Purpose
To assess the potential additive effects of short‐term display use and contact lens (CL) wear on the ocular surface and tear film.
Methods
Thirty‐four healthy volunteers (20.87 ± 2.33 years ...old) participated in this study. Participants' dry eye symptoms, ocular surface, tear film and pupil size were assessed before and after executing a 20‐min reading task on a computer and a smartphone with and without CL wear, or with CL wear and artificial tear instillation. Measurements included the Ocular Surface Disease Index (OSDI) questionnaire; 5‐item Dry Eye Questionnaire (DEQ‐5); tear meniscus height (TMH); noninvasive keratograph break‐up time (NIKBUT); bulbar conjunctival redness (BR) and pupil size.
Results
Higher symptoms were reported after reading on both displays with and without CLs (p ≤ 0.001) for short periods. BR was higher and NIKBUT shorter after reading on the computer regardless of wearing CLs (p ≤ 0.02 and p ≤ 0.02, respectively), while TMH increased for all conditions (p ≤ 0.02) except for CL computer reading (p = 0.23). Reading with CLs did not lead to greater signs of dry eye (BR, NIKBUT) and symptoms compared with reading unaided (p > 0.05), although a smaller increase in TMH was observed when reading on the computer with CLs (p = 0.005). Artificial tear instillation during CL wear led to a smaller increase in symptoms (p ≤ 0.02), a smaller increase in BR (p ≤ 0.04) and a decrease in NIKBUT (p = 0.02) compared to reading without correction.
Conclusions
Disposable CL wear had no additive effects on signs and symptoms of dry eye when using digital devices for short periods. The instillation of artificial tears is an effective strategy for reducing the impact of display use in CL wearers.
Purpose
To assess the impact of computer use on the ocular surface of individuals after laser in situ keratomileusis (LASIK).
Methods
The dry eye symptoms and ocular surface of 18 post‐LASIK young ...individuals and 18 controls were evaluated before and after performing a 30‐min task on a computer without (Visit 1) and with (Visit 2) initial instillation of artificial tears. Symptoms were assessed using the Ocular Surface Disease Index (OSDI), Symptom Assessment in Dry Eye questionnaire version two (SANDE II) and Computer Vision Syndrome Questionnaire (CVS‐Q). The ocular surface was assessed by measuring corneal higher order aberrations, tear meniscus height (TMH), conjunctival redness, blink rate and incomplete blinking, lipid layer thickness (LLT) and non‐invasive keratograph break‐up time (NIKBUT).
Results
SANDE II scores were >0 after the computer task in both groups (p ≤ 0.01). SANDE II and CVS‐Q scores did not differ between LASIK and controls (p ≥ 0.43). Greater bulbar–temporal conjunctival redness, TMH and LLT and shorter NIKBUT were found after computer use in the LASIK group (p ≤ 0.04), whereas no changes were observed in the controls (p ≥ 0.20). Lower SANDE II and CVS‐Q scores were reported at Visit 2 compared with Visit 1 in both groups (p ≤ 0.01). Likewise, no worsening of dry eye signs was observed at Visit 2 (p ≥ 0.11).
Conclusions
Ocular symptoms reported during computer use were comparable between the groups. However, a worsening of dry eye signs was mostly observed in post‐LASIK individuals. The instillation of artificial tears was effective in preventing the effects of computer use on the ocular surface in post‐LASIK patients.
Purpose
To compare the optical and visual performance of a dual‐focus (DF) contact lens used for myopia control with a single‐vision (SV) contact lens of the same material.
Methods
A randomised, ...double‐masked crossover study. Twenty‐eight healthy, myopic volunteers between 18 and 32 years of age (23.49 ± 4.07 years) participated in this study. The sensory dominant eye for distance vision was determined. Refraction, best‐corrected visual acuity (VA) and aberrations for 3 mm and 5 mm pupil diameters were quantified without a contact lens in situ. Subjects were fitted with two contact lens designs: DF and SV, both made of omafilcon A material. The Quality of Vision (QoV) questionnaire, over‐refraction, best‐corrected VA, stereopsis at 40 cm, best‐corrected photopic and mesopic contrast sensitivity, light disturbance and aberrations were assessed 25 min after contact lens insertion.
Results
There were no statistically significant differences in best‐corrected VA and stereopsis between the baseline, DF and SV conditions. Photopic and mesopic contrast sensitivity were lower for the DF contact lens at all frequencies, with the exception of the mesopic contrast sensitivity at 18 cycles per degree (p = 0.23). Higher order aberrations and light disturbance size and irregularity were higher for the DF contact lens (p < 0.001). No differences were found in higher order aberrations between baseline and the SV contact lens condition for each pupil diameter. QoV scores also revealed lower frequency, severity and bothersome scores with the SV contact lens than with the DF contact lens (p < 0.001).
Conclusions
The DF contact lens design decreased the psychophysical and psychometric visual quality scores in the short‐term under dim‐light conditions when compared with a single‐vision contact lens design of the same material. VA and stereopsis were unaffected by the lens design.
Purpose
To assess changes in visual function and optical and tear film quality in computer users.
Methods
Forty computer workers and 40 controls were evaluated at the beginning and end of a working ...day. Symptoms were assessed using the Quality of Vision questionnaire (QoV), 5‐item Dry Eye Questionnaire (DEQ‐5) and Symptom Assessment in Dry Eye version II (SANDE II). Tear film quality was evaluated using the Medmont E300 dynamic corneal topography tool to measure the tear film surface quality (TFSQ), TFSQ area and auto tear break‐up time (TBUT). Optical quality was assessed by measuring high, low and total ocular aberrations with a Hartmann–Shack wavefront sensor. Visual performance was assessed by measuring photopic and mesopic visual acuity, photopic and mesopic contrast sensitivity and light disturbance.
Results
Poorer DEQ‐5, QoV and SANDE II scores were obtained in computer workers at the end of the working day compared with controls (p ≤ 0.02). Computer workers exhibited a higher (worse) TFSQ and TFSQ area at visit 2 compared with visit 1 (p ≤ 0.04), while no significant differences in TBUT (p = 0.19) or ocular aberrations were observed (p ≥ 0.09). Additionally, both light disturbance (p ≤ 0.04) and mesopic and photopic contrast sensitivity worsened at several spatial frequencies (p ≤ 0.04) throughout the working day in computer workers, while visual acuity remained unchanged (p ≥ 0.07). In contrast, control subjects exhibited no decrease in any variable during the day.
Conclusions
While visual acuity remained unchanged, several aspects of visual function and quality of vision decreased over a day of computer use. These changes were accompanied by greater dry eye symptoms and tear film changes, which are likely to have played a fundamental role. The present study provides insight into new metrics to assess digital eye strain.
Digital display use has been accepted to be implicated as a contributing factor for dry eye disease (DED). Abnormal blinking during computer operation, including a reduced blink rate and an ...incomplete eyelid closure, increased palpebral fissure as consequence of high visualization angles, and meibomian gland dysfunction associated to long-term display use, are behind the increased prevalence of dry eye signs and symptoms found in digital display users. Previous research reveals significant reductions in tear volume and stability, alterations in tear film composition, including increased osmolarity, inflammatory cytokines, oxidative stress markers and reduced mucin secretion, eyelid abnormalities and ocular surface damage, encompassing corneal and conjunctival staining and bulbar redness, as a direct consequence of digital display use. In this regard, individual differences in the way that the various digital displays are typically set up and used may account for differences in their effects on induced dryness signs and symptoms. Furthermore, factors such as the use of contact lenses or inappropriate working environments, usually accompanying the use of displays, may significantly increase the prevalence and the severity of induced dry eye. Other factors, such as old age and female gender are also relevant in the appearance of associated alterations. Finally, clinicians should adopt a treatment strategy based on a multidirectional approach, with various treatments being applied in conjunction.
To assess systemic, environmental and lifestyle risk factors for dry eye disease (DED) in a Mediterranean Caucasian population.
A cross-sectional study was performed on 120 Caucasian participants ...aged between 18 and 89 years (47.0 ± 22.8 years). Medical history, information regarding environmental conditions and lifestyle, Ocular Surface Disease Index, Dry Eye Questionnaire-5, non-Invasive (Oculus Keratograph 5 M) breakup time, tear film osmolarity and ocular surface staining parameters were assessed in a single clinical session to allow DED diagnosis based on the guidelines of the Tear Film and Ocular Surface Society Dry Eye Workshop II Diagnostic Methodology Report. A multivariate logistic regression model was constructed including those variables with a p-value less than 0.15 in the univariate analysis.
A prevalence of 57.7 % for DED was found. No age differences were found between those with and without DED (U = 1886.5, p = 0.243). Nevertheless, the DED group had more females (X2 = 7.033, p = 0.008). The univariate logistic regression identified as potential risk factors for DED the following: female sex, sleep hours per day, menopause, anxiety, systemic rheumatologic disease, use of anxiolytics, daily medication, ocular surgery, poor diet quality, more ultra-processed food in diet, not drinking caffeine and hours of exposure to air conditioning per day. Multivariate logistic regression revealed that hours of sleep per day, menopause and use of anxiolytics were independently associated with DED (p ≤ 0.026 for all).
DED is associated with systemic, environmental and lifestyle risk factors. These findings are useful to identify potentially modifiable risk factors, in addition to conventional treatments for DED.
To compare the in vitro optical quality at different focal points of two new bifocal intraocular lenses (IOLs) and one new trifocal IOL.
The AcrySof ReSTOR SV25T0 (+2.5 diopter D add) and the AcrySof ...ReSTOR SN6AD1 (+3.0 D add) with two main foci (Alcon Laboratories, Fort Worth, TX) and the AT LISA tri 839MP with three main foci (Carl Zeiss Meditec, Dublin, CA) were evaluated. The optical quality of the IOLs was measured with the PMTF optical bench (LAMBDA-X, Nivelles, Belgium). The optical quality of the IOLs was quantified by the modulation transfer function (MTF) at five different focal points (0.0, -1.5, -2.0, -2.5, and -3.0 D) and for 3.0- and 4.5-mm apertures. The through-focus MTF of the IOLs was also recorded.
For the 0.0 D focal point, the AcrySof ReSTOR (+2.5 D add) obtained the highest MTF values for all apertures. For the -2.5 D focal point, the AcrySof ReSTOR (+3.0 D add) showed the highest MTF values for 3.0 mm. For the -3.0 D focal point at 3.0- and 4.5-mm aperture, the best values were obtained with the AcrySof ReSTOR (+3.0 D add) and the AT LISA, respectively. For the -1.5 D focal point, the trifocal IOL provided better values. For the -2.0 D focal point, all IOLs provided comparable results. The through-focus MTF curves showed three and two peaks for the trifocal and bifocal IOLs, respectively.
The trifocal IOL provides a better optical quality at the -1.5 D focal point. However, the optical quality of the trifocal IOL significantly decreases compared to the bifocal IOLs at far distance and -2.5 D focal points.
To evaluate the benefits on the eyes of taking breaks based on the 20-20-20 rule.
Bespoke computer software using the laptop webcam to assess user breaks, eye gaze and blinking, and emitting ...personalized reminders of breaks based on the 20-20-20 rule, was downloaded onto the laptops of 29 symptomatic computer users. Digital eye strain (DES), binocular vision and dry eye were assessed before and after two weeks of using the reminders and one week after the discontinuation of the strategy. Binocular measurements included visual acuity, accommodative posture, stereopsis, fixation disparity, ocular alignment, accommodative facility, positive/negative vergences and near point of convergence. Symptoms were evaluated using the computer vision syndrome questionnaire, ocular surface disease index (OSDI), and symptom assessment in dry eye questionnaire (SANDE) versions one and two. Dry eye signs were assessed by measuring tear meniscus height, conjunctival redness, blink rate and incomplete blinking, lipid layer thickness, non-invasive keratograph break-up time, corneal and conjunctival staining and lid wiper epitheliopathy.
A decrease in the duration of computer work and the duration of breaks, along with an increase in the number of breaks taken per day was observed as a result of the 20-20-20 rule reminders (p ≤ 0.015). No changes on any binocular parameter were observed after the management period (p ≥ 0.051), except for an increase in accommodative facility (p = 0.010). Dry eye symptoms and DES decreased with the rule reminders (p ≤ 0.045), although this improvement was not maintained one week after discontinuation (p > 0.05). No changes on any ocular surface and tear film parameter were observed with the rule reminders (p ≥ 0.089).
The 20-20-20 rule is an effective strategy for reducing DES and dry eye symptoms, although 2 weeks was not enough to considerably improve binocular vision or dry eye signs.
Purpose
The aim of this study is to develop a new objective semiautomatic method for analysing Meibomian glands visibility quantitatively.
Methods
One hundred twelve healthy volunteers aged between ...18 and 90 years (48.29 ± 27.46 years) participated in this study. Infrared meibography was obtained from the right upper eyelid through Oculus Keratograph 5 M. Meibographies were classified into 3 groups: Group 1 = patients with good subjective glands visibility and a gland dropout percentage < 1/3 of the total Meibomian gland area; Group 2 = patients with low subjective glands visibility and a gland dropout < 1/3; and Group 3 = patients with low subjective glands visibility and a gland dropout > 1/3. New metrics based on the visibility of the Meibomian glands were calculated and later compared between groups. Rho Spearman test was used to assess the correlation between each metric, and Meibomian gland dropout percentage with the entire sample and after excluding Group 2. A
p
value less than 0.05 was defined as statistically significant.
Results
Fifty-six subjects were classified in Group 1 (24.48 ± 9.62 years), 19 in Group 2 (69.16 ± 21.30 years) and 37 in Group 3 (73.59 ± 13.70 years). No statistically significant differences were found between Groups 1 and 2 in dropout percentage. All metrics, with the exception of entropy, showed a higher Meibomian gland visibility in Group 1 than in the other two groups. Moderate correlations were statistically significant for all metrics with the exception of entropy. Correlations were higher after excluding Group 2.
Conclusion
The proposed method is able to assess Meibomian gland visibility in an objective and repeatable way, which might help clinicians enhance Meibomian gland dysfunction diagnosis and follow-up treatment.
Purpose
This study aimed to develop and validate new metrics to objectively assess the lipid layer thickness (LLT) through the analysis of grey intensity values obtained from the Placido disk pattern ...reflected onto the tear film.
Methods
Ocular surface parameters were measured using Oculus Keratograph 5 M in 94 healthy volunteers (43.8 ± 26.8 years). Subjects’ LLT was subjectively classified into 4 groups using an interferometry-based grading scale. New metrics based on the intensity of the Placido disk images were calculated and compared between groups. The repeatability of the new metrics and their diagnostic ability was analysed through receiver operating characteristics (ROC) curves. The level of agreement between the new objective tool and the existing subjective classification scale was analysed by means accuracy, weighted Kappa index and
F
-measure.
Results
Mean pixel intensity, median pixel intensity and relative energy at 5.33 s after blinking achieved the highest performance, with a correlation with LLT between
r
= 0.655 and 0.674 (
p
< 0.001), sensitivity between 0.92 and 0.94, specificity between 0.79 and 0.81, area under the ROC curve between 0.89 and 0.91, accuracy between 0.76 and 0.77, weighted Kappa index of 0.77 and
F
-measure between 0.86 and 0.87.
Conclusion
The analysis of grey intensity values in videokeratography can be used as an objective tool to assess LLT. These new metrics could be included in a battery of clinical tests as an easy, repeatable, objective and accessible method to improve the detection and monitoring of dry eye disease and meibomian gland dysfunction.
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