scholarly journals Dry eye disease and its treatment in women over 45 years

2021 ◽  
Vol 21 (2) ◽  
pp. 103-107
Author(s):  
E.A. Drozdova ◽  
◽  
V.E. Balan ◽  

Epidemiological studies demonstrate an increase in age-related prevalence of dry eye disease (DED) and its higher occurrence in women. In addition to age-related alterations of structures producing tear film, the reduction of androgen levels and other regulating hormones is important for DED development. The role of estrogens and progesterone in the regulation of lacrimal and meibomian gland activity is still disputable. Additional factors of DED development in women are a high rate of comorbidities affecting gland functions, use of cosmetics and cosmetic procedures, contact lens wearing. The results are partial atrophy of meibomian glands, changes in the quality and amount of their secret, increased tear evaporation. Cationic nano-emulsion that addresses the deficiency and stabilize the lipid layer, increases water content, and reduces tear osmolarity is recommended for DED in women. Keywords: dry eye disease, tear film, meibomian glands, postmenopausal, lipid layer, tear osmolarity, artificial tears, cationic nano-emulsion. For citation: Drozdova E.A., Balan V.E. Dry eye disease and its treatment in women over 45 years. Russian Journal of Clinical Ophthalmology. 2021;21(2):103–107. DOI: 10.32364/2311-7729-2021-21-2-103-107.

2021 ◽  
Vol 62 (7) ◽  
pp. 922-930
Author(s):  
Tae Hwan Kim ◽  
Byunghoon Chung ◽  
Kang Yoon Kim ◽  
Ikhyun Jun ◽  
Kyoung Yul Seo ◽  
...  

Purpose: The efficacy of using preservative-free 0.15% sodium hyaluronate eyedrops for dry eye disease after femtosecond laser- assisted cataract surgery (FLACS) was evaluated. Methods: This prospective randomized study was conducted on patients with dry eye who were scheduled for FLACS among those with Tear Film & Ocular Surface Society Dry Eye Workshop II Dry Eye Levels 1 and 2. In total, 37 eyes scheduled for FLACS were randomized to the treatment group (n = 19) or control group (n = 18). Corneal and conjunctival fluorescein staining (CFS), tear breakup time (TBUT), Schirmer I test (SIT) value, ocular surface disease index (OSDI), meibomian gland evaluation result, and lipid layer thickness were evaluated for all patients, preoperatively and at 1 and 3 months postoperatively. Results: In the treatment group, the OSDI and CFS scores were significantly lower at 3 months postoperatively than at baseline, but the TBUT and SIT values were significantly increased. In the control group, TBUT was significantly shorter at 3 months postoperatively than at baseline, SIT values were significantly decreased at 1 and 3 months postoperatively compared with the baseline, and meibum quality was significantly aggravated at 1 month postoperatively compared with the baseline. In the treatment group, OSDI improved significantly from baseline at 1 and 3 months. TBUT increased significantly in the treatment group at postoperative 3 months. Meibomian gland quality showed clinically better results in the treatment group than in the control group at postoperative 3 months. There were no significant differences in corneal and CFS, lipid layer thickness, and other dry eye disease parameters between the treatment and control groups. Conclusions: Preservative-free 0.15% sodium hyaluronate eyedrops were effective for improving dry eye symptoms and tear film stability after FLACS.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ricaurte Ramiro Crespo-Treviño ◽  
Anna Karen Salinas-Sánchez ◽  
Francisco Amparo ◽  
Manuel Garza-Leon

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.


2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Sameera Irfan

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.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yong Woo Ji ◽  
Hyojin Seong ◽  
Sujung Lee ◽  
Mutlaq Hamad Alotaibi ◽  
Tae-im Kim ◽  
...  

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.


2021 ◽  
Vol 10 (19) ◽  
pp. 1382-1386
Author(s):  
Swapneel Mathurkar ◽  
Sachin Daigavane ◽  
Madhumita Prasad ◽  
Kervi Mehta

BACKGROUND Meibomian gland dysfunction (MGD) is one of the causes of evaporative dry eye disease. It is the terminal duct obstruction of the Meibomian gland and is associated with glandular secretion changes. These changes lead to decreased amount of lipids secretion which accounts for instability of tear film leading to evaporative dry eye disease. Chronic smoking also causes irritative, burning eyes along with unstable tear film. We wanted to study the corelation of chronic smoking with Meibomian gland dysfunction. METHODS This is a hospital based observational cross-sectional study that enrolled a total of 100 subjects having Meibomian gland disease (MGD), out of whom 61 were smokers and 39 were non-smokers. All enrolled subjects underwent tear film breakup time (TBUT), Schirmer I test (SIT) and slit-lamp microscope examination of lid margin abnormalities, Meibomian gland expression as well as meibum. RESULTS Our study found that the patients with Meibomian gland dysfunction with the history of chronic smoking had a remarkably decreased value of tear film break up time (TBUT), Schirmer’s 1 Test which explains the dry eye symptoms as compared to MGD patients without smoking. No significant differences were seen in lid margin irregularity and meibum secretion. Meibomitis is found in 29 smokers with MGD and 5 non-smokers with MGD which is not significant. CONCLUSIONS Chronic smoking is associated with MGD. KEY WORDS Cigarette Smoking, Meibomian Gland Dysfunction, Tear Film Tests


2019 ◽  
Vol 25 (4) ◽  
pp. 51-55
Author(s):  
Т.М. Zhmud ◽  
N.V. Malachkova ◽  
O.O. Andrushkova ◽  
К.Y. Hrizhymalska

An important problem to date is the dysfunction of meibomian glands in patients with type 2 diabetes. The aim of our work was to analyze the prevalence of meibomian gland dysfunction and signs of dry eye disease in patients with type 2 diabetes. We examined 40 patients (80 eyes) with compensated type 2 diabetes mellitus and symptoms of dry eye disease, who made up the main group at the age of 54.00±8.00 years, and 30 patients (60 eyes) of practically healthy people, aged 51.00±8.00 years. All patients underwent visiometry, biomicroscopy, ophthalmoscopy, tonometry, compression test to evaluate the secretion of meibomian glands, Schirmer’s test for compression before and after 30 min. Afterwards, Norn test, meibography, Demodex mite test, laboratory tests (lipidogram, blood glucose, glycosylated hemoglobin). In addition, standard OSDI, McMonnies Dry Eye Questionnaire questionnaires were used and an average clipping rate of1 min was determined. Statistical processing of the obtained results was carried out using the license package “Statistica 8.0” using parametric estimation methods. Our study has shown that in patients with diabetes for more than 5 years, dry eye disease occurs more often and is dominated by moderate and severe severity. Each patient in the study group, together with the symptoms of dry eye, had signs of dysfunction of the meibomian glands of varying degrees of severity according to the compression test and objective symptoms of the disease. A significant difference was found between the clipping frequency in the control group and the main one (p≤0.01). Compared with the control group, patients with diabetes have a longer interval between the clipping movements. Meibography data show that patients in the primary group have changes in the meibomian glands in 90% of cases, while in the control group – 44%. Thus, it was found that patients with type 2 diabetes had dysfunction of meibomian glands of moderate severity in 90% of cases, which is associated with the duration of diabetes.


2018 ◽  
Vol 1 (1) ◽  
pp. e28-e31
Author(s):  
Liem Hieu Nguyen ◽  
Edward H. Jaccoma

Background and Objectives A chalazion, also known as a stye, is a common and chronic inflammatory problem of the eyelids where one or more Meibomian glands are blocked. Previous studies have shown that a chalazion is a sign of Meibomian Gland Dysfunction (MGD) and evaporative dry eye disease. The prevalence of chalazia in the pediatric population has recently been noted. In this report, we will describe two pediatric cases of chalazion that are associated with MGD and related dry eye disease.  Methods This is a case report of non-genetically related 7-year-old and 16-year-old patients as they were each seen for newly developed chalazia. Results External exam in both patients showed chalazia, waxy plugs and poor Meibomian gland expression. Meibography showed shorten, truncated, and dilated Meibomian glands with rapid tear break-up times leading to the diagnosis of evaporative dry eye disease due to MGD. Conclusion These cases serve to confirm an increase in the prevalence of MGD in the pediatric population and to emphasize the need for early screening for dry eye disease.  Key Words: Chalazion - Meibomian gland dysfunction - Pediatric Dry Eye Disease


Author(s):  
Isha Chandrakar ◽  
Shruti Sanghavi

Dry eye disease (DED) is a multifactorial disease in which the tear film’s homeostasis is lost, along with other ocular symptoms such as tear film instability and high osmolarity, neurosensory abnormalities, and ocular surface inflammation and damage. DED is a condition of lacrimal apparatus which is responsible for tear production. The tear film is a mixture of mucin, aqueous (water and solutes like NacI, sugar, urea, proteins,), lipids secreted by goblet cells, lacrimal glands, and meibomian glands, respectively. It keeps the eye moist, provides oxygen to the cornea, and has antibacterial properties. The lipid layer prevents the evaporation of the aqueous. DED is categorized into (i)Aqueous-tear deficiency, characterized by a deficiency of lacrimal glands to secrete tears, (ii)Evaporative DED, associated with increased tear loss by evaporation because there is a deficiency of the meibomian glands. The mechanism of DED might be loss of tear through evaporation or insufficient aqueous production or a combination of the two. DED is a widespread eye problem, which is often left untreated. It causes irritation, itching, dryness, foreign body sensation, and discomfort; severe case causes conjunctival congestion, keratinization, erosion of the corneal epithelium, and plaque formation. If left Univision- threatening vision-threatening, leading to complications like corneal ulceration and perforation. Various clinical tests are used to diose DED, including tear breakup time, tear osmolarity, Schirmer test, Rose Bengal staining, and expression of inflammatory markers. There is no cure for DED at present. The following modalities are used for its treatment: use of punctual and canalicular plugs, artificial tear products like polyethylene glycol/propylene glycol with guar HP, consuming food rich in omega-three fatty acids, antioxidants zeaxanthin, and lutein, Use of anti-inflammatory drugs, mucolytics, secretagogues. Reducing or avoiding mild risk factors like prolonged reading, prolonged use of contact lenses, excessive screen time, etc. Treatment of causative disease.  Appropriate management and establishing reasonable patient expectations are necessary to ensure patient satisfaction and adherence to the treatment.


Author(s):  
Dong Fang Hui ◽  
I Bezkorovayna ◽  
H Pavlovska

The work is dedicated to the features of the eye surface examination, and clinical and functional disruptions in the tear film in 112 (224 eyes) young people aged 18 to 30 years. Based on the analysis of the common objective methods results, such as determination of the Ocular Surface Disease Index, conducting the Shirmer II test, the LIPCOF test, the tear meniscus and tear film rupture time estimation, we have refined scientific data on indicators that characterize dry eye disease. Interferometric studies using the SBM ICP Tearscope (Italy) and iPad Pro (USA) showed a decrease in the thickness of the tear film lipid layer below 80 nm in 64% of the surveyed. The interferometry data well associated with known eye surface methods, demonstrating the highest level of sensitivity. The thinning of the lipid layer below 30 nm, detected in 33% of the subjects, was characteristic for the eyes with dry eye disease.


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