scholarly journals LASIK and Dry Eye Disease: A Case Report

2021 ◽  
Author(s):  
Priyancaa Jeyabaladevan
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Case Reports ◽  
Significant Risk ◽  
Vital Staining ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Patient Centered ◽  
Dry Eyes ◽  
Use Of Resources

Background: Post- Laser- assisted in situ keratomileusis (LASIK) dry eye is one of the most common postoperative dry eyes after ophthalmic surgeries. Clinically, patients have positive vital staining of the ocular surface, decreased tear breakup times, reduced corneal sensitivity, and decreased visual acuity. In majority of patients, symptoms last about one month, but some patients can experience these symptoms for more than a year. Case presentation: A 29-year-old female with Dry Eye Disease (DED) secondary to isotretinoin use wanted to undergo LASIK for refractive improvement. Ophthalmologists were thorough in informing the patient of the significant risk of post-operative dry eyes, especially in patients with pre-operative DED. A cautious approach was taken by the ophthalmologist, and the patient’s opinion and needs considered. Post-operatively, the patient continues to have DED but reports it is not worse than pre-LASIK and continues to be complaint with dry eye disease treatment. Conclusions: In patients with existing DED, clinicians are vigilant in progressing with LASIK, due to post-operative dry eye symptoms. Careful patient selection and preoperative ocular surface management is recommended for such patient groups. This case reports highlights the importance of clinicians allowing patients to come to an informed decision regarding their care. This patient-centered approach is a model of care that respects patients’ experiences, values, needs and preferences, whilst improving clinical outcomes, better use of resources and increased satisfaction with care.

scholarly journals LASIK and Dry Eye Disease: A Case Report

2021 ◽  
Vol 4 (3) ◽  
Author(s):  
Priyancaa Jeyabaladevan ◽  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Case Reports ◽  
Significant Risk ◽  
Vital Staining ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Patient Centered ◽  
Dry Eyes ◽  
Use Of Resources

Background: Post- Laser- assisted in situ keratomileusis (LASIK) dry eye is one of the most common postoperative dry eyes after ophthalmic surgeries. Clinically, patients have positive vital staining of the ocular surface, decreased tear breakup times, reduced corneal sensitivity, and decreased visual acuity. In majority of patients, symptoms last about one month, but some patients can experience these symptoms for more than a year. Case presentation: A 29-year-old female with Dry Eye Disease (DED) secondary to isotretinoin use wanted to undergo LASIK for refractive improvement. Ophthalmologists were thorough in informing the patient of the significant risk of post-operative dry eyes, especially in patients with pre-operative DED. A cautious approach was taken by the ophthalmologist, and the patient’s opinion and needs considered. Post-operatively, the patient continues to have DED but reports it is not worse than pre-LASIK and continues to be complaint with dry eye disease treatment. Conclusions: In patients with existing DED, clinicians are vigilant in progressing with LASIK, due to post-operative dry eye symptoms. Careful patient selection and preoperative ocular surface management is recommended for such patient groups. This case reports highlights the importance of clinicians allowing patients to come to an informed decision regarding their care. This patient-centered approach is a model of care that respects patients’ experiences, values, needs and preferences, whilst improving clinical outcomes, better use of resources and increased satisfaction with care.

scholarly journals Meibomian Gland Dysfunction

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Sameera Irfan
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Treatment Strategies ◽  
Tear Film ◽  
Meibomian Gland ◽  
Dry Eye Disease ◽  
Meibomian Gland Dysfunction ◽  
Eye Disease ◽  
Treatment Protocols ◽  
Dry Eyes

Dry eyes is a common, chronic condition that has a prevalence of about 5- 50%.1 According to the Dry Eye Workshop II report (DEWS II report), published in 2017, the updated definition of Dry Eye Disease is, “a multifactorial disease of the ocular surface characterised by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyper-osmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.” The Tear Film & Ocular Surface Society (TFOS) released their report on the international work on Meibomian Gland Dysfunction (MGD)2 in 2011, which defined MGD, classified it and considered it as the primary cause of dry eye disease worldwide. Previously dry eye disease was considered as an aqueous deficiency problem, but after this report by TFOS, there is a paradigm shift towards “not producing enough lipids to retain the tears that are being produced”. This has led to a huge impact on the treatment protocols which were previously focused on managing the sequelae and symptoms of dry eyes rather than targeting directly on the underlying cause, the MGD. It has now been accepted worldwide that dry eye occurs when the ocular surface system cannot adequately protect itself from the desiccating stress due to the lack of a healthy meibomian gland secretion. This article is mainly focussed on the Meibomian Gland Dysfunction, discussing the normal anatomy of the glands, how they are affected by disease, its implications on the ocular surface and finally, the various treatment strategies. Key words: Blepharitis, Dry eyes, Meibomian gland dysfunction, blepharospasm.

scholarly journals Új nemzetközi konszenzusnyilatkozat a száraz szem definíciójáról, felosztásáról, etiológiájáról, diagnosztikájáról és terápiájáról

2018 ◽  
Vol 159 (20) ◽  
pp. 775-785 ◽  
Author(s):  
András Berta ◽  
Edit Tóth-Molnár ◽  
Adrienne Csutak
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Scientific Literature ◽  
Tear Film ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Dry Eyes ◽  
Working Groups ◽  
Diagnostics And Therapy

Abstract: Ten years have passed since the publication of the DEWS Report that summarized the information based on scientific literature concerning dry eye disease. Hundreds of papers have been published since then and time has come for a new summary. Organized by the Tear Film & Ocular Surface Society, 12 working groups summerized former and recent data. The DEWS II Report was created. The authors of the present publication summarize the most important changes in definition, classification, diagnostics, and therapy concerning dry eye disease. They also disclose the relevant changes on which the non-ophthalmologist specialists have to be informed. The DEWS II Report published by TFOS consists of 11 chapters. Completely new chapters deal with the role of sensation/pain and iatrogenic dry eyes. Orv Hetil. 2018; 159(20): 775–785.

scholarly journals Meibomian gland dysfunction and keratopathy are associated with dry eye disease in aniridia

2018 ◽  
Vol 103 (1) ◽  
pp. 119-124 ◽  
Author(s):  
Erlend Christoffer Sommer Landsend ◽  
Hilde Røgeberg Pedersen ◽  
Øygunn Aass Utheim ◽  
Jiaxin Xiao ◽  
Muhammed Yasin Adil ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Vital Staining ◽  
Meibomian Gland ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Control Group ◽  
Healthy Controls ◽  
Congenital Aniridia

AimsTo investigate the aetiology and characteristics of dry eye disease (DED) in a Nordic cohort of patients with congenital aniridia.MethodsThirty-four Norwegian and one Danish subject with congenital aniridia and 21 healthy controls were examined. All subjects underwent an extensive dry eye examination, including evaluation of meibomian glands (MGs) by meibography, measurement of tear production and tear film osmolarity and grading of vital staining of the ocular surface. Moreover, slit-lamp biomicroscopy was undertaken, including grading of aniridia-associated keratopathy (AAK).ResultsMean tear film osmolarity was significantly higher (314±11 mOsmol/L) in patients with aniridia compared with the healthy control group (303±11 mOsmol/L, p=0.002). Vital staining score was higher in the aniridia group (4.3±3.0) compared with healthy controls (2.4±1.6, p=0.02). The degree of staining correlated positively with the stage of AAK (r=0.44, p=0.008) and negatively with corneal sensitivity (r=−0.45, p=0.012). Number of expressible MGs was lower in aniridia subjects (2.9±1.6) than in controls (4.0±1.3, p=0.007). MG loss, staged from 0 to 3, was higher in the aniridia group than in the control group, both in upper eyelid (0.86±0.89 vs 0.10±0.31, p=0.001) and lower eyelid (0.94±0.73 vs 0.30±0.47, p=0.003). Computerised analyses showed thinning (p=0.004) and lower density (p<0.001) of the MGs compared with the healthy population.ConclusionsPatients with congenital aniridia demonstrate increased tear film osmolarity, ocular surface staining, loss of MGs and lower MG expressibility. We conclude that meibomian gland dysfunction and keratopathy are related to development of DED in aniridia.

scholarly journals The role of KPI-121 0.25% in the treatment of dry eye disease: penetrating the mucus barrier to treat periodic flares

2021 ◽  
Vol 13 ◽  
pp. 251584142110127
Author(s):  
Preeya K. Gupta ◽  
Nandini Venkateswaran
Keyword(s):  
Drug Delivery ◽  
Dry Eye ◽  
Ocular Surface ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Eye Drops ◽  
Short Term ◽  
Short Term Treatment ◽  
Loteprednol Etabonate ◽  
Mucus Barrier

The tear film, which includes mucins that adhere to foreign particles, rapidly clears allergens and pathogens from the ocular surface, protecting the underlying tissues. However, the tear film’s ability to efficiently remove foreign particles during blinking can also pose challenges for topical drug delivery, as traditional eye drops (solutions and suspensions) are cleared from the ocular surface before the drug can penetrate into the conjunctival and corneal epithelium. In the past 15 years, there has been an increase in the development of nanoparticles with specialized coatings that have reduced affinity to mucins and are small enough in size to pass through the mucus barrier. These mucus-penetrating particles (MPPs) have been shown to efficiently penetrate the mucus barrier and reach the ocular surface tissues. Dry eye disease (DED) is a common inflammatory ocular surface disorder that often presents with periodic flares (exacerbations). However, currently approved immunomodulatory treatments for DED are intended for long-term use. Thus, there is a need for effective short-term treatments that can address intermittent flares of DED. Loteprednol etabonate, an ocular corticosteroid, was engineered to break down rapidly after administration to the ocular surface tissues and thereby reduce risks associated with other topical steroids. KPI-121 is an ophthalmic suspension that uses the MPP technology to deliver loteprednol etabonate more efficiently to the ocular tissues, achieving in animal models a 3.6-fold greater penetration of loteprednol etabonate to the cornea than traditional loteprednol etabonate ophthalmic suspensions. In clinical trials, short-term treatment with KPI-121 0.25% significantly reduced signs and symptoms of DED compared with its vehicle (placebo). Recently approved KPI-121 0.25%, with its novel drug delivery design and ease of use, has the potential to effectively treat periodic flares of DED experienced by many patients.

scholarly journals Dexamethasone-Loaded Nanostructured Lipid Carriers for the Treatment of Dry Eye Disease

Pharmaceutics ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 905
Author(s):  
Sangeeta Kumari ◽  
Madhuri Dandamudi ◽  
Sweta Rani ◽  
Elke Behaeghel ◽  
Gautam Behl ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Pilot Scale ◽  
Dry Eye Disease ◽  
Rapid Screening ◽  
Eye Disease ◽  
Topical Steroids ◽  
Nanostructured Lipid Carrier ◽  
The Impact ◽  
Ophthalmic Formulation

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.

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

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.

scholarly journals A Survey on How Ocular Surface Demodex Infestation Interactively Associates with Diabetes Mellitus and Dry Eye Disease

2021 ◽  
Author(s):  
Chang Huang ◽  
Shuze Chen ◽  
Sheng Fu ◽  
Yingli Li ◽  
Zhenhao Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Dry Eye ◽  
Ocular Surface ◽  
Cross Sectional Study ◽  
General Information ◽  
Potential Interaction ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Cross Sectional ◽  
Demodex Infestation

Abstract Purpose Prevention of ocular surface (OS) Demodex infestation plays an important role in OS hygiene and variety of factors may be associated with it, in which diabetes mellitus (DM) or dry eye disease (DED) has caught the attention of most scholars. However, there has been no research on whether there was a potential interaction between DM and DED in the process of OS Demodex infestation. This cross-sectional study was implemented in Zhujiang Hospital of Southern Medical University. Methods Ophthalmologic interviews, questionnaires, and examinations were conducted. Factors including general information, DM status, dry eye condition, etc. were collected to study the correlation of DM and DED on OS Demodex infestation. Results After statistical analysis, we found that both DM (P < 0.001) and DED (P = 0.013 < 0.05) are closely associated with OS Demodex infestation. Compared with DED, DM has higher priority association with OS Demodex infestation, and patients with both diseases have a significant higher risk of OS Demodex infestation (R = 0.197, P < 0.001). Meanwhile, age (R = 0.299, P < 0.001) and hypertension (P < 0.05) were also correlated with OS Demodex infestation. Conclusion This study provides a new evidence-based basis for clinical prevention and management of OS Demodex infestation.

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