The investigation of the effect of incense use on patients with dry eye diseases: A clinical interview-based study

Abstract

Background Incense is burning regularly in Saudi culture. Studies show that incense smoke is considered one of the indoor air pollutants and has been associated with affecting human health. Therefore, this study compared DED patients with cataract patients concerning their incense use, frequency of DED symptoms, blood inflammatory biomarkers, and ocular examination in patients in King Abdulaziz Medical Center (KAMC)- Jeddah, Saudi Arabia. Methodology A total of 64 patients participated in the prospective research study from August 2022 to December 2022 and performed a cross-sectional interview study at ophthalmology outpatient clinics using a pre-designed, validated questionnaire. The participants were divided into two groups: the study group, DED diagnosis, and the control group, cataract diagnosis. Blood biomarker tests and demographic data were gathered and analyzed. The means, standard deviations, and medians of the blood test and TBUT results were calculated. The PLR and NLR were calculated, and the correlation between all PLR, NLR, and TBUT values was investigated. Statistical analysis was utilized to determine the incense risk factors associated with the diagnosis. Results Patients with DED were older adults, more females, and high BMI. The type of incense used was high in synthetic wood. The dry eye disease symptoms frequency was eye fatigue (66.7%), and the highest intensity was itching (29.5%). There were increases in tear break-up time (TBUT) and inflammatory blood biomarkers values between groups with insignificant differences. There was a positive correlation with significant differences among DED patients between NLR and PLR and between TBUT (OS) and TBUT (OS). Conclusion This study shows that incense smoke might be a risk factor for increased tear break-up time and inflammatory blood biomarkers and has been indicated to cause dry eye symptoms. Additionally, the availability of a blood provocative test detecting DED ability markers besides ocular examination will be a significant advantage for managing DED to prevent adverse outcomes. It is recommended that people use natural incense rather than synthetic incense, use incense smoke for shorter periods, and ventilate their surroundings when burning incense at home to prevent dry eye disease and other health problems.