Effect of Face Mask on Tear Film Stability in Eyes With Moderate-to-Severe Dry Eye Disease

Abstract Background: The tear film breakup time (tBUT) is a clinical evaluation of evaporative dry eye disease assessed by instilling topical fluorescein into the eyes. In the present study, we introduce a new diagnostic test, blinking tolerance time (BTT), for self-evaluation of tear-film stability. We compared the results with the tBUT and validated the BTT test for self-assessment of tear film instability.Methods: This was a prospective controlled study involving 212 eyes of 106 participants 20–79 years of age. A total of 114 eyes of 57 dry eye patients and 98 eyes of 49 healthy subjects were included in the study. All patients and subjects were administered the following tests to diagnose dry eye disease: Ocular Surface Disease Index, BTT, tBUT, slit-lamp examination, corneal stain score, and Schirmer I test (without anesthesia). Patients and subjects were instructed not to blink for as long possible after reset blinking. The time interval between the reset blink and the next blink was measured. The mean of 3 tBUT values in both the right and left eyes was defined as tBUTBE. Correlations between the BTT and tBUTBE were also evaluated. To evaluate the diagnostic efficacy of the BTT and tBUT tests, receiver operating characteristic (ROC) curves were generated to obtain a cutoff score, and the sensitivities of the tests against the specificity at all possible thresholds were plotted.Results: Spearman’s correlation analysis revealed a significant weakly positive correlation between BTT and tBUTBE (r = 0.447; p=0.000). The intraclass correlation coefficient (ICC) of the tBUT was 0.679 (95% confidence interval [CI]: 0.575–0.765) and the ICC of the BTT was 0.904 (95% CI: 0.867–0.932). The area under the ROC curve did not significantly differ between the tBUTBE (0.678) and BTT (0.628, p=0.641). When the cutoff value of the BTT test was set to 8.1 s, the sensitivity was 63.3% and the specificity was 56.1%.Conclusion: The BTT test is a simple, inexpensive, and effective method for self-diagnosing dry eye that can also be used in the clinical setting.

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Easy and effective test to evaluate tear-film stability for self-diagnosis of dry eye syndrome: blinking tolerance time (BTT)

BMC Ophthalmology ◽

10.1186/s12886-020-01686-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Hyung Bin Hwang ◽

Yong Ho Ku ◽

Eun Chul Kim ◽

Hyun Seung Kim ◽

Man Soo Kim ◽

...

Keyword(s):

Dry Eye ◽

Tear Film ◽

Dry Eye Disease ◽

Controlled Study ◽

Eye Disease ◽

Cutoff Score ◽

Time Interval ◽

Film Stability ◽

Tolerance Time ◽

Tear Film Stability

Abstract Background The tear film breakup time (tBUT) is a clinical evaluation of evaporative dry eye disease assessed by instilling topical fluorescein into the eyes. In the present study, we introduce a new diagnostic test, blinking tolerance time (BTT), for self-evaluation of tear-film stability. We compared the results with the tBUT and validated the BTT test for self-assessment of tear film instability. Methods This was a prospective controlled study involving 212 eyes of 106 participants 20–79 years of age. A total of 114 eyes of 57 dry eye patients and 98 eyes of 49 healthy subjects were included in the study. All patients and subjects were administered the following tests to diagnose dry eye disease: Ocular Surface Disease Index, BTT, tBUT, slit-lamp examination, corneal stain score, and Schirmer I test (without anesthesia). Patients and subjects were instructed not to blink for as long possible after reset blinking. The time interval between the reset blink and the next blink was measured. The mean of 3 tBUT values in both the right and left eyes was defined as tBUTBE. Correlations between the BTT and tBUTBE were also evaluated. To evaluate the diagnostic efficacy of the BTT and tBUT tests, receiver operating characteristic (ROC) curves were generated to obtain a cutoff score, and the sensitivities of the tests against the specificity at all possible thresholds were plotted. Results Spearman’s correlation analysis revealed a significant weakly positive correlation between BTT and tBUTBE (r = 0.447; p = 0.000). The intraclass correlation coefficient (ICC) of the tBUT was 0.679 (95% confidence interval [CI]: 0.575–0.765) and the ICC of the BTT was 0.904 (95% CI: 0.867–0.932). The area under the ROC curve did not significantly differ between the tBUTBE (0.678) and BTT (0.628, p = 0.641). When the cutoff value of the BTT test was set to 8.1 s, the sensitivity was 63.3% and the specificity was 56.1%. Conclusion The BTT test is a simple, inexpensive, and effective method for self-diagnosing dry eye that can also be used in the clinical setting.

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Laser Acupuncture Improves Tear Film Stability in Patients with Dry Eye Disease: A Two-Center Randomized-Controlled Trial

The Journal of Alternative and Complementary Medicine ◽

10.1089/acm.2020.0524 ◽

2021 ◽

Author(s):

Wen-Long Hu ◽

Hun-Ju Yu ◽

Li-Yen Pan ◽

Pei-Chang Wu ◽

Chih-Chin Pan ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Dry Eye ◽

Controlled Trial ◽

Tear Film ◽

Dry Eye Disease ◽

Laser Acupuncture ◽

Eye Disease ◽

Film Stability ◽

Randomized Controlled ◽

Tear Film Stability

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Dry eye disease in students with myopia during COVID-19 pandemic

Archive of Ukrainian Ophthalmology ◽

10.22141/2309-8147.9.3.2021.247907 ◽

2021 ◽

Vol 9 (3) ◽

pp. 34-37

Author(s):

M.V. Panchenko ◽

P.A. Bezditko

Keyword(s):

Distance Learning ◽

Dry Eye ◽

Contact Lenses ◽

Tear Film ◽

Face Mask ◽

Corneal Topography ◽

Dry Eye Disease ◽

Eye Disease ◽

Eye Drops ◽

Ocular Surface Disease Index

Background. Today, the urgent problem is coronavirus disease 2019 pandemic in the whole world. Safety measures such as the use of masks, distance learning have been implemented. However, ophthalmologists, as well as the general population, should know that a face mask together with prolonged use of digital devices leads to an increase in the number of dry eye cases in many patients. The purpose was to study the frequency of dry eye disease in students with myopia. Materials and methods. The study involved 96 medical students diagnosed with myopia taken by random sampling, who were examined by an ophthalmologist. Apart from the standard ophthalmologic examination, all patients underwent the evaluation of the stability of the precorneal tear film by means of corneal topography, and Norn test (tear break-up time (TBUT)). There was also used a standard questionnaire designed to assess the severity of dry eye disease symptoms (Ocular Surface Disease Index). Results. The corneal topography of the 47 patients did not demonstrate any reduction in TBUT. The average time of the concentric ring remained stable for 20.2 ± 3.0 seconds. But 49 individuals exhibited signs of tear film instability over time compared to 47 patients without TBUT impairment. In 47 people without impairments, corneal topography demonstrated that this indicator in Norn test varied from 25 to 18 seconds, i.e. was within the age norm (21.5 ± 3.5 seconds on average). In 3 patients with a minimum TBUT on keratotopography, its value during the Norn test was 9 seconds. In 36 patients with reduced TBUT according to both methods, there was a weak degree of dry eyes, in 10 — moderate, in 3 — severe. The most common complaints were a sandy, gritty sensation in the eyes, visual discomfort when working at a computer and in windy weather, and with prolonged use of a protective mask. Conclusions. Among students who were on distance learning, 51.04 % of individuals have objectively confirmed dry eye disease. People wearing contact lenses have a more pronounced degree of dry eye, so it is mandatory for ophthalmologists to prescribe lubricating eye drops.

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The correction of conjunctivochalasis using high-frequency radiowave electrosurgery improves dry eye disease

Scientific Reports ◽

10.1038/s41598-021-82088-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yong Woo Ji ◽

Hyojin Seong ◽

Sujung Lee ◽

Mutlaq Hamad Alotaibi ◽

Tae-im Kim ◽

...

Keyword(s):

Dry Eye ◽

High Frequency ◽

Symptomatic Relief ◽

Tear Film ◽

Signs And Symptoms ◽

Meibomian Gland ◽

Dry Eye Disease ◽

Eye Disease ◽

Film Stability ◽

Staining Score

AbstractWe aimed to determine the clinical impact of conjunctivochalasis (CCh) and its correction using high-frequency radiowave electrosurgery (HFR-ES), for signs and symptoms of dry eye disease (DED). Forty patients diagnosed with symptomatic CCh were prospectively enrolled. As a result, patients with CCh had moderate to severe DED and most of them exhibited meibomian gland dysfunction (MGD). Corneo-conjunctival fluorescein staining score (CFS) and all lid-parallel-conjunctival-folds scores (LIPCOFs) were positively correlated. Nasal LIPCOF significantly correlated with symptoms and tear volume. Central, temporal, and total LIPCOF significantly correlated with MG loss, MGD stage, and lipid layer thickness. Independent significant factors associated with total LIPCOF included CFS, tear break-up time, and MGD stage. One month following HFR-ES, CCh was completely resolved in all cases. Patient age and preoperative nasal LIPCOF were determinants of outcomes associated with postoperative improvements in symptoms. Ocular surface parameters significantly improved, but MGD-related signs did not. Collectively, CCh associated with MGD severity deteriorates not only tear film stability and reservoir capacity, leading to DED exacerbation. Therefore, CCh should be corrected in patients with DED and MGD. Younger patients with nasal CCh are likely to experience more symptomatic relief after HFR-ES. Particularly, management for MGD should be maintained after CCh correction.

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Tear Proteomics Study of Dry Eye Disease: Which Eye Do You Adopt as the Representative Eye for the Study?

International Journal of Molecular Sciences ◽

10.3390/ijms22010422 ◽

2021 ◽

Vol 22 (1) ◽

pp. 422

Author(s):

Ming-Tse Kuo ◽

Po-Chiung Fang ◽

Shu-Fang Kuo ◽

Alexander Chen ◽

Yu-Ting Huang

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Tear Film ◽

Dry Eye Disease ◽

Eye Disease ◽

Mechanistic Studies ◽

Clinical Tests ◽

Tear Proteins ◽

Proteomic Data ◽

Surface Performance

Most studies about dry eye disease (DED) chose unilateral eye for investigation and drew conclusions based on monocular results, whereas most studies involving tear proteomics were based on the results of pooling tears from a group of DED patients. Patients with DED were consecutively enrolled for binocular clinical tests, tear biochemical markers of DED, and tear proteome. We found that bilateral eyes of DED patients may have similar but different ocular surface performance and tear proteome. Most ocular surface homeostatic markers and tear biomarkers were not significantly different in the bilateral eyes of DED subjects, and most clinical parameters and tear biomarkers were correlated significantly between bilateral eyes. However, discrepant binocular presentation in the markers of ocular surface homeostasis and the associations with tear proteins suggested that one eye’s performance cannot represent that of the other eye or both eyes. Therefore, in studies for elucidating tear film homeostasis of DED, we may lose some important messages hidden in the fellow eye if we collected clinical and proteomic data only from a unilateral eye. For mechanistic studies, it is recommended that researchers collect tear samples from the eye with more severe DED under sensitive criteria for identifying the more severe eye and evaluating the tear biochemical and proteomic markers with binocular concordance drawn in prior binocular studies.

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A distinct cytokines profile in tear film of dry eye disease (DED) patients with HIV infection

Cytokine ◽

10.1016/j.cyto.2016.08.026 ◽

2016 ◽

Vol 88 ◽

pp. 77-84 ◽

Cited By ~ 12

Author(s):

Rupesh Agrawal ◽

Praveen Kumar Balne ◽

Anuradha Veerappan ◽

Veonice Bijin Au ◽

Bernett Lee ◽

...

Keyword(s):

Hiv Infection ◽

Dry Eye ◽

Tear Film ◽

Dry Eye Disease ◽

Eye Disease

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Cationic Thiolated Poly(aspartamide) Polymer as a Potential Excipient for Artificial Tear Formulations

Journal of Ophthalmology ◽

10.1155/2016/2647264 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Mária Budai-Szűcs ◽

Gabriella Horvát ◽

Barnabás Áron Szilágyi ◽

Benjámin Gyarmati ◽

András Szilágyi ◽

...

Keyword(s):

Dry Eye ◽

Tear Film ◽

Dry Eye Disease ◽

Eye Disease ◽

Eye Drops ◽

Thiol Groups ◽

Physiological Properties ◽

Disulphide Bond Formation ◽

Polymer Bearing

Dry eye disease is a relatively common ocular problem, which causes eye discomfort and visual disorders leading to a decrease in the quality of life. The aim of this study was to find a possible excipient for eye drop formulations, which is able to stabilize the tear film. A cationic thiolated polyaspartamide polymer, poly[(N-mercaptoethylaspartamide)-co-(N-(N′,N′-dimethylaminoethyl)aspartamide)] (ThioPASP-DME), was used as a potential vehicle. Besides satisfying the basic requirements, the chemical structure of ThioPASP-DME is similar to those of ocular mucins as it is a protein-like polymer bearing a considerable number of thiol groups. The solution of the polymer is therefore able to mimic the physiological properties of the mucins and it can interact with the mucus layer via disulphide bond formation. The resultant mucoadhesion provides a prolonged residence time and ensures protective effect for the corneal/conjunctival epithelium. ThioPASP-DME also has an antioxidant effect due to the presence of the thiol groups. The applicability of ThioPASP-DME as a potential excipient in eye drops was determined by means of ocular compatibility tests and through examinations of the interactions with the mucosal surface. The results indicate that ThioPASP-DME can serve as a potential eye drop excipient for the therapy of dry eye disease.

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