“…DES can be caused by various factors such as aging, smoking, health condition, and medications, but it can also be caused by PM exposure. Continuous PM exposure reduces tear film stability, influences the tear osmolality [9], delays corneal epithelium wound healing by inhibiting cell migration [15], and increases oxidation stress on the ocular surface [16]. Furthermore, PAH mixtures increase eye irritation and photosensitivity [17], and high concentrations of heavy metals are associated with DES induction [17,18].…”