bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study of dry eye disease in type 2 diabetes mellitus and its association with diabetic retinopathy in Western India
Authors: Mansuri Farhad , Bhole Pradnya K , Parmar Dipali 
Published: April 2023

Purpose:
The study was conducted to evaluate occurrence of dry eye disease (DED) in type 2 diabetes mellitus (DM) and its association with diabetic retinopathy (DR) in the affected patients in western India.

Methods:
One hundred and five type 2 diabetic patients referred to a tertiary eye care center were consecutively selected. A detailed systemic history was evaluated. DED was assessed by Ocular Surface Disease Index questionnaire, Schirmer’s test, tear breakup time (TBUT), and fluorescein staining of cornea and conjunctiva, graded according to the National Eye Institute workshop grading. All patients underwent detailed fundus evaluation and DR, if present, was graded according to Early Treatment Diabetic Retinopathy (ETDRS) criteria.

Results:
Prevalence of DED in type 2 diabetics was 43.81% (92/210 eyes). The prevalence and severity of DED was found to be more in patients having higher glycosylated hemoglobin levels (P < 0.0001). Prevalence of DED was found to be high in those not taking any treatment (P < 0.0001). A statistically significant association was found between duration of DM and presence of DED (P = 0.02). Among the patients with DED, a majority had proliferative diabetic retinopathy (PDR; 57/92 eyes, 61.96%).

Conclusion:
The study highlights a significant correlation between DED and DM, and hence, examination for DED with fundus examination should be an integral part of the assessment of type 2 diabetics.
A comparative study to evaluate the effect of various postoperative treatment protocols on dry eye and patient satisfaction after phacoemulsification
Authors: Bharucha Khurshed , Zanzarukiya Jatin , Hegade Atul , Deshpande Rahul , Shetty Rakesh , Deshpande Madan 
Published: April 2023

Purpose:
Foreign body sensation and irritation are common after cataract surgery, as is the exacerbation of dry eye disease if present. This study compared postoperative dry eye treatments and patient satisfaction.

Methods:
Age-related cataract patients undergoing phacoemulsification were recruited and were divided randomly into 4 postoperative treatment groups: Group A: Antibiotic + Steroids; Group B: Antibiotic + Steroids + Mydriatic; Group C: Antibiotic + Steroids + Mydriatic + Non-steroidal Ant-inflammatory drugs (NSAIDs); Group D: Antibiotic + Steroids + Mydriatic + NSAID + Tear substitute. Patients were assessed at 1, 3, and 5 weeks post-operatively for uncorrected distance and near vision, best corrected visual acuity (BCVA) for distance and near, Schirmer’s-1 test, and Tear Film Break-Up Time test. At each visit, patients were assessed for dry eye-related subjective parameters using Ocular Surface Disease Index questionnaire.

Results:
Study participants numbered 163. (87 male and 76 female patients). No statistically significant difference was present in visual acuity for near and distance. The mean values of Schirmer’s test and TFBUT were better in group D patients at each postoperative visit, with significant differences noted in comparison with other groups. The patient response to pain and dry eye symptoms was superior in groups C and D, with group D producing the best results. Compared to group A, patients in groups C and D were more satisfied with their vision and surgery.

Conclusion:
The addition of tear substitutes to steroids and NSAIDs has been associated with decreased dry eye-related symptoms and a better subjective feeling of vision, although no significant difference was noted in vision measured objectively.
A study on correlation of computer vision syndrome and dry eye disease and knowledge regarding its associated factors amongst health professionals
Authors: Patel Haji , Jain Rashmi , Kamath M Atul , Bappal Anupama 
Published: April 2023

Purpose:
To know the magnitude and determinants of dry eye syndrome among health professionals and to study the correlation of computer vision syndrome with dry eye disease.

Methods:
In total, 501 participants took part in the study, which included history followed by baseline ocular examination, which included visual acuity using Snellen’s chart and anterior segment examination using a slit lamp. Later, a questionnaire was administered to health professionals to be filled out for analysis in the present study.

Results:
The symptoms reported occasionally were burning (35.5%), itching (34.5%), foreign body sensation 22.6%, and tearing (35.3%). The majority of participants used mobiles and laptops (56.1%) as a display. Also, 53.3% of participants have heard about dry eye syndrome, and the source of information was from friends and doctors in 17% of participants. One hundred twenty-one participants (24.2%) had taken the consultation for ocular symptoms. Eighty-six participants had mild, 29 participants had moderate, and 6 participants had severe dry eye disease, respectively.

Conclusion:
The pandemic effect, and the drastic shift of educational media from the classroom to the digital platform have increased the use of mobiles, laptops, or other digital pads for learning. This has increased the risk for health professionals.
Dry eye among medical students before and during COVID-19
Authors: Lulla Nandini H , Loganathan M , Balan Madhu V G , Swathi S 
Published: April 2023

Purpose:
Dry eye is a multifactorial disease of the ocular surface. It showed an increased incidence during the pandemic situation, which may be due to long hours of exposure to electronic gadgets. We aimed to find the prevalence of dry eye disease among medical students during the coronavirus disease 2019 (COVID-19) pandemic and pre-pandemic periods.

Methods:
This was a cross-sectional study conducted in a tertiary care teaching institute. This was an institution-based, cross-sectional study conducted among medical students. A modified Ocular Surface Disease Index (OSDI) questionnaire was used to find the severity and prevalence of dry eye disease. Considering 95% confidence interval (CI) and prevalence as 50%, the calculated sample size was 271. Online responses were collected and entered in an Excel sheet. The Chi-square test, univariate and multivariate logistic regression were used for statistical analysis.

Results:
Data were collected from 271 medical students; the prevalence of dry eye disease was 41.5 and 55.19 during the pre-pandemic and pandemic periods, respectively. There was a significant rise in dry eye disease cases during the pandemic when compared to pre-pandemic period (P < 0.05). The odds of getting dry eye disease were 1.7 times more during the pandemic than pre-pandemic.

Conclusion:
The lockdown situation during the pandemic forced people to use electronic gadgets for work, recreation, and academics. Prolonged screen time predisposes to the development of dry eye disease.
Omega-3 fatty acids supplements for dry eye - Are they effective or ineffective?
Authors: Bhargava Rahul , Pandey Kankambari , Ranjan Somesh , Mehta Bhavya , Malik Anu 
Published: April 2023

Purpose:
To evaluate effectiveness of omega-3 fatty acid supplements in relieving dry eye symptoms and signs in symptomatic visual display terminal users (VDT).

Methods:
A randomized controlled study was done; eyes of 470 VDT users were randomized to receive four capsules twice daily for 6 months (O3FAgroup), each containing 180 mg of eicosapentaenoic acid and 120 mg docosahexaenoic acid. The O3FA group was compared with another group (n = 480) who received four capsules of a placebo (olive oil) twice daily. Patients were evaluated at baseline, 1, 3, and 6 months, respectively. The primary outcome was improvement in omega-3 index (a measure of EPA and DHA ratio in RBC membrane). Secondary outcomes were improvement dry eye symptoms, Nelson grade on conjunctival impression cytology, Schirmer test values, tear film breakup time (TBUT), and tear film osmolarity. Means of groups (pre-treatment, 1, 3, and 6-months) were compared with repeated measure analysis of variance.

Results:
At baseline, 81% patients had low omega-3 index. In the O3FA group, a significant increase in omega-3 index, improvement in symptoms, reduction in tear film osmolarity, and increase in Schirmer, TBUT, and goblet cell density was observed. These changes were not significant in the placebo group. Improvement in test parameters was significantly (P < 0.001) better in patients with low omega3 index (<4%) subgroup.

Conclusion:
Dietary omega-3 fatty acids are effective for dry eye in VDT users; omega-3 index appears to be the predictor to identify potential dry eye patients who are likely to benefit from oral omega-3 dietary intervention.
Assessment of prevalence of dry eye among medical students using ocular surface disease index questionnaire – Is COVID-19 to be really blamed?
Authors: Aberame AR , Bhandary Sulatha V , Rao Lavanya G , Gupta Chandni 
Published: April 2023

Purpose:
An undergraduate research conducted during the pre-covid times, to highlight the importance of screen time and its association with dry eye in medical students. The aim was to study the prevalence of dry eye among medical students using the ocular surface index (OSDI) questionnaire.

Methods:
This was a cross-sectional study. This study was conducted among medical students using an OSDI questionnaire in the pre-covid times. Based on the pilot study, the minimum sample size calculated was 245. A total of 310 medical students participated in the study. These medical students answered the OSDI questionnaire. The OSDI score was used to categorize students with dry eye as mild (13–22 points), moderate (23–32 points), and severe (33–100 points). In addition, the associations between the OSDI score and possible risk factors such as gender, contact lens/spectacle wear, laptop/mobile usage, and duration of exposure to air conditioners were also studied.

Results:
The analysis of the study revealed that out of 310 students, dry eye was seen in 143 (46.1%) and severe dry eyes were seen in 50 (16.1%). A high OSDI score (>13 points) was associated with the usage of a laptop/mobile for more than 6 h in 40 (52.6%) (P < 0.001).

Conclusion:
The prevalence of dry eye among medical students was 46.1% in the present study. Longer duration of usage of visual display units (laptop/mobile) was the only factor that showed a statistically significant association with dry eye in our study.
Tear film dysfunction after clear corneal phacoemulsification in diabetics and non-diabetics
Authors: Momin Aseera A , Nikose Archana S , Thakre Uttkarsha D 
Published: April 2023

Purpose:
A prospective cohort study was conducted in a tertiary eye care centre to study the incidence of tear film dysfunction and its recovery in diabetics and non-diabetics after clear corneal phacoemulsification.

Methods:
A total of 50 diabetics and 50 non-diabetics underwent clear corneal phacoemuslfication. Schirmer’s I test (SIT), tear film break-up time (TBUT), corneal staining, tear meniscus height (TMH), and ocular surface disease index (OSDI) assessment were done preoperatively, postoperatively at 7 days, 1 month, and 3 months in both groups to assess tear film function.

Results:
Both groups showed decreased SIT and TBUT values on postoperative Day 7, after which they gradually improved. SIT and TBUT values in diabetics were significantly lower than that in non-diabetics postoperatively (P < 0.001). SIT in non-diabetics reached baseline levels at postoperative 3 months. OSDI scores reached peak levels in both groups on postoperative Day 7, but were higher in diabetics than non-diabetics (P < 0.001). OSDI scores gradually improved over 3 months but remained over baseline levels in both groups. Corneal staining was positive in 22% diabetics and 8% non-diabetics at postoperative Day 7. However, none of the patients had corneal staining at 3 months. Tear meniscus height (TMH) did not reveal any significant difference between the two groups at any time interval.

Conclusion:
We concluded that tear film dysfunction after clear corneal incision occurs in both groups, but is more severe and recovers more slowly in diabetics than non-diabetics.
Evaluation of post-operative dry eye in upper and lower eyelid reconstruction: A cross-sectional study
Authors: Ganguly Purban , Bhunia Jit , Das Kalishankar , Ghosh Asim K , Chatterjee Sumana , Chatterjee Debadyuti , Bhutia Dichen W , Ray Angana S , Ayub Asif 
Published: April 2023

Purpose:
In cases of eyelid malignancies requiring full thickness excisional biopsy followed by reconstruction of the created defect, the Meibomian glands are lost. Post-operative varying degrees of dry eye disease (DED) are expected in such patients. The aim was to evaluate the objective and subjective statuses of DED in cases of full thickness eyelid reconstruction following excisional biopsy because of malignancies.

Methods:
This was a cross-sectional pilot study. Objective and subjective dry eye parameters are assessed in cases of full thickness eyelid reconstruction following excisional biopsy because of malignancies in 37 eyes at 6 months post-operative follow-up. Analysis of variance and Chi square test were used for statistical analysis.

Results:
When compared with fellow eye, all the parameters were found to be statistically significant (P < 0.0). Subjective assessment of dry eye by ocular surface disease index (OSDI) scoring did not corroborate with the objective data (p 0.00). Lower eyelid reconstruction showed a minimum number of dry eye cases (P > 0.05).

Conclusion:
Prevalence of post-operative dry eye is more with increasing percentage of full thickness upper eyelid reconstruction. Disparity was found between objective and subjective parameters of dry eye in patients requiring varying percentages of upper eyelid reconstruction because of malignancies.
Study of tear function before and after laser-assisted in-situ keratomileusis
Authors: Singh Smita , Shukla Ajay K , Garkal Priyanka , Yadav Vinita 
Published: April 2023

Purpose:
This work assesses the change in tear function after LASIK surgery.

Methods:
This prospective, observational study was conducted in the Refractive Clinic of a tertiary care rural hospital. Tear dysfunction symptoms and the tear function tests were assessed in 269 eyes of 134 patients, OSDI score was used to document the tear dysfunction symptoms. Tear function was assessed by tear meniscus height, tear film break-up time (TBUT), Lissamine green staining, corneal fluorescein staining, Schirmer test 1 without anesthesia before and at 4–6 weeks and 10–12 weeks after LASIK surgery.

Results:
Preoperatively OSDI score was 8.54 ± 7.71. It increased to 15.11 ± 9.18 postoperatively at 4–6 weeks after LASIK surgery and 13 ± 9.56 at 10–12 weeks after LASIK surgery Mean TBUT preoperatively was 7.82 ± 3.57 sec which decreased to 5.34 ± 2.56 sec at 4–6 weeks and to 4.53 ± 2.63 sec at 10–12 weeks postoperatively. The number of eyes with clear secretion decreased from 40.5% preoperatively to 23.4% at 4–6 weeks and to 22.3% at 10–12 weeks postoperatively, whereas the granular and cloudy secretions increased significantly in eyes after LASIK surgery. The prevalence of eyes with Lissamine green score >3 (dry eye) increased from 17.1% preoperatively to 27.9% at 4–6 weeks and to 30.5% at 10–12 weeks. Similarly, the number of eyes showing positive fluorescein corneal staining increased from 5.6% preoperatively to 19% postoperatively at 4–6 weeks. Mean Schirmer score was 28.83 ± 6.39 mm preoperatively, 22.47 ± 5.38 mm at 4–6 weeks, and 21.27 ± 4.99 mm at 10–12 weeks after LASIK surgery.

Conclusion:
The prevalence of dry eye increased after LASIK as was assessed by an increase in the tear dysfunction symptoms using OSDI score and the deranged values of various tear function tests after LASIK surgery.
A randomized controlled study evaluating outcomes of intense pulsed light and low-level light therapy for treating meibomian gland dysfunction and evaporative dry eye
Authors: D’Souza Sharon , James Edwin , Koul Ameeta , Modak Durgalaxmi , Kundu Gairik , Shetty Rohit 
Published: April 2023

Purpose:
This randomized, controlled, blinded study evaluates the efficacy of intense pulsed light (IPL) therapy with low-level light therapy (LLLT) in the treatment of meibomian gland dysfunction (MGD) and evaporative dry eye (EDE) compared to a control group.

Methods:
Hundred patients with MGD and EDE were randomized into control (50 subjects, 100 eyes) and study group (50 subjects, 100 eyes). The study group underwent three sittings of IPL with LLLT 15 days apart and were followed up 1 month and 2 months after the last treatment sitting. The control group underwent sham treatment and was followed up at the same intervals. The patients were evaluated at baseline and 1 month and 3 months (post 1st treatment) for dry eye. Schirmer’s test and tear breakup time (TBUT), OSDI, meibomian gland expression, and meibography.

Results:
The study group showed significant improvement in OSDI scores (P < 0.0001) compared to the control group and a significant improvement in TBUT (P < 0.005) compared to the control group. There was no change in schirmer’s test and an improvement in the meibomian gland expression but not significant.

Conclusion:
The results show that a combined therapy of IPL with LLT is effective in treating MGD with EDE compared to controls, and repeated treatment sessions have a cumulative effect on the disease outcomes.
Study of correlation between vitamin D3 levels and dry eye
Authors: Bhatt Rupal B , Patel Naitik H , Shah Abhishek T , Ranpara Kaushambi H 
Published: April 2023

Purpose:
Dry eye is a prevalent disorder of tear film resulting from either decreased tear production or increased tear evaporation. It is becoming a serious issue due to its disturbing symptoms, which become progressively troublesome affecting the work efficiency of patients and increasing financial burden due to lifelong dependency on eye drops. If not detected early, it can lead to sight-threatening complications. This study aims to explore serum vitamin D3 deficiency as a causative factor of dry eye.

Methods:
The study was conducted in the outpatient department of a tertiary care hospital in India, for a period of two years from September 2018 to September 2020. About 40 patients who had dry eye and 20 controls were enrolled in this study. They were given an Ocular Surface Disease Index (OSDI) questionnaire, examined for signs of dry eye on slit lamp with Schirmer’s test and tear film break-up time. All 60 participants were subjected to serum vitamin D3 level laboratory test and its deficiency prevalence was correlated with dry eye and its severity.

Results:
Serum vitamin D3 deficiency was found to be more prevalent in patients with dry eye. There was no gender predilection or change in prevalence with increasing age. Vitamin D3 level was negatively correlated with OSDI and positively with Schirmer’s test 1 and 2 and tear film break-up time (TBUT) scores.

Conclusion:
The prevalence of vitamin D3 deficiency was not consistently found to be associated with the increasing severity of dry eye.
Effect of maqui-berry extract in dry eye disease – A clinical and molecular analysis
Authors: Kundu Gairik , Shetty Rohit , D’Souza Sharon , Gorimanipalli Bhavya , Koul Ameeta , Sethu Swaminathan 
Published: April 2023

Purpose:
This study aims to investigate the effects of maqui-berry extract (MBE) in improving signs and symptoms of dry eye disease (DED) along with ocular surface inflammation in patients with DED.

Methods:
Twenty patients were randomly assigned to a MBE or a placebo group (PLC). DED parameters including Schirmer’s test 1 (ST1), tear film break-up time (TBUT), ocular surface disease index (OSDI), and corneal staining were assessed before treatment and 2 months post-treatment. Tear fluid samples before and after treatment from a subset of these patients were collected from the study subjects using sterile Schirmer’s strips, and the levels of interleukin (IL)-1β, IL-10, IL-6, IL-17A, tumor necrosis factor-α (TNFα), matrix metalloproteinase-9 (MMP9), soluble intercellular adhesion molecule-1 (sICAM1), and vascular endothelial growth factor-A (VEGF-A) were measured using a microfluidic cartridge-based multiplex ELISA.

Results:
The MBE group demonstrated a significant (p < 0.05) decrease in OSDI scores along with a significant increase in Schirmer’s test 1 compared to the PLC group. No significant change in TBUT and corneal staining was observed between the study groups. Levels of proinflammatory factors such as IL-1β, IL-6, IL-17A, TNFα, and MMP9 were observed to be significantly reduced, along with a significant increase in IL-10 levels following treatment in the MBE group compared with the PLC group.

Conclusion:
Consumption of MBE resulted in the resolution of DED signs and symptoms, along with a reduction in ocular surface inflammation.
Automatic segmentation and quantified analysis of meibomian glands from infrared images
Authors: Vunnava Krishna Poojita , Shetty Rohit , Prabhu Sahana M , Tiwari Piyush , Kummelil Mathew Kurian 
Published: April 2023

Purpose:
An algorithm for automated segmentation of meibomian glands from infrared images obtained using a novel prototype infrared hand-held imager has been proposed in this study. Meibomian gland dysfunction (MGD) is quantified in terms of five clinically relevant metrics. A comparison of these metrics in patients with MGD has been presented against a sample of the normative healthy population.

Methods:
This is a prospective cross-sectional observational study. Patients presenting to the clinics were enrolled after written informed consent. The everted eyelids of 200 eyes of patients (of which 100 were healthy and 100 were diagnosed with MGD) were imaged using a prototype hand-held camera. The proposed algorithm was used to process the images using enhancement techniques and the glands were automatically segmented. A comparison of glands of normal eyes versus MGD-affected eyes is performed using five metrics presented in this study: (i) drop-out, (ii) length, (iii) width, (iv) the number of glands, and (v) the number of tortuous glands.

Results:
The 95% confidence interval for the metrics did not show any overlap between the two groups. In MGD patients, the drop-out ratio was higher than normal. The length and number of glands were significantly lesser than normal. A number of tortuous glands were more in the MGD group. The metrics for MGD versus healthy and cut-off ranges were computed in the results.

Conclusion:
The prototype infrared hand-held meibographer and the proposed automatic algorithm for gland segmentation and quantification are effective aids in MGD diagnosis. We present a set of five metrics, which are clinically relevant for guiding clinicians in the diagnosis of MGD.