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Purpose: To determine the prevalence of dry eye disease symptoms and contact lens wear in Mexican high school students. Methods: A cross-sectional association study included a group of high school students who were selected from a random sampling of classrooms. The authors used the Ocular Surface Disease Index (OSDI) questionnaire as a surrogate measure for dry eye disease symptoms, and contact lens wear was also investigated. Results: Seven hundred fifty-nine students with a mean age of 16.12 ± 0.96 years were surveyed and 55.7% of the students were girls (423 of 759). The average OSDI score was 25.11 ± 20.61 points. Girls had higher scores (28.25 ± 21.48 points) than boys (21.14 ± 18.74 points), and the difference was statistically significant ( P < .001). Forty-three students (6.1%) wore contact lenses and had higher OSDI scores (34.26 ± 23.13 and 24.51 ± 20.31 points, respectively) and the difference was also statistically significant ( P = .002). Conclusions: Symptoms of mild and moderate dry eye disease are prevalent in high school students and, as reported in previous studies, girls are more affected than boys. [ J Pediatr Ophthalmol Strabismus . 2021;58(5):287–291.]

We aimed to evaluate the characteristics and colonization by pathogenic microorganisms of the ocular surface in patients in a burn center and to determine their association with sedation, mechanical ventilation, and periocular burn. We prospectively evaluated 40 patients during an 8-mo period. Five evaluations where performed, at baseline and weekly on four more occasions or until hospital discharge or death. On each visit, we assessed periocular burn, lid position, Bell’s phenomenon, Schirmer’s test, presence of chemosis, conjunctival hyperemia, and exposure keratopathy; conjunctival fornix swabs were taken for microbiology culture. Also, we documented the level of sedation, mechanical ventilation status, and systemic and ocular treatment. Absent Bell’s phenomenon and chemosis were significantly different at baseline in patients under mechanical ventilation, sedation, and in those with a periocular burn. The cumulative incidence of exposure keratopathy was 22.5% and the cumulative incidence of ocular surface colonization by pathogenic microorganisms was 32.5%. Both outcomes were associated with mechanical ventilation and periocular burn. The most frequent pathogenic microorganisms on the ocular surface were Candida parapsilosis, Acinetobacter baumanii, and Pseudomonas aeuroginosa. We did not observe any case of a persistent epithelial defect, infectious keratitis, corneal perforation or corneal opacity in this cohort. Results from our study may benefit future patients by allowing better risk stratification and treatment strategies for the ocular surface care in burn units.

Purpose To present the process of cultural and psychometric adaptation, and clinical validation of a new version in the Spanish language of the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8). Materials and methods The translation-retro-translation method was applied to the CLDEQ-8 questionnaire. Two independent native Spanish-speaking translators adapted the questionnaire from English to Spanish, and then a committee of experienced clinicians (CE) evaluated the semantic equivalence and designed a Spanish version of the CLDEQ-8 questionnaire. The resulting translated version was tested conducting a pilot study in contact lens users and assessing their perception and overall understanding of the terminology. The results were analyzed and a final version was designed. The final version was retro-translated to English by a native English-speaking translator and compared with the original CLDEQ-8 version to confirm there were no meaningful differences. To clinically validate the new instrument, a prospective study was conducted to apply the new Spanish CLDEQ-8 to 50 contact lens users. Results Fifty patients were studied with an average age of 21.50 ± 1.66 years. The average CLDEQ-8 score was 13.28 ± 6.81 points (range 1–31). The internal consistency (Cronbach's alpha) was 0.89, with a corrected index of homogeneity >0.50 for all evaluated items. Conclusions The process of trans-cultural adaptation of the questionnaire CLDEQ-8 resulted in the elaboration of a reliable and much needed instrument capable of measuring frequency and intensity of dry eye symptoms in Spanish-speaking contact lens users.

ResumenObjetivoComparar los valores de grosor corneal central obtenidos mediante el tomógrafo de cámara de Scheimpflug con anillos de plácido (Sirius®), y la paquimetría ultrasónica; y conocer la repetibilidad intraobservador de ambos equipos.Material y métodosSe realizaron estudios de grosor corneal central con ambos equipos en 30 personas sanas. Para evaluar la repetibilidad, se realizaron 3 mediciones para cada individuo con cada equipo y se evaluó el coeficiente de variación, la desviación estándar y el coeficiente de correlación intraclase. Para conocer la concordancia entre ambos equipos, se calculó la diferencia de medias con la t de Student pareada y se realizaron gráficas de Bland y Altman.ResultadosPara el equipo Sirius®, el coeficiente de variación fue del 0.291% y para el paquímetro ultrasónico del 0.238%. La desviación estándar fue 0.123μm y 0.101μm para el Sirius® y el paquímetro ultrasónico respectivamente, y el coeficiente de correlación intraclase fue mayor de 0.95 en todas las mediciones. El paquímetro ultrasónico midió sistemáticamente valores más altos y estadísticamente significativos que el Sirius® (media 543.867 vs. 558.267μm, Sirius® y paquímetro ultrasónico respectivamente), sin embargo, esta diferencia no es clínicamente significativa.ConclusionesEn la evaluación de córneas normales, la medición del grosor corneal central con ambos equipos mostró una alta repetibilidad y adecuada concordancia. Aunque la medición del grosor corneal central fue sistemáticamente más baja con el Sirius® que con el paquímetro ultrasónico, esta diferencia carece de significación clínica.AbstractObjectiveTo assess the repeatability and comparability of the central corneal thickness measurements obtained from a novel Scheimpflug camera with a Placido-disc topographer (Sirius®) and ultrasound pachymetry.Material and methodsIn a sample of thirty unoperated eyes of healthy subjects, the central corneal thickness was analyzed by a single examiner using the Sirius® and the ultrasound pachymeter. Repeatability of three sets of measurements from each device were evaluated using the coefficient of variation, standard deviation, and intraclass correlation coefficient. T-test with Bonferroni adjustment and Bland and Altman plots were used to assess agreement between devices.ResultsFor the Sirius® the coefficient of variation was 0.291%, and for the ultrasound pachymeter was 0.238%. The standard deviation was 0.123μm and 0.101μm for Sirius® and US respectively and the intraclass correlation coefficient was higher than 0.95 in all measurements. Ultrasound pachymetry systematically yielded higher values and statistically significant (mean 543.867 vs 558.267μm Sirius® and ultrasound pachymeter respectively), but the difference was not clinically significant.ConclusionIn the assessment of normal corneas, central corneal thickness measured with both devices showed high repeatability and good agreement. Even though central corneal thickness measurements obtained by Sirius® were systematically lower than those obtained by ultrasound pachymeter, they do not have clinical significance.

ResumenObjetivoDescribir los diferentes hallazgos presentados por el síndrome de displasia ectodérmica, ectrodactilia y paladar hendido y proporcionar información que ayude a conocer qué cambios están relacionados con la displasia en sí y cuáles son secundarios.Reporte de casoSe revisaron a una madre e hija con diagnóstico sistémico de síndrome de displasia ectodérmica, ectrodactilia y paladar hendido, ambas presentaron una ausencia de los orificios de salida de las glándulas de Meibomio, ojo seco severo de predominio evaporativo, y además la madre presenta un leucoma corneal central con neovascularización superficial.ConclusionesEl síndrome de displasia ectodérmica, ectrodactilia y paladar hendido puede causar vascularización corneal secundaria a alteraciones crónicas de la superficie ocular, secundaria a la ausencia de los orificios de las glándulas de Meibomio con la consecuente deficiencia de la capa lipídica en la película lagrimal, la cicatrización conjuntival progresiva y la insuficiencia de células límbicas, con afectación de la agudeza visual usualmente en la etapa adulta.AbstractObjectiveDescribe the different findings presented by the ectodermal dysplasia, ectrodactyly and clefting syndrome and provide information to help you know what changes are related to the dysplasia itself and which are secondary.Case reportA mother and daughter with a diagnosis of ectodermal dysplasia, ectrodactyly and clefting syndrome was reviewed, both showed an absence of the ducts of Meibomian glands with a predominantly evaporative dry eye. In addition, the mother has a central leucoma with superficial vascularization.ConclusionsEctodermal dysplasia, ectrodactyly and clefting syndrome can cause corneal vascularization secondary to chronic alterations of the ocular surface associated to absence of Meibomian gland orifices with tear film lipid layer deficiency, cicatricial conjuntivitis, and limbal stem cell deficiency; causing decreased visual acuity in early adulthood.

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To evaluate the effects of oral antivirals in reducing the frequency of recurrence of HSV keratitis. Our main objective is to evaluate the prophylactic effect of oral antivirals on HSV deeper corneal involvement (i.e., necrotizing and non‐necrotizing stromal keratitis, endotheliitis, and iritis) because of its implications for visual impairment.

To assess the repeatability and comparability of six anterior segment biometry parameters obtained with a novel Scheimpflug camera with a Placido disc topographer (Sirius) and slit-scanning tomography with a Scheimpflug camera (Pentacam), in a sample of 16 unoperated eyes of healthy subjects. The anterior segment was analyzed by a single examiner using the Sirius and the Pentacam analyzers. Mean simulated keratometry (Sim K), flat and steep axis keratometry (K f and K s ), central and thinnest corneal thicknesses (CCT and TCT), and anterior chamber depth (ACD) measurements were evaluated. Repeatability of three sets of measurements from each device was assessed using the coefficient of variation (CV), within-subject standard deviation, and intraclass correlation coefficient (ICC). Bonferroni-adjusted t-tests, and Bland and Altman plots were used to establish agreement between devices. For both devices the CV of repeated measurements was 0.95 in all measurements except for Sirius K s (ICC = 0.869). For all parameters evaluated, the Pentacam systematically yielded higher values, although differences were statistically significant in only three parameters—0.31 diopters for K s , 10.1 μm for CCT and 12.4 μm for TCT. In the assessment of normal corneas both devices showed overall high repeatability. Although good agreement was found in three parameters (Sim K, K f and ACD) these devices do not seem to be interchangeable for pachymetric determination.

To determine if chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (HSCT) is associated with stable or progressive dry eye disease and to determine the true incidence in patients with no prior history of dry eye disease.A nonconcurrent cohort study at a single institution with 136 patients who had no previous history of dry eye disease before HSCT. Survival analysis was used to estimate dry eye disease incidence. The incidence rate was calculated using life tables as the number of observed dry eye disease cases divided by the person-time at risk accumulated by the cohort. Transition probabilities were calculated from time of transplant to time of diagnosis, and then to last recorded visit.Incidence rate was 0.8 cases of dry eye disease per person-year, and half of the population at risk developed dry eye disease during the first 10 months post transplant. Time to develop dry eye disease was 2.5 months for mild dry eye disease, 9.6 months for moderate dry eye disease, and 13.2 months for severe dry eye disease. In terms of cumulative incidence, 73% of subjects developed dry eye disease (50% mild, 16% moderate, and 7% severe) at the time of diagnosis.Our findings suggest that dry eye disease associated with cGVHD is an extremely frequent event and shows a wide spectrum of severity, with a mild form presenting early and a moderate to severe form presenting later after HSCT. These findings need to be studied further to elucidate if these are two different pathophysiological entities or just different expressions of the same pathology.

PURPOSE: To study the outcomes of cataract surgery in patients with graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (HSCT). METHODS: Retrospective review of 72 eyes of 41 patients (age, 17-69 years at the time of surgery) with chronic GVHD after HSCT, who underwent cataract surgery between 2008 and 2012 at the Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan. Ophthalmic data collected included best-corrected visual acuity (BCVA), responses to Ocular Surface Disease Index (OSDI) questionnaire, dry eye severity, and postoperative complications. RESULTS: BCVA improved from 20/49 to 20/25 (P < 0.0001) after surgery. Eight patients (20%) had pretransplantation total body irradiation and 39 patients (95%) received systemic corticosteroids for the treatment of GVHD. Postoperative complications included cystoid macular edema (4 eyes), corneal ulceration with perforation (2 eyes: 1 infected and 1 sterile), and band keratopathy (1 eye). After surgery, subjective OSDI responses and dry eye disease (DED) did not change significantly from before cataract surgery, although OSDI showed a trend toward worsening. CONCLUSIONS: With careful monitoring and management of DED and concurrent ocular surface disease, cataract surgery generally has good visual outcomes in patients with GVHD. However, aggravation of the preexisting ocular surface disease is frequent, and despite meticulous postoperative maintenance therapy, vision-threatening complications may occur.

We report the case of a 32-year-old male with spontaneous crystalline lens dislocation into the anterior chamber with corneal touch and increased intraocular pressure. The case was handled in a conservative way: before bringing the patient to supine position, pharmacological pupil dilation with tropicamide plus phenylephrine was performed. One drop was instilled every 15 min for 1 hour. Once the posterior displacement of the lens behind the iris was confirmed, 2 % pilocarpine was used to reverse pupil dilation. The patient remained on topical 2 % pilocarpine and 5 % sodium chloride solution.

ResumenObjetivoComparar los valores de la queratometría corneal central obtenidos mediante el tomógrafo de cámara de Scheimpflug con anillos de Plácido (Sirius®), el queratómetro manual tipo Bausch & Lomb® (MK1 Reichert®) y biómetro óptico IOLMaster®; y conocer la repetibilidad intraobservador de estos equipos.Material y métodosSe realizaron estudios de poder corneal central con 3 equipos en 30 personas sanas. Para evaluar la repetibilidad, se llevaron a cabo 3 mediciones para cada individuo con cada equipo y se evaluó el coeficiente de variación, la desviación estándar y el coeficiente de correlación intraclase. Para conocer la concordancia entre los equipos, se calculó la diferencia de medias con t de Student pareada y se realizaron gráficas de Bland y Altman.ResultadosTodos los equipos demostraron una alta reproducibilidad con coeficientes de variación menores al 0.30% para todas las mediciones (0.291 y 0.237%, 0.238 y 0.361%, 0.238 y 0.208% para la queratometría más plana y más curva del equipo Sirius®, queratómetro manual e IOLMaster® respectivamente) y un coeficiente de correlación intraclase mayor de 0.95 en todas las mediciones. El poder queratométrico más bajo fue del queratómetro manual (41.988 D QMP y 43.277 D QMC), seguido del Sirius® (42.285 D QMP y 43.510 D QMC) y finalmente el IOLMaster® (42.483 D QMP y 43.763 D QMC), con una diferencia estadísticamente significativa.ConclusionesPara la evaluación de córneas sin enfermedad, la medición del poder queratométrico corneal central con los 3 equipos mostró una alta repetibilidad, sin embargo no hubo una concordancia y la diferencia entre los equipos fue estadísticamente significativa.AbstractObjectiveTo assess the repeatability and comparability of the central keratometric power measurements obtained from a novel Scheimpflug camera with a Placido-disc topographer (Sirius®), manual keratometer and IOLMaster®.Material and methodsIn a sample of 30 unoperated eyes of healthy subjects, the central corneal power was analyzed by a single examiner using the Sirius®, the manual keratometer and the IOLMaster®. Repeatability of 3 sets of measurements from each device were evaluated using the coefficient of variation, standard deviation, and intraclass correlation coefficient. T-test with Bonferrioni adjustment and Bland and Altman plots were used to assess agreement between devices.ResultsAll instruments showed high reproducibility with coefficient of variation less than 0.30% for all measurements (0.291% and 0.237%, 0.238% and 0.361%, 0.238% and 0.208% for the flattest (FK) and steepest keratometry of Sirius®, manual keratometer and IOLMaster® respectively) and a higher intraclass correlation coefficient of 0.95 in all measurements. The manual keratometer has the lowest keratometric power (FK 41,988 and SK 43,277 D), followed by Sirius® (FK 42.285 D and SK 43.510 D) and finally the IOLMaster® (FK 42.483 D and SK 43.763 D), with a statistically significant differences.ConclusionIn the assessment of normal corneas, central corneal power measured with this 3 devices showed high repeatability however there was no agreement between the equipments and the differences were statistically significant.