Background: Nutritional imbalances significantly affect ocular physiology, contributing to dry eye disease, cataracts, age-related macular degeneration (AMD), and optic neuropathies. This review summarizes recent evidence on how micronutrient deficiencies and obesity influence eye health. Methods: A narrative search was performed in PubMed, Scopus, and ScienceDirect (last 10 years). Human studies evaluating associations between micronutrients, dietary patterns, obesity, and ocular diseases were included. Out of 843 records, 50 studies met the eligibility criteria. Results: Deficiencies in vitamins A, D, E, C, and B-complex were consistently linked to ocular surface inflammation, retinal oxidative stress, cataracts, AMD, and nutritional optic neuropathies. Altered levels of zinc, copper, selenium, and magnesium were associated with impaired photoreceptor function, glaucoma risk, and retinal degeneration. Obesity emerged as an independent risk factor for AMD, diabetic retinopathy, and glaucoma through mechanisms involving oxidative stress and vascular dysfunction. Evidence from AREDS/AREDS2 supports targeted antioxidant supplementation in intermediate AMD. Conclusions: Adequate nutritional status and metabolic balance play a critical role in preserving ocular health. Early detection and correction of deficiencies may prevent or slow the progression of several eye diseases. Further high-quality trials are needed to define optimal nutritional recommendations.

Background: Sarcoidosis is a systemic inflammatory disease characterized by the formation of non-caseating granulomas, predominantly affecting the lungs and lymph nodes. However, the disease can affect any organ, including the eye, where it most commonly manifests as uveitis and dry eye disease (DED). The Ferning Test (FT), a non-invasive method for tear film analysis, offers insight into tear quality. Through this study, we aimed to evaluate the ability of the FT to diagnose and differentiate DED in patients with sarcoidosis. Methods: The study included a sample of 30 patients, divided into three groups, each consisting of 10 patients: one group of patients with sarcoidosis and dry eye disease (S-DED), one group of patients with DED without other systemic pathologies, and a control group of healthy individuals. Tear film samples were collected from the right eye of each participant, without stimulation, by microcapillarity. A drop of tear was spread on a microscope slide, allowed to dry, and then examined under a microscope to analyze the crystallization pattern. Results: Microscopic analysis revealed a significant difference in the structure and morphology of crystallization, as well as in the number of formed branchings, in sarcoidosis patients compared to patients in the other two groups. This finding suggests a distinct alteration in tear film composition in patients with sarcoidosis. Conclusions: Based on these results, the FT represents a valuable and promising tool for the diagnosis of DED associated with sarcoidosis. Being a non-invasive, easy-to-perform, and inexpensive test, it can be widely implemented in any ophthalmology department, opening perspectives for the test to become an important component among the diagnostic elements of dry eye syndrome in patients with sarcoidosis.

Tear film alterations are commonly associated with ocular pathology. The tear film plays a vital role in maintaining the optical properties of the cornea and contains essential elements required for healing and preserving the integrity of the ocular surface. As a biological fluid, the tear film is easily collected using non-invasive techniques, making it a promising candidate for analysis and often referred to as an ideal biofluid. Several studies have attempted to identify biomarkers in the tear film that could be linked to systemic or ocular disorders, with the goal of developing tools for diagnosis or even early prevention. The quality and quantity of the tear film are influenced by hormonal status, emotional experiences related to social and familial events, and the work environment. Systemic disorders are often reflected at the ocular level through alterations in the tear film. Obesity is a well-recognized public health concern, extensively studied and investigated, much like other common systemic conditions. The presence of low-grade, chronic inflammation associated with excess body weight has been validated in several studies. The strategies for preventing obesity induced dry eye disease are based on regular physical activity, maintaining adequate hydration through sufficient fluid intake, weight loss, and the supplementation of essential fatty acids. This narrative literature review aims to highlight the tear film alterations associated with obesity. The article is intended for ophthalmologists, general practitioners, nutritionists, and researchers.

Objectives: The study examined tear and serum alterations using the ferning test and quantified the number of branches formed during the controlled drying of these biological fluids (tears and serum), in order to identify a potential diagnostic patterning test in individuals with obesity. Methods: A total of 61 patients aged between 25 and 72 years were enrolled (median age [interquartile range] = 39.0 [26] years). BMI values ranged from 19.1 to 47.5 kg/m², with a median BMI (interquartile range) of 29.3 (12.1) kg/m². Results: The Kruskal–Wallis test showed statistically significant differences among at least two Schirmer classes with respect to the number of branches observed in dried tears at a brightness threshold of 220 (H(2) = 8.485, p = 0.014). According to the Dunn post hoc test, Schirmer Class 1 showed a markedly lower number of branches compared with Classes 2 and 3 (p < 0.031 and p < 0.021), whereas no significant difference was found between Classes 2 and 3. The Kruskal–Wallis test further suggested the presence of statistically significant differences in the number of branches in dried serum, quantified using ImageJ2 at a brightness threshold of 190, across visceral fat classes (H(2) = 9.583, p = 0.008). Dunn’s post hoc tests revealed that the number of branches in serum analyzed at a brightness threshold of 190 was significantly higher in visceral fat class 3 compared to class 1 (p_holm = 0.006), while no statistically significant differences were observed between classes 1 and 2 or between classes 2 and 3 (p_holm > 0.05). Conclusions: In addition to other obesity-specific complications patients with obesity exhibit an increased risk of developing dry eye syndrome. The combined assessment of DPT in both the tear film and serum may represent a new method for analyzing obesity-associated biomarkers. Further studies are required to determine the sensitivity and specificity of these approaches in diagnosing systemic alterations induced by excess adipose tissue.

Dry eye disease (DED) has increasingly been linked to oxidative stress; however, the specific redox mechanisms underlying different clinical phenotypes remain incompletely understood. This study aimed to evaluate tear film oxidative stress profiles in patients with primary DED and sarcoidosis-associated DED (S-DED) by assessing lipid peroxidation, antioxidant enzyme activity, and total tear protein content, and to explore their relationship with clinical tear film dysfunction. Tear samples were analyzed for superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities, as well as for malondialdehyde (MDA) and total protein levels, alongside standard clinical tests of tear film stability and secretion. Both DED groups exhibited significant oxidative alterations compared to controls, but with distinct redox signatures. Primary DED was characterized by markedly increased tear MDA levels, indicating predominant lipid peroxidation, whereas S-DED showed a more pronounced impairment of antioxidant defense, reflected by preserved or increased SOD activity in the context of significantly reduced GPx activity. Total tear protein levels were reduced in both groups, with evidence suggesting qualitative protein alterations in S-DED. The tear collection method significantly influenced the measured levels of several oxidative stress markers, underscoring the importance of sampling technique when interpreting tear-based redox profiles. Oxidative stress markers correlated with clinical measures of tear film dysfunction, supporting their physiological relevance. These findings demonstrate that DED encompasses heterogeneous oxidative stress mechanisms and that sarcoidosis acts as a modifier of ocular surface redox homeostasis. Distinct tear-based redox profiles differentiate primary from sarcoidosis-associated dry eye, highlighting the potential value of oxidative biomarkers for phenotyping DED beyond tear deficiency alone.

Central retinal artery occlusion (CRAO) is an acute ophthalmic emergency causing irreversible vision loss due to retinal ischemia. Inflammation is increasingly recognized as a contributor to vascular occlusions, but the relationship between systemic inflammatory biomarkers and structural retinal damage in CRAO remains unclear. This retrospective study included 37 patients with non-arteritic CRAO presenting within 168 h of symptom onset. Optical coherence tomography (OCT) classified ischemic severity as mild, moderate, or severe based on inner retinal morphology. Systemic inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and systemic inflammation response index (SIRI), were calculated from admission blood tests, and associations were analyzed using ordinal logistic regression. Increasing severity correlated with higher NLR and SII values (p < 0.05). Univariable analysis showed significant associations for NLR, SII, neutrophil count, white blood cell count, and central macular thickness (CMT). Multivariable regression identified NLR (OR = 8.398, p = 0.007) and CMT (OR = 1.052, p = 0.001) as independent predictors of greater ischemic damage. Other indices were not significant. These findings indicate that NLR is the primary systemic inflammatory predictor of OCT-defined severity in acute CRAO, with CMT providing complementary structural information.