Purpose: This study aimed to investigate the effects of tricyclic antidepressants, selective serotonin reuptake inhibitors, and selective serotonin noradrenaline reuptake inhibitors on the ocular surface. Methods: The study included 330 eyes of 165 patients using antidepressants and 202 eyes of 101 controls. Tear fluid breakup time, Schirmer I test, and Ocular Surface Disease Index (OSDI) questionnaire were administered. Beck Depression Inventory and Beck Anxiety Inventory were applied to record drug use, dosages, psychiatric disease duration, and remission time. Results: Mean tear fluid breakup time was 14.29 ± 4.81 (4-26) sec, and Schirmer I test value was 16.05 ± 5.89 (2-28) mm in study group. Tear fluid breakup time was 18.16 ± 2.12 (15-24) sec and Schirmer I test value was 16.64 ± 2.31 (15-24) mm in control group (p<0.001 and p=0.005, respectively). In study group, 38.18% (n=63) of patients had dry eye, and 17% (n=18) of patients in control group had dry eye (p<0.001). The mean OSDI score was 82.56 ± 16.21 (66-100) in the tricyclic antidepressants Group, 60.02 ± 29.18 (10-100) in the serotonin reuptake inhibitors Group, and 22.30 ± 20.87 (0-75) in the serotonin-noradrenaline reuptake inhibitors Group (p<0.001). Mean tear fluid breakup time was 14.36 ± 3.35 (10-20) sec in tricyclic antidepressants Group, 13.94 ± 5.81 (4-26) sec in the serotonin reuptake inhibitors Group, and 14.93 ± 4.20 (6-20) sec in serotonin-noradrenaline reuptake inhibitors Group (p=0.730). The mean Schirmer I test value was 9.90 ± 7.22 (2-30) mm in tricyclic antidepressants Group, 15.55 ± 5.15 (2-25) mm in serotonin reuptake inhibitors Group and 17.71 ± 4.21 (10-30) mm in serotonin-noradrenaline reuptake inhibitors Group (p<0.001). There was no statistically significant difference between OSDI score, tear fluid breakup time, and Schirmer I test values in serotonin reuptake inhibitors and serotonin-no­radrenaline reuptake inhibitors subgroups. Conclusions: Dry eye is common in antidepressant users, but considering the ocular surface, serotonin-noradrenaline reuptake inhibitors may be more reliable than other antidepressants. Patients using serotonin-noradrenaline reuptake inhibitors have lower OSDI scores. Serotonin-noradrenaline reuptake inhibitors, which are useful in chronic pain syndromes, may also have a corrective effect on dry eye symptoms.

The visual system plays an important role in providing postural balance. Visual input must have good quality to ensure proper balance. The aim of this work is to compare the use of soft contact lenses and spectacles in terms of postural stability. Patients who wore both soft spherical or toric contact lenses and spectacles were examined between February and July, 2021. A detailed ophthalmic examination, including contact lens evaluation, was performed. The aim was to fully correct the refractive error and to prescribe the most appropriate spectacle and contact lens correction. After 1 month of use, patients were subjected to the balance test. The balance tests were repeated using the Biodex Balance System (Biodex Inc. Shirley, New York, USA), first with contact lenses and then with spectacles, 15 minutes later. Static and dynamic postural stability indices were compared. Thirty patients were included in the study. The mean age of the study group was 31.33 ± 4.54 (26-40) years. All patients had myopic refractive errors (20 patients with myopia and 10 patients with myopia and astigmatism). The mean spherical equivalent was -2.95 ± 1.81 (-4.50-(-0.50)) D. Static stability index score was found to be statistically significantly better in tests with contact lenses (p = 0.004). Among the dynamic postural stability parameters, overall stability index and antero-posterior stability index (APSI) scores with contact lenses were better than with spectacles, but the difference was not statistically significant (p > 0.05 for both). Medio-lateral stability index (MLSI) score was better in tests with contact lenses (p < 0.001). Contact lenses may provide better static and dynamic postural balance than spectacles in young patients with myopic refractive errors.

Horizontal rectus muscle surgeries may cause changes in corneal and anterior segment parameters. Corneal topography is an important device for identifying these alterations. The aim of this work is to evaluate the effects of horizontal rectus muscle surgeries on corneal topography, anterior chamber parameters and corneal wavefront aberrations. Patients who had horizontal rectus muscle surgery from a single hospital in Turkey between September 2021 and March 2022 were invited to participate. Anterior segment parameters and corneal wavefront aberrations were analysed using a Pentacam device. Axial lengths were measured with an intraocular lens biometric instrument. Tests were performed prior to surgery and 3 months after surgery and results were compared. Parameters with significant change were determined in the whole study group, single muscle and two-muscle groups. The amount of change (Δ) in all parameters was compared between the groups that underwent single muscle and two-muscle surgeries. For this prospective study, 44 eyes of 35 patients were included. The mean age was 18.10 ± 6.93 (7-28) (mean ± standard deviation (range)) years. Of the eyes, 22 (50%) underwent single muscle recession surgery. Two-muscle surgeries (recession and resection combination) were performed in 22 eyes. In the whole study group, axial length, anterior corneal surface-steep keratometry, anterior corneal astigmatism and anterior chamber volume increased significantly in the postoperative period (p = 0.002, p < 0.001, p < 0.001, and p = 0.007 respectively). Anterior corneal surface-flat keratometry decreased significantly (p = 0.002). While root mean square (RMS)-Spherical aberration increased significantly for the total corneal surface (p < 0.001), RMS-Trefoil 0° decreased (p = 0.039). Only ΔSteep keratometry and ΔMean keratometry parameters were changed significantly between the two groups. Horizontal muscle surgeries may cause changes in corneal topography, anterior chamber parameters and corneal aberrations. The number of muscles operated during the surgery does not seem to greatly affect the magnitude of changes that occur.