Assessment of Tear Film Parameters in Smokers and Subjects with a High Body Mass Index

Abstract

SIGNIFICANCE:The current study compares the ocular tear film parameters in three different groups using a single noninvasive, practical, and easy-to-use tool.PURPOSE: This study aimed to assess the tear film in smokers, those with a high body mass index (BMI), and healthy subjects using the EASYTEAR view+.METHODS: Thirty men with a high BMI (>25 kg/m 2 ; 24.4 ± 6.4 years), 30 smokers (25.1 ± 6.1 years), and 30 healthy subjects (22.2 ± 3.5 years) were recruited. Each subject completed the Ocular Surface Disease Index, followed by the assessment of noninvasive tear breakup time, tear meniscus height (TMH), and lipid layer patterns (LLPs).RESULTS: Significant differences were found in the median TMH scores between smokers and healthy subjects ( P = .03) and between subjects with a high BMI and the healthy ones ( P = .04). The median LLP score was significantly ( P < .001) higher in normal subjects (4.0 [1.0]) than in smokers (2.4 [1.0]) and subjects with high BMI (2.0 [1.3]). For subjects with a high BMI, the noninvasive tear breakup time score was strongly correlated (Spearman rank correlation coefficient; r) with TMH (r = 0.552, P = .002) and LLP (r = 0.555, P = .001). The LLP showed that grade B (lipid layer thickness, 30 to 50 nm; more compact) was common in subjects with a high BMI, grade C (50 to 80 nm, gray waves) was predominant in smokers, and grade D (~80 nm, dense white-blue layer) represented the majority of normal eye subjects.CONCLUSIONS: Smokers and individuals with a high BMI showed significantly lower lipid layer grades and tear meniscus height scores compared with the control group. The assessment of tear film parameters using the EASYTEAR view+ supports the findings of previous studies that implicate smoking and high BMI as risk factors for dry eye.

Assessment of Tear Osmolarity in Smokers Using TearLab and I-Pen Systems

“…As such, the association between dry eye and smoking has been clearly established. The median OSDI score in the current study was comparable to those reported for smokers and subjects with a high body mass index [ 18 , 47 ], but lower compared with the OSDI scores for subjects with diabetes and refractive errors [ 48 – 50 ].…”

Correlation between osmolarity measurements using the TearLab™ and I-Pen® systems in subjects with a high body mass index

“…It should be noted that the median OSDI score for the control group (median 6. [39][40][41] For the study group, the median OSDI score (median 8.0 (IQR 6.8)) was comparable to smokers (median 8.3 (IQR 16.2)) 39 and lower than for subjects with high BMI (median 10.2 (IQR 16.4)), 39 diabetes (median 12.0 (IQR 8.3)), 40 myopia (median 11.0 (IQR 7.5)), 41 and hyperopia (median 10.0 (IQR 33.5)). 41 As reported in a study by Alanazi et al, in subjects with high BMI, there were strong correlations between age and OSDI scores (r = 0.522; p = 0.018), tear meniscus height (TMH) measurements (r =-0.503; p = 0.024) and tear ferning (TF) grades (r = 0.579; p = 0.007).…”

Assessment of tear film parameters post-treatment with commercial eyelid cleaning wipes: a pilot study

“…This device also measures NITBUT, TMH, and LLP. A cutoff of NITBUT than 10s was employed to indicate dryness, while a TMH value below 0.2 mm was considered indicative of dryness [20] . Lipid Layer Pattern Lipid layer patterns were evaluated for each participant based on images captured using EASYTEAR View+ (EASYTEAR S.R.L., Via Maioliche, Trento, Italy).…”