Purpose
To demonstrate the application of Scanning Electron Microscopy with Energy-Dispersive X-Ray Spectroscopy (SEM/EDS) for analyzing Schirmer strips for particle concentration, size, morphology, and type distribution.
Methods
A cross-sectional design was used. Patients were prospectively recruited from the Miami Veterans Affairs (VA) Healthcare System eye clinic and underwent a complete ocular surface examination. Size, type and chemical composition of PM Schirmer strips (from the left eye) were analyzed using SEM/EDS.
Results
Schirmer strips from all six patients showed particle loading, ranging from 1 to 33 particles, while the blank Schirmer strip that served as a control showed no particle loading. The majority of particles were coarse, with an average size of 19.7 μm (95% confidence interval 15 μm to 24.4 μm). All samples contained organic particles (e.g. pollen and mold), and five of the six samples contained non-organic particles. The non-organic particles were composed of silicon, minerals, and metals including gold and titanium. The size of aluminum and iron particles was ≥ 62 μm, whereas the size of two other metals, zinc and gold, were smaller, i.e. < 20 μm. Most metal particles were elongated compared to the organic particles that were round.
Conclusion
Although SEM/EDS has been extensively used in biomedical research, its novel application to assess the size, morphology and chemical composition of the ocular surface particles, offers an unprecedented opportunity to tease out the role of PM exposure in the ocular surface disease and disorder.