Autoimmune Dry Eye without Significant Ocular Surface Co-Morbidities and Mental Health

Dry eye symptoms can negatively affect the psychological, physical, and social functioning, which can potentially impair the health-related quality of life. This review evaluated the association between autoimmune related dry eye in the absence of significant ocular surface co-morbidities and mental health. This review found a significantly higher prevalence of mental health disorders (such as depression and anxiety) in systemic lupus erythematous, rheumatoid arthritis, systemic sclerosis, Behcet’s disease, and primary Sjogren’s syndrome patients when compared to the general population. Moreover, patients with depression and anxiety interpret ocular sensations differently than healthy controls and the perception of dry eye symptoms can be influenced by their mood. Somatization is common in depression, and this could influence the perception of ocular discomfort. Anti-depressants and anxiolytics with their potential side effects on the tear film status may also contribute or aggravate the dry eye symptoms in these patients. Although ophthalmologists manage the dry eye disease, as per standardized algorithms, they should be mindful of different ocular sensation interpretation and coexistent mental health issues in a large number of this patient group and initiate a multidisciplinary management plan in certain cases. While rheumatologists look after their autoimmune condition, it may be worth liaising with GP and/or psychiatrist colleagues in order to address their neuropathic type pain and mental health co-morbidities.

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In Vivo Confocal Microscopic Evaluation of Corneal Langerhans Cells in Dry Eye Patients§

The Open Ophthalmology Journal ◽

10.2174/1874364101408010051 ◽

2014 ◽

Vol 8 (1) ◽

pp. 51-59 ◽

Cited By ~ 19

Author(s):

Federica Machetta ◽

Antonio M Fea ◽

Alessandro G Actis ◽

Ugo de Sanctis ◽

Paola Dalmasso ◽

...

Keyword(s):

Confocal Microscopy ◽

Dry Eye ◽

Ocular Surface ◽

Tear Film ◽

Surface Damage ◽

Nerve Plexus ◽

Sjogren Syndrome ◽

Central Cornea ◽

Eye Symptoms ◽

Dry Eye Symptoms

Purpose. To assess inflammatory involvement of cornea in dry eye by means of confocal microscopy, evaluating the presence and distribution of Langherans cells (LCs). Methods: 98 eyes of 49 subjects were enrolled: 18 subjects affected by Sjögren Syndrome Dry Eye (SSDE), 17 with Non-Sjögren Syndrome Dry Eye (NSSDE), 14 healthy volunteeers. Dry eye symptoms, tear film, ocular surface damage and corneal confocal microscopy were analized. Results: A significant increase of LCs density was observed at sub-basal nerve plexus (SSDE = 79 cells/mm2 and NDE = 22 cells/mm2; p = 0,0031) and sub-epithelial nerve plexus (SSDE = 38 cells/mm2 and NDE = 3 cells/mm2; p = 0,0169) in central cornea of SSDE group. An increased number of LCs from the center to the periphery of the cornea was observed, significant only in healthy volunteers group. In dry eye patients there was an increase in LCs density in both peripheral and central cornea with a significant difference between NDE (14,66 cells/mm2) and SSDE (56,66 cells/mm2) only in central cornea (p = 0,0028). In SSDE group, mean density of LCs in central cornea results also superior to NSSDE group (29,33 cells/mm2). There was no correlation between LCs density and dry eye symptoms, tear film deficiency and ocular surface damage. Conclusion: This study demonstrates the activation of an inflammatory and immunological reaction in cornea of NSSDE and SSDE patients. Confocal microscopy can be an important diagnostic tool in evaluation and follow-up of dry eye disease.

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Investigation of Meibomian Gland Function and Dry Eye Disease in Patients with Graves’ Ophthalmopathy

Journal of Clinical Medicine ◽

10.3390/jcm9092814 ◽

2020 ◽

Vol 9 (9) ◽

pp. 2814

Author(s):

Sachiko Inoue ◽

Motoko Kawashima ◽

Reiko Arita ◽

Ai Kozaki ◽

Kazuo Tsubota

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Normal Subjects ◽

Meibomian Gland ◽

Clinical Activity ◽

Upper Eyelid ◽

Graves Ophthalmopathy ◽

Related Quality ◽

Eye Symptoms ◽

Dry Eye Symptoms

We prospectively evaluated the relationship between meibomian gland dysfunction (MGD) and Graves’ ophthalmopathy (GO) in 19 patients (38 eyes) with subjective dry eye symptoms, compared to 14 age-matched normal participants (14 eyes). Extraocular muscle and lacrimal gland enlargement were evaluated by magnetic resonance imaging (MRI). Ocular surface examinations included fluorescein staining for keratoconjunctival epithelial damage, tear breakup time (TBUT) evaluation, and Schirmer’s test. Dry eye symptoms were evaluated with the Dry Eye-related Quality-of-Life Score (DEQS) questionnaire. Lid-margin abnormalities, meibum grade, and meiboscores were assessed using meibography. Clinical activity scores and T2 signal intensity ratios were used to define GO activity. All GO patients had obstructive MGD and 79% exhibited levator muscle enlargement. Ocular surface parameters of TBUT (p = 0.000), meibum score (p = 0.000), eyelid vasculitis (p = 0.000), meiboscore of the upper lid (p = 0.002), total meiboscores (p = 0.001), and DEQS (p = 0.000) significantly differed between GO patients and normal subjects. In addition, GO patients had significantly more abnormalities of the central region of the upper eyelid than normal subjects (p = 0.000). Thus, MGD might be related to eye discomfort and deterioration of the ocular surface in GO patients. Inflammation and morphological meibomian gland changes might be characteristic of GO.

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Optimum | Tangible Hydra-PEG™ – Gaining Momentum in the Industry

The Eye ◽

10.33791/2222-4408-2021-4-31-34 ◽

2021 ◽

Vol 23 (4) ◽

pp. 31-34

Author(s):

M. Conway

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Surface Coating ◽

Clinical Case ◽

Contact Lenses ◽

Ocular Surface Disease ◽

Corneal Ectasia ◽

Corneal Lens ◽

Eye Symptoms ◽

Dry Eye Symptoms

The issue of hydrophilicity of the surface of gas permeable contact lenses remains one of the persistent problems. Tangible Hydra-PEG™ surface coating is applied to gas permeable contact lenses to significantly improve wettability and wearing comfort. Although it is mainly used to alleviate dry eye symptoms in scleral and corneal lens users, particularly for those patients with corneal ectasia and/or Ocular Surface Disease (OSD), it can be used in other modalities. This article describes the development of the product and describes the benefits of its use in a clinical case.

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Comparable effects on tear film parameters after femtosecond laser-assisted and conventional cataract surgery

International Ophthalmology ◽

10.1007/s10792-020-01532-z ◽

2020 ◽

Vol 40 (11) ◽

pp. 3097-3104 ◽

Cited By ~ 1

Author(s):

Marc Schargus ◽

Svetlana Ivanova ◽

Gesa Stute ◽

H. Burkhard Dick ◽

Stephanie C. Joachim

Keyword(s):

Femtosecond Laser ◽

Cataract Surgery ◽

Dry Eye ◽

Surgical Techniques ◽

Tear Film ◽

Schirmer Test ◽

Fluorescein Staining ◽

Significant Difference ◽

Eye Symptoms ◽

Dry Eye Symptoms

Abstract Purpose Dry eye symptoms after conventional cataract surgery are a very common problem. Until now, only few data are available on objective tear film parameters in regard to femtosecond laser-assisted cataract surgery (LCS). Aim of this study was therefore to analyze and compare tear film parameter changes between LCS and conventional cataract surgery. Methods A consecutive group of 34 patients, scheduled for cataract surgery, were randomly selected for either LCS or conventional cataract surgery (17 patients/group). Tear film assessments including tear film osmolarity, Schirmer test, MMP-9 analysis via quantitative ELISA, corneal sensitivity, corneal fluorescein staining, and conjunctival fluorescein staining were sequentially evaluated pre- as well as 1 and 3 months postoperatively. Results Both groups showed no significant difference in baseline characteristics. All surgeries were performed without any complications. After 1 and 3 months, there was no statistically significant difference in regard to tear film osmolarity (1 month: p = 0.81, 3 months: p = 1.0), Schirmer test (1 month: p = 0.35, 3 month: p = 0.08), and MMP-9 concentration (1 month: p = 0.36, 3 month: p = 0.28) between the two groups. Conclusions Neither LCS nor conventional cataract surgery affected objective tear film parameters significantly during our 3-month postoperative observation period. Hence, both surgical techniques can be equally used to treat patients without prior dry eye symptoms.

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Photophobia and sensations of dryness in patients with migraine occur independent of baseline tear volume and improve following botulinum toxin A injections

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312649 ◽

2018 ◽

Vol 103 (8) ◽

pp. 1024-1029 ◽

Cited By ~ 7

Author(s):

Ryan J Diel ◽

Jodi Hwang ◽

Zachary A Kroeger ◽

Roy C Levitt ◽

Constantine D Sarantopoulos ◽

...

Keyword(s):

Botulinum Toxin ◽

Chronic Migraine ◽

Dry Eye ◽

Botulinum Toxin A ◽

Demographic Data ◽

Tear Film ◽

Phenol Red ◽

Toxin A ◽

Eye Symptoms ◽

Dry Eye Symptoms

BackgroundTo evaluate the efficacy of botulinum toxin A (BoNT-A) in reducing photophobia and dry eye symptoms in individuals with chronic migraine. Additionally, we aimed to evaluate tear film volume as a potential contributor to symptoms in these patients.MethodsRetrospective review of 76 patients who received BoNT-A for chronic migraine between 23 August 2017 and 13 December 2017 at the Miami Veterans Affairs Medical Center Neurotoxin Clinic. Demographic data and all comorbidities were queried via chart review. Standardised validated surveys were administered to assess symptoms prior to and after BoNT-A injection. Preinjection tear volumes were obtained using the phenol red thread (PRT) test.ResultsPreinjection migraine, photophobia and dry eye symptom scores were all significantly correlated, p<0.05, and none were associated with preinjection PRT results. After BoNT-A, improvements in migraine, photophobia and dry eye symptoms were also significantly correlated, p<0.05 and similarly did not associate with preinjection PRT results. Photophobia scores significantly improved following BoNT-A, while dry eye symptoms significantly improved in those with severe symptoms at baseline (DEQ-5 score ≥12), p=0.027. In logistic regression analysis of all individuals with dry eye symptoms (DEQ-5 ≥6), individuals with more severe dry eye symptoms were more likely improve, OR 1.27, 95% CI 1.06 to 1.51, p<0.01.ConclusionsBoNT-A significantly improved photophobia in patients being treated for migraine and also improved dry eye symptoms in patients with severe symptoms at baseline, independent of baseline tear film volume. These improvements may be due to modulation of shared trigeminal neural pathways.

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