Search Results (164)

Background/Objectives: To explore potential dry eye-related ocular surface functional alterations in women at the time of first diagnosis of endometriosis or adenomyosis in a real-world clinical setting. Methods: This was a cross-sectional case–control study. Patients were evaluated at the time of initial diagnosis, prior to initiation of any hormonal therapy, to reflect real-world clinical conditions. Participants underwent a standardized ocular surface assessment comprising the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer test, and multimodal TearCheck^® analysis, including Non-Invasive Break-Up Time (NIBUT), Tear Film Stability Evaluation (TFSE), Meibography, and Abortive Blinking^®. Results: A total of 71 women were included: 41 with endometriosis or adenomyosis and 30 without known gynecological disease. Patients reported significantly higher OSDI scores than controls (p < 0.05). Objective testing demonstrated lower Schirmer values, reduced tear film stability, and more pronounced Meibomian gland dropout in the patient group (all p < 0.05). Differences were consistently observed across both subjective and objective parameters. Conclusions: Women with endometriosis and/or adenomyosis exhibited significantly altered ocular surface parameters compared with women without known gynecological disease. These findings suggest a possible association between gynecological disease and ocular surface dysfunction. Greater awareness of potential ocular involvement may encourage closer collaboration between gynecology and ophthalmology in the care of affected patients. Full article

Background: Dry eye disease (DED) is a multifactorial disease. Numerous risk factors might cause DED, including indoor air pollution, such as incense. Incense (Bakhoor) is widely used in many cultures, including Saudi Arabia, although its smoke contains toxic chemicals that pose serious health hazards. This research investigates the link between the Schirmer II test and tear fluid proteins in DED patients. The study focuses on identifying the ocular examinations, hypothesizing that incense smoke, particularly from synthetic types, exacerbates DED. Methods: This pilot cross-sectional study was conducted at King Abdulaziz Medical City (KAMC) in Jeddah, Saudi Arabia. Participants were recruited from the Cornea and Ophthalmology Clinics. Eye assessments analyzed tear protein concentrations, including tear collection using Schirmer II test strips and tear break-up time (TBUT). The study included DED patients who used incense. Tear fluid from the Schirmer test of 20 randomly selected patients was used for protein analysis of total protein, lactoferrin, and Immunoglobulin E. Inclusion criteria were male and female subjects aged 18 years or older, diagnosed with DED, and using incense. The sample size was 55 participants, selected via convenience sampling. Subjective data were collected through questionnaires, as well as objective data from the tear test and the sample and analyzed with SPSS. Descriptive and inferential statistics were used, with statistical significance set at p-value < 0.05. Results: The Ocular Comfort Index (OCI) categories showed that 21.8% had no symptoms, 40.0% had low symptoms, 30.9% had moderate symptoms, and 7.3% reported high symptoms. TBUT values and Schirmer test scores decreased with increasing OCI severity, with no statistical significance. The mean (SD) of total protein in the right and left eyes for high OCI was 7.19 (1.39) and 7.42 (0.91), respectively, with no statistical significance. The immunoglobulin E levels in the right and left eyes for high OCI were 301.71 (55.97) and 301.71 (47.14), respectively, with no statistical significance. The mean (SD) of lactoferrin in the right and left eyes for high OCI was 163.77 (10.42) and 159.43 (1.68), respectively, with no statistical significance. Conclusions: The study findings demonstrate alignment in incense-using patients between subjective OCI symptom scores and objective clinical diagnostic measures. Specifically, higher OCI scores are associated with lower TBUT and Schirmer II test values, as well as changes in tear biomarkers such as IgE and lactoferrin. These findings emphasize the potential of using simple screening methods combined with bioanalytical markers for early detection of ocular surface disease. This highlights the potential health risks associated with incense exposure, particularly for individuals predisposed to DED. The urgency for further research to explore the long-term effects of incense on ocular health and to raise awareness about its potential impact on populations with high incense usage cannot be overstated. Full article

Background: Rebamipide (REB) is a poorly water-soluble drug with limited ocular bioavailability, necessitating advanced delivery strategies for sustained therapy in dry eye disease. Methods: In the present study, micelle-assisted ocular inserts were developed using non-ionic surfactants to enhance REB solubilization, drug loading, and controlled ocular delivery. The intrinsic solubility of REB in simulated tear fluid (STF, pH 7.4) was evaluated and compared with micellar systems. The formulations were characterized for particle size, polydispersity index, and zeta potential. Ocular inserts were fabricated via UV photopolymerization and evaluated for physicochemical properties, drug content, in vitro drug release, ex vivo permeation, cytocompatibility using SIRC cells, and histopathological analysis. Results: REB exhibited low intrinsic solubility in STF (26.05 ± 1.00 µg/mL), which was significantly enhanced in micellar systems, particularly with Solutol HS 15 (306.71 ± 1.10 µg/mL) and Tween 80 (263.18 ± 1.19 µg/mL). All micellar formulations formed stable nanosized micelles (7.5–15.1 nm) with low polydispersity (PDI < 0.35) and near-neutral zeta potential (−0.08 to −2.81 mV). The prepared ocular inserts showed uniform thickness, weight, and physiological surface pH. Micelle-assisted inserts demonstrated significantly higher drug content (87.40 ± 3.25 to 99.19 ± 2.44 µg/insert) compared to plain REB inserts (21.41 ± 2.28 µg/insert). In- vitro studies revealed sustained drug release over 24 h (92.25 ± 1.64 to 100.50 ± 1.10%), whereas plain inserts showed burst release. Ex vivo permeation studies indicated enhanced drug permeation (up to 77.30 ± 0.34 µg) and improved flux (1.38–8.52 µg/cm²·h) compared to plain REB. Cytocompatibility studies confirmed >90% SIRC cell viability, and histopathological analysis showed no structural damage to corneal tissue. Conclusions: Micelle-assisted ocular inserts, particularly those formulated with Solutol HS 15 and Tween 80, provide a promising platform for sustained, safe, and effective ocular delivery of Rebamipide in the management of dry eye disease. Full article

Background/Objectives: Dry eye disease (DED) is now widely considered to be the most prevalent ocular surface-related disease and has attracted increasing clinical attention in recent years. DED is well-studied in thyroid orbitopathy, but scarce data are available in patients with papillary thyroid carcinoma (PTC). Methods: We analyzed 29 PTC cases with radioactive iodine (RAI) treatment (Group 1), 22 PTC cases without RAI (Group 2), and 26 normal control individuals (Group 3). All participants were evaluated with the Ocular Surface Disease Index (OSDI), meibomian gland secretion quality, and lid margin grading. Non-contact meibography and non-invasive tear breakup time measurements were completed using the Sirius Scheimpflug camera. Thyrotropin (TSH), free thyroxine, and free triiodothyronine were measured. Results: TSH values were significantly lower in both patient groups than in controls (p < 0.001). The proportion of participants with a lower meibomian gland secretion quality score ≥ 1 was 34.5% in Group 1, 22.7% in Group 2, and 7.1% in Group 3 (p = 0.002). There was a higher proportion of a meibomian gland atrophy score ≥ 1 in Groups 1 and 2 than in controls (p = 0.007). No differences were found between groups in lower lid margin score, Oxford values, upper meibomian gland expressibility or upper meibography scores (p = 0.485, p = 0.064, p = 0.256, p = 0.069). OSDI scores were higher in both PTC groups than in controls (6.25 and 8.12 vs. 2.52), with borderline overall significance (p = 0.050) and higher pairwise scores versus controls (both p = 0.034). Conclusions: Meibomian gland dysfunction was observed in PTC patients regardless of RAI treatment, suggesting that TSH suppression itself may contribute to the development of ocular surface changes. Full article

Background/Objectives: Corneal epithelial thickness (CET) alterations reflect distinct mechanisms in aqueous-deficient and evaporative dry eye disease (DED) subtypes. In this study, we compare the CET profiles between patients with Sjögren’s syndrome (SS) and those with meibomian gland dysfunction (MGD) to elucidate the underlying mechanisms. Methods: We retrospectively analyzed 30 patients with SS and 30 age- and sex-matched with MGD. Assessments included corneal staining, Ocular Surface Disease Index (OSDI), tear meniscus height (TMH), non-invasive breakup time, lipid layer thickness (LLT), and anterior segment optical coherence tomography (AS-OCT) CET mapping. Regional CET and superior–inferior asymmetry were compared. Results: The SS group exhibited higher corneal staining scores (2.18 ± 1.23 vs. 1.03 ± 1.18, p = 0.001) and lower TMHs (0.14 ± 0.06 vs. 0.18 ± 0.07 mm, p = 0.013), while the MGD group reported greater OSDI scores (40.39 ± 22.49 vs. 31.25 ± 22.81, p = 0.029). A significantly thinner central epithelium (p = 0.043) and localized inferior paracentral thinning (2–5 mm zone, p = 0.008) were noted in SS. Corneal staining was identified as the primary independent predictor of central and inferior CET reduction in both groups. In the MGD group, LLT was associated with the preserved inferior CET (p = 0.045) and superior–inferior thickness difference (p = 0.015). Conclusions: Distinct structural signatures are observed between DED subtypes. SS features central/inferior thinning from aqueous deficiency-mediated friction, whereas MGD shows a relatively preserved epithelial thickness influenced by LLT. Regional CET analysis may provide mechanistic insights into DED subtyping. Full article

Background: To evaluate the effects of a preservative-free artificial tear formulation containing trehalose, sodium hyaluronate, and N-acetyl-aspartyl-glutamate (NAAGA) on ocular surface parameters and quality of life in patients with primary open-angle glaucoma (POAG) treated with preserved versus preservative-free prostaglandin analogues. Methods: For this prospective, observational clinical study, thirty-eight patients (76 eyes) with POAG receiving stable topical prostaglandin therapy were enrolled and divided into two groups: preserved prostaglandins (Group 1, n = 44) and preservative-free prostaglandins (Group 2, n = 32). All patients received adjunctive preservative-free artificial tears (trehalose, sodium hyaluronate, NAAGA) three times daily for one month. Assessments at baseline (T0) and 1 month (T1) included best-corrected visual acuity (BCVA), intraocular pressure (IOP), contrast sensitivity, Schirmer test, tear break-up time (BUT), Efron grading scale, Ocular Surface Disease Index (OSDI), visual field (VF) indices (Mean Deviation (MD), Pattern Standard Deviation (PSD), Visual Field Index (VFI)), and quality of life (QoL) measured using Visual Analogue Scales (VAS). Results: After 1 month, both groups demonstrated significant improvement in ocular surface parameters. Schirmer test increased by approximately 4–5 mm (p = 0.001 in both groups), and BUT improved by 5 s (p = 0.001 in both groups). OSDI scores significantly decreased (Group 1: –18.5; Group 2: –23; p = 0.001 for both), and Efron grading significantly improved (p = 0.001 in both groups). Artificial tears-related QoL markedly increased in both groups (p = 0.001), while pathology-related QoL remained unchanged. IOP showed a modest but significant reduction in both groups (Group 1 p = 0.011; Group 2 p = 0.003), without intergroup differences. VFI significantly improved in both groups from T0 to T1 (Group 1 p = 0.013; Group 2 p = 0.04). Group 1 also showed an improvement in terms of PSD (p = 0.025). Conclusions: Adjunctive treatment with preservative-free artificial tears containing trehalose, sodium hyaluronate, and NAAGA significantly improved tear film stability VF indexes, ocular surface signs and symptoms, and patient-reported QoL in POAG patients treated with prostaglandins, regardless of preservative status. Routine ocular surface optimization should be considered an integral component of comprehensive glaucoma management. Full article

Background/Objectives: Dry eye disease (DED) is a multifactorial condition affecting the ocular surface. It is characterized by tear film instability, hyperosmolarity, inflammation, and oxidative stress. First-line treatment for DED relies on lubricating and hydrating eye drops, usually containing hyaluronic acid (HA), which supports tear film stability and epithelial healing. However, HA alone cannot correct oxidative stress, a key driver of cellular damage and inflammation in DED. Accordingly, this study aimed to evaluate the antioxidant capacity of Malva sylvestris tincture (MalvaT) and its physicochemical properties in experimental eye-drop formulations containing HA. Methods: The antioxidant activity of reconstituted MalvaT lyophilisate (Malva) was assessed in cell-free assays against several oxygen radicals and in cell-based assays using the human HaCat keratinocyte cell line. The refractive index was measured in eye-drop formulations containing 0.15% or 0.3% HA and 0.5% MalvaT. Surface tension was assessed in eye-drop formulations containing 0.15% HA and increasing concentrations (0.25–2.0%) of MalvaT. Results: Malva showed potent oxygen radical scavenging activity in both cell-free and cell-based assays, indicating its antioxidant capacity and the efficient cellular uptake of antioxidant components. The refractive indices of experimental eye-drop solutions containing HA and MalvaT were close to that of tear fluid (1.334). The surface tension of the experimental eye-drop formulations, while not impacted by 0.15% HA, was significantly reduced by increasing concentrations of MalvaT (p < 0.0001). At the concentration of 0.5% MalvaT, the mean surface tension was reduced from 68.17 mN/m (HA control) to 59.80 mN/m (HA + MalvaT), thereby bringing it closer to that of tear fluid. Conclusions: This pre-clinical study suggests that combining the antioxidant properties of Malva tincture with the lubricating and hydrating effects of HA in eye-drop formulations exhibiting optimal rheological characteristics may offer a promising therapeutic approach for managing DED. Full article

Background/Objectives: Conjunctival closure may influence early postoperative comfort and wound healing after pediatric strabismus surgery. We compared fibrin glue with absorbable sutures using anterior segment optical coherence tomography (AS-OCT)-based conjunctival thickness, serial clinical scores, ocular-surface screening, and operative time. Methods: We retrospectively reviewed 82 children (5–15 years) who underwent bilateral medial rectus recession. The conjunctiva was closed with 8-0 polyglactin 910 (Vicryl) (suture group, n = 40) or fibrin glue (fibrin group, n = 42) according to routine practice; right eyes were analyzed. Conjunctival thickness was measured by AS-OCT preoperatively and at week 6. The comfort questionnaire (CQ) score and inflammation score (IS) were recorded on postoperative day 1 and weeks 1, 2, and 6. Total operative time and closure time were obtained from surgical video recordings. Ocular Surface Disease Index-6 (OSDI-6) and non-invasive keratographic break-up time (NIKBUT) were assessed preoperatively and at week 6 in cooperative children (n = 62). Results: Conjunctival thickness increased in both groups and was slightly higher at week 6 with sutures (p < 0.001), with a slightly greater percentage increase (p = 0.001). CQ and IS were worse with sutures through week 2 (all p < 0.05) and converged by week 6 (both p > 0.05). Fibrin glue shortened total operative time (32.75 vs. 35.46 min; p < 0.05) and closure time (3.90 vs. 5.35 min; p < 0.001). In the ocular-surface subset, OSDI-6 and NIKBUT did not differ between groups at week 6. No infections or granulomas occurred; two early conjunctival wound gaps occurred in the fibrin group and one resolved with topical management, while the other met the dehiscence definition (≥2 mm) and required re-suturing, and both healed without sequelae. Conclusions: In pediatric strabismus surgery, fibrin glue demonstrated better early comfort with a modest difference in conjunctival thickness at week 6 along with slightly shorter operative time while clinical scores converged by week 6, and ocular-surface screening outcomes were similar. Full article

Background/Objectives: Keratitis is an ocular disease caused by microbial infection or by non-infectious damage due to UV light exposure, chemical exposure, or eye injuries. Methods: Moxifloxacin-loaded ufasomes (MOX-UFAs) were optimized using a full factorial design (1².2³) after being prepared by the vortex mixing method. The study evaluated the effects of the oleic acid amount, surface active agent (SAA) amount, and SAA type as independent factors on the entrapment efficiency percent (EE%), particle size (PS), polydispersity index (PDI), zeta potential (ZP), and the amount released after 6 h (Q6h%). Results: The optimized ufasomes (UFAs) formulation was spherical, with an EE% of 78.37 ± 3.91%, PS of 203.13 ± 20.31 nm, PDI of 0.334 ± 0.016, and ZP of −25.42 ± 1.27 mV. The in vitro release of moxifloxacin (MOX) from the UFAs was maintained for more than 6 h in the range of 40.0–75.0%. The optimum MOX-UFAs formulation was incorporated into an in situ gel (Pluronic F-127/HPMC K4M). The ex vivo studies (corneal permeation and confocal laser scanning microscopy) proved the successful retention of the MOX-UFAs-laden in situ gel. Furthermore, the in vitro and in vivo antimicrobial studies revealed their significant antimicrobial effect against Pseudomonas aeruginosa. In addition, the Draize test proved the tolerability of MOX-UFAs-laden in situ gel in animals. Conclusions: The incorporation of MOX-UFAs into Pluronic F-127/HPMC K4M in situ gel could successfully provide sustained ocular delivery and improve the bioavailability of MOX for the management of keratitis. Full article

Background/Objectives: Post-coronavirus syndrome (long-COVID) refers to a multi-systemic range of symptoms that follows acute SARS-CoV-3 infection. Long-COVID has been linked with autonomic neuropathy as well as dry-eye disease (DED), an umbrella term that includes a variety of ocular symptoms and signs. Despite these associations, little is known about the co-occurrence of DED and dysautonomia symptoms in individuals with long-COVID. This study aims to examine relationships between dysautonomia and ocular symptoms in a long-COVID patient population. Methods: Cross-sectional study of 162 veterans with long-COVID. The Composite Autonomic Symptom Score-31 (COMPASS-31) assessed dysautonomia symptoms, and the NASA lean test and heart-rate variability metrics captured dysautonomia signs. Dry-eye disease (DED) symptoms were measured with the 5-Item Dry-Eye Questionnaire (DEQ5) and the Ocular Surface Disease Index (OSDI), while ocular pain intensity and neuropathic pain descriptors were evaluated using a Numerical Rating Scale (NRS) and select questions from the Neuropathic Pain Symptom Inventory modified for the Eye (NPSI-Eye), respectively. Results: Most participants (78%) reported DED symptoms (DEQ5 ≥ 6). Nearly all COMPASS-31 domains were associated with DED symptoms, with the strongest correlation observed between the OSDI and pupillomotor scores (r = 0.67, p < 0.001). Among the autonomic signs, the strongest associations were observed between the change in systolic and diastolic blood pressure from baseline to 8 min and ocular pain triggered by temperature (r = −0.44 and r = −0.48, respectively, p < 0.01 for both). On linear regression analyses, pupillomotor and secretomotor symptoms remained positively associated with DED symptoms, while autonomic signs were most closely related to ocular pain metrics, with fluctuating blood pressure changes during orthostasis relating to neuropathic symptoms. Conclusions: DED symptoms, including ocular pain intensity, relate to autonomic symptoms in a long-COVID cohort. While associations with autonomic signs were less consistent, these data suggest that subtle autonomic variability relates to ocular pain in the long-COVID setting. Full article

Background and Objectives: This study evaluates the safety, tolerability, and efficacy of preservative-free Dorzolamide 2%-Timolol 0.5% (PF-DT), with a focus on improving the ocular microenvironment in a real-world transition setting. Materials and Methods: A prospective, multicenter, open-label study involving thirty patients with dry eye disease previously treated with BAK-DT was conducted. Participants were transitioned to PF-DT, and evaluated at weeks 4, 12, and 24. The primary endpoint was the Ocular Surface Disease Index (OSDI) score. Secondary outcomes included Break-Up Time (BUT), Schirmer test results, corneal staining, conjunctival hyperemia, intraocular pressure (IOP), and patient satisfaction. Results: Twenty-five patients completed the study. The OSDI improved from 21.5 to 12.5 (p < 0.001), with 60.0% of patients showing improvement and 52.0% achieving complete symptom resolution. Among eyes with corneal staining, 78.4% demonstrated a reduction of at least one grade, and 50.0% of those with conjunctival redness showed similar improvement. By week 24, 78.0% exhibited no corneal staining, and 50.0% had no conjunctival redness. BUT increased from 5.0 to 7.0 (p < 0.01), while IOP decreased by 1 mmHg (p < 0.01). Satisfaction regarding comfort (≥80%) and handling (≥50%) was high, with 88.0% preferring PF-DT. Conclusions: Transitioning to PF-DT improved ocular surface health while maintaining IOP control, supporting the benefits of preservative-free formulations in restoring microenvironment homeostasis and enhancing tolerability and patient satisfaction. Full article

Background and Objectives: Tear film instability and corneal surface irregularity are important sources of variability in keratometric and corneal topographic measurements, particularly affecting astigmatic magnitude and axis. Accurate preoperative biometry is crucial for optimal refractive outcomes in cataract surgery. Dry eye disease (DED) may compromise the reproducibility of keratometric parameters, leading to errors in intraocular lens (IOL) power calculation. This study aimed to evaluate the impact of DED on the reproducibility of keratometric measurements and to assess the effect of a four-week treatment with lipid-containing artificial tears on these parameters in cataract patients. Materials and Methods: This cross-sectional study included 116 patients scheduled for cataract surgery, of whom 65 (56.0%) had DED and 51 (44.0%) served as controls. All patients underwent two preoperative keratometric measurements 10–20 min apart (IOL1 and IOL2). The control group proceeded to surgery the next day, while surgery in the DED group was postponed. Patients with DED received preoperative therapy with lipid-containing artificial tears. Follow-up assessments occurred one month after therapy (keratometric measurement named IOL3) and eight weeks postoperatively. Clinical evaluation included slit-lamp examination, dry eye testing according to Dry eye Workshop II (DEWS II) criteria: Ocular surface Disease Index (OSDI), Tear Break-Up Time (TBUT), Schirmer I, Oxford staining, and meibomian gland assessment), ocular biometry, and postoperative spherical equivalent measurement using an auto ref-keratometer. Nonparametric statistical analyses were applied to evaluate associations between parameters. Results: In the DED group, corneal astigmatism showed a significant difference between IOL1 and IOL2 (Wilcoxon signed-rank test {Z = 2.43; p = 0.015}). Significant changes in predicted IOL power were observed between pretreatment and posttreatment values (t = 2.57; p = 0.013) and between IOL2 and IOL3 (t = 2.23; p = 0.029), indicating improved keratometric stability following tear film therapy. No additional significant correlations were identified. Conclusions: DED adversely affects the reproducibility of keratometric measurements and may compromise IOL power selection. Preoperative identification and treatment of DED, followed by repeated biometry after tear film stabilization, are strongly recommended to enhance refractive accuracy and optimize surgical outcomes in cataract patients. Full article

Background: Aloe vera gel in 0.3% hyaluronate (AV/HA) could mitigate glaucoma therapy-related ocular surface disease (GTOSD). Methods: Thirty-nine patients diagnosed with GTOSD and receiving AV/HA or HA underwent ocular surface disease index (OSDI), Symptom Assessment iN Dry Eye (SANDE), National Eye Institute Visual Function Questionnaire (NEI VFQ)-25 questionnaires, and tear matrix metalloproteinase-9 (MMP-9), break-up time (BUT), corneal fluorescein staining (CFS), Schirmer test I (STI), and bulbar conjunctival hyperemia (BCH) determination. Results: After one month, AV/HA increased BUT (5 (7–4.5) to 7 (8–5.5)) and STI (12 (19.5–8) to 13.5 (20–10)), while it decreased BCH (2.2 (2.3–1.3) to 2.1 (2.2–1.2)) and CFS (3 (4–2) to 2 (3.0–1.5)) (p < 0.001). SANDE and OSDI scores were reduced from 36.18 (38.5–20.5) to 22.91 (31.5–17.21), and 29.5 (32.5–19.5) to 20 (26.5–18) (p < 0.001). HA reduced BCH from 2.75 (3.20–2.15) to 2.25 (2.30–1.90) (p = 0.014) and CFS from 3.5 (5–2.75) to 2.5 (4–2) (p = 0.014), while it increased BUT (p = 0.036). The SANDE score decreased from 28.95 (47.6–20.9) to 26.86 (36.41–19.90) (p = 0.009), whereas the OSDI decreased from 40 (49–19.5) to 29 (42–19.75) (p = 0.005). Any significant change in NEI VFQ-25 was collected. A trend for an MMP-9 immunoassay positivity reduction was observed in AV/HA (0.073). Conclusions: These findings invite considering lubricants enriched with natural anti-inflammatory agents, such as Aloe vera, as a potential adjunctive option to improve the ocular surface in glaucoma. Full article

Background/Objectives: Meibomian gland dysfunction (MGD) has been shown to be more prevalent in patients with keratoconus (KC) in Turkey, Egypt, and Israel but has not been examined in the Palestinian Authority (PA). Therefore, this study compared the prevalence and clinical features of MGD in patients with keratoconus versus healthy controls seen in an optometry clinic in the PA. Methods: Patients with KC and healthy controls who were non-contact lens wearers were recruited. Habitual visual acuity (VA), tear break-up time (TBUT), meibography, meibomian gland (MG) expressibility (MES) and quality score (MQS), and Schirmer test were evaluated. MGD was defined by an Ocular Surface Disease Index (OSDI) Questionnaire score ≥ 13, TBUT < 10 s, and MG loss > Grade 1. Outcomes were compared using Mann–Whitney U tests, Chi-Square tests and Spearman correlation. Results: The study included 33 eyes of 17 KC (mean age: 29.2 ± 7.7, range:19–50) and 27 right eyes of 27 control participants (mean age: 34.2 ± 11.7, range:18–56). MGD was prevalent in 67% of KC and 30% of control participants. VA was significantly worse (0.8 + 0.2 vs. 1.0 + 0.0, p < 0.001), with significantly greater MG loss in the lower eyelids (p = 0.002), and shorter TBUT (4.1 ± 1.5 s vs. 5.7 ± 1.7 s, p < 0.001) in the KC group. No significant differences were found in symptoms, MES, MQS, MG loss in the upper eyelids, or Schirmer test. Conclusions: KC patients exhibited a significantly higher prevalence and severity of MGD signs compared with controls. These findings highlight the importance of comprehensive ocular surface evaluation and management in this population. Full article

The aim of this study was to evaluate the performance and safety of T2769 (Thealoz^® Total), a preservative-free eye drop combining 0.15% sodium hyaluronate, 3% trehalose, and 2.45% N-acetylaspartyl-glutamate (NAAGA), in contact lens wearers with dry eye symptoms and discomfort. This prospective, single-arm investigation enrolled 34 adult contact lens wearers with Ocular Surface Disease Index (OSDI) scores ≥ 18 and Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) scores ≥ 12. Patients instilled one drop of T2769 three to six times daily for 36 days. Performance assessments included CLDEQ-8, ocular discomfort and symptoms, OSDI, soothing sensation, and ocular signs. Safety assessments included adverse events (AEs), far BCVA, and ocular tolerance. CLDEQ-8 improved from the baseline at Day 36 (−12.6 ± 5.0; p < 0.001) and as early as D15, with similar improvements in ocular discomfort, OSDI, and total symptom score. Soothing sensation was judged important by 79.4% of patients at D36. Ocular surface staining, tear break-up time, and the Schirmer test improved at D15 and D36, while conjunctival hyperaemia improved in 82.4% of patients at D36. Two non-serious treatment-related AEs (photophobia and blurred vision) occurred in one patient. BCVA was unchanged, and tolerance was rated very satisfactory/satisfactory. In conclusion, T2769 was safe and effective for reducing contact lens-associated dry eyes and discomfort. Full article