Syftet med studien var att genom en litteraturstudie undersöka cigarettröknings påverkan på torra ögon och ögats främre delar. Har cigarettrökning en negativ inverkan på parametrarna för torra ögon? Litteraturstudien genomfördes utifrån sökningar via Web of Science och Pubmed på tidigare kliniska studier och vetenskapliga publikationer. Sökningarna utfördes mellan 2021-03-18 och 2021-03-26. För att specificera sökresultaten skulle artiklarna finnas i fulltext och vara publicerade från år 2016-2021. Sökorden som tillämpades var ”dry eye and smoking” och ”dry eye + smoking”. Studier med färre än 50 deltagare och litteraturstudier/reviews exkluderades. De fem mest relevanta artiklarna utifrån sökresultaten valdes ut för att ingå i studien. Totalt deltog 2692 personer i studierna. Mängden cigarettrökning varierade mellan studierna. Frågeformulären som utfördes var Ocular Surface Disease Index (OSDI) och Mcmonnies Dry Eye Questionnaire (MDEQ), dessa visade en statistisk signifikant skillnad på symptompoäng mellan rökare och icke-rökare i två av fem studier. Det sågs en statistisk signifikant skillnad i Tear Break Up Time (TBUT) mellan testgrupperna i tre av fem studier. Studien visar att cigarettrökning påverkar torra ögon, torra ögonsymptom, ögats främre delar och meibomska körtlarna negativt. Dock ses stora variationer i vad som påverkas inom olika grupper, vilket gör det svårt att fastställa exakt vilken påverkan cigarettrökning har på torra ögon. Fler studier med fler deltagare, ett bestämt antal cigaretter per dag under en bestämd period samt tydliga riktlinjer för utvärdering av DED behövs för att fastställa cigarettröknings påverkan på torra ögon.

Human tear film is an accessible biospecimen rich with useful biological information. As tear protein biomarkers for both ocular and systemic diseases have been identified in tears, efforts are being made to create point-of-care tests useful for clinical diagnoses. However, there are significant obstacles to tear diagnostics, including inadequate sampling methods and biomarkers with insufficient sensitivity and specificity. Furthermore, tear film diagnostics are particularly challenging for dry eye disease (DED) patients, where low tear volume makes sampling more difficult and the multifactorial nature of DED makes identifying the exact pathological subtype very complex. As soft contact lenses (SCLs) are designed for optimal ocular surface interaction and concentrate proteins on the eye regardless of tear volume, we hypothesized that we could improve tear sampling methods for research and diagnostic purposes. We further hypothesized that we could identify new and existing and DED biomarkers using SCL tear film sampling. To begin, we demonstrate SCL sampling in vitro and then compare SCLs to other current tear sampling methods in vivo. Objectively, we observe that SCLs do not show signs of ocular surface irritation, regardless of previous SCL use. We also see that SCLs sample similar types and amounts of proteins relative to other methods. Subjective assessments of tear sampling methods are also made by subjects. Our results indicate that training and experience in tear sampling are key components which may significantly impact subject experience as well as the tear type collected. Next, we optimized our tear sampling method by comparing different SCLs materials in search of an ideal lens. Our data show that certain combinations of SCL materials and mass spectrometry (MS) sample preparation methods can lead to significant polymer contamination in MS. Furthermore, we observe individual protein binding specificity based on SCL chemistry. Our experiments reveal etafilcon A and verofilcon A lenses as the optimal SCL materials for tear film sampling. Finally, a pilot study in DED candidates using SCL sampling confirms the presence of previously reported biomarkers in DED subjects as well as identifies new biomarkers for future validation studies. We also correlate clinical metrics to biochemical findings and identify correlations between tear film homeostasis and pathologic phenotypes. Ultimately, these studies demonstrate SCL sampling is an advantageous alternative to current tear film sampling methods, useful for biomarker discovery, and potentially, clinical diagnostics.

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Background/Aims: This study aimed to analyze the effects of perinatal history on tear film properties and lid geometry in adults born preterm. Methods: The Gutenberg Prematurity Eye Study (GPES) is a German prospective examination of adults born preterm and term aged 18 to 52 years with Keratograph® 5M and Schirmer test I. Main outcome measures were first non-invasive tear film break-up time (F-NITBUT), bulbar redness (BR), Schirmer test, and nasal palpebral angle measurement. The associations with gestational age (GA), birth weight (BW), and BW percentile, retinopathy of prematurity (ROP), ROP treatment, and other perinatal factors were evaluated using regression analyses. Results: 489 eyes of 255 preterm and 277 eyes of 139 full-term individuals (aged 28.6 +/− 8.8 years, 220 females) were included. Of these, 33 participants (56 eyes) had a history of spontaneously regressed ROP and 9 participants (16 eyes) had a history of ROP treatment. After adjustment for age and sex, lower F-NITBUT (<20 s) was associated with ROP treatment (OR = 4.42; p = 0.025). Lower GA correlated with increased bulbar redness (B = −0.02; p = 0.011) and increased length of wetting in the Schirmer test (B = −0.69; p = 0.003). Furthermore, low GA was associated with narrowing of the nasal palpebral angle (B = 0.22; p = 0.011) adjusted for age and sex, but not when considering ROP in the multivariable model. Conclusion: Our analyses indicate that perinatal history affects ocular surface properties, tear production and lid geometry in adults born term and preterm. This might indicate that affected persons have a predisposition to diseases of the corneal surface such as the dry eye disease.

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Syfte: Syftet med studien var att jämföra två metoder vid undersökning av tårfilmsanalys; tårflödesbeteende-metoden och fluorescein break-up mönster och om deras mätresultat överensstämmer med varandra. Detta för att diskutera om någon av metoderna kunde vara ett bättre alternativ att adaptera ute i praktiken för vårdgivare inom ögonvården. Metod: Initialt fick deltagarna besvara en OSDI-enkät (ocular surface disease index), därefter gjordes resterande mätningar i biomikroskopet. I biomikroskopet utfördes initialt dem icke-invasiva mätningarna som tillhörde tårflödesbeteende-metoden (mätning av TMH (tårmeniskhöjd), debrishastighet efter blinkning och mätning av lipidlagrets interferensmönster) även NiBUT (non-invasive tear break-up time) utfördes. Efter dem icke-invasiva mätningarna tillsattes fluorescein i inferiora temporala fornix och dem invasiva testerna; TBUT (tear break-up time) och FBUP (fluorescein break-up mönster) utfördes tre gånger. Alla mätningar dokumenterades med video. Tre oberoende bedömningar utfördes. Studien undersökte om resultatet av tårflödesbeteendet och FBUP hade ett samband och vilken utav metoderna som fick en högre intravaliditet utefter dem bedömningar som utfördes. Resultat: Totalt deltog 26 deltagare varav 4 exkluderades. Deltagarna var mellan 19–57 år gamla med en genomsnittsålder på 35 år och en standardavvikelse på ±12,3 år. Samtliga presenterade med en OSDI ≥13, alternativt hade en visuellt frekvent blinkfrekvens. Det återfanns ett samband mellan tårflödesbeteende-metoden och FBUP i studien, dock ingen av klinisk signifikans ((bedömare 1, Cramer’s V= 0,46 p=0,06) (bedömare 2, Cramer’s V=0,33 p=0,32) (bedömare 3, Cramer’s V=0,33 p=0,34)). Tårflödesbeteende-metoden (Fleiss kappa =0,29, p=0,40) och FBUP (Fleiss kappa =0,25, p=0,40) uppvisade båda på en mindre god intra-validitet Slutsats: Det finns ett samband mellan tårflödesbeteende-metoden och FBUP men ingen statistisk signifikans. Intravaliditeten är marginellt högre vid tårflödesbeteende-metoden än vid FBUP i studien. / Aim: The aim of this study was to compare two methods used during tear-film analysis; tear-flow behaviour, and fluorescein break-up pattern and if their measured results are in an agreement. This in order to discuss which one of the methods would be more suitable to apply in clinical practice for healthcare workers in the field of optometry.  Method: Initially the participants filled out an OSDI questionnaire (ocular surface disease index), thereafter measurements were done in the biomicroscope. Initially the non-invasive measurements such as the tear-flow behaviour method (measurements of TMH (tear meniscus height), speed of debris movement across the tear film after blinking and measurements of the lipid layer interference) and NiBUT (non-invasive break-up time) were measured. Afterwards fluorescein was applied in the inferior temporal fornix and the invasive measurements; TBUT (tear break-up time) and FBUP (fluorescein break-up pattern) were measured three times. All measurements done in the biomicroscope were documented with video and three independent assessments were done. This study looked at the results from the tear-flow behaviour and FBUP and if they agreed with one another. It also looked into which one of the methods presented a higher intra-validity in regard to the assessments made. Results: The study had a total of 26 participants, of which 4 were excluded. The participants were between the ages of 19-57 years old with an average age of 35 years with a standard deviation of ±12,3 years. The participants presented with an OSDI of ≥13, with exceptions made if a participant visually had a high blink frequency. A correspondence between the tear-flow behaviour method and  FBUP could be observed, however none of statistical significance ((assessor 1, Cramer’s V= 0,46 p=0,06) (assessor 2, Cramer’s V=0,33 p=0,32) (assessor 3, Cramer’s V=0,33 p=0,34)). The intra-validity of the tear-flow behaviour method (Fleiss kappa =0,29, p=0,40) and FBUP (Fleiss kappa =0,25, p=0,40) were both categorized as weak intra-validity.  Conclusion: There is a correspondence between the tear-flow method and FBUP, without statistical significance. The intra-validity was marginally higher within the tear-flow method compared to FBUP in the study.