Journal of Dry Eye Disease

INTENSE PULSED LIGHT (IPL) TREATMENT FOR DUPILUMAB INDUCED OCULAR SURFACE DISEASE (DIOSD)

Sathi Maiti, Laura M Periman, Natasha Balani — Mon, 03 Jan 2022 00:00:00 -0500

Purpose
To report a case of dupilumab induced ocular surface disease (DIOSD) managed with intense pulsed light (IPL) as an effective adjunct therapy to topical steroids and topical immunomodulator lifitegrast.
Methods
Discussion of a patient’s case with accompanying anterior segment and meibography photos with diagnosed DIOSD for which adjunct therapy with IPL was an effective treatment after limited relief from and difficulty with adherence to traditional treatment with topical steroids and lifitegrast ophthalmic solutions. Conclusion
This case demonstrates the complexity of management required to treat patients with DIOSD and its chronic nature. IPL as a nonpharmaceutical adjunct therapy to topical steroids and immunomodulators in the treatment of DIOSD showed improved signs and symptoms of DIOSD.

In Vivo Wettability of HydraGlyde® Silicone Hydrogel Lens With and Without HydraGlyde® Containing Lens Care Solution

Shi Jie Wong, Fakhruddin Barodawala, Azam N. H. Azmi — Tue, 22 Mar 2022 00:00:00 -0400

Contact lens care solutions are readily available over-the-counter at any pharmacy, optical shop, or eye care specialist centers. The use of a non-compatible solution may damage or alter the material of the contact lens, and may cause changes in the efficiency of the lens, thereby reducing comfort of the wearer. Hence, this research was carried out to determine the wettability of HydraGlyde® Silicone Hydrogel lens with and without HydraGlyde® containing lens care solutions. The right eye of 25 subjects (mean age: 22.8 ± 1.3 years old) were studied. The subjects needed to come for two visits [1 week apart] at approximately the same time of the day. Each subject received the pre-soaked lenses with and without HydraGlyde® Moisture Matrix randomly. The subjects wore the lenses for 8 h. Non-Invasive Tear Breakup Time (NIKBUT) was measured using OCULUS® Keratograph 5M, followed by a subjective questionnaire response.
Parametric paired t-test showed no significant differences in PLTF NIKBUT baseline (16.25 ± 3.75 s)
and after 8 h of lens wear (15.02 ± 3.81 s) when lenses soaked in a solution with HydraGlyde® Moisture Matrix (p > 0.05). However, a significant difference was found in PLTF NIKBUT baseline (16.16 ± 2.79 s), and after 8 h of lens wear (14.74 ± 3.73 s) when lenses were soaked in a solution without HydraGlyde® Moisture Matrix (p < 0.05). The change in the PLTF NIKBUT baseline and after 8 h of lens wear for the solution with and without HydraGlyde® Moisture Matrix (?1.23 ± 3.89 s and 1.68 ± 3.58 s respectively) were not statistically significant (p > 0.05). The subjective questionnaire revealed a preference towards a solution with HydraGlyde® Moisture Matrix with a mean score of 68.84 ± 15.36% compared to without HydraGlyde® Moisture Matrix with a mean score of 62.80 ± 14.00% (p < 0.05). A lens care solution con-taining HydraGlyde® Moisture Matrix is advised to be prescribed along with HydraGlyde® silicone hydrogel lens to achieve optimum lens performance.

The Sequelae of Bilateral Conjunctivitis as an Initial Presentation of Presumed COVID-19 Positive Female

Danielle Piser, Carson Day, Jennifer Harthan — Tue, 23 Aug 2022 10:33:43 -0400

Background and Objective
Presented is a case of a 28-year-old female, who was diagnosed with presumed COVID-19 (SARS-CoV-2) and the sequelae of her bilateral conjunctivitis. Since December 2019, the presence of severe acute respiratory syndrome COVID-19 has swept worldwide, infecting over 170 million to date and counting. It has been discovered that the virus can make its way to the eyes due to an abundance of human angiotensin-converting enzyme-2 on the conjunctiva. There are limited reports accounting for bilateral keratocon-junctivitis associated with SARS-CoV-2, and even less reporting as the initial symptom and the sequelae of the ocular findings that can be associated with a COVID-19 positive patient. In this report, the signs, symptoms, management, and treatment of COVID-19 related keratoconjunctivitis will be discussed.
Methods
Presented is a case of a 28-year-old female diagnosed with presumed COVID-19 and the sequelae of her bilateral conjunctivitis.
Result
A 28-year-old female initially presented to her local emergency room on 7/9/2020 for bilateral red eyes and loss of taste and smell. She tested positive for COVID-19 at that time via a polymerase chain reaction nasopharyngeal swab. There was no conjunctival swab or serology testing of her tears performed. Her ocular symptoms persisted for an additional 3 weeks when she finally presented to our clinic, with bilateral keratoconjunctivitis, after testing negative for the virus 14 days prior.
Conclusion
This case presents findings of an initial presentation of bilateral conjunctivitis secondary to presumed COVID-19. The sequelae of the patient’s ocular findings after testing negative for COVID-19 were of specific interest. This case provides a resource to help guide eye care professionals in proper questioning of those diagnosed with COVID-19 about ocular symptoms they had initially, as well as symptoms that occurred after systemic resolution of the virus infection. Furthermore, this case can help educate eye care professionals on the possible sequalae, management, and treatment of COVID-19-related keratoconjunctivitis to ensure full resolution of its effect and provide a good visual outcome for patients. We will continue to learn more about COVID-19 and its effects on the eye as well as the effect of COVID-19 vaccines on ocular manifestations of the virus.

Management of Glaucoma Medication Induced Dry Eye Disease with Self-retained Cryopreserved Amniotic Membrane

Zarmeena Vendal — Wed, 02 Nov 2022 00:00:00 -0400

Background
Approximately half of glaucoma patients have dry eye disease (DED) due to anti-glaucoma medication use. Herein, we evaluated the effectiveness of self-retained cryopreserved amniotic membrane (AM) in managing glaucoma-induced DED.

Methods
A retrospective chart review was conducted on consecutive patients treated with self-retained cryopreserved AM (Prokera Slim, BioTissue, Miami, FL) for ocular surface disease induced by chronic use of glaucoma medication. Data collected included demographics, diagnosis, associated signs and symptoms, concomitant therapies, and benefit duration.

Results
Eight eyes of eight female patients (aged 80.0 ± 3.9 years) developed DED from chronic use (8.4 ± 2.3 years) of glaucoma medication. DED was refractory despite use of conventional therapies, including topical cyclosporine (n=7), gels (n=5), artificial tears (n=5), and lifitegrast (n=2). However, after treatment with self-retained cryopreserved AM, SPK grade significantly improved from 3.25 ± 0.7 to 0.38 ± 0.5 (p=0.01). Furthermore, visual acuity (VA) improved in all patients by an average of 1.4 ± 0.5 lines (range: 1-2), with a significant improvement in LogMAR VA observed post-treatment (logMAR .28 to .16, p=0.01). This was accompanied by decreased pain (n=5), decreased foreign body sensation (n=5), and improved comfort (n=2) that lasted an average duration of 5.3 ± 1.0 months.

Conclusion
This retrospective study suggests that a single placement of self-retained cryopreserved AM can restore corneal surface health with a lasting benefit in patients with glaucoma-induced DED who are refractory to conventional therapy directly or indirectly by promoting blinking and tearing reflexes.