scholarly journals CORRELATION BETWEEN UREA LEVELS IN LACRIMAL FLUID AND PATHO-PHYSIOLOGY OF DRY EYE SYNDROMES

2020 ◽  
pp. 1-3
Author(s):  
Anil Sharma ◽  
Narendra Kumar Keisham ◽  
Archana Sharma
Keyword(s):  
Dry Eye ◽  
Tear Film ◽  
Test Group ◽  
Sample Volume ◽  
Dry Eye Syndromes ◽  
Dry Eyes ◽  
Urea Level ◽  
Lacrimal Fluid ◽  
Schirmer’S Test ◽  
Single Centre Study

Introduction : In the ocular surface there is a well- coordinated system of enzymes that can produce urea independent of external urea supply. Urea locally formed from ocular tissues is important for the composition of the tear fluid. In eyes with dry syndromes this production is affected. Estimation of urea levels in the lacrimal fluid may prompt a newer treatment for dry eyes utilising urea. This study was done to evaluate the correlation between serum urea levels and pathophysiology of dry eye syndromes. Materials and methods: A prospective, observational, single-centre study. 50 patients of dry eye disease were included in the subjects and 50 controls were included in the study based on schirmer’s test. Tear film urea was estimated wih semi autoanalyser erba chem 5. When sample volume was not sufficient it was diluted with sterile water and urea was estimated after calculating for dilution factor. Blood urea was estimated with Erba Chem EM 360 working on similar principle Results: In the test group, the urea level in tear film ranged from 14.01 mg % to 39 mg % with a mean of 26.78 +/- 5.70 mg %. In the controls the levels of urea in the tear film ranged from 21.06 mg% to 56.00 mg% with a mean of 41.72±6.86 mg%. Conclusions: Levels of urea in tear film in normal individuals without dry eyes is similar to urea levels in the blood. Tear film urea levels were significantly lower in patients with dry eye diagnosed with Schirmer’s Test. Decreased tear film urea level in dry eyes is unrelated to blood urea levels and may play a role in the pathophysiology of dry eyes. This needs further investigation.

scholarly journals MPC Polymer Promotes Recovery from Dry Eye via Stabilization of the Ocular Surface

Pharmaceutics ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 168
Author(s):  
Noriaki Nagai ◽  
Shunsuke Sakurai ◽  
Ryotaro Seiriki ◽  
Misa Minami ◽  
Mizuki Yamaguchi ◽  
...  
Keyword(s):  
T Cell ◽  
Dry Eye ◽  
Therapeutic Potential ◽  
Rabbit Model ◽  
Tear Film ◽  
Relevant Information ◽  
Corneal Epithelial Cell ◽  
Epithelial Cell Line ◽  
Dry Eyes ◽  
Lacrimal Fluid

The polymer that includes 2-methacryloyloxy ethyl phosphorylcholine (MPC) is well-known as an effectively hydrating multifunction agent. In this study, we prepared an MPC polymer (MPCP) using radical polymerization with co-monomers—MPC/Stearyl Methacrylate/N,N-dimethylacrylamide—and evaluated the MPCP’s usefulness for dry eye treatment using a rabbit model treated with N-acetylcysteine. The MPCP particle size was 50–250 nm, and the form was similar to that of micelles. The MPCP viscosity (approximately 0.95 mPa·s) was 1.17-fold that of purified water, and a decrease in the transepithelial electrical resistance value (corneal damage) was not observed in the immortalized human corneal epithelial cell line HCE-T cell (HCE-T cell layer). The MPCP enhanced the water maintenance on the cornea, and the instillation of MPCP increased the lacrimal fluid volume and prolonged the tear film breakup time without an increase in total mucin contents in the lacrimal fluid of the normal rabbits. The therapeutic potential of the MPCP for dry eye was evaluated using an N-acetylcysteine-treated rabbit model, and, in our investigation, we found that MPCP enhanced the volume of lacrimal fluid and promoted an improvement in the tear film breakup levels. These findings regarding the creation and characteristics of a novel MPCP will provide relevant information for designing further studies to develop a treatment for dry eyes.

scholarly journals Evaluation of Tear Film Urea Level as a Diagnostic Marker of Dry Eye Disease: A Pilot Study

2021 ◽  
Author(s):  
Gurunadh Satyanarayana Velamakanni ◽  
Anil Sharma ◽  
Hitender S. Batra ◽  
Subrahmanya Murti Velamakanni ◽  
Mansur Khan ◽  
...  
Keyword(s):  
Dry Eye ◽  
Large Scale ◽  
Diagnostic Marker ◽  
Tear Film ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
P Value ◽  
Urea Level ◽  
Cutoff Value ◽  
Schirmer’S Test

Abstract Introduction Urea secreted in the sweat is important for skin moisture. Similarly, ocular surface moisture is maintained by the conjunctiva. Based on this, the level of urea in tear film can be used as a potential diagnostic test for dry eye disease (DED). One of the standard tests for DED is Schirmer's test (ST). The aim of this study was to compare tear film urea to values of ST. Methods Fifty patients symptomatic for DED having ST ≤ 10 mm/5 min were enrolled in the study. Fifty age- and sex-matched asymptomatic subjects with ST > 10 mm/5 min were taken as controls. All patients were subjected to an estimation of tear film urea, collected using micropipettes, and analyzed by an Erba Chem 5 semi-autoanalyzer. Based on the ST reading as per the Dry Eye Workshop 2007 (DEWS) classification, dry eye was classified as dry eye (≤ 10 mm/5 min), severe dry eye (≤ 5 mm/5 min), and very severe dry eye (≤ 2 mm/5 min). Tear film urea values were compared with ST values that were considered standard. Statistical analysis was done using Medcalc version 19.7. A p-value ≤ 0.05 was considered significant. Results The mean tear film urea levels in cases were (26.78 ± 5.70 mg/dL) significantly lower compared with controls (41.72 ± 6.86 mg/dL). The area under the receiver characteristic operator curve (AUC) for tear film urea in diagnosing DED was 0.936 (p < 0.0001) with a cutoff of ≤ 37.2 mg/dL, yielding a sensitivity of 96% and a specificity of 76%. For diagnosing severe DED, the AUC for tear film urea was 0.824 (p < 0.0001) with a cutoff value of ≤ 23.4 mg/dL, yielding a sensitivity of 60.8% and a specificity of 92.59%. For diagnosis of very severe DED, the AUC for tear film urea was 0.972 (p < 0.0001) with a cutoff value of ≤ 19.8 mg/dL, yielding a sensitivity of 100% and a specificity of 93.62%. On comparing ST values to tear film urea, the regression coefficient was 0.85 (p < 0.0001), suggesting a linear relationship between ST and tear film urea. Conclusion The study demonstrates that tear film urea can be a potential diagnostic marker for DED. The study also indicates that tear film urea level is linearly related to Schirmer's test values and provides an approximate diagnostic cutoff level for the design of future large-scale studies.

scholarly journals Determination of Risk Factors and Treatment of Dry Eye Disease in Type 1 Diabetes Before Corneal Complications at Sindh Institute of Ophthalmology And Visual Sciences

2017 ◽  
Vol 11 (1) ◽  
pp. 355-361 ◽  
Author(s):  
Shehnilla Shujaat ◽  
Muhammad Jawed ◽  
Shahzad Memon ◽  
Khalid Iqbal Talpur
Keyword(s):  
Risk Factors ◽  
Type 1 Diabetes ◽  
Dry Eye ◽  
Tear Film ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Diabetic Patients ◽  
Dry Eyes ◽  
Department Of Ophthalmology

Objective: The objective of this study was to assess and determine the risk factors and treatment of dry eye disease in type 1 diabetes before any ocular surface or corneal complication occurs. This study was conducted at Sindh Institute of Ophthalmology And Visual Sciences, Hyderabad, Pakistan. Methodology: Subjects and methods for observational study were undertaken at the Department of Ophthalmology Sindh Institute Of Ophthalmology And Visual Sciences, Hyderabad, Pakistan. Hundred confirmed cases of type 1 diabetes were included in the study by non probability convenience sampling. Tear film breakup time and schrimer test were carried out to determine dry eye disease. Data was collected by self-prepared questionnaire and entered and analyzed by using Statistical Program for Social Sciences (SPSS, version 20.0). The frequencies and percentage were recorded and any associations with predisposing factors were statistically analyzed by t test. Results: Out of hundred patients, 71 (71%) were found to have dry eyes (P<0.001). The mean age of the subject in this study was 50.97 years (range 30-70 years). Old age was related to high risk of dry eye disease (P<0.001). There was no big difference in the incidence of dry eyes in males and females. Long duration was found to be related with increased occurrence of dry eyes (P<0.001). We found higher values for abnormal tear film break up time than schirmer test values leading to increased occurrence of evaporative dry eyes. Conclusion: There is marked increase in frequency/ risk of developing dry eye disease in type 1 diabetes patients. Therefore, it is recommended to have periodic ophthalmic examination for type 1 diabetic patients.

scholarly journals Dry Eye Disease among Pregnant Women at a Tertiary Care Hospital in Kathmandu

2020 ◽  
Vol 22 (3) ◽  
pp. 146-152
Author(s):  
Aparna Rizyal ◽  
B Shrestha ◽  
A Khadka
Keyword(s):  
Pregnant Women ◽  
Dry Eye ◽  
Tertiary Care ◽  
College Teaching ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Care Hospital ◽  
Dry Eyes ◽  
Schirmer’S Test ◽  
Woman's Body

Pregnancy is characterized by many significant changes in a woman’s body which helps develop the fetus optimally. During pregnancy, there is marked maternal endocrine upregulation, hormonal profile modifications and interactions leading to dry eyes. Pregnancy causes most parts of a woman’s body to change, and the eyes are no exception. Dry eye disease is a common pregnancy problem that usually begins towards the end of the first trimester. Since, there is a dearth of literature on dry eye disease during pregnancy in Nepal, a study was conducted to estimate the prevalence of dry eyes disease among pregnant women and to find its association with socio-demographic characteristics and their gestation period, at Nepal Medical College Teaching Hospital. A total of 84 pregnant women in different trimesters volunteered for this study. The upper and lower limits for estimated mean age were 26.67 years to 25.03 years at 95% confidence level. The prevalence of dry eyes was 89.3% by tear break up time test and 27.4% by Schirmer’s test respectively. The association between gestational age and dry eyes by Schirmer’s test was statistically significant.

scholarly journals Effects of warm compress on tear film, blink pattern and Meibomian gland function in dry eyes after corneal refractive surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xueyi Zhou ◽  
Yang Shen ◽  
Jianmin Shang ◽  
Xingtao Zhou
Keyword(s):  
Dry Eye ◽  
Corneal Thickness ◽  
Tear Film ◽  
Meibomian Gland ◽  
Blink Rate ◽  
Lipid Layer ◽  
Dry Eyes ◽  
Mean Values ◽  
Before And After ◽  
Gland Function

Abstract Background To assess the effects of warm compress (WC) on tear film lipid layer, blink pattern and Meibomian gland function in patients with dry eye following femtosecond laser small incision lenticule extraction (SMILE) and laser-assisted subepithelial keratomileusis (LASEK). Methods We enrolled 37 eyes of 37 participants, each with dry eye for more than 2 years following SMILE (25 eyes) or LASEK (12 eyes). WC was performed using a spontaneously heating eye mask. Tear film break-up time (TBUT), tear film lipid layer thickness (TFLLT), blink pattern, Meibomian secretory function scores (MGS), visual acuity, spherical equivalent (SE), keratometry, central corneal thickness (CCT) and aberration were assessed before and after WC. Results After WC, the following mean values all increased relative to baselines: CCT, SE, minimum (Min-), maximum (Max-) and average (Ave-) TFLLT, TBUT, total MGS (TMGS), number of glands secreting any liquid (MGL), and complete blink rate (CBR) (p values ranging from < 0.001 to 0.042). Partial blink frequency (PBF) and partial blink rate (PBR) decreased (p = 0.002 in both cases). The decrease of PBF was higher in SMILE subgroup than in LASEK (p = 0.030). TBUT variation was positively correlated with that of Ave-TFLLT and TMGS (p = 0.046, 0.028, respectively). Max-TFLLT variation was correlated with that of TMGS (p = 0.020). Conclusions WC may temporarily increase tear film thickness and stability, decrease partial blink, and partly augment Meibomian gland function in dry eye patients after corneal refractive surgeries. Future studies are required to investigate long term clinical efficacy and safety.

A study to assess the efficacy of topical cyclosporine A 0.05% in the management of dry eye with meibomiam gland dysfunction

2022 ◽  
Vol 7 (4) ◽  
pp. 667-671
Author(s):  
Prajwalli Reddy ◽  
Wajeeha Umam
Keyword(s):  
Dry Eye ◽  
Cyclosporine A ◽  
Ocular Surface ◽  
Tear Film ◽  
Meibomian Gland ◽  
Meibomian Gland Dysfunction ◽  
Control Group ◽  
Dry Eyes ◽  
Group A ◽  
Group B

: Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface. Meibomian Gland Dysfunction (MGD) is an abnormality of the meibomian gland that blocks the secretion of lipids. Without sufficient lipid production, tears evaporate quickly causing Dry Eye.MGD is associated with multiple pathological mechanisms including inflammation, microbial factors and lipid deficiencies. Topical Cyclosporine A (CsA) 0.05% is a calcineurin inhibitor that reduces inflammation by specifically inhibiting T‑cell activity, which reduces ocular surface inflammation and improves tear film dynamics. This was a prospective observational study done on 100 patients at the Department of Ophthalmology Basaveshwar teaching and general hospital, on patients of dry eyes due to meibomian gland dysfunction. Patients who were diagnosed with dry eyes due to meibomian gland dysfunction were invited to take part in the study. Patients were divided randomly into two groups of 50 patients each. This study, was explained in detail to them. An informed consent was obtained. Patients fulfilling the inclusion criteria were listed.All OSDI scores (symptom intensity, frequency and aggravation) revealed decreasing patterns throughout the observation period in both the groups. In single analysis, the cyclosporine A 0.05% group showed a significant improvement for each score at 3 months (p &#60; 0.01, p = 0.01, p = 0.02, respectively). The mean TBUT after treatment in the group A (cyclosporine A group) increased to 12.36± 3.58(p&#60;0.001) seconds, and in the group B (Control group) the TBUT score increased to 11.01±3.06 seconds. After 3 Months, there was statistically significant improvement in the mean Schirmer’s scores in both the treatment groups, however improvement was significantly greater in Cyclosporine A group. Prior to the treatment in group A (Cyclosporine A) mean Lissamine staining score was 2.73±0.15 and post treatment it reduced to 1.32±0.15 which was statistically significant (P&#60;0.001). In group B (Control group) score before treatment was 2.46±0.15 and after treatment it reduced to 2.39±0.27 (p=0.11), not much difference was seen. : Findings from our study showed that there were significant improvements in the dry eye conditions due to defect in meibomian gland by treatment of topical Cyclosporine A 0.05% and sodium hyaluronate 0.1%.

scholarly journals Assessment of tear secretion and tear film instability in cases with pterygium and normal subjects

2013 ◽  
Vol 5 (1) ◽  
pp. 16-23 ◽  
Author(s):  
Narayani Roka ◽  
SP Shrestha
Keyword(s):  
Dry Eye ◽  
Tear Film ◽  
Strong Relationship ◽  
Normal Subjects ◽  
Controlled Study ◽  
Control Group ◽  
P Value ◽  
Tear Secretion ◽  
Schirmer’S Test ◽  
Significant Difference

Introduction: Dry eye is a common disorder affecting a significant percentage of the population. Materials and methods: This study is a prospective, hospital-based, case-controlled study conducted between January 2009 and May 2010. Seventy-six pterygium cases and 152 age-and- sex matched controls presenting to the OPD of Manipal Teaching Hospital were included. The TBUT Schirmer’s test and basal tear secretion were estimated in all patients. A TBUT of less than 10 seconds and a Schirmer’s test of less than 10 mm were considered abnormal. Results: Pterygium was bilateral in 15 (19.7 % ) and unilateral in 61 (80.3 %) patients. Ninety-two (92.1 %) pterygium patients reported either one or more of the six dry eye symptoms. Redness was the most common (67 %) symptom reported. The mean Schirmer’s test I, mean basal secretion and mean TBUT values were 16.19 mm, 10.01 mm and 10.56 seconds in pterygium cases and 20.22 mm,13.25 mm and 26.25 seconds in the control group respectively. There was a statistically significant difference in the dry eye results between the pterygium cases and the control group (p value < 0.05). The odds ratio between pterygium and dry eye was 3.28. Dry eye was present in 26 % of the normal patients and in 54 % of the pterygium cases. Conclusion: There is a strong relationship between dry eye and pterygium. Nepal J Ophthalmol 2013; 5(9):16-23 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7816

scholarly journals Computer Vision Syndrome Prevalence and Associated Factors Among the Medical Student in Kist Medical College

2018 ◽  
Vol 1 (1) ◽  
pp. 29-31
Author(s):  
Anjila Basnet ◽  
Pragya Basnet ◽  
Poojyashree Karki ◽  
Shriraj Shrestha
Keyword(s):  
Medical Students ◽  
Dry Eye ◽  
Tear Film ◽  
Visual Display ◽  
Daily Basis ◽  
Medical College ◽  
Schirmer’S Test ◽  
Computer Vision Syndrome ◽  
Break Up ◽  
Observational Descriptive Study

Introduction: Computers and other visual display terminals are now an essential part of our daily life. In the present era, use of computer has increased many folds, and its use has been associated with increased health risks, especially eyes.Materials and Methods: This hospital-based prospective, observational, descriptive study. “Specific Computer Users Questionnaire’’regarding the visual symptoms was put used. Schirmer’s test –I, and Tear film break up time were evaluated in all students.Results: Among 100 medical students 74% of the medical students sampled who used to spend 2 hours or more on their digital screens on a daily basis were complaining of one or more of CVS manifestation. Eye strain, burning eyes, neck, shoulder, or back pain, dryness, irritation and redness of eyes, headaches during or after working on computer and overall body fatigue were recorded in 89%,87%,78%,77%,71%and 68% respectively. Dry eye was associated with CVS in 58 % in right eye and 55% in left eye according to-Tear film break up time measurement whereas 59 % students have dry eye in right eye and 57% students have dry eye in left eye according to Schirmer’s test – I measurement.Conclusions: Symptoms of CVS increase with increased duration of working on digital screens for 2 hours or more. The factors associated with the severity of CVS were hours of digital screens use per day and dry eye..Nepalese Medical Journal, vol.1, No. 1, 2018, Page: 29-31

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