species (ROS) were measured. Treatment with 0.01% and 0.1% CJ extracts decreased apoptosis in HCE cells. In addition, band intensities of PRX 1, 4, and 5, as well as MnSOD, after hydrogen peroxide (H2O2) treatment showed a significant improvement after pretreatment with 0.01% and 0.1% CJ extracts. Mice treated with 0.1% CJ extract showed significantly improved clinical parameters when compared to those of the EDE control and BSS groups. A significant decrease in the levels of inflammatory markers and intracellular ROS was observed in the 0.01% and 0.1% CJ extract groups. Camellia japonica extracts promoted antioxidative protein expression and suppressed apoptosis in HCE cells. Furthermore, CJ extracts improved clinical signs of dry eye and reduced oxidative stress and the expression of inflammatory markers, suggesting that eye drops containing CJ extract could be used as an adjunctive treatment for dry eye.

  6. Lifitegrast Ophthalmic Solution 5.0% versus Placebo for Treatment of Dry Eye Disease: Results of the Randomized Phase III OPUS-2 Study.

    Science.gov (United States)

    Tauber, Joseph; Karpecki, Paul; Latkany, Robert; Luchs, Jodi; Martel, Joseph; Sall, Kenneth; Raychaudhuri, Aparna; Smith, Valerie; Semba, Charles P

    2015-12-01

    Lifitegrast is an integrin antagonist that decreases T-cell-mediated inflammation associated with dry eye disease (DED). We report the results of OPUS-2, a phase III study evaluating the efficacy and safety of lifitegrast compared with placebo for the treatment of DED. A 12-week, multicenter, randomized, prospective, double-masked, placebo-controlled clinical trial. Adults aged ≥18 years with use of artificial tears within 30 days, inferior corneal staining score ≥0.5 (0-4 scale), Schirmer tear test (without anesthesia) ≥1 and ≤10 mm, and eye dryness score ≥40 (0-100 visual analogue scale [VAS]). Subjects were randomized 1:1 after 14-day placebo run-in to lifitegrast ophthalmic solution 5.0% or placebo twice daily for 84 days. Co-primary efficacy end points were change, from baseline to day 84, in eye dryness score (VAS, both eyes) and inferior corneal fluorescein staining score in the designated study eye. Secondary end points were change, from baseline to day 84, in ocular discomfort score (0-4 scale) in study eye, eye discomfort score (VAS), total corneal staining score in the study eye, and nasal conjunctival lissamine green staining score (0-4 scale) in the study eye. Treatment-emergent adverse events (TEAEs) were recorded. A total of 718 subjects were randomized: placebo, n = 360; lifitegrast, n = 358 (intent-to-treat population). Lifitegrast-treated subjects experienced greater improvement in eye dryness than placebo-treated subjects (treatment effect, 12.61; 95% confidence interval [CI], 8.51-16.70; P lifitegrast-treated subjects: ocular discomfort (nominal P = 0.0005) and eye discomfort (nominal, P lifitegrast-treated subjects (33.7%) than placebo-treated subjects (16.4%) experienced ocular TEAEs; no ocular TEAEs were serious. Lifitegrast met the co-primary symptom end point (eye dryness) but not the co-primary sign end point (inferior corneal staining). Secondary end point findings were consistent with this pattern. Most ocular TEAEs were mild

  7. Rationale for anti-inflammatory therapy in dry eye syndrome Bases da terapia antiinflamatória em síndrome do olho seco

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    CS De Paiva

    2008-12-01

    Full Text Available 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.Olho seco é uma doença multifatorial que resulta em disfunção da unidade lacrimal glandular. Evidências sugerem que inflamação está involvida na patogênese da doença. Mudanças na composição das lágrimas, incluindo aumento de citocinas, quimiocinas, metaloproteinases e o número de células T na conjuntiva são encontrados em pacientes com olho seco e em modelos animais. Esta inflamação é responsável em parte pelos sintomas de irritação, doença epitelial de surperfície ocular e função epitelial de barreira alterada em olho seco. Existem várias terapias antiinflamatórias que se direcionam para um ou mais mediadores/vias que foram identificados e são discutidos em detalhe.

  8. Efficacy and safety of two new formulations of artificial tears in subjects with dry eye disease: a 3-month, multicenter, active-controlled, randomized trial

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    Simmons PA

    2015-04-01

    Full Text Available Peter A Simmons, Haixia Liu, Cindy Carlisle-Wilcox, Joseph G Vehige Allergan Clinical Research, Allergan, Inc., Irvine, CA, USA Purpose: To evaluate and compare the efficacy and safety of two investigational artificial tear formulations (CHO-1 and CHO-2 containing carmellose sodium, hyaluronic acid at different concentrations, and osmoprotectants, with a standard carmellose sodium-containing formulation (Refresh Tears [RT] in the treatment of dry eye disease. Subjects and methods: In this 3-month, double-masked, multicenter study, subjects (n=305 were randomized 1:1:1 to receive CHO-1, CHO-2, or RT, used as needed but at least twice daily. The primary endpoint was change in ocular surface disease index (OSDI score from baseline to day 90. Other key outcomes included symptoms evaluated on a visual analog scale, corneal and conjunctival staining, and adverse events. Results: OSDI scores and dry eye symptoms showed a rapid and sustained reduction from baseline in each group. Both CHO-1 and CHO-2 met the primary efficacy endpoint of noninferiority to RT in day 90 OSDI score change from baseline. OSDI ocular symptoms subscale improved more with CHO-1 than CHO-2 (P=0.048. In subjects with clinically relevant baseline ocular surface staining (>14 total score of a maximum of 55, day 90 improvements were greater with CHO-1 and CHO-2 than RT (P≤0.044. Day 90 improvements in OSDI ocular symptoms subscale scores were also greater with CHO-1 than RT (P<0.007 in subjects with clinically relevant ocular staining. All treatments were well tolerated.Conclusion: Both combination artificial tear formulations were efficacious and well tolerated in subjects with dry eye. CHO-1 demonstrated the best performance in improving ocular symptoms and reducing ocular staining in this heterogeneous study population. Keywords: dry eye syndromes, ophthalmic solutions, carmellose, hyaluronic acid

  9. Potential Importance of Ozone in the Association Between Outdoor Air Pollution and Dry Eye Disease in South Korea.

    Science.gov (United States)

    Hwang, Sung Ha; Choi, Yoon-Hyeong; Paik, Hae Jung; Wee, Won Ryang; Kim, Mee Kum; Kim, Dong Hyun

    2016-03-10

    Air pollution is an important public health concern and the ocular surface is continuously exposed to pollutants in outdoor air. Ocular surface abnormalities related to air pollution are thought to be a subtype of dry eye disease (DED). However, to date, there is no large-scale study evaluating an association between air pollution and DED that includes multiple air pollutants. To investigate associations between outdoor air pollution and DED in a Korean population. A population-based cross-sectional study using data on 16 824 participants in the fifth Korea National Health and Nutrition Examination Survey was conducted from January 1, 2010, to December 31, 2012. Data analysis was conducted from September 1 to 30, 2015. Dry eye disease was defined as previously diagnosed by an ophthalmologist or the presence of frequent ocular pain and discomfort. Outdoor air pollution measurements (mean annual humidity, particulate matter with aerodynamic diameter Sociodemographic factors and previously known factors associated with DED were applied as covariates (model 1 controlled for sociodemographic factors and model 2 controlled for sociodemographic, behavioral, and clinical factors). Among 16 824 participants (7104 men and 9720 women), higher ozone levels and lower humidity levels were significantly associated with symptoms and diagnosis of DED. In model 1, an increase in ozone levels of 0.003 ppm was significantly associated with symptoms and diagnosis of DED (symptoms: odds ratio [OR], 1.16; 95% CI, 1.02-1.30; P = .04; diagnosis: OR, 1.21; 95% CI, 1.05-1.40; P = .008), while a 5% increase in humidity levels was significantly associated with decreased symptoms and diagnoses of DED (symptoms: OR, 0.87; 95% CI, 0.77-0.98; P = .03; diagnosis: OR, 0.86; 95% CI, 0.76-0.97; P = .01). In model 2, an increase in ozone levels of 0.003 ppm was significantly associated with symptoms and diagnosis of DED (symptoms: OR, 1.17; 95% CI, 1.02-1.34; P = .03; diagnosis

  10. Prevalence of dry eye disease in visual display terminal workers: a systematic review and meta-analysis.

    Science.gov (United States)

    Courtin, Romain; Pereira, Bruno; Naughton, Geraldine; Chamoux, Alain; Chiambaretta, Frédéric; Lanhers, Charlotte; Dutheil, Frédéric

    2016-01-14

    To evaluate the prevalence and risk factors of dry eye disease (DED) in workers using visual display terminals (VDT). Systematic review and meta-analysis. We searched PubMed, Cochrane Library, Embase and Science Direct databases for studies reporting DED prevalence in VDT workers. 16 of the 9049 identified studies were included, with a total of 11,365 VDT workers. Despite a global DED prevalence of 49.5% (95% CI 47.5 to 50.6), ranging from 9.5% to 87.5%, important heterogeneity (I(2)=98.8%, p<0.0001) was observed. Variable diagnosis criteria used within studies were: questionnaires on symptoms, tear film anomalies and corneoconjunctival epithelial damage. Some studies combined criteria to define DED. Heterogeneous prevalence was associated with stratifications on symptoms (I(2)=98.7%, p<0.0001), tears (I(2)=98.5%, p<0.0001) and epithelial damage (I(2)=96.0%, p<0.0001). Stratification of studies with two criteria adjusted the prevalence to 54.0% (95% CI 52.1 to 55.9), whereas studies using three criteria resulted in a prevalence of 11.6% (95% CI 10.5 to 12.9). According to the literature, prevalence of DED was more frequent in females than in males and increased with age. Owing to the disparity of the diagnosis criteria studied to define DED, the global prevalence of 49.5% lacked reliability because of the important heterogeneity. We highlight the necessity of implementing common DED diagnostic criteria to allow a more reliable estimation in order to develop the appropriate preventive occupational actions. 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/

  11. Prevalence of Diagnosed Dry Eye Disease in the United States Among Adults Aged 18 Years and Older.

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    Farrand, Kimberly F; Fridman, Moshe; Stillman, Ipek Özer; Schaumberg, Debra A

    2017-10-01

    To provide current estimates of the prevalence of diagnosed dry eye disease (DED) and associated demographics among US adults aged ≥18 years. Cross-sectional, population-based survey. Data were analyzed from 75 000 participants in the 2013 National Health and Wellness Survey to estimate prevalence/risk of diagnosed DED overall, and by age, sex, insurance, and other demographic factors. We weighted the observed DED prevalence to project estimates to the US adult population and examined associations between demographic factors and DED using multivariable logistic regression. Based on weighted estimates, 6.8% of the US adult population was projected to have diagnosed DED (∼16.4 million people). Prevalence increased with age (18-34 years: 2.7%; ≥75 years: 18.6%) and was higher among women (8.8%; ∼11.1 million) than men (4.5%; ∼5.3 million). After adjustment, there were no substantial differences in prevalence/risk of diagnosed DED by race, education, or US census region. However, there was higher risk of diagnosed DED among those aged 45-54 years (odds ratio [OR]: 1.95; 95% confidence interval [CI]: 1.74-2.20) and ≥75 years (OR: 4.95; 95% CI: 4.26-5.74), vs those aged 18-34 years. Risk was also higher among women vs men (OR: 2.00; 95% CI: 1.88-2.13) and insured vs uninsured participants (OR: 2.12; 95% CI: 1.85-2.43 for those on government and private insurance vs none). We estimate that >16 million US adults have diagnosed DED. Prevalence is higher among women than men, increases with age, and is notable among those aged 18-34 years. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Determination of inmune response and inflammation mediators in tears: Changes in dry eye and glaucoma as compared to healthy controls.

    Science.gov (United States)

    Benitez-Del-Castillo Sánchez, J; Morillo-Rojas, M D; Galbis-Estrada, C; Pinazo-Duran, M D

    2017-05-01

    To determine the expression profile of immune response and inflammation (IRI) mediator molecules in tears from patients with dry eye (DE), and those suspected of having or have primary open-angle glaucoma (POAG) under treatment and compare them with healthy controls. A prospective observational cohort study including 107 participants sub-divided into: healthy controls (CG; n=30), patients with DE (DEG; n=41) and patients suspected of having or have POAG and on hypotensive treatment (POAG-G; n=36). Tear samples were collected by capillary to be processed using a multi-immunoassay system based on flow cytometry (Luminex R-200 ®), in order to determine the interleukins (IL): 1β, 2, 4, 5, 6, and 10, and the growth factors: Tumour necrosis alpha (TNF-α), vascular endothelial (VEGF), and granulocyte-macrophage colony stimulating- (GM-CSF). Data were processed using the SPSS 20.0 program. Molecules that significantly increased in tears from DEG vs. POAG-G patients were: IL-1 (P=.01), IL-6 (P=.004), IL-10 (P=.04), whereas VEGF significantly decreased in the DEG. The POAG-G showed significantly higher IL-6 values (P<.0001) as compared to the CG. When comparing both the DEG and POAG-G, significant differences were observed in tear expression of IL-4 (P=.004), IL-6 (P=.002), TNF-α (P=.03), GM-CSF (P=.03), and VEGF (P=.002). The increased expression of IRI mediators in tears from patients with DE or POAG strongly demonstrated the importance of immune response in both pathologies. However, the different molecules involved also suggest distinct signalling pathways for these processes that still require further research. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Red blood cell fatty acid analysis for determining compliance with omega3 supplements in dry eye disease trials.

    Science.gov (United States)

    Gadaria-Rathod, Neha; Dentone, Peter G; Peskin, Ellen; Maguire, Maureen G; Moser, Ann; Asbell, Penny A

    2013-11-01

    To evaluate pill counts and red blood cell (RBC) membrane fatty acid profiles as measures of compliance with oral omega3 polyunsaturated fatty acids (ω3 PUFAs) and to compare the two techniques. Sixteen dry eye disease subjects were given oral ω3 PUFA or placebo for 3 months. Compliance was measured by pill counts and blood tests at baseline and 3 months. The Wilcoxon signed-rank tests and rank-sum tests were used to compare changes from baseline and the difference between the two groups; Spearman correlation coefficients were used to assess the relationship of pill counts to changes in blood FAs. Pill counts for the ω3 (n=7) and placebo (n=9) groups showed a mean consumption of 4.39 and 4.76 pills per day, respectively. In the ω3 group, the median change from baseline was +1.46% for eicosapentaenoic acid (EPA) (P=0.03), +1.49% for docosahexaenoic acid (DHA) (P=0.08), and -1.91% for arachidonic acids (AA) (P=0.02). In the placebo group, median changes in all measured FAs were small and not statistically significant. The difference in change in FA levels between the two groups was significantly greater for EPA (P=0.01) and AA (P=0.04). The correlations between pill counts and changes in EPA (r=0.36, P=0.43) and DHA (r=0.17, P=0.70) were not strong. RBC FA analysis can be used to measure compliance in the active group and also monitor the placebo group for nonstudy ω3 intake. Low correlation of pill counts with blood levels suggests that pill counts alone may be inaccurate and should be replaced or supplemented with objective measures.

  14. Comparison of Two Marketed Hydroxypropyl Methylcellulose Based Artificial Tear Drops in Young Patients with Dry Eye Syndrome

    Directory of Open Access Journals (Sweden)

    Haleh Kangari

    2015-10-01

    Full Text Available Background: Artificial tears have been among the first line of therapy in management of Dry Eye Syndrome (DES. This study was conducted to compare a local artificial tear with an imported one in reduction of DES. This comparison would help to evaluate the cost and benefits of each drop in the proper management of DES.Materials and Methods: In this double-blind randomized clinical trial study, a total 65 students meeting our inclusion criteria for DES entered the study. The OSDI questionnaire, TBUT, corneal and conjunctival staining and Schirmer test, were performed. The patients were divided into two groups by block randomization. Group 1 received first drop and group 2 received second drop. Both groups were instructed to use the drops 4 times a day for 14 days. The same tests were performed by the same examiner who was blind to the treatment type after two weeks. Repeated measured ANOVA was used to analyze the data.Results: A total of 58 patients completed the study. In both groups, after the intervention, the OSDI scores (P<0.001, TBUT score (P=0.041, corneal (P<0.001 and conjunctival staining scores (P<0.001 showed improvement in compare to those before the intervention. However, the Schirmer test score did not show significantly difference before and after intervention. In comparing two groups the OSDI scores, the TBUT score, the corneal and conjunctival staining scores and the Schirmer scores did not show statistically significant difference.Conclusion: The two artificial tears equally reduced the symptoms and signs of DES in two weeks.

  15. Hydroxypropyl Cellulose Ophthalmic Inserts (Lacrisert) Reduce the Signs and Symptoms of Dry Eye Syndrome and Improve Patient Quality of Life

    Science.gov (United States)

    McDonald, Marguerite; D’Aversa, Gerard; Perry, Henry D.; Wittpenn, John R.; Donnenfeld, Eric D.; Nelinson, Donald S.

    2009-01-01

    Purpose: A multicenter, 2-visit, open-label, 4-week study was conducted to determine the acceptability of hydroxypropyl cellulose ophthalmic inserts in adult patients with a history of dry eye syndrome (DES). Methods: At visit 1, patients (N = 520) were evaluated, screened by slit-lamp biomicroscopy, and completed the Ocular Surface Disease Index (OSDI), a validated measure of quality of life. Patients were trained in the proper placement and use of hydroxypropyl cellulose ophthalmic inserts and were contacted by telephone on day 3 of the study. At week 4, patients were given a clinical evaluation and completed a second questionnaire. Answers determined changes in symptoms and quality of life. Adverse events were monitored throughout the study. Results: Four hundred eighteen patients completed the study and reported significant improvements in discomfort, burning, dryness, grittiness, stinging, and light sensitivity (P = .05) after 4 weeks use of hydroxypropyl cellulose ophthalmic inserts. Significant improvements in clinical signs (keratitis, conjunctival staining, and tear volume) were reported. Contact lens wearers reported significant improvements similar to nonwearers, with a strong trend toward improvement in light sensitivity. Mean OSDI total scores, measuring quality of life, significantly improved by 21.3% (from 41.8 ± 22.38 to 32.9 ± 21.97, P ≤ .0215). The most commonly reported adverse event leading to discontinuation was blurred vision, observed in 8.7% of patients (n = 45). Compliance during the study was good; 41.5% of subjects were fully compliant. Of the 58.5% of subjects who missed doses, the majority (69.4%) missed only one to five. Conclusions: Hydroxypropyl cellulose ophthalmic inserts significantly reduced symptoms and clinical signs of moderate to severe DES. They also significantly improved DES in patients wearing contact lenses. Patients experienced a statistically significant improvement in quality of life, as measured by the OSDI, of

  16. The association of vitamin D deficiency with tear break-up time and Schirmer testing in non-Sjögren dry eye.

    Science.gov (United States)

    Kurtul, B E; Özer, P A; Aydinli, M S

    2015-08-01

    To investigate the effect of vitamin D deficiency on tear break-up time (TBUT) and Schirmer test scores and to assess their relationship in non-Sjögren dry-eye patients. Thirty-four patients with serum vitamin D deficiency and 21 control subjects with normal vitamin D levels were included in this study. The TBUT and Schirmer-1 test without topical anesthesia were performed to all patients. The mean TBUT were 5.18±2.15 and 7.36±3.10 s and Schirmer scores were 12.18±6.44 and 18.57±8.99 mm in the study and control groups, respectively. TBUT scores and Schirmer-1 results of the study group were significantly lower than the control group (P=0.01 and 0.007, respectively). The mean vitamin D levels were 11.50±1.8 ng/ml in the study group and 32.8±8.72 ng/ml in control group (P=0.001). Dry-eye symptoms were detected in all patients in the study group and 15% of the patients in the control group. We demonstrated that vitamin D deficiency decreases the TBUT and Schirmer test values and may be associated with dry-eye symptoms in non-Sjögren syndrome.

  17. Comparing self-reported optometric dry eye clinical practices in Australia and the United Kingdom: is there scope for practice improvement?

    Science.gov (United States)

    Downie, Laura E; Rumney, Nicholas; Gad, Anne; Keller, Peter R; Purslow, Christine; Vingrys, Algis J

    2016-03-01

    The aim of this study was to compare the self-reported clinical practice behaviours of optometrists in Australia and the United Kingdom (UK) with respect to the diagnosis and management of dry eye disease (DED). We also sought to examine whether the reported practices of clinicians in each region were consistent with current evidence-based recommendations for DED. An online survey was distributed to optometrists (Australia, n = 654; UK, n = 1006). Respondents provided information about practice modality, years of optometric experience, preferred diagnostic and management strategies (stratified by DED severity) and the information/evidence base used to guide patient care. A total of 317 completed surveys were received (response rates, Australia: 21%, UK: 17%). Optometrists in both regions demonstrated similarly strong knowledge of tear film assessment and adopted both subjective and objective techniques to diagnose DED. Patient symptoms were considered the most important, valuable and commonly performed assessment by both Australian and UK respondents. UK practitioners valued and utilised conjunctival signs and tear meniscus height assessments more than Australian optometrists (p practices was continuing education conferences. This study highlights a range of parallels and divergences in dry eye clinical practice between Australian and UK optometrists. Our data identify both areas of strength in the adoption of evidence-based practice, as well as some potential to improve international translation of dry eye research evidence into practice. © 2016 The Authors Ophthalmic & Physiological Optics © 2016 The College of Optometrists.

  18. What Is Dry Eye?

    Medline Plus

    Full Text Available ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

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