Purpose:To assess the effect of oral re-esterified omega-3 fatty acids on tear osmolarity, matrix metalloproteinase-9 (MMP-9), tear break-up time (TBUT), Ocular Surface Disease Index (OSDI), fluorescein corneal staining, Schirmer score, meibomian gland dysfunction (MGD) stage and omega-3 index in subjects with dry eyes and confirmed MGD.Methods:This was a multicenter, prospective, interventional, placebo-controlled, double-masked study. Subjects were randomized to receive 4 softgels containing a total of 1680 mg of eicosapentaenoic acid/560 mg of docosahexaenoic acid or a control of 3136 mg of linoleic acid, daily for 12 weeks. Subjects were measured at baseline, week 6, and week 12 for tear osmolarity, TBUT, OSDI, fluorescein corneal staining, and Schirmer test with anesthesia. MMP-9 testing and omega-3 index were done at baseline and at 12 weeks.Results:One hundred five subjects completed the study. They were randomized to omega-3 (n = 54) and control group (n = 51). Statistically significant reduction in tear osmolarity was observed in the omega-3 group versus control group at week 6 (−16.8 ± 2.6 vs. −9.0 ± 2.7 mOsm/L, P = 0.042) and week 12 (−19.4 ± 2.7 vs. −8.3 ± 2.8 mOsm/L, P = 0.004). At 12 weeks, a statistically significant increase in omega-3 index levels (P < 0.001) and TBUT (3.5 ± 0.5 s vs. 1.2 ± 0.5 s, P = 0.002) was also observed. Omega-3 group experienced a significant reduction in MMP-9 positivity versus control group (67.9% vs. 35.0%, P = 0.024) and OSDI scores decreased significantly in omega-3 (−17.0 ± 2.6) versus control group (−5.0 ± 2.7, P = 0.002).Conclusions:Oral consumption of re-esterified omega-3 fatty acids is associated with statistically significant improvement in tear osmolarity, omega-3 index levels, TBUT, MMP-9, and OSDI symptom scores.

No abstract

in her son. She had diffuse corneal guttata and a slightly up-drawn pupil in both eyes (Figure 2). Intraocular pressure was normal. Indirect ophthalmoscopy revealed a normal retina in the right eye and several peripheral inferior chorioretinal scars in the left eye. The nature of the chorioretinal scars could not be resolved. She had neurologic signs and symptoms suggestive of multiple sclerosis. There were no other family members with similar ocular abnormalities. Comment. This family presents a unique combination of corneal findings that do not fit into known diseases or syndromes. There is some overlap with Peters anomaly, which is usually a sporadic condition characterized by central corneal opacity and defects in the corneal endothelium, Descemet membrane, and posterior stroma. 1-5 In our 2 patients, the corneal opacities were superior and peripheral, and there were no visible defects in Descemet membrane. Furthermore, the disease trait appeared to be inherited in an autosomal dominant fashion. Axenfeld-Rieger anomaly is also autosomal dominant and includes posterior embryotoxon, iris stromal hypoplasia, corectopia, and polycoria, and it can be complicated by glaucoma. 1-3 Visual acuity is normal. Our patients had reduced visual acuity

The fatty acid composition of the diet of seven free‐living subjects (five men and two women) aged 41–56 years was altered for 1 month. The aim was to increase the intake of monounsaturated fatty acids (MUFAs) from subjects current habitual levels of 12% dietary energy to a target intake of 18% dietary energy, and to decrease saturated fatty acid (SFA) from habitual levels of 16% dietary energy to target levels of 10% dietary energy. The change in fatty acid intake was achieved by supplying volunteers with foods prepared using MUFA‐containing spreads or olive oil (ready meals, sweet biscuits and cakes) and also by supplying spreads, cooking oil and MUFA‐enriched milk for domestic use. Body weight and plasma total cholesterol measurements were made at baseline and at 2 and 4 weeks on the diet as an aid to maintaining subject compliance. MUFA consumption was significantly increased from 12% dietary energy to 16% dietary energy (P<0.01), and SFA intake was reduced from 16% dietary energy to 6% dietary energy (P<0.01) during the 4‐week intervention. The diet failed to achieve the target increase in MUFA but exceeded the target reduction in SFA. This was due to the fact that subjects reduced their total fat intake from a mean habitual level of 38% dietary energy to a mean level of 30% dietary energy. During the dietary period, mean plasma cholesterol levels were lower at 2 weeks (P<0.01) and at 4 weeks (P<0.01) than the baseline, with a mean reduction of 20% over the dietary period. This study demonstrates the difficulty of achieving increased MUFA intakes (by SFA substitution) in free‐living populations when only a limited range of fatty‐acid modified food products are provided to volunteers.

ObjectiveThe Wood’s lamp, a handheld instrument that uses long-wave ultraviolet (UV) light with magnification of 2–3 times, is commonly used by non-ophthalmologists for examining patients with eye complaints. The goal of current research was to determine the sensitivity and specificity of the Wood’s lamp for common eye abnormalities.Study designWe examined a convenience sample of patients, 18 years of age and older, who presented for eye complaints to an urgent clinic of a large ophthalmology practice. This prospective observational trial was performed from December 2016 until July 2017. An ophthalmologist examined the patient’s eyes with a Wood’s lamp, followed by examination of the eyes using a slit lamp. The Wood’s lamp was compared with the slit lamp, which served as the gold standard.ResultsThere were 73 patients recruited. The mean age of study subjects (29 female and 44 male) was 49 years. The overall sensitivity of the Wood’s lamp was 52% (38/73; 95% CI 40% to 64%). Based on the principal final diagnosis made with the slit lamp, the Wood’s lamp only detected 9 of 16 corneal abrasions, 5 of 10 corneal ulcers, 5 of 9 corneal foreign bodies, 0 of 4 cases of non-herpetic keratitis, 1 of 2 cases of herpes keratitis, 1 of 5 rust rings and 18 of 28 other diagnoses.Conclusions and relevanceExamination using the Wood’s lamp fails to detect many common eye abnormalities. Our findings support the need for a slit lamp examination of patients with eye complaints whenever possible.

No abstract

No abstract

Although many new and helpful treatments for dry eye disease have been developed, there remains a subset of patients who continue to look for easier or more effective treatments. A consecutive group of 28 moderate to severe dissatisfied dry eye patients in one practice were surveyed after initial exposure to and trial with a novel intranasal neurostimulation technique. Results were overall positive. Seventy-one percent had a favorable impression. Average rating on 1-10 scale was 6.92. Twenty-five percent purchased the device immediately despite no insurance coverage. Of those who did not buy, 100% said they would consider purchase later. Time and experience will show how valuable this new technology is and how it fits in the dry eye armamentarium.