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Objective: To evaluate the accuracy of diagnosing dry eye disease (DED) by using the Visionix VX120+, to establish reference values for tear meniscus height (TMH) and non-invasive break-up time (NIBUT), and to compare the NIBUT measurements with the fluorescein tear break-up time (FBUT), Methods: fifty-eight subjects (34 dry eye and 24 control) were enrolled. The TMH, first NIBUT, and NIBUT50% were evaluated with the Visionix VX120+, and the FBUT was measured with a slit-lamp. The Receiver Operating Characteristic (ROC) curve was used to evaluate the diagnostic performance, and the Bland–Altman method was performed to analyze the agreement. Results: The areas under the curve were 0.62, 0.60, and 0.70 for the TMH, first NIBUT, and NIBUT50%, respectively. The optimal cut-off values (sensitivity, specificity) were 0.29 (0.62, 0.67), 5.05 (0.85, 0.46), and 7.35 (0.65, 0.79) for the TMH, first NIBUT, and NIBUT50%, respectively. The mean differences (lower, upper limits of agreement) were −1.10 (−8.78, 6.58) and 1.55 (−5.68, 8.78) for the first NIBUT vs. FBUT and the NIBUT50% vs. FBUT, respectively. Conclusions: In conclusion, the NIBUT50% can be a useful tool for dry eye screening, with acceptable values of sensitivity and specificity. First, the NIBUT and NIBUT50% should not be used interchangeably with the FBUT.

PURPOSE: To use artificial intelligence to identify relationships between morphological characteristics of the Meibomian glands (MGs), subject factors, clinical outcomes, and subjective symptoms of dry eye. METHODS: A total of 562 infrared meibography images were collected from 363 subjects (170 contact lens wearers, 193 non-wearers). Subjects were 67.2 % female and were 54.8 % Caucasian. Subjects were 18 years of age or older. A deep learning model was trained to take meibography as input, segment the individual MG in the images, and learn their detailed morphological features. Morphological characteristics were then combined with clinical and symptom data in prediction models of MG function, tear film stability, ocular surface health, and subjective discomfort and dryness. The models were analyzed to identify the most heavily weighted features used by the algorithm for predictions. RESULTS: MG morphological characteristics were heavily weighted predictors for eyelid notching and vascularization, MG expressate quality and quantity, tear film stability, corneal staining, and comfort and dryness ratings, with accuracies ranging from 65 % to 99 %. Number of visible MG, along with other clinical parameters, were able to predict MG dysfunction, aqueous deficiency and blepharitis with accuracies ranging from 74 % to 85 %. CONCLUSIONS: Machine learning-derived MG morphological characteristics were found to be important in predicting multiple signs, symptoms, and diagnoses related to MG dysfunction and dry eye. This deep learning method illustrates the rich clinical information that detailed morphological analysis of the MGs can provide, and shows promise in advancing our understanding of the role of MG morphology in ocular surface health.

This doctoral thesis in Public Health evaluates the effectiveness of the "Caring for My Eyes" program, designed to prevent dry eye associated with computer use in ophthalmology patients aged 18 to 25 at Dafi Salud Surco Pueblo Hospital during 2023. Through an experimental design and applying a pre-test and post-test methodology to a sample of 40 patients, this study investigates the impact of the experimental program on improving ocular health. The findings reveal a significant improvement in dry eye prevention, with a mean difference of 6.88 and an incidence of 0.811, corroborating the general hypothesis of the research on the program's effectiveness. The strength of the correlation between participation in the program and the participants' ocular health indicates a considerable positive impact, highlighting the relevance of incorporating preventive strategies in the ophthalmological management of young adults. This study contributes to the existing literature on the prevention of technology-induced ocular diseases, demonstrating the importance of educational and preventive interventions targeted at at-risk populations. With these results, the thesis proposes a reflection on the need to integrate programs like "Caring for My Eyes" into ophthalmological health services to mitigate the negative effects of prolonged computer use on vision, providing a solid foundation for future research and public health policies focused on the prevention of visual disorders., La presente tesis doctoral en Salud Pública evalúa la efectividad del programa "Cuidando mis ojos", diseñado para prevenir el ojo seco asociado al uso de ordenadores en pacientes de oftalmología de 18 a 25 años en el Hospital Dafi Salud Surco Pueblo durante el 2023. A través de un diseño experimental y aplicando una metodología de pre test y post test a una muestra de 40 pacientes, este estudio investiga la incidencia del programa experimental en la mejora de la salud ocular. Los hallazgos revelan una mejora significativa en la prevención del ojo seco, con una diferencia de medias de 6,88 y una incidencia de 0,811, corroborando la hipótesis general de la investigación sobre la efectividad del programa. La fuerza de la correlación entre la participación en el programa y la salud ocular de los participantes indica un impacto positivo considerable, subrayando la relevancia de incorporar estrategias preventivas en el manejo oftalmológico de jóvenes adultos. Este estudio contribuye a la literatura existente sobre prevención de enfermedades oculares inducidas por el uso de tecnología, demostrando la importancia de intervenciones educativas y preventivas dirigidas a poblaciones en riesgo. Con estos resultados, la tesis propone una reflexión sobre la necesidad de integrar programas como "Cuidando mis ojos" en los servicios de salud oftalmológica para mitigar los efectos negativos del uso prolongado de ordenadores en la vista, ofreciendo una base sólida para futuras investigaciones y políticas de salud pública enfocadas en la prevención de trastornos visuales.

Syfte: Syftet med litteraturstudien är att undersöka om det finns en skillnad i bakteriell normalflora på den okulära ytan hos individer med torra ögon, i jämförelse med friska ögon. Metod: Studien var en litteraturöversikt. Sökningar utfördes i tre databaser, och inkluderade kliniska studier som undersökte sammansättningen av den okulära ytans bakterieflora hos friska ögon respektive torra ögon. Sökorden som användes var microb*, microorganism*, bacteria*, flora, ocular, conjunctiva*, cornea*, 16S. Sökningar utfördes i databaserna PubMed, Web of Science och Science Direct mellan 21 mars 2024 och 5 april 2024. Resultat: I majoriteten av studierna var de vanligaste fyla Actinobacteria, Firmicutes och Proteobacteria, för både friska och torra ögon. Bacillus, Corynebacterium, Cupriavidus, Cutibacterium och Staphylococcus var bland de vanligaste släktena för friska ögon. Vanligaste släkten för torra ögon var Acinetobacter, Bacillus, Chelatococcus, Corynebacterium, Cupriavidus, Cutibacterium, Pseudomonas och Staphylococcus. Acinetobacter, Chelatococcus och Pseudomonas sågs däremot inte enbart hos torra ögon, utan förekom även bland friska ögon. Slutsats: Det fanns ingen konsekvent skillnad i den bakteriella normalfloran mellan friska och torra ögon, på fylum- eller släktnivå. Skillnader kan möjligtvis förekomma i relativ förekomst, och vidare studier kan utreda ifall detta samband finns., Purpose: The purpose of this literature review is to investigate if there is a difference in the bacterial microbiota of the ocular surface in eyes affected by dry eye disease (DED), in comparison to healthy eyes. Method: This study was a literature review. Searches were conducted in three databases, and included clinical studies that investigated the composition of the bacterial microbiota of the ocular surface in healthy eyes compared to subjects with DED. The keywords used were microb*, microorganism*, bacteria*, flora, ocular, conjunctiva*, cornea*, 16S. The searches were conducted in the databases PubMed, Web of Science and Science Direct, between 21 March 2024 and 5 April 2024. Result: In a majority of the studies the most common phyla were Actinobacteria, Firmicutes och Proteobacteria, for both healthy and dry eyes. Bacillus, Corynebacterium, Cupriavidus, Cutibacterium och Staphylococcus were the most common genera for healthy eyes. Acinetobacter, Bacillus, Chelatococcus, Corynebacterium, Cupriavidus, Cutibacterium, Pseudomonas och Staphylococcus were most common for dry eyes. Acinetobacter, Chelatococcus och Pseudomonas were however not exclusive to DED, but could also be seen in healthy eyes. Conclusion: No consistent difference could be observed in the composition of the bacterial microbiota between healthy and dry eyes, at the phylum or genus level. Differences in relative abundance might exist, and further research could explore if such a connection is real.

Purpose:To assess dry eye disease characteristics of pediatric patients with diabetes.Twenty-one patients with type-1 diabetes mellitus (DM), 20 with type-2 DM, 19 with maturity-onset diabetes of the young (MODY), and 20 control participants were included in the study. Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time (TBUT) analysis, Schirmer test with anesthesia, and conjunctival impression cytologic analysis were performed.In Group 1, the Schirmer test and TBUT values were lower than the control group. In groups 1 to 3, OSDI scores were higher than the control group. In Groups 1 and 2, the goblet cell density was lower than the control group.Dry eye parameters of all three diabetic groups were adversely affected in favor of dry eye disease. Children with MODY have increased OSDI scores. Alterations in the conjunctival impression cytology were observed more prominently in patients with type-1 DM.This was a prospective, cross-sectional study. This study included 21 patients in group 1 who had been diagnosed with type-1 DM, 20 patients in group 2 who had been diagnosed with type-2 DM, 19 patients in group 3 who had been diagnosed with MODY, and 20 healthy participants in the control group. This study was conducted in collaboration with the departments of ophthalmology, pediatric endocrinology and metabolism, and histology embryology in a tertiary hospital. The study was designed considering the stipulations given by the Declaration of Helsinki, and appropriate approval was obtained from the ethics committee (approval code 2021/07-33). The parents or legal guardians of the patients or participants provided written informed consent before they participated in the study. Patients with diabetes were selected from among ophthalmology clinic patients who had been referred by the pediatric endocrinology and metabolism clinic to undergo routine eye screening. The control group consisted of healthy participants who did not have any systemic or ocular

Objective: Determine morphological and morphometric parameters of corneal epithelium in dogs, and determine the cellular alterations that occur in canine keratoconjunctivitis sicca (KCS) using impression cytology. Study animals: 60 dogs divided into 2 groups: dogs with Schirmer tear test (STT) ≥ 15 mm/min and absence of ocular disease, and dogs with STT < 15 mm/min and clinical signs of KCS. Procedures: Impression cytology was used to collect corneal samples. The percentage of eyes with cell changes, the number of such cells and the percentage of cells with structural alterations in each group were determined. The possible correlation between corneal epithelium alterations and decreased tear production was evaluated. Results: A significant positive correlation existed between STT and the area of the cytoplasm and nucleus of corneal cells. A significant negative correlation was found between STT and the nucleus/cytoplasm (N:C) ratio, and the presence of cellular changes. Significant difference existed between the number of pyknotic nuclei, being higher among animals with all stages of KCS. Conclusion: Corneal impression cytology can be used to assess the corneal epithelium in healthy eyes and eyes with KCS, demonstrating its usefulness as a diagnostic tool especially in mild and early cases., Depto. de Medicina y Cirugía Animal, Fac. de Veterinaria, TRUE, pub

Dry eye disease affects a substantial segment of the word population with increasing frequency. It is a multifactorial disease of the ocular surface and tear film, which causes ocular discomfort, visual disturbances, and tear instability with potential damage to the cornea and conjunctiva. Because of its multifactorial etiology, the use of different pharmacological treatment for dry eye treatment has been proposed, which include anti-inflammatory molecules, lubricants or comfort agents, and secretagogues. However, in some cases these pharmacological approaches only relieve symptoms temporarily, and consequently, eye care professionals continue to have difficulties managing dry eye. To improve pharmacological therapy that allows a more efficient and long-term action, effective ocular drug delivery of the currently available drugs for dry eye treatment is required. Contact lenses are emerging as alternative ophthalmic drugs delivery systems that provide an increased residence time of the drug at the eye, thus leading to enhanced bioavailability and more convenient and efficacious therapy. In this article, we reviewed the different techniques used to prepare contact lens-based drug delivery systems and focused on articles that describe the delivery of compounds for dry eye treatment through contact lenses., Redes Temáticas de Investigación Cooperativa en Salud, Universidad Complutense de Madrid, Depto. de Optometría y Visión, Unidad Docente de Bioquímica y Biología Molecular, Fac. de Óptica y Optometría, TRUE, pub

Received: 12 September 2021; Accepted: 07 March 2022; Published: 01 April 2022, Background: Ocular surface disease in glaucoma patients is a significant ocular co-morbidity that can affect 40% to 59% of these patients worldwide. The current study was aimed at evaluating the potential clinical benefit of an intense pulsed light (IPL)-based treatment in glaucomatous patients with ocular surface disease due to prolonged hypotensive eyedrop treatments. To our knowledge, this is the first series analyzing the therapeutic effect of this treatment option in this type of patients. Methods: This non-comparative prospective case series study enrolled a total of 30 glaucoma patients ranging in age from 57 to 94 years old and treated with hypotensive eyedrops for years with dry eye symptomatology. All patients received four sessions of IPL treatment using the Optima IPL system (Lumenis, Yokneam, Israel) adjusted to the official optimized Lumenis setting. Changes in symptomatology, corneal staining, conjunctival hyperemia, non-invasive break-up time (NIBUT), tear osmolarity, tear meniscus height (TMH), meiboscore and meibomian gland expressibility was analyzed after treatment. Results: Statistically significant reductions were observed after IPL treatment in the symptomatology scores measured with different questionnaires [ocular surface disease index (OSDI), standard patient evaluation of eye dryness (SPEED) and symptom assessment questionnaire in dry eye (SANDE)] as well as with the visual analogue scale (P < 0.001). Mean change in OSDI was − 15.0 ± 11.3. A significant reduction was found after treatment in the corneal staining score (P < 0.001). A significant reduction was found in tear film meniscus height (P = 0.012), as well as in tear film osmolarity (P = 0.001). A significant reduction was also found in meibomian gland expressibility (P = 0.003), changing the percentage of grade 3 eyes from 44.4% before IPL to 17.2% after treatment. Conclusions: IPL therapy combined with meibomian gland expression (MGX) seems to be an effective option to improve sym, Depto. de Inmunología, Oftalmología y ORL, Unidad Docente de Inmunología, Oftalmología y ORL, Fac. de Medicina, Fac. de Óptica y Optometría, TRUE, pub

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited, Circadian rhythm and the molecules involved in it, such as melanopsin and melatonin, play an important role in the eye to regulate the homeostasis and even to treat some ocular conditions. As a result, many ocular pathologies like dry eye, corneal wound healing, cataracts, myopia, retinal diseases, and glaucoma are affected by this cycle. This review will summarize the current scientific literature about the influence of circadian patterns on the eye, focusing on its relationship with increased intraocular pressure (IOP) fluctuations and glaucoma. Regarding treatments, two ways should be studied: the first one, to analyze if some treatments could improve their effect on the ocular disease when their posology is established in function of circadian patterns, and the second one, to evaluate new drugs to treat eye pathologies related to the circadian rhythm, as it has been stated with melatonin or its analogs, that not only could be used as the main treatment but as coadjutant, improving the circadian pattern or its antioxidant and antiangiogenic properties., Ministerio de Economía, Comercio y Empresa (España), Depto. de Optometría y Visión, Unidad Docente de Bioquímica y Biología Molecular, Fac. de Óptica y Optometría, TRUE, pub

The eye is a metabolically active structure, constantly exposed to solar radiations making its structure vulnerable to the high burden of reactive oxygen species (ROS), presenting many molecular interactions. The biomolecular cascade modification is caused especially in diseases of the ocular surface, cornea, conjunctiva, uvea, and lens. In fact, the injury in the anterior segment of the eye takes its origin from the perturbation of the pro-oxidant/antioxidant balance and leads to increased oxidative damage, especially when the first line of antioxidant defence weakens with age. Furthermore, oxidative stress is related to mitochondrial dysfunction, DNA damage, lipid peroxidation, protein modification, apoptosis, and inflammation, which are involved in anterior ocular disease progression such as dry eye, keratoconus, uveitis, and cataract. The different pathologies are interconnected through various mechanisms such as inflammation, oxidative stress making the diagnostics more relevant in early stages. The end point of the molecular pathway is the release of different antioxidant biomarkers offering the potential of predictive diagnostics of the pathology. In this review, we have analysed the oxidative stress and inflammatory processes in the front of the eye to provide a better understanding of the pathomechanism, the importance of biomarkers for the diagnosis of eye diseases, and the recent treatment of anterior ocular diseases., Unión Europea, Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

This study was published in memory of Jesus Pintor, who passed away on 2 April 2019. He founded and led our research group working continuously on the relation between purinergic signaling and dry eye., Depto. de Optometría y Visión, Unidad Docente de Bioquímica y Biología Molecular, Fac. de Óptica y Optometría, TRUE, pub

Received 13 December 2013; revised 4 November 2014; accepted 9 November 2014; published online 9 December 2014, Purpose: To compare signs and symptoms of dry eye in keratoconus (KC) patients versus healthy subjects. Methods: A total of 15 KC patients (KC group, n = 15 eyes) and 16 healthy subjects (control group, 16 eyes) were enrolled in this study. The Schirmer I test with no anesthetic, tear break-up time (TBUT), corneal staining characteristics, and ocular surface disease index (OSDI) scores were evaluated for both groups. Impression cytology, combined with/scanning laser confocal microscopy (LCM), was performed to evaluate goblet cell density, mucin cloud height (MCH), and goblet cell layer thickness (CLT). Finally, tear concentrations of di-adenosine tetraphosphate (Ap4A) were assessed. Results were statistically analyzed using Shapiro–Wilk and non-parametric Wilcoxon rank sum tests. Statistical significance was set at p < 0.05. Results: KC patients had lower tear volumes and greater corneal staining than did healthy subjects (p < 0.05). OSDI scores were 44.96 ± 8.65 and 17.78 ± 6.50 for the KC and control groups, respectively (p < 0.05). We found no statistically significant differences in TBUT between groups. Impression cytology revealed lower goblet cell densities in KC group patients versus control group subjects (84.88 ± 32.98 and 128.88 ± 50.60 cells/mm,2 respectively, p < 0.05). There was a statistically significant reduction in MCH and CLT in KC group patients compared with control group subjects. Ap4A tear concentrations were higher in KC group patients than in control group subjects (2.56 ± 1.10 and 0.15 ± 0.12 µM, respectively, p < 0.05). Conclusions: The parameters evaluated in this study indicate that KC patients suffer greater symptoms of dry eye and greater tear instability, primarily due to the decreased mucin production in their tears, than do healthy patients with no KC., Depto. de Optometría y Visión, Unidad Docente de Bioquímica y Biología Molecular, Fac. de Óptica y Optometría, TRUE, pub

Age-related eye diseases, including dry eye, glaucoma, age-related macular degeneration, and diabetic retinopathy, represent a major global health issue based on their increasing prevalence and disabling action. Unraveling the molecular mechanisms underlying these diseases will provide novel opportunities to reduce the burden of age-related eye diseases and improve eye health, contributing to sustainable development goals achievement. The impairment of neutrophil extracellular traps formation/degradation processes seems to be one of these mechanisms. These traps formed by a meshwork of DNA and neutrophil cytosolic granule proteins may exacerbate the inflammatory response promoting chronic inflammation, a pivotal cause of age-related diseases.In this review, we describe current findings that suggest the role of neutrophils and their traps in the pathogenesis of the above-mentioned age-related eye diseases. Furthermore, we discuss why these cells and their constituents could be biomarkers and therapeutic targets for dry eye, glaucoma, age-related macular degeneration, and diabetic retinopathy. We also examine the therapeutic potential of some neutrophil function modulators and provide several recommendations for future research in age-related eye diseases, Instituto de Salud Carlos III, Ministerio de Ciencia, Innovación y Universidades (España), Universidad de Barcelona, Generalitat de Catalunya, Universidad Complutense de Madrid - Banco de Santander, Depto. de Optometría y Visión, Unidad Docente de Bioquímica y Biología Molecular, Fac. de Óptica y Optometría, TRUE, pub

Introducción: Las células caliciformes secretan mucinas, citocinas y antígenos específicos para la respuesta immunitaria de la superficie ocular. Las alteraciones en la densidad de células caliciformes y de su secreción provocan inestabilidad de la película lagrimal y, por ello, ojo seco. Objetivo: Se estudiaron las conexiones entre las publicaciones, las citaciones y las revistas sobre célula caliciforme y ojo seco, con el objetivo de analizar el tamaño de sus grupos y núcleo, y cuantificar el volumen de literatura existente para dirigir futuras investigaciones sobre el tema. Método: La búsqueda de “goblet cell and dry eye” se realizó en Web of Science y luego se analizó con CitNetExplorer® para obtener las publicaciones más citadas e identificar los grupos y núcleo de publicaciones. Resultados: 555 publicaciones y 3066 citaciones fueron generadas por WoS. Los años 2016 y 2017 son los que tienen mayor número de publicaciones. La más citada fue The definition and classification of dry eye disease: report of the definition and classification subcommittee of the International Dry Eye Worshop, de Lemp et al., publicada en 2007. Empleando la función Cluster resultaron tres grupos con diferentes áreas de investigación en este campo: ojo seco, mucinas y tratamientos. Conclusiones: El estudio de la célula caliciforme y del ojo seco es relevante para los investigadores, mostrándose además conexiones entre ellos. Aumentar el conocimiento de la célula caliciforme producirá mejoras en los tratamientos del ojo seco., Background: Goblet cells (GC) secrete mucins, cytokines, and specific antigens for the immune response of the ocular surface. Alteration in goblet cell density and its secretion leads to an unstable tear film and, eventually, dry eye. This study analyzed the connections between the most cited publications and their citations and journals on GC and dry eye to analyze data like the size of their clusters and core, and quantify the volume of literature available to guide future research. Methods: "Goblet cell and dry eye" terms were searched through Web of Science and analyzed with CitNetExplorer® to obtain top-cited publications and identify clusters and core publications. Results: Five hundred and fifty-five publications with 3066 citations generated on the web have been found. We should mention that 2016 and 2017 were the years with the highest number of publications. The most quoted ones were "the definition and classification of dry eye disease like a report on the definition and classification subcommittee of the International Dry Eye Worshop" by Lemp et al., 2007. Three groups on different research areas on this same field were found using the clustering function: Dry eye, mucins, and treatment. Conclusion: Goblet cell and dry eye are relevant topics for researchers with connections between the two. Further knowledge on goblet cell will improve dry eye treatments. © 2022 Authors. All rights reserved., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Depto. de Optometría y Visión, Depto. de Inmunología, Oftalmología y ORL, Fac. de Óptica y Optometría, Fac. de Medicina, TRUE, inpress

Eye conditions frequently occur in critical patients who require intensive care, requiring in all cases the intervention of nursing personnel to mitigate the physical and psychological effects that affect the patients' living standards. The objective of this study was to identify the procedure that nursing staff should follow for the eye care of patients in critical condition and thus take the necessary measures for the application of therapeutic treatments to avoid eye damage that affects the life of the patients. the patients. To this end, a systematic review was carried out during the period from 01-01-2017 to 06-30-2022 where eye damage in critically ill patients, its causes and the treatments that health personnel should apply from the point of view were identified. medical and psychological. 80 articles were consulted, of which a total of 30 were selected for analysis, where it was evident that the main ocular damages reported in critically ill patients were dry eye syndrome and ocular ulceration mainly due to COVID-19 (23%) and cancer (7.5%), more than 90% of eye conditions were reported in adults. The nursing approach involves monitoring patients to avoid complications that affect the ocular system, followed by palliative treatments that include the use of drugs, pulsed light and acupuncture and psychological therapy, since there is an intimate relationship between depression and eye damage in critically ill patients., Las afecciones oculares ocurren con frecuencia en pacientes críticos que ameritan cuidados intensivos, requiriendo en todos casos la intervención de personal de enfermería para mitigar los efectos físicos y psicológicos que afectan los estándares de vida de los pacientes. El objetivo de este estudio fue identificar el procedimiento que debe seguir el personal de enfermería para el cuidado ocular de aquellos pacientes en estado crítico y de esa manera tomar las medidas necesarias para la aplicación de los tratamientos terapéuticos para evitar daños oculares que afecten la vida de los pacientes. Para ello llevó a cabo una revisión sistemática durante el periodo de 01-01-2017 al 30-06-2022 donde se identificaron los daños oculares en pacientes críticos, sus causas y los tratamientos que debe aplicar el personal de salud desde el punto de vista médico y psicológico. Se consultaron 80 artículos de los cuales se seleccionaron para su análisis un total de 30, donde se evidenció que los principales daños oculares reportados en pacientes críticos fueron el síndrome de ojo seco y ulceración ocular a causa principalmente del COVID-19 (23 %) y cáncer (7,5 %), más del 90 % de las afecciones oculares fueron reportadas en adultos. El abordaje de enfermería implica la monitorización de los pacientes para evitar complicaciones que afecten el sistema ocular, seguido de tratamientos paliativos que incluyen el uso de fármacos, luz pulsada y acupuntura y la terapia psicológica, ya que existe una íntima relación entre la depresión y los daños oculares en pacientes críticos.

Purpose. To compare the ocular surface symptoms and signs in an adult population of silicone-hydrogel (Si-Hy) contact lens (CL) wearers with another modality of CL wear, overnight orthokeratology (OK). Materials and Methods. This was a prospective and comparative study in which 31 myopic subjects were fitted with the same Si-Hy CL and 23 underwent OK treatment for 3 months. Dry eye questionnaire (DEQ) was filled in at the beginning of the study and then after 15 days, 1 month, and 3 months using each CL modality. The tear quality was evaluated with noninvasive tear break-up time. Tear production was measured with Schirmer test. Tear samples were collected with Schirmer strips being frozen to analyze the dinucleotide diadenosine tetraphosphate (Ap4A) concentration with High-Performance Liquid Chromatography (HPLC). Results. After refitting with ortho-k, a reduction in discomfort and dryness symptoms at the end of the day (, ) was observed. No significant changes were observed in Ap4A concentration in any group. Bulbar redness, limbal redness, and conjunctival staining increased significantly in the Si-Hy group (, Kruskal–Wallis test). Conclusion. Discomfort and dryness symptoms at the end of the day are lower in the OK CL group than in the Si-Hy CL group., Xunta de Galicia, Redes Temáticas de Investigación Cooperativa en Salud (España), Fundación para la Ciencia y la Tecnología (Portugal), Depto. de Optometría y Visión, Unidad Docente de Bioquímica y Biología Molecular, Fac. de Óptica y Optometría, TRUE, pub

Purpose: To study the concentrations of diadenosine polyphosphates in the ocular surface after PRK and LASIK. Methods: Sixty-one patients (30 males and 31 females) with ages ranging from 20 to 63 (34.04 ± 9.13 years) were recruited in Balear Institute of Ophthalmology, Palma de Mallorca, Spain. LASIK was performed in 92 eyes of 46 patients and PRK in 25 eyes of 15 patients. Variations in the levels of diadenosine polyphosphate (Ap4A and Ap5A), Schirmer I (Jones test), TBUT, corneal staining together with the Dry Eye Questionnaire to evaluate discomfort and dryness were studied. All tests were performed at the preoperative visit and at 1-day, 2-week, 1-month and 3-month postoperative visits. Results: Ap4A showed a 5 and 3.5 fold increase at the 1-day visit for LASIK and PRK, respectively. LASIK patients continued having higher statistically significant concentrations (p = 0.01) all over the follow-up. Ap5A showed no significant differences at any visit. Tear volume decreased during the 3 months in LASIK. The PRK cases had a normal volume at 1 month. TBUT in LASIK increased at the 1-day visit (p = 0,002) and decreased from the 2 weeks onwards and for the PRK, decreased by a 35% at the 1-day visit and kept reduced for a month. Discomfort only increased at the 1-day visit (p = 0.007). Dryness frequency was similar in all visits. Conclusions: Ap4A levels only are increased in refractive surgery patients during the first day after the surgery. This increasing suggests that Ap4A may help accelerating the healing process., Depto. de Optometría y Visión, Unidad Docente de Bioquímica y Biología Molecular, Fac. de Óptica y Optometría, TRUE, pub

(English) Meibomian gland dysfunction (MGD) is a chronic and diffuse abnormality of the meibomian glands (MGs) that occurs in 38% of contact lens (CL) wearers, though the influence of CLs on MGD is equivocal. A topical literature review examining the influence of CL wear on MGs found 15 studies reporting an effect of CLs on MGs vs. seven studies who did not. Discrepancies may be due to varying definitions of MGD, types of questionnaires, assessment methods, CL types, and measurement of one vs. both eyelids. The review concluded that the effect of CL wear on MGD should be addressed with a prospective study including non-CL wearing controls and employing an objective assessment of MGs. The Cobra HD meibographer is an objective instrument used in research studies whose inter-session repeatability (ISR), inter-examiner reproducibility (IER) and within-subject variability (WSV) has not been investigated. These measures were evaluated in participants with and without dry eye (DE) symptoms based on their Ocular Surface Disease Index (OSDI) questionnaire. Seventy-two participants (mean age: 23±5 years, 36 asymptomatic) were examined by Examiner 1 in sessions S1 and S2 to calculate the ISR, and seventy-four (mean age: 23±5 years, 37 asymptomatic) were measured on the same day by examiners E1 and E2 to determine the IER. WSV was determined from three consecutive measurements of the same eyelid. Mean MG loss of the upper (S1:13.5±9.5%,S2:12.8±8.5%, E1:12.7±8.2%, E2:13.1±8%) and lower eyelids (S1:7.5±6.9%,S2:7.3±6.3%, E1:7±6.2%, E2:7.4±6.2%) was not significantly different between sessions or examiners for all cohorts for both eyelids. The ISR within-subject standard deviations (Sw) for the upper and lower eyelids were 1.3% and 1.0%; mean difference (md) was 0.7±3.5% [CI:-6.25%- 7.62%] and 0.1±2.1% [CI:-3.94%- 4.17%], respectively. IER ICC values were >0.86 for all conditions, Sw was 1.3% and 1.2% with md of -0.4±3.2% [CI:-6.65%- 5.9%] and -0.4±2.9% [CI:-6.15%- 5.31%], respecti, (Català) La disfunció de les glàndules de Meibomi (MGD) és una anomalia crònica i difusa de les glàndules de Meibomi (MG) que ocorre en el 38% dels usuaris de lents de contacte (LC), encara que la seva influència a la MGD és equívoca. Una revisió de la literatura especialitzada va trobar 15 estudis que van informar d’un efecte de les LC a les MG enfront de set que no. Les discrepàncies poden ser degudes a les diferents definicions de MGD, tipus de qüestionaris, mètodes d'avaluació, tipus de LC i mesurament d'una o de les dues parpelles. Es va concloure que la influència de les LC a la MGD hauria d'abordar-se amb estudis prospectius que incloguin controls no usuaris i una avaluació objectiva. El meibògraf Cobra HD és un instrument de recerca del qual no s’han constatat la repetibilitat entre sessions (ISR), reproductibilitat inter examinadors (IER) i variabilitat intra subjecte (WSV). Aquestes mesures es van avaluar en participants amb símptomes d'ull sec i sense (DE) segons el qüestionari de l'Índex de malaltia de la superfície ocular (OSDI). 72 participants (23±5 anys, 36 asimptomàtics) van ser avaluats per l'examinador 1 a les sessions S1 i S2 per calcular la ISR, i 74 (23±5 anys, 37 asimptomàtics) el mateix dia pels examinadors E1 i E2 per a determinar la IER. La WSV es va establir a partir de tres mesures consecutives de la mateixa parpella. La pèrdua mitjana de MG de les parpelles superior (S1:13.5±9.5%, S2:12.8±8.5%, E1:12.7±8.2%, E2:13.1±8%) i inferior (S1:7.5±6.9 %, S2:7.3± 6.3%, E1:7±6.2%, E2:7.4±6.2%) no va ser significativament diferent entre sessions ni examinadors per a totes les cohorts i per a les dues parpelles. Les desviacions estàndard (Sw) de la ISR intra subjecte per a les parpelles superior i inferior van ser 1.3 % i 1 %; la diferència mitjana (md) va ser 0.7±3.5% i 0.1±2.1%, respectivament. Els valors de IER ICC van ser >0.86 per a totes les condicions, la Sw 1.3% i 1.2% amb md -0.4±3.2% i -0.4±2.9%, respectivament. La Sw WSV <1.4 % i els valor, (Español) La disfunción de las glándulas de Meibomio (MGD) es una anomalía crónica y difusa de las glándulas de Meibomio (MG) que ocurre en el 38 % de los usuarios de lentes de contacto (LC), aunque su influencia en la MGD es equívoca. Una revisión de la literatura especializada encontró 15 estudios que informaron un efecto de las LC en las MG frente a siete que no. Las discrepancias pueden deberse a las distintas definiciones de MGD, tipos de cuestionarios, métodos de evaluación, tipos de LC y medición de uno frente a ambos párpados. Se concluyó que la influencia de las LC en la MGD debería abordarse con estudios prospectivos que incluya controles no usuarios y la evaluación objetiva. El meibógrafo Cobra HD es un instrumento de investigación cuya repetibilidad entre sesiones (ISR), reproducibilidad inter examinadores (IER) y variabilidad intra sujeto (WSV) no han sido determinadas. Estas medidas se evaluaron en participantes con y sin síntomas de ojo seco (DE) según el cuestionario del Índice de enfermedad de la superficie ocular (OSDI). 72 participantes (23±5 años, 36 asintomáticos) fueron evaluados por el examinador 1 en las sesiones S1 y S2 para calcular la ISR, y 74 (23±5 años, 37 asintomáticos) en el mismo día por los examinadores E1 y E2 para determinar la IER. La WSV se estableció a partir de tres medidas consecutivas del mismo párpado. La pérdida media de MG de los párpados superior (S1:13.5±9.5%, S2:12.8±8,5%, E1:12.7±8.2%, E2:13.1±8%) e inferior (S1:7.5±6.9%, S2:7.3± 6.3%, E1:7±6.2%, E2:7.4±6.2%) no fue significativamente diferente entre sesiones ni examinadores para todas las cohortes y para ambos párpados. Las desviaciones estándar (Sw) de la ISR intra sujeto para los párpados superior e inferior fueron 1.3 % y 1 %; la diferencia media (md) fue 0.7±3.5% y 0.1±2.1%, respectivamente. Los valores de IER ICC fueron >0.86 para todas las condiciones, la Sw 1.3% y 1.2% con md -0.4±3.2% y -0.4±2.9%, respectivamente. La Sw WSV <1.4 % y los valores de ICC >0.89 p, Postprint (published version)

Objetivos: Evaluar la eficacia de un lubricante oftálmico con aceite de semilla de girasol ozonizado, fosfolípidos de soja y 0,3% de hipromelosa en población usuarias de LC. Material y método: Estudio prospectivo, longitudinal y controlado de 46 sujetos. Los participantes se dividieron en grupo tratamiento y grupo control de manera aleatoria y equitativa. Al primer grupo se les administró la lágrima compuesta por aceite de semilla de girasol ozonizado, fosfolípidos de soja y 0,3% de hipromelosa. Y el grupo control, se trató con una lágrima compuesta por hipromelosa. Se analizó la altura del menisco lagrimal (AML) en población usuaria de lentes de contacto (LC) a través de una metodología no invasiva por interferometría óptica (Ocular Surface Analyser), así como la sintomatología con el test CLDEQ8. Resultados: El volumen del menisco lagrimal no fue significativamente mayor en ninguno de los dos grupos, sin embargo, el grupo tratamiento experimentó un mayor confort con sus lentes de contacto. Conclusión: El aceite de semilla de girasol ozonizado, fosfolípidos de soja y 0,3% de hipromelosa resultó ser un método poco efectivo para el tratamiento del ojo seco en lo que se refiere al volumen del menisco lagrimal., Objectives: To evaluate the effectiveness of an ophthalmic lubricant containing ozonized sunflower seed oil, soy phospholipids, and 0.3% hypromellose in users of contact lenses. Material and method: Prospective, longitudinal, controlled study with 46 subjects. The participants were randomly and equally divided into a treatment group and a control group. The treatment group received the eye drop composed of ozonized sunflower seed oil, soy phospholipids, and 0.3% hypromellose. The control group was treated with an eye drop composed of hypromellose. The height of the tear meniscus (HTM) in contact lens users was analyzed using non-invasive optical interferometry (Ocular Surface Analyzer), as well as symptomatology using the CLDEQ8 test. Results: The volume of the tear meniscus was not significantly greater in neither of the two groups; however, the treatment group experienced greater comfort with their contact lenses. Conclusion: Ozonized sunflower seed oil, soy phospholipids, and 0.3% hypromellose proved to be an ineffective method for the treatment of dry eye in terms of tear meniscus volume.

IRPL was traditionally used for the treatment of a variety of dermatological diseases such as rosacea. However, third-generation equipment was created specifically for periocular application with multiple homogeneously sculpted pulses “It is the only IRPL device medically certified to treat Meibomian Gland Dysfunction.” Several hypotheses or effects of how the device works have been proposed. Ablation of the small telangiectatic vessels around the eyelid, elimination or reduction of the ectoparasite Demodex, which resides in the meibomian glands and consumes meibum secretions in patients who have rosacea, photomodulation of the glands stimulates cellular activity, improving the micro and macro structure of the meibomian glands. In addition, the modification would decrease the inflammation surrounding them.

PurposeChronic graft-versus-host disease (cGVHD) is a significant cause of morbidity and mortality among patients after allogeneic hematopoietic stem cell transplant (HCT). The objective of our study was to determine if early assessment of matrix metalloproteinase-9 (MMP-9) and dry eye (DE) symptoms (via the DE Questionnaire-5 [DEQ-5]) had prognostic utility for the development of cGVHD and/or severe DE symptoms after HCT.Materials and methodsThis was a retrospective study of 25 individuals who underwent HCT and had MMP-9 (InflammaDry) and DEQ-5 performed on day 100 post-HCT (D + 100). Patients also completed the DEQ-5 at 6, 9, and 12 months post-HCT. The development of cGVHD was determined by chart review.ResultsOverall, 28% of patients developed cGVHD over a median follow-up of 229 days. At D + 100, 32% of patients had a positive MMP-9 in at least one eye and 20% had a DEQ-5 ≥6. However, neither the presence of a positive MMP-9 nor a DEQ-5 score ≥6 at D + 100 predicted the development of cGVHD (MMP-9: hazard ratio [HR]: 1.53, 95% confidence interval [CI]: 0.34-6.85, P = 0.58; DEQ-5 ≥6: HR: 1.00, 95% CI: 0.12-8.32, P = 1.00). In addition, neither of these measures predicted the development of severe DE symptoms (DEQ-5 ≥12) over time (MMP-9: HR: 1.77, 95% CI: 0.24-12.89, P = 0.58; DEQ-5 >6: HR: 0.03, 95% CI: 0.00-889.93, P = 0.49).ConclusionWithin our small cohort, DEQ-5 and MMP-9 assessment at D + 100 did not predict the development of cGVHD or severe DE symptoms.

This work was supported also by FEDER-CICYT FIS-PI17/00079 and FIS- PI17/00466, and the Research Group UCM 920415., Purpose. Artificial tears are widely used in the treatment of dry eye disease, although current formulations do not closely resemble natural tears. The purpose of this study was the design and characterization of a novel in situ gelling artificial tear formulation, containing both lipid and aqueous components, in order to resemble natural tears and replenish the tear film. Methods. Liposomes, containing phosphatidylcholine, cholesterol, vitamins A and E, were prepared by the thin-film hydration method. The aqueous phase of the formulation was comprised of gellan gum, hydroxypropyl methylcellulose, levocarnitine, electrolytes (sodium chloride and potassium chloride), trehalose, and borates. The artificial tear was characterized in terms of liposome size, pH, surface tension, and viscosity. In vitro tolerance studies were performed in a human epithelial carcinoma cell line (HeLa) and a murine macrophage cell line (J774). In vivo tolerance was assessed in rabbits. Results. Liposomes presented a unimodal distribution with a mean size of 200.1 ± 4.4 nm. The resulting surface tension was 53.4 ± 1.1 mN/m (at 33°C) and the pH was 7.6 ± 0.1. The viscosity of the formulation presented a mean value of 4.0 ± 0.1 mPa.s within the shear rate interval of 200-1000 s-1 at 33°C. Cell viability remained higher than 90% in both cell lines. No discomfort or clinical signs were observed in rabbits. Conclusions. The liposome-based and in situ gelling artificial tear formulation presented good tolerance and suitable properties for topical ophthalmic administration. It may be beneficial in the treatment of dry eye disease., Unión Europea. H2020, Universidad Complutense de Madrid, Depto. de Farmacia Galénica y Tecnología Alimentaria, Fac. de Farmacia, TRUE, pub

Revista de O.A., Dry eye syndrome is a common disorder provoking changes in tear quantity and composition being the most common ophthalmic manifestation of systemic inflammatory diseases. Untreated dry eye could cause increased risk of ocular infection, corneal ulcer and blindness. Only a few drugs are authorized so far for the treatment of dry eye disease and the possibilities of evolution in this sector are immense. Accordingly, the future tendency is towards the development of drugs to control the inflammation or stimulate the mucin and tear secretion. A significant number of new potential solutions are under development or placed in the pharmaceutical pipeline, promising better results and lesser side effects, but still leaving unattended the main causes of the disease. In this article, we review the corresponding literature, recent clinical trials data and patents concerning future pharmaceutical compounds for dry eye disease treatment, presenting the new strategic movements of the pharmaceutical industry., El síndrome de ojo seco es un trastorno bastante común, provocando cambios en la cantidad y la composición de lágrima, siendo la manifestación oftálmica más común de enfermedades inflamatorias sistémicas. El ojo seco no tratado puede provocar un aumento del riesgo de infección ocular, úlceras corneales y en casos extremos ceguera. Actualmente sólo unos pocos fármacos están autorizados para el tratamiento de la enfermedad y las posibilidades de evolución en este sector son inmensas. La tendencia del futuro está dirigida hacia el desarrollo de fármacos que controlan la inflamación o estimulan la secreción de las mucinas y de las lágrimas. Un número significativo de nuevos compuestos están en desarrollo o ya están en ensayos clínicos, con aparentes mejores resultados y efectos secundarios menos adversos, pero una vez más dejando desatendidas las principales causas de la enfermedad. En este artículo revisamos la literatura correspondiente, los últimos datos de los ensayos clínicos y las patentes relativas a futuros compuestos farmacéuticos para el tratamiento de la enfermedad del ojo seco, desvelando los nuevos movimientos estratégicos de la industria farmacéutica., Ministerio de Economía y Competitividad de España (MINECO), Ministerio de Sanidad, Servicios Sociales e Igualdad, Unidad Docente de Bioquímica y Biología Molecular, Fac. de Óptica y Optometría, TRUE, pub

Open Access funded by King Saud University Under a Creative Commons license https://www.elsevier.com/journals/saudi-journal-of-ophthalmology/1319-4534/open-access-journal, Dry eye syndrome is a common tears and ocular surface multifactorial disease, described by changes in the ocular surface epithelia related to reduced tears quantity and ocular surface sensitivity, leading to inflammatory reaction. Managing the eye inflammation proved helpful to patients with dry eye disease and current treatment is based on the use of topically applied artificial tear products/lubricants, tear retention management, stimulation of tear secretion and using anti-inflammatory drugs. In this article we revise the corresponding literature and patents assembling the new treatment approaches of novel and future pharmaceutical compounds destined for the dry eye disease treatment. The most frequent categories of compounds presented are secretagogues and anti-inflammatory drugs. These compounds are the research outcome of novel therapeutic strategies designed to reduce key inflammatory pathways and restore healthy tear film., Ministerio de Economía y Competitividad (MINECO), Ministerio de Salud, Sevicios Sociales e Igualdad de España, RETICS, Unidad Docente de Bioquímica y Biología Molecular, Fac. de Óptica y Optometría, TRUE, pub

Introduction: Dry eye disease is a common disorder provoking changes in tear film and ocular surface. Untreated dry eye could cause ocular infections, corneal ulcer and blindness. Only a few drugs are authorized so far for the treatment of dry eye disease and the possibilities of evolution in this sector are immense. Consequently, a significant number of new potential solutions are under development or placed in the pharmaceutical pipeline, promising better results and lesser side effects.Areas covered: In this article, the corresponding literature and recent Phase III clinical trial data and the corresponding literature, for dry eye disease treatment are reviewed, revealing the new strategic movements in drug pipelines.Expert opinion: From the clinical trial results, the advancement in tear substitutes and secretagogues in addressing specific deficiencies of tear components even though not resolving the underlying conditions of the disease is evident. The vast majority of new compounds under development are anti-inflammatories, steroids, non-steroids and antibiotics; however, there are also some novel lubricating drops and mucin-tear secretagogues. A future aggressive therapy for dry eye, depending on the severity of the symptoms, would include combinations of soft steroids, anti-inflammatories, such as cyclosporine A, with the addition of the new polyvalent mucin and tear secretagogues., Ministerio de Economía y Competitividad (MINECO), Ministerio de Salud, Servicios Sociales e Igualdad de España, Unidad Docente de Bioquímica y Biología Molecular, Fac. de Óptica y Optometría, TRUE, pub

En Open Access en la web del editor, Purpose. To analyze the levels of the diadenosine polyphosphates Ap4A and Ap5A in tears, in a set of control subjects and in groups of symptomatic and nonsymptomatic persons with dry eye. Methods. Ninety-seven subjects participated in the study. The subjects were divided into five experimental groups: control subjects; symptomatic patients with normal tear secretion; symptomatic patients with low tear secretion; forced blink; and corneal mechanical stimulation provided by a gas esthesiometer. The Schirmer I test was used to measure and collect tear secretions from each subject. All samples were processed by high pressure liquid chromatography (HPLC) and their Ap4A and Ap5A levels determined. Results. The levels of Ap4A and Ap5A in tears were greater in all symptomatic patients than in control subjects, especially in symptomatic subjects with low tear secretion. Within the symptomatic subjects with normal tear secretion, significant differences in concentrations of Ap4A and Ap5A were found between men and women. In the forced blink experiments, concentrations of the Ap4A and Ap5A rose with increasing blink frequency. When the cornea was mechanically stimulated, the levels of Ap4A and Ap5A rose significantly during both moderate and high-flow rate tests. Conclusions. The increased levels of Ap4A and Ap5A in tears of patients with dry eye allow these dinucleotides to be used as objective biomarkers in dry eye conditions., Ministerio de Industria y Comercio de España, Ministerio de Educación y Ciencia de España, Depto. de Optometría y Visión, Unidad Docente de Bioquímica y Biología Molecular, Fac. de Óptica y Optometría, TRUE, pub

Purpose: The present study aimed to determine the relationship of non-modifiable (rheumatoid arthritis, thyroid diseases, and arterial hypertension) and modifiable risk factors (diuretics, antidepressants, or anxiolytics tranquilizers) with the different Dry Eye Disease (DED) diagnostics in a sample adjusted by antihistamines intake. Methods: A total of 400 participants were included in a cross-sectional study. Before a dry eye examination, participants completed an online self-administered OSDI questionnaire with six additional questions about possible DED risk factors. The Tear Film and Ocular Surface Society Dry Eye Workshop II (TFOS DEWS-II) diagnostic criteria of DED was used. Based on signs and/or symptoms, participants were divided into 4 groups: No DED, Pre-clinical DED, Predisposition to DED and DED. Since the symptom scores would have been altered by the use of antihistamines, the analysis of each outcome was adjusted for this factor, where those participants were assumed to be symptomatic. Results: Multivariable logistic regression found thyroid disease as a possible risk factor for DED (OR 4.53, 95 % CI 1.04-19.73; Fisher's exact, p = 0.044; Crameŕs V = 0.140, p = 0.024). No association was found between the studied parameters and Pre-clinical DED (Fisher's exact, all p ≥ 0.398; Crameŕs V, all p ≥ 0.242) or Predisposition to DED (Fisher's exact, all p ≥ 0.065; Crameŕs V, all p ≥ 0.031). Conclusion: Participants with thyroid disease were more likely to develop DED, therefore, thyroid disease could be a risk factor for DED.

The windows to the soul are the eyes. Since the Vedic and Samhita  times, Ayurvedic ancient writings have discussed the eye and its  disorders, demonstrating the significance of the eye and ways to protect  it. Because of this, eye care has always been a top priority. Clinical  characteristics of Dry eye are frequently observed in Suskaksipaka in  Ayurveda. It's common to equate dry eyes to shushkakshipaka. However, a closer examination of the dry eye symptoms reveals two  Ayurvedic terms that are closely related to the illness. The first stage of  vartma roga (disease of the lid), which is defined as vata prakopa over  the surface structures of the eye due to a lack of snigdha bhava, either in  the form of abnormal aqueous or lipid component of tear film, which in  turn creates difficulty in opening the lids, pricking pain, and a gritty  feeling, is known as Krichronmeela. Shushkakshipaka, a sarvakshi disease, appears when pita becomes engaged in the pathophysiology and  samprapti deepens into the dhatus over the surface structures of the eye,  such as the conjunctiva and cornea.&nbsp

Several lifestyle choices made by contact lens wearers can have adverse consequences on ocular health. These include being non-adherent to contact lens care, sleeping in lenses, ill-advised purchasing options, not seeing an eyecare professional for regular aftercare visits, wearing lenses when feeling unwell, wearing lenses too soon after various forms of ophthalmic surgery, and wearing lenses when engaged in risky behaviors (e.g., when using tobacco, alcohol or recreational drugs). Those with a pre-existing compromised ocular surface may find that contact lens wear exacerbates ocular disease morbidity. Conversely, contact lenses may have various therapeutic benefits. The coronavirus disease-2019 (COVID-19) pandemic impinged upon the lifestyle of contact lens wearers, introducing challenges such as mask-associated dry eye, contact lens discomfort with increased use of digital devices, inadvertent exposure to hand sanitizers, and reduced use of lenses. Wearing contact lenses in challenging environments, such as in the presence of dust and noxious chemicals, or where there is the possibility of ocular trauma (e.g., sport or working with tools) can be problematic, although in some instances lenses can be protective. Contact lenses can be worn for sport, theatre, at high altitude, driving at night, in the military and in space, and special considerations are required when prescribing in such situations to ensure successful outcomes. A systematic review and meta-analysis, incorporated within the review, identified that the influence of lifestyle factors on soft contact lens dropout remains poorly understood, and is an area in need of further research. Overall, this report investigated lifestyle-related choices made by clinicians and contact lens wearers and discovered that when appropriate lifestyle choices are made, contact lens wear can enhance the quality of life of wearers.

The tear flm has an important role on the quality of the vision process and is of importance in the felds of ophthalmology and optometry. The lipid layer, the outermost part of the tear flm, can be investigated with the Langmuir technique, as well as the interaction of components of the aqueous part of the tear flm with those of the lipid layer. Dysfunctions in the stability and composition of the tear flm are the causes of eye diseases, as the dry eye syndrome. For the treatment of this disease, the artifcial tears are used, and one type of them are the lipid tears, which can be investigated with the Langmuir technique. This technique can also be used to investigate the infuence on the lipid layer of other artifcial tear components or medicines instilled in the eye. This review presents investigations where the Langmuir technique has been used in relation with the tear flm. In particular, the surface properties of natural tears and of four commercial lipid-containing artifcial tears have been reported and discussed in connection with their composition., Peer Reviewed, Postprint (published version)

Cyclosporine A (CsA) is used for the treatment of dry eye (DE) with good clinical results, improving tear secretion and decreasing subjective symptoms. These effects are attributed to the improved tear film dynamics, but there are no data on the effect of CsA on the abnormal sensory nerve activity characteristic in DE. Our purpose was to evaluate the CsA effect on the enhanced activity of corneal cold thermoreceptors in a tear-deficient DE animal model using in vitro extracellular recording of cold thermoreceptors nerve terminal impulses (NTIs) before and in the presence of CsA. NTI shape was also analyzed. Blinking frequency and tearing rate were also measured in awake animals before and after topical CsA. CsA increased the tearing and blinking of treated animals. CsA significantly decreased the peak response to cold of cold thermoreceptors. Neither their spontaneous NTIs discharge rate nor their cooling threshold were modified. CsA also seemed to reverse some of the changes in NTI shape induced by tear deficiency. These data suggest that, at least in part, the beneficial clinical effects of CsA in DE can be attributed to a direct effect on sensory nerve endings, although the precise mechanisms underlying this effect need further studies to be fully clarified.

Purpose: Anterior blepharitis is a frequent ocular condition which may result in severe ocular surface disease. In this study, advanced proteome analysis was performed to elucidate biological mechanisms underlying anterior blepharitis. Methods: All patients underwent full ophthalmological examination including Ocular Surface Disease Index score (OSDI). Measurement of non-invasive break-up time (NBUT), Oxford score, and meibography were performed. Tear film samples from treatment naïve patients with anterior blepharitis (n = 15) and age-matched controls (n = 11) were collected with Schirmer filtration paper. The samples were analyzed with label-free quantification nano liquid chromatography - tandem mass spectrometry (LFQ nLC-MS/MS). Significantly regulated proteins were identified with a permutation-based calculation with a false discovery rate at 0.05. Results: Among the 927 proteins detected, a total of 162 proteins were significantly changed. Regulated proteins were involved in cytoplasmic translation, positive regulation of B cell activation, complement activation and phagocytosis. High levels of plakin proteins, a group of proteins involved in cytoskeleton organization, were observed in anterior blepharitis, including plectin, desmoplakin, envoplakin, epiplakin, periplakin, and vimentin. The upregulation of plectin was confirmed with single reaction monitoring. Patients with anterior blepharitis had lower levels of immunoglobulin chains, VEGF coregulated chemokine 1 (CXCL17), and platelet-derived growth factor C. Conclusions: Anterior blepharitis was associated with a high level of plectin indicating a pronounced intracellular response with cytoskeletal reorganization. Our data suggest a lack of immunoglobulin chains and CXCL17 in anterior blepharitis with potential alterations in the ocular surface immune response.

Background. To validate the 17-item Computer Vision Symptom Scale questionnaire (CVSS17) in Italian. Methods. Cross-sectional validation study on video terminal (VDT) users and a reference sample of subjects not working at a VDT (control group), cognitively able to respond to a health status interview. The Italian self-administered version of the CVSS17 questionnaire was administered to all participants. The reliability and validity of the Italian translation of the CVSS17 were tested using standard statistical methods for questionnaire validation. The Rasch analysis was performed as well. Results. A total of 216 subjects were enrolled. Concerning the reliability, the Cronbach’s alpha coefficient was 0.925 (from 0.917 to 0.924), and the test–retest stability was 0.91 (<0.001). Concerning the validity, the control group had significantly better scores, and there were good correlations between responses to the CVSS17 and analogous domains of the GSS. Conclusion. The Italian version of the CVSS17 has shown psychometric properties comparable to those of the Spanish version, having good validity, discriminatory power, internal consistency and reliability. The questionnaire is a specific measure of vision-related quality of life in Italian-speaking VDT workers and can be used both in clinical practice and for research purposes., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Background: Ocular surface characteristics in children have not been as well investigated as in adults. Children’s digital device usage is rapidly increasing, and smartphones are the most commonly used device. The ocular surface impacts are unknown in children. In adults, use of digital devices induces ocular symptoms, adversely impacts blinking, and disrupts ocular surface homeostasis. Although blinking is integral to a healthy ocular surface, this is yet to be characterised in children, including the effects of digital devices. This thesis aims to characterise the ocular surface of children including blinking and to examine the impact of smartphone use on ocular surface homeostasis in children. Methods: The literature on ocular surface (symptoms, clinical indices, tear film function, blinking) of healthy children was reviewed and a meta-analysis of tear film stability and tear secretion was conducted. Cross-sectional studies of healthy school-aged children were conducted to examine the utility of commonly used adult-validated dry eye symptom questionnaires (SANDE, OSDI, NRS, OCI, DEQ-5, IOSS), and to characterise ocular surface clinical indices. This included blinking which was measured in situ using a novel eye tracking headset (Pupil Labs GmbH, Germany). The impact of one hour smartphone gaming on the ocular surface (including symptoms and blink parameters) of this paediatric population was examined with an intervention study. Blinking was also examined in situ under different conditions and tasks (reading from hard copy and on digital devices, conversation, walking) using the eye tracking headset in healthy adults. Repeatability of blink measurements (blink rate and interblink interval) in adults using the eye tracking headset was determined. Results: Ocular symptoms, tear film function and blinking were sparsely reported in children. The pooled mean by tear stability measurement methods in the meta-analysis were higher than previously reported in healthy adult

Background: Determine whether the presence of ocular symptoms in soft-contact-lens wearers changes depending on the refractive status. Methods: During the months of January to March 2022, the CLDEQ-8 questionnaire was administered to soft-contact-lens wearers. The statistical analysis was carried out using the SPSS 27.0 computer program (SPSS Inc., Chicago, IL, USA). Results: A total of 251 subjects participated in the study, with a higher percentage of myopes than hyperopes (82.1% versus 16.7%; p < 0.001). Out of all total participants, 21.5% suffered from dry-eye symptoms. It was noted that hyperopes presented a higher rate of dry-eye symptoms (p = 0.041). At the same time, the spherical equivalent was more positive in the participants with dry-eye symptoms (p = 0.014). Significant differences were found based on the symptoms present with contact lenses and the degree of myopia. The intensity of visual disturbances was higher in the participants with medium myopia (median [IQR]: 1/5 [2]) compared to those with low (median [IQR]: 0/5 [2]) and high myopia (median [IQR]: 0/5 [1]) (p = 0.009). Conclusions: Contact-lens wearers with hyperopia showed a higher rate of ocular dryness than those with myopia. In turn, wearing daily-replacement lenses could be one of the reasons for the lesser presence of ocular dryness compared to monthly-replacement lenses., Sección Deptal. de Óptica (Óptica), Fac. de Óptica y Optometría, TRUE, pub

This study was published in memory of Jesus Pintor, who passed away on 2 April 2019, Background: The purpose of this study was to synthesize melatonin-eluting contact lenses (CLs) and evaluate both the ocular kinetics of the released melatonin and its effect on tear volume and intraocular pressure. Methods: In vitro, melatonin-eluting CLs were synthesized by using non-functionalized (HEMA) and functionalized (HEMA/APMA) monomers. In vivo, a short-term prospective and randomized study was performed on 15 rabbits divided into two groups: 12 rabbits wearing functionalized CLs and 3 rabbits without CLs as a control. The melatonin levels in tears, aqueous humor, vitreous body and retina, tear volume, and intraocular pressure were measured for 8 h. Results: In vitro, both monomers did not show differences in terms of melatonin loading and release (p ≥ 0.05). In vivo, the melatonin concentration was elevated in tears and aqueous humor after 2 and 4 h of wearing CLs, respectively (p < 0.05). Additionally, the CLs increased tear volume for 2 h (p < 0.05). Conclusions: The melatonin-eluting CLs released their content over the ocular surface for at least 2 h, which was associated with a secretagogue effect on tear volume. However, the increased amount of melatonin found in the aqueous humor had no effect on intraocular pressure., European Union’s Horizon 2020 programe, Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Comunidad de Madrid, Universidad Complutense de Madrid, Ministerio de Sanidad (España), Unidad Docente de Bioquímica y Biología Molecular, Fac. de Óptica y Optometría, TRUE, pub

Ocular chronic graft-versus-host disease (cGVHD) has been shown to significantly reduce quality of life after allogeneic hematopoietic stem cell transplantation (HSCT). To learn more about this bothersome complication, we investigated the relationship between ocular cGVHD and cGVHD in other organs. We also investigated the associations between ocular cGVHD and overall mortality, nonrelapse mortality, and relapse. In this single-center study, we retrospectively included 1221 consecutive adults who underwent allogeneic HSCT. Patients were examined by an ophthalmologist before HSCT and annually for 5 years after HSCT or more frequently if needed. Patients with dry eye disease before HSCT were excluded. The International Chronic Ocular GVHD Consensus Group criteria were used to diagnose ocular cGVHD. Nonocular cGVHD was diagnosed using the National Institute of Health criteria. Out of 601 patients who were diagnosed with systemic cGVHD during follow-up, 279 (46%) developed ocular cGVHD. Ocular cGVHD was more frequent in patients with extensive cGVHD compared to those with limited cGVHD (50% versus 29%; P < .0001) and was associated with cGVHD in skin (P < .0001), oral cavity (P = .0024), genitals (P = .0023), and nails (P = .031). The frequency of ocular cGVHD was higher in patients with skin cGVHD with sclerosis compared to those with skin cGVHD without sclerosis (70% versus 49%; P = .0003). In an adjusted time-dependent Cox model, ocular cGVHD was associated with increased nonrelapse mortality (adjusted hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.17 to 2.21; P = .003), whereas there was no support for an association with relapse (adjusted HR, .85; 95% CI, .53 to 1.36; P = .5). Special attention to eye problems after HSCT should be given to patients with extensive cGVHD and cGVHD in ectodermal-derived organs (skin, mouth, nails, and genitals). Furthermore, ocular cGVHD is a potential risk factor for nonrelapse mortality.

Producción Científica, Ministerio de Ciencia, Innovación y Universidades (grants SAF-2016-77080-P, FPU17/02715 and FPU15/01443)

[EN] The Tear Film Lipid Layer (TFLL) acts primarily as an interface between the aqueous layer and air. Tear film lipid is composed of a thin layer of polar lipids that interact with the secretory layer of the underlying mucosa and a thicker layer of non-polar lipids at the air interface. The tear film has a complex structure and composition that protects the cornea, promotes wound healing, and maintains high-quality vision. Plasma Rich in Growth Factor (PRGF) eye drops emerged as an exciting new treatment for corneal epitheliopathies, including aqueous deficient dry eye. The purpose of this study was to compare the lipidomic profile of eye drops obtained from PRGF with tear lipidome to determine whether PRGF drops could be an adequate complement to tears in patients with impaired TFLL. To address this study, tears and blood was collected and processed from healthy donors to obtain PRGF eye drops. Samples were aliquoted and stored at -80°C until use. The lipid profiles of these samples were analysed by Ultrahigh Performance Liquid Chromatography (UHPLC) using a Vanquish UHPLC system to obtain untargeted lipidome profiles on a Q-Exactive HF-X hybrid quadrupole-Orbitrap mass spectrometer. In PRGF eye drops, 408 lipids were identified in ESI+mode and 183 in ESI- mode, and they were grouped into 15 different lipid classes from four distinct categories. By contrast, 112 lipid species were identified from tear samples in ESI+mode and 36 in ESI- mode, belonging to 12 lipid classes from six different categories. The relative abundance of most lipid species was much greater in the PRGF eye drops than in the tear, although there were some lipids present in tears that were not found in the PRGF, such as wax esters and (O-acyl)-omega-hydroxy fatty acids. In summary, these results suggest that the lipids present in PRGF eye drops could serve as a tear supplement in individuals in whom tear lipid composition is altered, although there are differences in the lipid profile of these

Hyperosmotic tear stimulates human corneal nerve endings, activates ocular immune response, and elicits dry-eye symptoms. A soft contact lens (SCL) covers the cornea preventing it from experiencing direct tear evaporation and the resulting blink-periodic salinity increases. For the cornea to experience hyperosmolarity due to tear evaporation, salt must transport across the SCL to the post-lens tear film (PoLTF) bathing the cornea. Consequently, limited salt transport across a SCL potentially protects the ocular surface from hyperosmotic tear. In addition, despite lens-wear discomfort sharing common sensations to dry eye, no correlation is available between measured tear hyperosmolarity and SCL-wear discomfort. Lack of documentation is likely because clinical measurements of tear osmolarity during lens wear do not interrogate the tear osmolarity of the PoLTF that actually overlays the cornea. Rather, tear osmolarity is clinically measured in the tear meniscus. For the first time, we mathematically quantify tear osmolarity in the PoLTF and show that it differs significantly from the clinically measured tear-meniscus osmolarity. We show further that aqueous-deficient dry eye and evaporative dry eye both exacerbate the hyperosmolarity of the PoLTF. Nevertheless, depending on lens salt-transport properties (i.e., diffusivity, partition coefficient, and thickness), a SCL can indeed protect against corneal hyperosmolarity by reducing PoLTF salinity to below that of the ocular surface during no-lens wear. Importantly, PoLTF osmolarity for dry-eye patients can be reduced to that of normal eyes with no-lens wear provided that the lens exhibits a low lens-salt diffusivity. Infrequent blinking increases PoLTF osmolarity consistent with lens-wear discomfort. Judicious design of SCL material salt-transport properties can ameliorate corneal hyperosmolarity. Our results confirm the importance of PoLTF osmolarity during SCL wear and indicate a possible relation between PoLTF osmolar

PrcisTracking failure frequency (TFF) increases with dry eye symptom severity and in the left eye.PurposeSymptoms of dry eye disease are commonly encountered in glaucoma patients and can be exacerbated by topical glaucoma medications. Dry eye disease may influence the reliability of visual field (VF) tests and impact the accurate interpretation of the results.Patients and methodsPatients at the Veterans Administration Medical Center San Diego completed the 5-item Dry Eye Questionnaire before VF testing between December 2018 and February 2019. VF reliability metrics were recorded for each patient. Standard reliability metrics included fixation losses, false positive, and false negative rates. Gaze tracking (GT) metrics included percent of stimuli with gaze deviations between 1 and 2 degrees, 3 and 5 degrees, 6 degrees or greater, and percent of stimuli with tracking failure (TFF). The use of glaucoma medications and artificial tears was also recorded.ResultsA total of 494 patients completed the 5-item Dry Eye Questionnaire and VF testing. There was no association between dry eye symptom severity and standard reliability metrics or most GT metrics. However, TFF increased as dry eye symptom severity increased (P=0.015). TFF was also greater in the left eye, which was tested second (P=0.012); no other reliability metrics were related to laterality. Patients were more likely to use artificial tears with increased dry eye symptom severity (P<0.001), but there was no relationship between symptom severity and glaucoma medication use.DiscussionDry eye symptom severity may influence the acceptable range or threshold of TFF when using GT metrics to determine VF reliability. Likewise, the acceptable range or threshold for TFF may be different between eyes.

Background: Ocular surface disease in glaucoma patients is a significant ocular co-morbidity that can affect 40% to 59% of these patients worldwide. The current study was aimed at evaluating the potential clinical benefit of an intense pulsed light (IPL)-based treatment in glaucomatous patients with ocular surface disease due to prolonged hypotensive eyedrop treatments. To our knowledge, this is the first series analyzing the therapeutic effect of this treatment option in this type of patients. Methods: This non-comparative prospective case series study enrolled a total of 30 glaucoma patients ranging in age from 57 to 94 years old and treated with hypotensive eyedrops for years with dry eye symptomatology. All patients received four sessions of IPL treatment using the Optima IPL system (Lumenis, Yokneam, Israel) adjusted to the official optimized Lumenis setting. Changes in symptomatology, corneal staining, conjunctival hyperemia, non-invasive break-up time (NIBUT), tear osmolarity, tear meniscus height (TMH), meiboscore and meibomian gland expressibility was analyzed after treatment. Results: Statistically significant reductions were observed after IPL treatment in the symptomatology scores measured with different questionnaires [ocular surface disease index (OSDI), standard patient evaluation of eye dryness (SPEED) and symptom assessment questionnaire in dry eye (SANDE)] as well as with the visual analogue scale (P < 0.001). Mean change in OSDI was − 15.0 ± 11.3. A significant reduction was found after treatment in the corneal staining score (P < 0.001). A significant reduction was found in tear film meniscus height (P = 0.012), as well as in tear film osmolarity (P = 0.001). A significant reduction was also found in meibomian gland expressibility (P = 0.003), changing the percentage of grade 3 eyes from 44.4% before IPL to 17.2% after treatment. Conclusions: IPL therapy combined with meibomian gland expression (MGX) seems to be an effective option to improve sym