Objectives: The aim of the study was to evaluate self-reported MADE during the COVID-19 pandemic in dental healthcare practitioners and identify their possible risk factors. Material and Methods: An anonymous questionnaire was sent to doctors of dental medicine in the time period from February 2022 to August 2022. The online questionnaire included demographic characteristics and clinical characteristics: presence and deterioration of DED symptoms while wearing the face mask, person-al protective face equipment, use of contact lenses, history of eye surgery, current use of medica-tions, number of hours wearing face mask, and evaluation of subjective DED symptoms using mod-ified Ocular Surface Disease Index (OSDI). Results: A total of 405 participants were included in the study and an overall prevalence of MADE was 29.1% (95% CI: 24.7 -33.6). The participants who used masks more than 6 hours per day during the whole day reported a higher OSDI score (12.5 (IQR = 2.6 - 29.2)) compared to the participants who used masks less than 6 hours/day (6.25 (IQR = 0 - 22.92); Mann-Whitney U Test p = 0.066). Multivariable logistic regression revealed the following possible risk factors for self-reported MADE: age (older than 61 years) OR: 3.522 (95% CI 1.448 -8.563); p=0.05, and wearing the face mask more than 6 h at work OR: 1.779 (95% CI 1.017 - 3.113); p=0.044. Conclusion: The prevalence of self-reported MADE among dental healthcare practitioners appears to be significant. The use of a face mask for a prolonged duration increases OSDI scores. MeSH Terms: face masks, dry eye, MADE, ocular discomfort, COVID-19, protective face equipment

Corneal crosslinking (CXL) is a medical procedure used to treat keratoconus. CXL works by strengthening the collagen fibers of the cornea through the application of riboflavin (vitamin B2) and ultraviolet (UV) light, which helps to stabilize the cornea and prevent further deterioration. There is a recognized risk that CXL can trigger the reactivation of dormant herpes simplex virus (HSV), leading to herpetic keratitis even in patients with no history of herpetic disease. We examined the medical history of 52 patients who underwent CXL procedures due to previously diagnosed keratoconus. We reviewed the patient’s medical histories to assess whether there was a herpes labialis infection and/or herpetic keratitis. Altogether, 52 eyes (from 52 patients) were analyzed. Of those, four (7.69%) patients were diagnosed with epithelial herpetic keratitis on the 5–8th day after surgery. All four patients had a history of herpes labialis and no prior HSV keratitis infection. Two patients developed herpetic keratitis despite prophylactic therapy with acyclovir 5 days before surgery. A positive history of HSV lip infection before CXL was present in 18/52 (34.62%). During a one-year follow-up period, no patient experienced a recurrence. Close follow-up is crucial for diagnosing herpetic keratitis after corneal crosslinking. The use of prophylactic antiviral therapy in patients who are asymptomatic and have a history of recurrent herpes labialis does not guarantee the prevention of infection.

Hashimoto’s thyroiditis (HT) is an autoimmune thyroid disease with characteristic lymphocytic infiltration and fibrosis. Chronic autoimmune changes that occur in the thyroid gland in HT may also affect the lacrimal gland. Objectives: This study aimed to analyze tear biomarkers and explore correlations between these biomarkers and clinical ocular parameters in patients with HT. Methods: A total of 150 participants were divided into three groups: HT (N = 50), non-HT DED (N = 50), and healthy controls (N = 50). The participants underwent a series of diagnostic tests for DED, including the Ocular Surface Disease Index, Tear Break-Up Time, Lid-Parallel Conjunctival Folds, Schirmer test without anesthetic, lissamine green and fluorescein staining. Tear samples were analyzed for cytokine and enzyme levels (interleukin 1β, tumor necrosis factor α, interleukin 6 (IL-6), interleukin 8, interleukin 10 (IL-10), interleukin 17A, matrix metalloproteinase 9 (MMP-9)) using ELISA and multiplex immunoassay. Statistical analyses were conducted to compare groups and assess biomarker correlations. Results: Dry eye disease was observed in more than half of the study group (27/50), with severe symptoms observed in 48.15% of the DED HT subgroup. IL-6 levels were significantly elevated in the DED HT subgroup compared to the non-HT DED group (p = 0.010), suggesting specificity for HT-associated DED. MMP-9 was elevated in both the HT and non-HT DED groups (p < 0.001) but lacked specificity for HT (p = 0.059). The DED HT subgroup exhibited significantly lower IL-10 levels (p = 0.008). Lissamine green staining and LIPCOF were significantly higher in the DED HT subgroup (p < 0.001). Conclusions: Dry eye disease is common in euthyroid HT patients without signs of TAO. This study highlights the potential role of IL-6. Lissamine green staining and LIPCOF are valuable diagnostic tools for assessing the ocular surface in DED HT patients.

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.

This pilot study evaluated the therapeutic effects of oral melatonin in patients diagnosed with primary Sjögren’s syndrome (pSS) and dry eye disease (DED). Twelve patients were treated with 5 mg of melatonin daily over an eight-week period. After treatment, significant improvements were recorded in Schirmer I test, tear break-up time (TBUT), and National Eye Institute (NEI) staining scores. Symptom severity decreased according to the Ocular Surface Disease Index (OSDI) and the EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI). Additionally, a significant reduction in serum interleukin-6 (IL-6) levels was observed, while C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) remained unchanged. Visual inspection of individual scores demonstrated a consistent trend of clinical improvement. No adverse effects were reported during the study period. These preliminary findings suggest that melatonin supplementation could represent a safe, adjunctive therapeutic strategy for managing autoimmune dry eye in pSS patients. Further large-scale clinical trials are warranted to confirm these results and explore the underlying mechanisms.