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Dry eye is a common, painful ocular disturbance that can result from systemic inflammatory diseases, localized eye problems, or commonly used medications. Current treatments address symptoms, but advances in understanding tear-film function may lead to new approaches.

Abstract Objectives To explore the clinical efficacy and safety of orthokeratology lenses combined with atropine eye drops of different concentrations in delaying the progression of low to moderate myopia in children and adolescents. Methods 150 myopic children who wore orthokeratology lenses at Henan Provincial Eye Hospital were selected and divided into three groups: 0.04% Atropine eye drops + orthokeratology lens set group (0.04ACO), 0.02% Atropine eye drops + orthokeratology lens set group (0.02ACO), 0.01% Atropine eye drops + orthokeratology lens set group (0.01ACO). After one year treatment, all patients stopped wearing orthokeratology lenses. The axial length (AL), pupil diameter, spherical equivalent (SER) and adverse drug reactions were compared. Results The SER of the subjects increased. The 0.04ACO group increased by (-0.03 ± 0.10) D. The 0.02ACO and 0.01ACO group increased by (-0.11 ± 0.10) D and (-0.29 ± 0.18) D respectively. The axial changes of the eyes in three groups of patients were 0.05 ± 0.07 mm in the 0.04ACO group, 0.09 ± 0.08 mm in the 0.02ACO group, and 0.18 ± 0.07 mm in the 0.01ACO group. After treatment, the diameters of the bright pupils (illuminance 329 ± 10LUX) were larger than those before treatment. Among the 18 patients with rapid progression, 66.67% were in a state of anxiety. Conclusion Orthokeratology lenses combined with atropine eye drops of different concentrations can synergistically delay the development of low to moderate myopia in children and adolescents. However, the combined use of 0.04% atropine eye drops has a better control effect. Acknowledgments This study was supported by project of Henan Province Medical Science and Technology Research and Development Program (No. LHGJ20220092), Leading Talents of Zhongyuan Science and Technology (No.224200510013), Natural Science Foundation of Henan Province (No.252300421269) and The Basic Research Project of Henan Eye Institute (No.20JCZD001).

Dry eye affects millions of individuals. In experimental models, dry eye disease is associated with T helper cell 17-mediated inflammation of the ocular surface that may cause persistent damage to the corneal epithelium. However, the initiating and perpetuating factors associated with chronic inflammation of the ocular surface remain unclear. The ocular microbiota alters ocular surface inflammation and may influence dry eye disease development and progression. Here, we collected serial samples of tears on awakening from sleep, closed eye tears, during a randomized clinical trial of a non-pharmaceutical dry eye therapy and used 16S rRNA metabarcoding to characterize the microbiome. We show the closed dry eye microbiome is distinct from the healthy closed eye microbiome, and that the microbiome remains distinct despite daily saline eye wash upon awakening. The ocular microbiome was described only recently, and this report implicates a distinct microbiome in ocular disease development. Our findings suggest an interplay between microbial commensals and inflammation on the ocular surface. This information may inform future studies of the pathophysiological mechanisms of dry eye disease.

To evaluate the incidence and severity pattern of dry eye after phacoemulsification. King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Prospective descriptive study. Samples were collected from ninety-two uncomplicated cataract patients who were 18 years old or older. Dry eye incidence and pattern were analyzed at days 0, 7, 30 and 90 after phacoemulsification using (1) Ocular Surface Disease Index (OSDI) questionnaire, (2) tear break up time (TBUT), (3) Oxford ocular surface staining system, and (4) Schirmer I test without anesthesia. Seven days after phacoemulsification, the incidence of dry eye was 9.8% (95% confidence interval; 3.6-16.0%). The severity of dry eye peaked seven days post-phacoemulsification and was measured by OSDI questionnaire and all three clinical tests. Within thirty days and 3 months post-surgery, both the symptoms and signs showed rapid and gradual improvements, respectively. However, dry eye post-phacoemulsification was not significantly associated with sex and systemic hypertension (P = 0.26, 0.17 and 0.73, respectively). The incidence of dry eye after phacoemulsification was 9.8%. Symptoms and signs of dry eye occurred as early as seven days post-phacoemulsification and the severity pattern improved over time. We recommend that ophthalmologists should evaluate patients both before and after phacoemulsification to prevent further damage to the ocular surface and able to manage the patient promptly and effectively so the patient will not have a poor quality of life and vision due to dry eye syndrome.

The precorneal tear film is maintained by blinking and exhibits different phases in the tear cycle. The tear film serves as the most anterior surface of the eye and plays an important role as a first refractive component of the eye. Alterations in tear film dynamics may cause both vision-related and ocular surface-related symptoms. Although the optical quality associated with the tear film dynamics previously received little attention, objective measurements of optical quality using wavefront sensors have enabled us to quantify optical aberrations induced by the tear film. This has provided an objective method for assessing reduced optical quality in dry eye; thus, visual disturbances were included in the definition of dry eye disease in the 2007 Dry Eye Workshop report. In addition, sequential measurements of wavefront aberrations have provided us with valuable insights into the dynamic optical changes associated with tear film dynamics. This review will focus on the current knowledge of the mechanisms of wavefront variations that are caused by different aspects of tear film dynamics: specifically, quality, quantity and properties of the tear film, demonstrating the respective effects of dry eye, epiphora and instillation of eye drops on the quality of vision.

Understanding the symptomatic dry eye disease (DED) and its associated risk factors among contact lens wearers is crucial for clinicians to tailor effective interventions, enhance patient care, and prevent contact lens dropout. This study investigated symptomatic DED and its associated risk factors among a sample of contact lens wearers in Jordan. This cross-sectional study assessed symptomatic DED in a cohort of contact lens wearers in Jordan using an online survey distributed across various social media platforms. A total of 301 participants completed the survey, which included demographic and contact lens profile questions and the Arabic version of the Ocular Surface Disease Index (ARB-OSDI) questionnaire. Statistical analyses explored the associations between OSDI scores, demographics, symptoms, visual-related functions affected by dryness, and triggers of dryness. Among the study population, 77.1% were females, 48.2% were aged 18–24 years old, and 24.87% were soft contact lens wearers. The mean OSDI score was 22.9 ± 17, with 70% showing mild-to-severe dry symptoms and 25% showing severe symptomatic DED. The ANOVA revealed a significant association between symptomatic DED, wearing face masks, longer contact lens age, and poor cleaning habits. The use of lubricant eye drops significantly reduced symptomatic DED with a mean OSDI score of 8.79. The most prevalent dryness symptoms were pain and blurred vision, affecting reading and TV watching in 50% of the population. Wind and air conditioning were the most common environmental triggers, reported by 67.8% and 66.4% of participants, respectively. A high proportion of symptomatic DED was reported in this study population. Wearing face masks, a longer contact lens age, and poor contact lens hygiene were correlated with exaggerated DED symptoms. Conversely, the use of lubricated eye drops reduces the symptoms of DED.

Lifitegrast ophthalmic solution 5% (Xiidra) is labeled for the treatment of dry eye disease, also known as keratoconjunctivitis sicca.1 It is an inhibitor of the lymphocyte function-associated antigen 1 (LFA-1) and has been shown to reduce immune-mediated inflammation.1 Drug Dosage Dose form Cost* Lifitegrast ophthalmic solution 5% (Xiidra) One drop in each eye every 12 hours Single-use ampule of 5% solution $527 *-Estimated retail price of one month's treatment based on information obtained at http://www.goodrx.com (accessed June 4, 2018). Safety No serious adverse effects have been reported with the use of lifitegrast in clinical trials of up to one year in duration.2 Lifitegrast is not systemically detectable despite long-term administration, making systemic effects unlikely.1,2 The medication has not been studied in women who are pregnant or breastfeeding, children, or adolescents.1 Tolerability Approximately one in eight patients will discontinue lifitegrast therapy because of adverse effects.2 The most common adverse effects are altered taste (16.2%), eye irritation or burning (15%), and visual acuity reduction (11.4%).2 Effectiveness Lifitegrast has been evaluated in four 12-week randomized controlled trials involving a total of 2,132 patients.3 Patients receiving lifitegrast initially had moderate symptoms, an average score of 40 to 70 on a scale of 0 to 100, and some corneal lesions on fluorescein stain.3 Patients who received lifitegrast experienced a small reduction in symptoms (an average of 14 to 38 points), although these scores were only five to 12 points better than with placebo.3 Corneal lesions improved at a rate similar to that of placebo. Bottom Line Studies have shown that lifitegrast will reduce the symptoms of dry eye disease in some patients, although the benefit is borderline clinically significant.

Purpose Atropine eye drops prevent the progression of myopia, but their use has not been tested in the Japanese schoolchildren population. Here, we evaluate the efficacy and safety of 0.01% atropine eye drops for myopia control in Japanese children. Study design Multicenter (7 university hospitals), randomized, double-masked, placebo-controlled trial. Methods Participants were 171 Japanese schoolchildren aged 6 to 12 years, with progressive myopia, spherical equivalence (SE) of −1.00 to −6.00 diopters (D), and astigmatism of ≤1.5 D. They were randomized to receive either 0.01% atropine ( n =85) or placebo ( n =86) eye drops once nightly OU for 24 months. Primary and secondary efficacy endpoints were changes in SE and axial length (AL), respectively, from baseline to month 24. Results Data from 168 subjects were analyzed. At month 24, compliance was similar in both groups (atropine: 83.3%; placebo: 85.7%). The least squares mean change in SE and AL from baseline were, respectively, −1.26 D (95% confidence interval [CI]: −1.35, −1.17) and 0.63 mm (0.59, 0.67) for atropine and −1.48 D (− 1.57, −1.39) and 0.77 mm (0.73, 0.81) for placebo. Inter-group differences were 0.22 D (95% CI: 0.09, 0.35; P  < 0.001) for SE and − 0.14 mm (−0.20, −0.08; P  < 0.001) for AL. Three patients experienced mild allergic conjunctivitis side effects, with no inter-group difference in incidence (atropine: 2.4%; 2/84 patients; placebo: 1.4%; 1/84 patients). Conclusion With good compliance, 0.01% atropine is effective and safe for preventing the progression of childhood myopia.

Human umbilical cord blood (HUCB) serum eye drops contain growth factors, neurotrophic agents, and antimicrobial compounds that may promote ocular surface healing and regeneration. Sjögren's syndrome is a chronic autoimmune condition characterized by reduced tear production and ocular surface damage, often resulting in severe dry eye symptoms. Mustard gas chemical veterans also suffer from similar debilitating ocular complications due to chronic inflammation and meibomian gland dysfunction. While conventional treatments offer symptomatic relief, they lack essential components of natural tears. This pilot randomized controlled trial will evaluate the efficacy of HUCB eye drops in three patient groups: (A) Sjögren's patients treated with HUCB drops, (B) Sjögren's patients receiving conventional treatment, and (C) mustard gas veterans receiving conventional treatment in the right eye and HUCB drops in the left eye. Patients will be assessed using subjective and objective tools, including the Ocular Surface Disease Index (OSDI), visual acuity, tear film breakup time (TBUT), SM tube test, and fluorescein staining based on SICCA criteria. Group allocation will follow a blocked randomization sequence for groups A and B; group C will follow a within-subject paired-eye design. Follow-up will occur at 30 and 60 days. This study aims to assess the regenerative potential of HUCB serum in patients with autoimmune and chemically induced dry eye. Its results may support broader clinical use of HUCB drops in treating severe ocular surface disorders, including conditions like Stevens-Johnson syndrome and industrial chemical exposures. This trial was registered at the Iranian Registry of Clinical Trials (Registration number: IRCT20230925059512N1, Registration date: 2024-08-11).

Dry eye disease (DED) is a multifactorial and highly prevalent disorder of the ocular surface, characterized by tear film instability, ocular discomfort, inflammation, and visual fluctuation [...].Dry eye disease (DED) is a multifactorial and highly prevalent disorder of the ocular surface, characterized by tear film instability, ocular discomfort, inflammation, and visual fluctuation [...].