Background/Objectives: Modern life is inconceivable without visual display terminal (VDT) work, including smartphones, computers, and games for both children and adults. VDT work under air conditioning and low humidity poses a high risk of dry eye and digital eye strain. Methods: Thirty-one participants were randomly divided into two groups using a desktop humidifier with photocatalytic technology, namely the \"with mist\" (humidifier) group and \"without mist\" (control) group. Participants performed VDT tasks using the humidifier with or without mist for 1 h. Ocular subjective symptoms and objective tear film parameters were assessed before, immediately after, and 1.5 h after the VDT task with or without mist. (Registry ID: UMIN000054379) Results: Ocular symptom scores improved significantly in the humidifier group immediately after the VDT task and up to 1.5 h later compared to before the task (p < 0.001, =0.006, respectively). Immediately after the VDT task, tear meniscus height was significantly higher and non-invasive breakup time was significantly longer in the humidifier group than in the control group (p < 0.001, =0.040, respectively). Plugging of the meibomian gland orifices was significantly reduced only in the humidifier group immediately after the VDT task compared to before the VDT task and remained significantly reduced up to 1.5 h later (p = 0.004, 0.016, respectively). Conclusions: The use of the photocatalytic desktop humidifier during VDT task resulted in significant improvements in the tear film parameters and subjective symptoms. The photocatalytic desktop humidifier could be effective in alleviating dry eye and eye strain in computer users in a modern office environment.

Introduction  The emergence of electronic cigarettes as the \"healthier\" version of smoking has been popular, especially among young adults. However, knowledge about the potential effects of e-cigarettes on ocular structures is scarce. Objective  To compare the mean change in dry eye parameters between e-cigarette smokers and non-smokers and to correlate between dry eye parameters with device power output. Methodology A cross-sectional, single-visit study was conducted involving 85 e-cigarette smokers and 85 non-smokers. All participants were evaluated on dry eye parameters, including the Ocular Surface Disease Index (OSDI) score, tear meniscus height (TMH), tear break-up time (TBUT), cornea fluorescein staining, and Schirmer\'s I test. The mean change in dry eye parameters was compared between e-cigarette smokers and non-smokers. The correlation between dry eye parameters with device power output was analyzed. Results Specifically, 32.94% of e-cigarette smokers were found to have a TMH <0.2 mm, compared to only 5.88% of non-smokers (p<0.001). A significant change in mean TBUT was found between the e-cigarette smokers (10.41+2.65 seconds) and non-smokers (12.66+3.14 seconds, p<0.001). The lower mean Schirmer\'s I test was found among e-cigarette smokers (12.75+7.24 mm, p<0.001). No significant change in the median OSDI score and corneal fluorescein staining. The OSDI score and device power output were found to have a significant positive correlation (p=0.003). There was a significant association between dry eye signs and device power output, including TMH (p=0.047), TBUT (p=0.002), Schirmer\'s I test (p<0.001), and corneal fluorescein staining (p<0.001). Conclusion Electronic cigarette smokers are prone to develop dry eyes. Concern should be raised on the risk of electronic cigarette use on ocular health, and regulation on e-cigarette ban should be revisited.

UNASSIGNED: Approximately 85% of patients with thyroid eye disease experience ocular surface symptoms. Although corneal exposure plays a role in inducing inflammatory changes to the ocular surface, multiple studies reveal more complexity to the abnormal tear film composition and parameters in thyroid eye disease patients including those who do not have proptosis or increased corneal exposure. Currently, a majority of cases of thyroid associated dry eye symptoms are given treatments intended for ocular surface disease arising from different etiologies.
UNASSIGNED: Medline via Ovid, Cochrane CENTRAL, PubMed, and Google Scholar were systematically searched for articles evaluating the efficacy of treatments for dry eye symptoms in patients with thyroid eye disease. Articles were from all geographic regions and dates ranged from inception until October 2023.
UNASSIGNED: Seven papers ultimately met inclusion criteria and were included in this review. These papers revealed that multiple topical and non-topical treatment modalities address dry eye symptoms in thyroid eye disease and improve subjective and objective ocular surface parameters. However, due to the few studies that exist and due to disparities in sample size and study design, no overwhelming best practices were identified that could influence clinical practice.
UNASSIGNED: This systematic review identifies the current treatments that exist and highlights the clear unmet need for a large population suffering with dry eye symptoms. Ideally, further well-designed investigations into this area would target topical, non-invasive modalities to develop first line options for thyroid eye disease patients.

Meibomian gland dysfunction (MGD) is a prevalent worldwide eye disorder that causes eye irritation, inflammation, chronic dryness, and blurred vision. Traditional therapies offer temporary improvement, but their efficacy varies in severe MGD cases. Ocular intense pulsed light (IPL) has emerged as a novel therapy, providing long-term symptom relief and shorter treatment durations compared to traditional approaches. However, the impact of IPL on the bacterial community within the eyes remains limited. To address this, we conducted a preliminary study using metagenomics and next-generation sequencing. We compared the bacterial eyelash communities of Thai females with severe MGD before and after 2-4 IPL treatments, and against a group of healthy females. Our findings revealed higher bacterial diversity in healthy individuals compared to severe MGD cases. IPL treatments increased diversity in the MGD group, making their core bacterial community more similar to that of healthy subjects. Notably, the presence of Koribacteraceae in severe MGD and Bifidobacterium in healthy individuals and post-IPL-treated MGD exemplified this shift. Clustering analysis showed a closer relationship between post-IPL-treated MGH and healthy subjects, while the pre-IPL treatment group formed a separate branch. These results suggest that IPL treatment can reshape the eyelash microbiome in MGD cases, but further research is needed to understand the implications and the microbiome\'s role in MGD pathogenesis and treatment response.

UNASSIGNED: The American Optometric Association defines computer vision syndrome (CVS), also known as digital eye strain, as \"a group of eye- and vision-related problems that result from prolonged computer, tablet, e-reader and cell phone use\". We aimed to create a well-structured, valid, and reliable questionnaire to determine the prevalence of CVS, and to analyze the visual, ocular surface, and extraocular sequelae of CVS using a novel and smart self-assessment questionnaire.
UNASSIGNED: This multicenter, observational, cross-sectional, descriptive, survey-based, online study included 6853 complete online responses of medical students from 15 universities. All participants responded to the updated, online, fourth version of the CVS questionnaire (CVS-F4), which has high validity and reliability. CVS was diagnosed according to five basic diagnostic criteria (5DC) derived from the CVS-F4. Respondents who fulfilled the 5DC were considered CVS cases. The 5DC were then converted into a novel five-question self-assessment questionnaire designated as the CVS-Smart.
UNASSIGNED: Of 10 000 invited medical students, 8006 responded to the CVS-F4 survey (80% response rate), while 6853 of the 8006 respondents provided complete online responses (85.6% completion rate). The overall CVS prevalence was 58.78% (n = 4028) among the study respondents; CVS prevalence was higher among women (65.87%) than among men (48.06%). Within the CVS group, the most common visual, ocular surface, and extraocular complaints were eye strain, dry eye, and neck/shoulder/back pain in 74.50% (n = 3001), 58.27% (n = 2347), and 80.52% (n = 3244) of CVS cases, respectively. Notably, 75.92% (3058/4028) of CVS cases were involved in the Mandated Computer System Use Program. Multivariate logistic regression analysis revealed that the two most statistically significant diagnostic criteria of the 5DC were ≥2 symptoms/attacks per month over the last 12 months (odds ratio [OR] = 204177.2; P <0.0001) and symptoms/attacks associated with screen use (OR = 16047.34; P <0.0001). The CVS-Smart demonstrated a Cronbach\'s alpha reliability coefficient of 0.860, Guttman split-half coefficient of 0.805, with perfect content and construct validity. A CVS-Smart score of 7-10 points indicated the presence of CVS.
UNASSIGNED: The visual, ocular surface, and extraocular diagnostic criteria for CVS constituted the basic components of CVS-Smart. CVS-Smart is a novel, valid, reliable, subjective instrument for determining CVS diagnosis and prevalence and may provide a tool for rapid periodic assessment and prognostication. Individuals with positive CVS-Smart results should consider modifying their lifestyles and screen styles and seeking the help of ophthalmologists and/or optometrists. Higher institutional authorities should consider revising the Mandated Computer System Use Program to avoid the long-term consequences of CVS among university students. Further research must compare CVS-Smart with other available metrics for CVS, such as the CVS questionnaire, to determine its test-retest reliability and to justify its widespread use.

OBJECTIVE: This study investigated the involvement of discoidin domain receptor (DDR) in dry eye and assessed the potential of specific DDR inhibitors as a therapeutic strategy for dry eye by exploring the underlying mechanism.
METHODS: Dry eye was induced in Wistar rats by applying 0.2% benzalkonium chloride (BAC), after which rats were treated topically for 7 days with DDR1-IN-1, a selective inhibitor of DDR1. Clinical manifestations of dry eye were assessed on Day-7 post-treatment. Histological evaluation of corneal damage was performed using haematoxylin and eosin (H&E) staining. In vitro, immortalized human corneal epithelial cells (HCECs) exposed to hyperosmotic stress (HS) were treated with varying doses of DDR1-IN-1 for 24 h. The levels of lipid peroxidation in dry eye corneas or HS-stimulated HCECs were assessed. Protein levels of DDR1/DDR2 and related pathways were detected by western blotting. The cellular distribution of acyl-CoA synthetase long chain family member 4 (ACSL4) and Yes-associated protein (YAP) was evaluated using immunohistochemistry or immunofluorescent staining.
RESULTS: In dry eye corneas, only DDR1 expression was significantly up-regulated compared with normal controls. DDR1-IN-1 treatment significantly alleviated dry eye symptoms in vivo. The treatment remarkably reduced lipid hydroperoxide (LPO) levels and suppressed the expression of ferroptosis markers, particularly ACSL4. Overexpression or reactivation of YAP diminished the protective effects of DDR1-IN-1, indicating the involvement of the Hippo/YAP pathway in DDR1-targeted therapeutic effects.
CONCLUSIONS: This study confirms the significance of DDR1 in dry eye and highlights the potential of selective DDR1 inhibitor(s) for dry eye treatment.

Background: To determine the differences in the effects of intense pulsed light (IPL) treatment when including the upper and lower lid or lateral canthus area in patients with meibomian gland dysfunction (MGD). Methods: Patients who underwent three IPL treatment sessions at 3-week intervals were divided into three groups according to the treatment sites: group A, lower lid; group B, upper and lower lids; and group C, lower lid and lateral canthal area. Before and after the IPL treatment sessions, we obtained the lid abnormality score (LAS), meibum expressibility (ME), meibum quality (MQ), lipid layer thickness (LLT), type I Schirmer test (ST), tear break-up time (TBUT) test, corneal fluorescein staining scores (CFSs), and Ocular Surface Disease Index (OSDI). Results: IPL treatment significantly improved LASs, ME, MQ, TBUT, CFS, and OSDI values in all groups. Differences in LAS values before and after IPL treatment were significantly greater in groups B and C than those in group A. Conclusions: IPL treatment encompassing the upper lid and lateral canthus together with the lower lid elicited additional improvement in patients with MGD. The additional effect on treating the lateral canthus was similar to the effect observed on the additional treatment of the upper lid.

OBJECTIVE: To assess the feasibility and the diagnostic accuracy of the new tool, DEvice© (AI, Rome, Italy), for screening patients with dry eye disease (DED).
METHODS: This study was performed at the University Magna Græcia of Catanzaro. Enrolled patients were classified as affected by DED (group 1) or not (group 2) using an already validated tool (Keratograph 5M, Oculus, Germany), evaluating the noninvasive keratograph breakup time (NIKBUT), tear meniscus height (TMH), meibomian gland loss (MGL), and bulbar redness. All the patients were then examined by means of DEvice©, which allowed the measurement of the relative humidity (RH) and temperature of the ocular surface. Symptoms were scored using the Ocular Surface Disease Index (OSDI) questionnaire.
RESULTS: Overall, 40 patients (17 males and 23 females, mean age 38.0 ± 17.1 years) were included: of these, 20 belonged to group 1 and the remaining 20 to group 2. Using Keratograph 5M, significant differences between groups 1 and 2 were detected for NIKBUT-first (respectively, 4.97 ± 1.85 vs. 13.95 ± 4.8 s; p < 0.0001) and for NIKBUT-average (10.55 ± 4.39 vs. 15.96 ± 4.08 s; p = 0.0003). No statistically significant changes were detected for TMH (p = 0.565), MGL (p = 0.051), and bulbar redness (p = 0.687). Using Device©, a statistically significant higher value of RH was found in group 1 compared to group 2 (respectively, 85.93 ± 10.63 vs. 73.05 ± 12.84%; p = 0.0049). A statistically significant correlation was found between RH and OSDI (r = 0.406; p = 0.009). The value RH showed a discriminating power to detect DED with an AUC = 0.782 (standard error 0.07264; 95% CI 0.6401-0.9249; p = 0.0022).
CONCLUSIONS: The DEvice© can effectively discriminate DED patients from healthy subjects. The parameter RH showed good sensitivity, making this tool ideal for a fast and noninvasive DED screening.

Cataracts are characterized by the crystalline lens of the eye becoming cloudy, and dry eye disease (DED) is a multifactorial disease in which the homeostasis of the tear film is lost. As the prevalence of both diseases increases with age, there is a high prevalence of DED among patients who are candidates for cataract surgery. In recent years, cataract surgery has evolved from vision restoration surgery to refractive surgery. To achieve good surgical outcomes, it is necessary to minimize postoperative refractive error in intraocular lens (IOL) power calculation, which requires accurate preoperative keratometry measurements. A stable tear film is important for the accuracy and reproducibility of keratometry measurements, and DED may have a deleterious effect. In this study, original articles that focused primarily on findings related to this topic were evaluated. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Although appropriate DED diagnoses were not presented in the articles evaluated in this review, it was confirmed that the clinical signs of DED, particularly the shortening of the tear film break-up time (TBUT), negatively impact IOL power calculations. Improvement in these clinical signs might mitigate the negative effects on these calculations.

The identification of new biomarkers of ocular diseases is nowadays of outmost importance both for early diagnosis and treatment. Epigenetics is a rapidly growing emerging area of research and its involvement in the pathophysiology of ocular disease and regulatory mechanisms is of undisputable importance for diagnostic purposes. Environmental changes may impact the ocular surface, and the knowledge of induced epigenetic changes might help to elucidate the mechanisms of ocular surface disorders. In this pilot study, we investigated the impact of extensive contact lens (CL) wearing on human corneal epithelium epigenetics. We performed ex vivo analysis of the expression of the miR-320 and miR-423-5p involved in the processes of cellular apoptosis and chronic inflammation. The human corneal epithelium was harvested from healthy patients before the photorefractive keratectomy (PRK). The patients were divided into two age- and sex-matched groups accordingly to CL wearing history with no CL wearers used as a control. The epithelium was stored frozen in dry ice at -80 °C and forwarded for miRNA extraction; afterwards, miRNA levels were detected using real-time PCR. Both miRNAs were highly expressed in CL wearers (p < 0.001), suggesting epigenetic modifications occurring in chronic ocular surface stress. These preliminary results show the relationships between selected miRNA expression and the chronic ocular surface stress associated with extensive CL use. MicroRNAs might be considered as biomarkers for the diagnosis of ocular surface conditions and the impact of environmental factors on ocular surface epigenetic. Furthermore, they might be considered as new therapeutic targets in ocular surface diseases.