Occult Thyroid Eye Disease in Patients Presenting with Dry Eye Symptoms

Abstract Background: Thyroid eye disease is thought to present as proptosis and/or severe conjunctival chemosis. Severe dry eye disease and its symptoms of non-specific eye pain and foreign body sensation in the eye can be overlooked as an early biomarker of thyroid disease. New infrared imaging can be used to evaluate dry eye and eyelid gland anatomy. Infrared imaging and detailed history of thyroid eye symptoms may lead to subsequent testing of thyroid function and more referrals to thyroid specialists. Purpose: Using infrared photography to evaluate dry eye complaints in patients: do they have thyroid disease? Methods: A retrospective chart review (2017–2019) of patients with dry eyes, eyelid imaging with infrared photography and thyroid lab testing was performed. Infrared photography with 820 nm wavelength (Heidelberg Spectralis, Heidelberg, Germany). Percentage loss of Meibomian glands was identified for each eye, then analyzed, per patient. The control population consisted of patients with no dry eye complaints, no thyroid testing or thyroid history. Exclusion criteria: patients over the age of 90 years and patients with a history of glaucoma, diabetes, cataract surgery, and eyelid surgery. Age matching was done (±5 years). Results: n=48 patients, avg age=57.73 years (sd=16.81, range 21–85 years). Thyroid patients: n=24 patients, male=10, female=14, avg age= 57.12 years (sd=16.65, med=55.5, range 23–83 years). Controls: n=24 patients, male=9, female=15, avg age=58.33 years (sd=17.30, med=58, range 21–85 years). Loss of Meibomian glands: thyroid=40.94%, control=5.10% (p<0.0001, t-test). Dry eye complaints: thyroid = 16/24, control = 0/24 (p<0.0001, x2). Discussion: Meibomian glands are glands in the upper and lower eyelids. These glands provide the lipid component of the tear film, thus slowing the evaporation of the tears and stabilizing the tear film with each blink. Meibomian gland loss would explain the dry eye symptoms in an abnormal thyroid patient population. Infrared photography can be performed with a #87 camera lens filter (cost = $65). The loss of Meibomian glands may be an early sign for thyroid disease. Conclusion: Infrared photography may be helpful in identifying severe dry eye, thus leading to increased awareness of thyroid eye disease symptoms in our patients in ophthalmology, endocrinology, and primary care.

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Dry eye disease, dry eye symptoms and depression: the Beijing Eye Study

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2013-303838 ◽

2013 ◽

Vol 97 (11) ◽

pp. 1399-1403 ◽

Cited By ~ 72

Author(s):

Antoine Labbé ◽

Ya Xing Wang ◽

Ying Jie ◽

Christophe Baudouin ◽

Jost B Jonas ◽

...

Keyword(s):

Dry Eye ◽

Dry Eye Disease ◽

Eye Disease ◽

Beijing Eye Study ◽

Eye Symptoms ◽

Dry Eye Symptoms

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Provocation of Dry Eye Disease during COVID-19 Lockdown

10.21203/rs.3.rs-858036/v1 ◽

2021 ◽

Author(s):

Nutnicha Neti ◽

Pinnita Prabhasawat ◽

Chareenun Chirapapaisan ◽

Panotsom Ngowyutagon

Keyword(s):

Mental Health ◽

Health Status ◽

Dry Eye ◽

Dry Eye Disease ◽

Mental Health Status ◽

Eye Disease ◽

Eye Symptoms ◽

The Mean ◽

The Impact ◽

Dry Eye Symptoms

Abstract To assess the impact of COVID-19 lockdown measures on dry-eye symptoms in a community-based population, a cross-sectional study was conducted during the first wave of the COVID-19 outbreak in Thailand. An online survey was distributed via social media between June and July 2020. The questionnaire elicited information on demographics, dry-eye symptoms, viewing habits, and mental health status. There were 535 respondents. Thirty-seven percent reported having been diagnosed with dry-eye disease (DED). During the lockdown, the mean dry-eye symptom score (DESS) of overall participants dropped significantly from 81.6±15.9 to 79.8±17.4 (P<0.001). The mean, daily, visual display terminal (VDT) usage increased from 10.55±5.16 hours to 13.08±5.65 hours (P<0.001). A negative correlation between age and VDT usage was observed in both the normal and lockdown situations. One-quarter of all participants had an abnormal mental health status. The female gender (OR 1.86; 95% CI 1.14–3.04) and increased VDT usage during the lockdown (OR 5.68; 95% CI 3.49–9.23) were independently associated with worsening dry-eye symptoms. The lockdown measures abruptly altered the behaviors and lifestyles of the overall population. Excessive exposure to VDTs were associated with deteriorated dry-eye symptoms, and it possibly contributed to the increased DED incidence in the general population.

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Case finding of dry eye disease in Norwegian optometric practice: a cross-sectional study

Scandinavian Journal of Optometry and Visual Science ◽

10.5384/sjovs.v14i1.131 ◽

2021 ◽

Vol 14 (1) ◽

pp. 1-6

Author(s):

Ann Elisabeth Ystenæs ◽

Ingeborg Sand ◽

Vibeke Sundling

Keyword(s):

Dry Eye ◽

Contact Lens ◽

Cross Sectional Study ◽

Case Finding ◽

Eye Disease ◽

Cross Sectional ◽

Eye Symptoms ◽

The Mean ◽

Breakup Time ◽

Dry Eye Symptoms

Optometrists are primary eye care providers, and it is essential that they efficiently identify patients who will benefit from dry eye management. The aim of the study was to explore case finding of dry eye disease (DED) in optometric practice. A cross-sectional study examining dry eye symptoms and signs in 186 patients (18–70 years of age) attending a routine eye examination, with DED defined according to the criteria of the Tear Film and Ocular Surface Society Dry Eye Workshop II. Standard statistical tests were used, and clinical diagnostics were explored using sensitivity, specificity, and receiveroperating curve (ROC) statistics. Fifty-six patients were contact lens wearers, and they were significantly younger than the non-contact lens wearers (mean age 35 (SD = 1) versus 48 (± 2) years). The mean best corrected visual acuity (BCVA) in the better eye was 1.0 (± 0.1) (decimal acuity). There was no difference in BCVA between contact lens wearers and non-contact lens wearers. The mean Ocular Surface Disease Index (OSDI) score was 22 (± 19), and 138 patients had at least one positive homeostasis marker. Eighty-six had DED, 52 had signs without symptoms, and 23 had symptoms without signs of DED. The sensitivity and specificity of OSDI in detecting any positive homeostasis marker were 62% and 54%, respectively. In all, 106 patients had meibomian gland dysfunction (MGD), of which 49 were asymptomatic. In a ROC analysis, an OSDI ≥ 13 showed a diagnostic ability to differentiate between patients with a fluorescein breakup time (FBUT) < 10 seconds and a fluorescein breakup time ≥ 10 seconds, but not between patients with and without staining or MGD. The majority of patients had dry eye signs and/or dry eye symptoms. Routine assessment of FBUT and meibomian glands may enable case finding of DED in optometric practice.

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Provocation of dry eye disease symptoms during COVID-19 lockdown

Scientific Reports ◽

10.1038/s41598-021-03887-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Nutnicha Neti ◽

Pinnita Prabhasawat ◽

Chareenun Chirapapaisan ◽

Panotsom Ngowyutagon

Keyword(s):

Mental Health ◽

Health Status ◽

Dry Eye ◽

Visual Display ◽

Dry Eye Disease ◽

Mental Health Status ◽

Eye Disease ◽

Eye Symptoms ◽

The Mean ◽

Dry Eye Symptoms

AbstractTo assess the impact of COVID-19 lockdown measures on dry-eye symptoms in a community-based population, a cross-sectional study was conducted during the first wave of the COVID-19 outbreak in Thailand. An online survey was distributed via social media between June and July 2020. The questionnaire elicited information on demographics, dry-eye symptoms, use of visual display terminals, and mental health status. There were 535 respondents. Thirty-seven percent reported having been diagnosed with dry-eye disease (DED). During the lockdown, the mean dry-eye symptom score (DESS) of overall participants dropped significantly from 81.6 ± 15.9 to 79.8 ± 17.4 (P < 0.001). The mean, daily, visual display terminal (VDT) usage increased from 10.55 ± 5.16 to 13.08 ± 5.65 h (P < 0.001). A negative correlation between age and VDT usage was observed in both the normal and lockdown situations. One-quarter of all participants had an abnormal mental health status. The female gender (OR 1.86; 95% CI 1.14–3.04) and increased VDT usage during the lockdown (OR 5.68; 95% CI 3.49–9.23) were independently associated with worsening dry-eye symptoms. The lockdown measures abruptly altered the behaviors and lifestyles of the overall population. Excessive exposure to VDTs were associated with deteriorated dry-eye symptoms, and it possibly contributed to the increased DED incidence in the surveyed population.

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Randomized, crossover clinical efficacy trial in humans and mice on tear secretion promotion and lacrimal gland protection by molecular hydrogen

Scientific Reports ◽

10.1038/s41598-021-85895-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Miyuki Kubota ◽

Motoko Kawashima ◽

Sachiko Inoue ◽

Toshihiro Imada ◽

Shigeru Nakamura ◽

...

Keyword(s):

Dry Eye ◽

Molecular Hydrogen ◽

Human Subjects ◽

Dry Eye Disease ◽

Eye Disease ◽

Efficacy Trial ◽

Tear Secretion ◽

Eye Symptoms ◽

New Treatment ◽

Dry Eye Symptoms

AbstractThe incidence of dry eye disease is increasing worldwide because of the aging population and increasing use of information technology. Dry eye disease manifests as tear-layer instability and inflammation caused by osmotic hypersensitization in tear fluids; however, to our knowledge, no agent that treats both pathologies simultaneously is available. Molecular hydrogen (H2) is known to be effective against various diseases; therefore, we aimed to elucidate the effects of H2on tear dynamics and the treatment of dry eye disease. We revealed that administering a persistent H2-generating supplement increased the human exhaled H2concentration (p < 0.01) and improved tear stability (p < 0.01) and dry eye symptoms (p < 0.05) significantly. Furthermore, H2significantly increased tear secretion in healthy mice (p < 0.05) and significantly suppressed tear reduction in a murine dry eye model (p = 0.007). H2significantly and safely improved tear stability and dry eye symptoms in a small exploratory group of 10 human subjects, a subset of whom reported dry eye symptoms prior to treatment. Furthermore, it increased tear secretion rapidly in normal mice. Therefore, H2may be a safe and effective new treatment for dry eye disease and thus larger trials are warranted.

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Assessment Of Dry Eye Symptoms And Quality Of Sleep In Engineering Students During The Covid-19 Pandemic

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl1.3593 ◽

2020 ◽

Vol 11 (SPL1) ◽

pp. 1202-1207

Author(s):

Pavithra S ◽

Dheepak Sundar M

Keyword(s):

Sleep Quality ◽

Dry Eye ◽

Screen Time ◽

Engineering Students ◽

Statistical Tests ◽

Quality Of Sleep ◽

Cross Sectional ◽

Eye Symptoms ◽

Dry Eye Symptoms

To assess dry eye symptoms (DES) and quality of sleep in engineering students during the Covid19 pandemic lockdown and also to assess the association between DES and sleep quality. A cross-sectional questionnaire-based study was carried out among 396 engineering students studying in Saveetha engineering college. The study tool used was a semi-structured google form questionnaire designed for assessing digital device usage, symptoms of dry eye disease and sleep pattern. Responses were analyzed using appropriate statistical tests. Overall 64.1% attained a score of more than 10, indicating the presence of DES. 70.2% of the study population used digital screens for more than 13 hours. A statistically significant association was found between increased screen time and presence of DES(p<0.05). 64.9% had a score of >18 indicating reduced sleep quality. About 77.1% of the students with DES had reduced sleep quality, and a significant association (p<0.01) was observed between the two. During the Covid19 pandemic lockdown, there appears to be rising prevalence of DES in student population, one of the reasons being increased screen time. The sleep quality was also found to be reduced, and a significant association was found between DES and sleep quality.

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