The Impact of Dry Eye Disease on Visual Performance While Driving

Dry eye disease (DED) or keratoconjunctivitis sicca is a chronic multifactorial disorder of the ocular surface caused by tear film dysfunction. Symptoms include dryness, irritation, discomfort and visual disturbance, and standard treatment includes the use of lubricants and topical steroids. Secondary inflammation plays a prominent role in the development and propagation of this debilitating condition. To address this we have investigated the pilot scale development of an innovative drug delivery system using a dexamethasone-encapsulated cholesterol-Labrafac™ lipophile nanostructured lipid carrier (NLC)-based ophthalmic formulation, which could be developed as an eye drop to treat DED and any associated acute exacerbations. After rapid screening of a range of laboratory scale pre-formulations, the chosen formulation was prepared at pilot scale with a particle size of 19.51 ± 0.5 nm, an encapsulation efficiency of 99.6 ± 0.5%, a PDI of 0.08, and an extended stability of 6 months at 4 °C. This potential ophthalmic formulation was observed to have high tolerability and internalization capacity for human corneal epithelial cells, with similar behavior demonstrated on ex vivo porcine cornea studies, suggesting suitable distribution on the ocular surface. Further, ELISA was used to study the impact of the pilot scale formulation on a range of inflammatory biomarkers. The most successful dexamethasone-loaded NLC showed a 5-fold reduction of TNF-α production over dexamethasone solution alone, with comparable results for MMP-9 and IL-6. The ease of formulation, scalability, performance and biomarker assays suggest that this NLC formulation could be a viable option for the topical treatment of DED.

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Ocular Surface Changes Associated with Ophthalmic Surgery

Journal of Clinical Medicine ◽

10.3390/jcm10081642 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1642

Author(s):

Lina Mikalauskiene ◽

Andrzej Grzybowski ◽

Reda Zemaitiene

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Anterior Segment ◽

Dry Eye Disease ◽

Postoperative Treatment ◽

Eye Disease ◽

Ophthalmic Surgery ◽

Patient’S Satisfaction ◽

The Impact ◽

Anterior Segment Surgery

Dry eye disease causes ocular discomfort and visual disturbances. Older adults are at a higher risk of developing dry eye disease as well as needing for ophthalmic surgery. Anterior segment surgery may induce or worsen existing dry eye symptoms usually for a short-term period. Despite good visual outcomes, ocular surface dysfunction can significantly affect quality of life and, therefore, lower a patient’s satisfaction with ophthalmic surgery. Preoperative dry eye disease, factors during surgery and postoperative treatment may all contribute to ocular surface dysfunction and its severity. We reviewed relevant articles from 2010 through to 2021 using keywords “cataract surgery”, ”phacoemulsification”, ”refractive surgery”, ”trabeculectomy”, ”vitrectomy” in combination with ”ocular surface dysfunction”, “dry eye disease”, and analyzed studies on dry eye disease pathophysiology and the impact of anterior segment surgery on the ocular surface.

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Comparative of meibomian gland morphology in patients with evaporative dry eye disease versus non-dry eye disease

Scientific Reports ◽

10.1038/s41598-021-00122-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ricaurte Ramiro Crespo-Treviño ◽

Anna Karen Salinas-Sánchez ◽

Francisco Amparo ◽

Manuel Garza-Leon

Keyword(s):

Dry Eye ◽

Healthy Subjects ◽

Morphological Changes ◽

Tear Film ◽

Meibomian Gland ◽

Dry Eye Disease ◽

Eye Disease ◽

Ocular Surface Disease Index ◽

Evaporative Dry Eye ◽

The Impact

AbstractMany recent studies have showed that morphological changes are one of the key signs of meibomian gland disease (MGD). These changes can be seen even before symptom onset, potentially underestimating the prevalence of MGD; however, until now, there is no conclusive information about the impact of meibomian gland (MG) morphology in tear film physiology and disease. This study aimed to investigate the prevalence of anatomical and morphological MG alterations between patients with evaporative dry eye disease (DED) and healthy controls. Retrospective chart review of seventy-five patients with evaporative DED and healthy individuals who had dry eye assessments included Ocular Surface Disease Index questionnaire, meibum quality, meibum expressibility, lid margin abnormality, ocular staining, non-invasive tear film break-up time, and meibography. We did not find significant differences in MG alterations in the upper lid between healthy and DED subjects. Patients with evaporative DED presented MG alterations in the lower lid more frequently than healthy subjects (54.8 vs. 30.3%; p = 0.03). The presence of shortened glands was the only MG alteration that was more prevalent in the lower lid in dry-eye patients than in healthy subjects (p < 0.05). Subjects with evaporative DED presented more alterations in the lower lid than healthy subjects.

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Patient-reported burden of dry eye disease in the UK: a cross-sectional web-based survey

BMJ Open ◽

10.1136/bmjopen-2020-039209 ◽

2021 ◽

Vol 11 (3) ◽

pp. e039209

Author(s):

Parwez Hossain ◽

Csaba Siffel ◽

Corey Joseph ◽

Juliette Meunier ◽

Jessica T. Markowitz ◽

...

Keyword(s):

Dry Eye ◽

Visual Function ◽

Work Productivity ◽

Dry Eye Disease ◽

Eye Disease ◽

Activity Limitations ◽

Life Questionnaire ◽

Cross Sectional ◽

Web Based ◽

The Impact

ObjectivesTo compare sociodemographics and vision-related quality of life (QoL) of individuals with or without dry eye disease (DED); and to explore the impact of DED symptom severity on visual function, activity limitations and work productivity.DesignCross-sectional web-based survey.SettingGeneral UK population.ParticipantsAdults ≥18 years with (N=1002) or without (N=1003) self-reported DED recruited through email and screened.Main outcome measuresAll participants completed the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25), with six additional questions (items A3–A8), and the EuroQol 5 dimensions 5 levels. DED participants also completed Impact of Dry Eye on Everyday Life questionnaire, 5-item Dry Eye Questionnaire and the Standardised Patient Evaluation of Eye Dryness questionnaire along with the Ocular Comfort Index, Work Productivity and Activity Impairment and the Eye Dryness Score (EDS), a Visual Analogue Scale.ResultsBaseline demographic and clinical characteristics were similar in participants with versus without DED (mean age, 55.2 vs 55.0 years; 61.8% vs 61.0% women, respectively) based on recruitment targets. Scores were derived from NEI VFQ-25 using the new 28-item revised VFQ (VFQ-28R) scoring. Mean (SD) VFQ-28R scores were lower in participants with versus without DED, indicating worse functioning (activity limitations, 73.3 (12.3) vs 84.4 (12.3); socioemotional functioning, 75.3 (21.5) vs 90.3 (16.2); total score, 71.6 (12.8) vs 83.6 (12.6)). Higher percentages of problems/inability to do activities were observed among those with versus without DED. The impact of DED on visual function was worse for participants with more severe DED symptoms, as assessed by EDS. In addition, a higher EDS was associated with worse symptoms on common DED scales and a worse impact on work productivity.ConclusionsDED symptoms were associated with negative effects on visual function, activities and work productivity, whereas worse DED symptoms had a greater impact on vision-related QoL and work productivity.

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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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PP47 Defining The Needs And Preferences Of Patients With Dry Eye Disease

International Journal of Technology Assessment in Health Care ◽

10.1017/s026646231800209x ◽

2018 ◽

Vol 34 (S1) ◽

pp. 83-84 ◽

Cited By ~ 1

Author(s):

Nigel Cook ◽

Brigitte Sloesen ◽

Anna Panapurina ◽

Gary Johnson ◽

Clementine Prince ◽

...

Keyword(s):

Qualitative Research ◽

Dry Eye ◽

Convergent Validity ◽

Online Survey ◽

Dry Eye Disease ◽

Eye Disease ◽

Health States ◽

Total N ◽

Preference Structures ◽

The Impact

Introduction:Dry eye disease (DED) is a common condition that significantly impacts patients’ quality of life. Previous studies have explored the impact of DED on patients’ lives qualitatively; however, patients’ preference structures have not been thoroughly explored quantitatively.Methods:A targeted literature review and social media listening project guided design of a discussion guide for in-depth patient interviews (n=12). These, in turn, guided construction of a quantitative questionnaire administered to moderate to severe DED patients, 40 per country in Australia, Germany, United States and United Kingdom (total n=160). Patients’ preference structures were explored through an online survey using a self-explicated conjoint methodology, because of its high respondent-friendliness. Additionally, we administered the EQ5D-5L instrument to determine the health states/utilities of patients. Reaction to a hypothetical novel treatment was further obtained to check for convergent validity with the self-explicated conjoint. Finally, we asked respondents to rate the ease and relevance of the questionnaire to them.Results:Qualitative research uncovered important patient perspectives that were built into the quantitative survey. For example, patients seek medical advice when their symptoms are not improving. Patients’ lives are most affected by sensitivity to light, itchy and tired eyes and an inability to perform computer/screen work; however, of most concern/worrying to them is that their DED will get worse and they go blind. Results from the quantitative preference research will also be shared and its implications for future clinical trials in DED outlined. The results of the patient research and preference study are to be shared with health technology assessment (HTA) bodies and regulators through the early dialogue scientific advice process.Conclusions:A process of using qualitative research to determine what matters to patients and then quantification through respondent-friendly preference research can identify outcomes that are most patient-relevant, to inform future drug development strategies.

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Impact of Attrition, Intercellular Shear in Dry Eye Disease: When Cells are Challenged and Neurons are Triggered

International Journal of Molecular Sciences ◽

10.3390/ijms21124333 ◽

2020 ◽

Vol 21 (12) ◽

pp. 4333 ◽

Cited By ~ 4

Author(s):

Gysbert-Botho van Setten

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Tear Film ◽

Dry Eye Disease ◽

Neural Regeneration ◽

Eye Disease ◽

Molecular Characteristics ◽

Treatment Regimens ◽

New Perspective ◽

The Impact

The mechanical component in the pathophysiology of dry eye disease (DED) deserves attention as an important factor. The lubrication deficit induced impaired mechano-transduction of lid pressure to the ocular surfaces may lead to the dysregulation of homeostasis in the epithelium, with sensations of pain and secondary inflammation. Ocular pain is possibly the first sign of attrition and may occur in the absence of visible epithelial damage. Attrition is a process which involves the constant or repeated challenge of ocular surface tissues by mechanical shear forces; it is enhanced by the thinning of corneal epithelium in severe DED. As a highly dynamic process leading to pain and neurogenic inflammation, the identification of the impact of attrition and its potential pathogenic role could add a new perspective to the current more tear film-oriented models of ocular surface disease. Treatment of DED addressing lubrication deficiencies and inflammation should also consider the decrease of attrition in order to stimulate epithelial recovery and neural regeneration. The importance of hyaluronic acid, its molecular characteristics, the extracellular matrix and autoregulative mechanisms in this process is outlined. The identification of the attrition and recognition of its impact in dry eye pathophysiology could contribute to a better understanding of the disease and optimized treatment regimens.

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