SUMMARY The aim was to determine feasibility and reliability of noninvasive tear break-up time (NIBUT) assessment using handheld lipid layer examination instrument, and to compare it with standard tear break-up time (TBUT) test. Fifty patients were enrolled, 31 with and 19 without dry eye symptoms. Schein questionnaire was used to assess dry eye symptoms. During examination, three NIBUT measurements were performed on each eye using handheld instrument, followed by three TBUT measurements. Receiver operating characteristic curves, sensitivity, specificity and logistic regression analysis were generated. Median NIBUT values were significantly shorter in dry eye symptom group than in control group in all three measurements (9, 8 and 8 s vs . 21, 22 and 21 s; p<0.001). TBUT values showed no significant difference between the groups in the first measurement (p=0.053), but the values were significantly shorter in dry eye symptom group in second and third measurements (p=0.020). The cutoff value to distinguish patients with symptoms of dry eye from control group was 12 seconds for NIBUT and 8 seconds for TBUT, with NIBUT having significantly higher sensitivity, specificity, area under the receiver operating characteristic curve and positive predictive value. NIBUT, measured by handheld lipid layer examination instrument, was superior to TBUT in detecting dry eye.

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Aim: To enquire whether patients with dry eye symptoms also report dry skin, whether their perception could be corroborated with objective measurement, and whether dry eye disease might be suspected based on patients' anamnesis.Methods: This cross-sectional study included 50 subjects (25 with and 25 without dry eye symptoms). Schein questionnaire was used to determine the severity of dry eye symptoms. Ocular signs were assessed by conjunctival hyperemia, ocular surface staining, Meibomian gland expression, tear lm lipid layer thickness, tear break-up time, lid parallel conjunctival folds, Schirmer test, and meibometry. Skin dryness was assessed by patients' perception of their facial skin dryness and measured by sebumeter.Results: Subjects without dry eye symptoms had self-reported oilier facial skin than those with dry eye symptoms (p<0.001). Sebumetry scores measured on the forehead and cheek were signi cantly higher in subjects without dry eye symptoms than dry eye subjects (p=0.003). After adjustment for age and gender in a logistic regression analysis, dry eye was independently and signi cantly associated with dry skin (AOR 0.69, p=0.040), higher LIPCOF score of both eyes (AOR 2.28, p=0.028), lower sebumetry score of the forehead (AOR 0.98, p=0.041) and cheek (AOR 0.98, p=0.041), and shorter TBUT score after gland expression (AOR 0.90, p=0.018).Conclusion: This study showed that ocular dryness was subjectively and objectively positively correlated to facial skin dryness -patients reliably described their skin condition: people with dry facial skin also had drier eyes.

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Purpose This study aimed to evaluate the level of treatment adherence and identify predictors of adherence in glaucoma patients during the coronavirus disease 2019 (COVID-19) pandemic in Zagreb, Croatia. Methods The cross-sectional study was conducted among primary open-angle glaucoma (POAG) patients at the Department of Ophthalmology, University Hospital Centre Zagreb, between 1st April 2020 and 1st April 2021. The sociodemographic data, clinical, and drug information were recorded. The treatment adherence was assessed through a self-administered questionnaire, the Culig Adherence Scale (CAS). Statistical analyses were performed using TIBCO Statistica™ 14.0.0. Results 113 POAG patients (48M/65F) with a mean age of 65.89 ± 8.53 years were included in this study. According to the CAS, only 39.8% of patients adhered to topical glaucoma treatment. Educational level was positively related to adherence to treatment (p = 0.022). The main predictors for adherence were the patients' positive attitude towards the drug's effect, family support, and good relationship with the healthcare providers (p < 0.05, respectively). The majority of patients stated forgetfulness as the main reason for skipping drug dosing. Conclusions Non-adherence to treatment was prevalent among patients with POAG during the COVID-19 pandemic in Zagreb, Croatia. Personal beliefs and attitudes towards treatment, family support, and patient-healthcare provider relationship were significant predictors of adherence. Special consideration should be given to the whole health system-level strategies targeting the adherence to treatment, especially in crises, in order to achieve positive therapeutic outcomes. The study protocol was registered in the DRKS - German Clinical Trials Register, DRKS-ID: DRKS00022081.