RESUMO
BACKGROUND: Dry eye is one of the most common ophthalmic conditions and can significantly impact quality of life. Meibomian gland dysfunction (MGD) is a major cause of evaporative dry eye. We sought to conduct a systematic review and meta-analysis to estimate the prevalence and incidence of dry eye and MGD in Central and South America and to identify factors associated with disease burden. METHODS: Data sources Ovid MEDLINE and Embase. STUDY SELECTION: A search conducted on August 16, 2021, identified studies published between January 1, 2010, and August 16, 2021, with no restrictions regarding participant age or language of publication. Case reports, case series, case-control studies, and interventional studies were excluded. DATA EXTRACTION AND SYNTHESIS: The review was based on a protocol registered on PROSPERO (CRD42021256934). Risk of bias was assessed in duplicate using a risk of bias tool designed for the purposes of descriptive epidemiological studies. Data were extracted by one investigator and verified by another for accuracy. Prevalence of dry eye and MGD were grouped based on study participant characteristics. MAIN OUTCOMES AND MEASURES: Prevalence and incidence of dry eye and MGD in Central and South America. Summary estimates from meta-analysis with 95% confidence intervals (CI). RESULTS: Fourteen studies (11,594 total participants) were included. The population prevalence of dry eye was 13% (95% CI, 12%-14%) in Brazil and 41% (95% CI, 39%-44%) in Mexico based on one study each. Meta-analyses suggested that dry eye prevalence was 70% among indoor workers (95% CI, 56%-80%; I2, 82%; 3 studies), 71% among students (95% CI, 65%-77%; I2, 92%; 3 studies), and 83% in general ophthalmology clinics (95% CI, 77%-88%; I2, 88%; 2 studies). MGD prevalence ranged from 23% among indoor workers (95% CI, 16%-31%; 1 study) to 68% in general ophthalmology clinics (95% CI, 62%-72%; 1 study). No studies reported incidence of dry eye or MGD. CONCLUSIONS: This systematic review and meta-analysis demonstrated considerable variation in the published prevalence of dry eye and MGD among the general population and subpopulations in Central and South America. Local and subpopulation estimates of dry eye disease burden may be valuable to assist needs assessments and implementation of measures to mitigate the condition.
Assuntos
Síndromes do Olho Seco , Disfunção da Glândula Tarsal , Humanos , Disfunção da Glândula Tarsal/complicações , Prevalência , Qualidade de Vida , Síndromes do Olho Seco/etiologia , Brasil , Glândulas Tarsais , LágrimasRESUMO
PURPOSE: We report our experience with the use of maternally derived serum eye drops as adjunctive treatment in the management of pediatric persistent corneal epithelial defects. METHODS: Five eyes of 4 patients were identified in a retrospective review of pediatric patients with persistent corneal epithelial defects who received maternal serum drops. Diagnoses associated with the defects comprised pontine tegmental cap dysplasia with bilateral cranial nerve V1, V2, V3, and VII palsies; pontine tegmental cap dysplasia with left cranial nerve V1, VII, and VIII palsies; traumatic left cranial nerve II, V1, V2, and VI palsies due to a basilar skull fracture; and Stevens-Johnson syndrome with ocular involvement. We evaluated the feasibility of using maternally derived serum drops; thus, we looked at the ability to prepare and tolerate the drops as well as any complications that could have been associated with treatment. Other data collected included visual acuity, corneal examination, and current and previous treatments. RESULTS: Both the duration of therapy and time of follow-up ranged from 5 to 28 months. All patients experienced improvement or resolution of their corneal epithelial defects within 3 weeks of initiating serum eye drops. Furthermore, there were no adverse effects from the use of allogeneic serum drops. CONCLUSIONS: Maternal serum eye drops are a well-tolerated and potentially beneficial addition to the management of pediatric persistent corneal epithelial defects.
Assuntos
Doenças da Córnea/tratamento farmacológico , Epitélio Corneano/patologia , Soluções Oftálmicas/uso terapêutico , Soro , Criança , Pré-Escolar , Doenças dos Nervos Cranianos/complicações , Epitélio Corneano/efeitos dos fármacos , Feminino , Humanos , Lactente , Masculino , Mães , Estudos Retrospectivos , Síndrome de Stevens-Johnson/complicaçõesRESUMO
PURPOSE: To report cases of acute globe rupture and bilateral corneal burns from electronic cigarette (EC) explosions. METHODS: Case series. RESULTS: We describe a series of patients with corneal injury caused by EC explosions. Both patients suffered bilateral corneal burns and decreased visual acuity, and one patient sustained a unilateral corneoscleral laceration with prolapsed iris tissue and hyphema. A review of the scientific literature revealed no prior reported cases of ocular injury secondary to EC explosions; however, multiple media and government agency articles describe fires and explosions involving ECs, including at least 4 with ocular injuries. CONCLUSIONS: Given these cases and the number of recent media reports, ECs pose a significant public health risk. Users should be warned regarding the possibility of severe injury, including sight-threatening ocular injuries ranging from corneal burns to full-thickness corneoscleral laceration.
Assuntos
Traumatismos por Explosões/etiologia , Lesões da Córnea/etiologia , Sistemas Eletrônicos de Liberação de Nicotina/efeitos adversos , Explosões , Queimaduras Oculares/etiologia , Lacerações/etiologia , Esclera/lesões , Adolescente , Traumatismos por Explosões/diagnóstico , Lesões da Córnea/diagnóstico , Queimaduras Oculares/diagnóstico , Traumatismos Faciais/etiologia , Humanos , Lacerações/diagnóstico , Masculino , Pessoa de Meia-Idade , Acuidade VisualRESUMO
PURPOSE: To report the case of a patient who initially presented with primary acquired melanosis (PAM) without atypia of the conjunctiva and later developed lentigo maligna of the eyelids and PAM with atypia of the conjunctiva. We illustrate the utility of combination topical therapy with adjunctive cryotherapy to treat extensive eyelid and conjunctival lesions. METHODS: Case report with a review of the current literature. RESULTS: Combination of imiquimod 5% cream (Aldara, 3M Pharmaceuticals) and cryotherapy for periorbital lentigo maligna with topical interferon-α2b for conjunctival PAM with atypia led to clinical resolution of pigmented lesions for 21 months. CONCLUSIONS: In our experience, combination topical therapy provides an effective alternative to surgery with superior cosmetic and functional outcomes.