scholarly journals TREATMENT FOR CONJUNCTIVOCHALASIS: A COMBINED APPROACH UTILIZING RADIOFREQUENCY CAUTERIZATION AND THERMALIDTM PROCEDURE

2021 ◽  
Vol 4 (1) ◽  
pp. e1-e10
Author(s):  
Liem Nguyen ◽  
Edward Jaccoma
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Symptomatic Relief ◽  
Retrospective Chart Review ◽  
Signs And Symptoms ◽  
Meibomian Gland ◽  
Significant Clinical Improvement ◽  
Pre Treatment ◽  
Tear Meniscus Height

BackgroundDry Eye Disease (DED) and related ocular surface diseases have multiple etiologies, but two of the most prevalent are Meibomian Gland Dysfunction (MGD) and Conjunctivochalasis (CCH). This study examines a customizable two-step approach utilizing radiofrequency to treat these two commonly coexisting condi-tions and provide patients with relief from DED signs and symptoms. Study DesignAn IRB approved retrospective chart review of 25 consecutively treated patients was conducted. Patients were included if they presented with DED symptoms and were treated with a combination treatment approach to improve both MGD and CCH, with pre- and post-treatment dry eye metrics outlined below. Follow-up visit information was compared to pre-treatment baseline to evaluate the efficacy and safety of treatment. ResultsStatistically significant results were observed in a decrease in symptoms as evaluated by the primary endpoints of the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire and an increase in the number of Meibomian Glands Yielding Liquid Secretion (MGYLS). Tear Meniscus Height also saw statistically significant improvement while Non-invasive Tear Break-Up Time (NTBUT) and Schirmer’s saw minor progress. Clinical evaluation and ocular surface photographs showed marked improvement in CCH with minimal observed side effects during post-operative follow-up visits. ConclusionA two-step approach utilizing a radiofrequency device to treat dry eye symptoms provides significant clinical improvement and symptomatic relief for a broad spectrum of patients who had received a variety of prior treatments for DED.

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

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.

scholarly journals Examination for Dry Eyes

2021 ◽  
Author(s):  
Tri Wahyu
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Signs And Symptoms ◽  
Eye Disease ◽  
Initial Examination ◽  
Laboratory Equipment ◽  
Dry Eyes ◽  
Potential Damage

Dry eye disease (DED) is a multifactorial disease of tears and ocular surface that results in various symptoms with the potential damage to the ocular surface. It can range from mild to severe signs and symptoms and may affect patient’s quality of life. Various techniques and methods have been developed to evaluate DED for initial examination or regular follow up. The simple evaluations that can be performed in clinic include eyelid examination, tear break-up time, and ocular surface stainings; while the advanced ones may require certain devices or laboratory equipment. Careful and thorough examinations are important to guide the clinician to assess and evaluate dry eye.

scholarly journals Evaluation of Dry Eye after Implantable Collamer Lens Surgery

2020 ◽  
Author(s):  
Haiting Chen ◽  
Xueyan Feng ◽  
Guangzeng Niu ◽  
Yuxiang Fan
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Case Series ◽  
Meibomian Gland ◽  
Quality Score ◽  
Control Group ◽  
Ocular Surface Disease Index ◽  
Implantable Collamer Lens ◽  
Lens Surgery ◽  
Breakup Time

<b><i>Objectives:</i></b> To evaluate dry eye (DE) and associated meibomian gland dysfunction parameters after Implantable Collamer Lens (ICL) surgery. <b><i>Methods:</i></b> This is a prospective observational case series. Patients who underwent ICL implantation without previous ocular diseases or ophthalmic treatments were enrolled. Their Ocular Surface Disease Index (OSDI), noninvasive breakup time (NIBUT), meibography, slit-lamp examination of the lid margin, corneal fluorescein staining (CFS), and Schirmer test I were examined preoperatively and at 1 and 3 months postoperatively. <b><i>Results:</i></b> A total of 117 eyes of 60 patients were enrolled, and 107 eyes completed 3-month follow-up period. OSDI, lid marginal abnormality, and meibomian gland (MG) secretion, and meibum quality score were significantly higher at 1 month postoperatively and recovered partially at 3 months after surgeries, while NIBUT was significantly decreased all the time. Patients with previous DE symptoms (OSDI score ≥12) showed not only lower Schirmer and TBUT values but also higher CFS, lid margin score, MG loss, MG secretion, and meibum quality scores compared with those in the control group after operations. Low Schirmer, NIBUT values, and high meibum quality score were determined as risk factors for DE symptoms after ICL surgery. <b><i>Conclusions:</i></b> ICL implantation has a bad influence on the ocular surface and MG functions. The influence may be more obvious in patients with existing DE.

scholarly journals Dry eye disease among Glaucoma patients on topical hypotensive medications, in a tertiary hospital, Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Miraf Sahlu ◽  
Abeba T. Giorgis
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Signs And Symptoms ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Eye Drops ◽  
Schirmer Test ◽  
Ocular Surface Disease Index ◽  
Cross Sectional ◽  
Corneal Staining

Abstract Background Dry eye disease is a multifactorial disease; causing various ocular symptoms with potential damage to the ocular surface. Applying hypotensive eye drops are presumed to initiate or exacerbate existing dry eye disease. The purpose of this study was to determine the frequency of signs and symptoms and severity of dry eye disease among glaucoma patients on topical hypotensive medications and controls. Methods A cross-sectional comparative study, involving 320 glaucoma patients and controls. Ocular Surface Disease Index (OSDI) symptoms score and Schirmer, tear breakup time and corneal staining tests were used to assess dry eye disease. Data was analyzed using SPSS version 24 software; p-value less than 0.05 was considered as statistically significant. Results Among the 160 study glaucoma patients, the mean duration of topical hypotensive medication use was 5.2 ± 5.21 years (range, 4 months - 32 years). Mild to severe level of OSDI score was found in 122 (76%) glaucoma patients and in 137 (86%) controls (p = 0.033). Mild to sever abnormal clinical tests in the glaucoma patients and control, respectively, were 106 (66%) vs 80 (50%) corneal staining (p = 0.045), 79 (49%) vs 72 (45%) TBUT (p = 0.021), and 91 (57%) vs 83 (52%) Schirmer test (p = 0.242). Test results at the level of sever: 2 (1%) vs 0 (0%) corneal staining, 50 (31%) vs 39 (24%) TBUT and 65 (41%) vs 60 (38%) Schirmer test in the glaucoma patents and controls, respectively. Corneal staining and TBUT had correlation with the number of drugs (p = 0.004 and 0.031, respectively), and more relationship of the two tests with total number of drops applied per day (p = 0.01 and p <  0.001, respectively). Patients on pilocarpine and timolol had more corneal staining and lower TBUT [(p = 0.011 and p <  0.001) and (p = 0.04 and 0.012), respectively]. Conclusions The study has identified glaucoma patients to be more affected by dry eye disease than non-glaucoma patients, and presence of significantly lower TBUT and higher corneal staining in the glaucoma patients on multidrops and multidose per day. We recommend consideration of evaluation and management of DED for glaucoma patients on multidrops and multidose hypotensive medications.

scholarly journals Platelet-rich plasma as an effective biological therapy in early-stage knee osteoarthritis: One year follow up

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 6
Author(s):  
Deepak Rai ◽  
Jyotsana Singh ◽  
Thimmappa Somashekharappa ◽  
Ajit Singh
Keyword(s):  
Knee Osteoarthritis ◽  
Early Stage ◽  
Platelet Rich Plasma ◽  
Symptomatic Relief ◽  
Womac Questionnaire ◽  
Significant Clinical Improvement ◽  
Bioactive Agents ◽  
One Year ◽  
Early Oa

Objective: PRP is produced by centrifugation of whole blood containing highly concentrated platelets, associated growth factors, and other bioactive agents which has been shown to provide some symptomatic relief in early knee osteoarthritis (OA). The principal objective of our study was to evaluate the effectiveness and safety of standardized intra-articular injection of autologous PRP in early osteoarthritis knee. Methods: A total of 98 eligible symptomatic patients received two injections of standardized PRP 3 weeks apart. Clinical outcomes were evaluated using the VAS and Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire before treatment and at 6 weeks, 3 months, 6 months, and 1 year after treatment. Secondary objectives were safety (side effects), and the effect of PRP on the different grades of knee degeneration. Results: There was a statistically significant improvement in mean VAS and WOMAC scores at 6 weeks, 3 months, 6 months, and slight loss of improvement at 1 year follow-up. There was also a correlation between the degree of degeneration and improvement in the mean scores. The decrease in mean pain score is more in grades 1 and 2 (early OA) than in grade 3. The intraarticular injection is safe, with no major complications. Conclusion: PRP is a safe and effective biological regenerative therapy for early OA Knees. It provides a significant clinical improvement in patients with some loss of improvement with time. More studies will be needed to confirm our findings.

TEAR FILM EVALUATION IN CASES OF PARKINSON’S DISEASE

2021 ◽  
pp. 22-24
Author(s):  
V. Meenakshi ◽  
Saswathi Bhushan ◽  
T. Jyothirmayi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dry Eye ◽  
Meibomian Gland ◽  
Blink Rate ◽  
Eye Symptoms ◽  
Tear Meniscus ◽  
Tear Meniscus Height ◽  
Dry Eye Symptoms ◽  
Meibomian Gland Disease

AIM: To evaluate tear lm status in cases of Parkinson's Disease and compare with a study group METHODS:50 patients of Parkinson's Disease and 50 age-gender matched controls were included in this study. Both groups underwent detailed history regarding dry eye symptoms,tear lm evaluation using slit-lamp bio-microscopy, uorescein staining, tear meniscus height, tear breakup time, Schirmer test, blink rate. Statistical analysis was done with Statistical Package for Social Sciences [SPSS] - Version 22.0 Released 2013 version RESULTS: There was a signicant difference between the various groups in terms of distribution of Meibomian Gland Disease 72.0% of the Case group as compared to 40% of control group had Meibomian Gland Disease,There was a signicant difference between the various groups in terms of distribution of Tear Meniscus Height <0.25Mm , Case group had the larger proportion of Tear Meniscus Height of <0.25Mm .There was a signicant difference between the various groups in terms of distribution of Tear Breakup Time <5 Sec, Schirmer's Test <5Mm in 5Min and Blink Rate <10 .There was no signicant difference between the various groups in terms of distribution of corneal Staining and dry eye symptoms. CONCLUSION: The study concluded that patient of Parkinson's disease had higher dry eye symptoms and Meibomian gland disease Also they have reduced Tear miniscus height,Tear lm break up time,Schirmer test I and Blink rate

Efficacy of cyclic therapy with terpinen-4-ol in Demodex blepharitis

2020 ◽  
pp. 112067212091908 ◽  
Author(s):  
Özlem Evren Kemer ◽  
Emine Esra Karaca ◽  
Dilay Özek
Keyword(s):  
Ocular Surface ◽  
Meibomian Gland ◽  
Disease Index ◽  
Ocular Surface Disease ◽  
Schirmer Test ◽  
Ocular Surface Disease Index ◽  
Tea Tree ◽  
Cyclic Treatment ◽  
Pre Treatment ◽  
Breakup Time

Purpose To describe the effectiveness of cyclic treatment with terpinen-4-ol, a tea tree oil component, on Demodex blepharitis. Methods The presence of Demodex was determined by eyelash rotation as proposed by Mastrota. Schirmer test, tear breakup time, ocular surface disease index, lid margin score, meibomian gland expressibility score, and Oxford grade were performed. Patients were advised to apply heat followed by terpinen-4-ol soaked wipes to eyelids twice a day for 2 weeks. At the end of 2 weeks, treatment was interrupted for 7–10 days. The same treatment was repeated once again. The patients were examined after the first and second cycle of treatment and after 1 year. Results There was a statistically significant improvement in Schirmer test (10.37 ± 4.73 and 13.13 ± 3.44 mm/5 min), tear breakup time (6.47 ± 3.31 and 7.6 ± 2.89 s), ocular surface disease index (47.94 ± 19.77 and 34.28 ± 13.40), lid margin score (3.2 ± 0.7 and 2.63 ± 0.71), meibomian gland expressibility scores (1.93 ± 0.64 and 1.4 ± 0.67), and Oxford grade (0.9 ± 0.8 and 0.5 ± 0.63) after the first cycle of treatment ( p < 0.05). The improvement in symptoms and tear function tests of the patients after the second cycle was significantly better than in pre-treatment levels. At 12-month follow-up, symptoms of two patients (93%) relapsed. Conclusion The administration of terpinen-4-ol to the eyelid margins in a cyclic manner in Demodex blepharitis is effective against adult and hatching Demodex and breaks the vicious cycle.

Classifying signs and symptoms of dry eye disease according to underlying mechanism via the Delphi method: the DIDACTIC study

2019 ◽  
Vol 103 (10) ◽  
pp. 1475-1480 ◽  
Author(s):  
Marc Labetoulle ◽  
Tristan Bourcier ◽  
Serge Doan
Keyword(s):  
Dry Eye ◽  
Signs And Symptoms ◽  
Underlying Mechanism ◽  
Meibomian Gland ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Eyelid Margin ◽  
Mixed Treatment ◽  
Evaporative Dry Eye ◽  
Initial List

Background/aimsDry eye disease (DED) is categorised by pathophysiology as aqueous deficient dry eye (ADDE), evaporative dry eye (EDE) or mixed. Treatment should be tailored to DED pathophysiology, but this is challenging to determine. This Delphi consultation aimed to categorise and weight signs and symptoms to help identify the evaporative or aqueous deficient DED origin.MethodsA panel of French DED experts created an initial list of 77 DED signs and symptoms. In a Delphi consultation, experts categorised items by DED pathophysiology. Likert scoring was used to indicate whether items were strongly or moderately indicative of ADDE or EDE. Items could also be judged non-applicable to DED, with the opportunity to suggest alternative diagnoses.ResultsExperts attributed 19 items (of which 11 were strongly indicative) to a pathophysiology of EDE and 12 items (of which four were strongly indicative) to ADDE. Items scored strongly indicative with agreement >90% for EDE were previous chalazia, rosacea/rhinophyma, telangiectasias of eyelid margin and thick non-expressible meibomian gland secretions, and for ADDE were Sjögren syndrome or associated disease, and Schirmer <5 mm after 5 min (without anaesthesia). Seventeen items indicated neither pathophysiology and 18 items were found to be suggestive of alternative diagnoses.ConclusionsThis Delphi consultation categorised signs and symptoms, using an innovative weighting system to identify DED pathophysiology. An algorithm integrating the weighting of each sign and symptom of an individual patient would be valuable to help general ophthalmologists to classify the DED subtype and tailor treatment to DED underlying mechanism.

scholarly journals Massive Demodicosis of the Eyes in a Patient with Sjögren Syndrome: A Case Report

2020 ◽  
Author(s):  
Marta Ziaja-Sołtys ◽  
Magdalena Kołodziejczyk ◽  
Beata Rymgayłło-Jankowska ◽  
Dominika Wróbel-Dudzińska ◽  
Ewa Suchodoła-Ratajewicz ◽  
...  
Keyword(s):  
Dry Eye ◽  
Meibomian Gland ◽  
Sjögren Syndrome ◽  
Dry Eye Syndrome ◽  
Ocular Infection ◽  
Sjogren Syndrome ◽  
Corneal Perforation ◽  
Therapeutic Success ◽  
Immune Systems

Abstract Purpose Demodex mites infestation, typically asymptomatic, is a problem for patients with weakened immune systems because it often takes the form of symptomatic, massive infection. The Demodex mites play an important role in the occurrence of a range of eye surface diseases such as Demodex blepharitis, Meibomian gland dysfunctions, conjunctivitis and corneal changes. The ocular infection is closely related to the systemic invasion. Our goal was to minimize infestation and alleviate the symptoms of massive demodicosis so as to prevent further damage to the cornea. Methods Our research note involves a 61-year old woman diagnosed with secondary Sjögren syndrome due to rheumatoid arthritis. On the background of the autoimmune disease, corneal perforation of the left eye occurred that was cured by surgery. Then during the follow-up visit the patient was found (microscopically) massively infected with Demodex mites and the developed symptoms were particularly severe. Results Adequate dry eye syndrome and massive demodicosis therapy significantly reduced the number of Demodex mites and improved the patient’s condition. Conclusion We would like to draw the attention of the physicians of different specialties that special care should be taken with respect to the therapy of dry eye syndrome and ocular demodicosis in patients with immunological disorders to achieve therapeutic success and avoid particularly dangerous consequences of these diseases.

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