Eye Discomfort and Air Pollution

Abstract

Discomfort eye syndrome (DES) comprises a series of ‘minor’ subjective symptoms in patients where no relevant clinical signs are observed suggesting ocular disease. Our study includes 100 DES patients, excluding video terminal users, selected from the First Aid Service of our Department over two peak periods in both winter and summer time. The Schirmer test I, ferning test, breakup time and conjunctival cytology (scraping and imprint) were performed and data were related to sex, age and air pollution indexes, recorded in the patients’ living zones. Our results demonstrate that: (i) the ocular surface cytology and the analysis of tear film changes provide significant information in those patients where no other clinical signs are evident; (ii) DES symptoms are more frequent in women than in men (ratio about 2:1), both with ages over 51 years; (iii) DES is significantly associated with ocular surface inflammation, as detected by cytological methods, and (iv) ocular surface subclinical inflammation and ocular dryness are related to high concentrations of atmospheric polluters, in both sexes.

Is dry eye an environmental disease?

“…Women showed higher frequency of symptoms that include ST<10 mm, and higher impression cytology score. In those subjects who lived in more polluted areas (urbanized compared to rural areas), impression cytology documented a greater frequency of keratinization and higher numbers of inflammatory cells (mainly mononuclear cells) in conjunctival scraping scores (44) . Exposure to NO 2 , traffic derived air pollutant, and ocular surface changes were studied in volunteers in Sao Paulo, Brazil, the largest city in Latin America, and compared with individuals from a countryside area.…”

“…Outdoor EDED risk factors include exhaust emissions from automobiles and industrial facilities common in densely populated cities (43,44) . Furthermore, occupational hazards related to large-scale agriculture and sugar cane processing can lead to exposure to gases, particulate matter, UV exposure, and altered microbiota (45,46) .…”

“…If more than one factor is involved, depending upon their characteristics they may interact at lower threshold values and induce EDED. Accordingly, the detrimental effects of environmental toxic agents on EDED epidemiology are not entirely understood (43,44,(60)(61)(62) . The impact of urban pollution and environmental toxins on the ocular surface has been evaluated in a few case-control studies.…”

Eye irritation and environmental factors in the office environment-hypotheses, causes and a physiological model

“…The cause(s) of eye irritation in the indoor environment is(are) unknown, although several suspected factors have been studied (7). One hypothesis is that eye and airway irritation is caused by indoor air pollution (8,9). Another, related to VDU work, is that eye and airway irritation is associated with a reduced blink frequency (blinks per minute) and an increase in water evaporation from the precorneal eye tear film, which could result in dehydration of the tear film (10).…”

The Eye - a Neglected Organ in Environmental and Occupational Medicine: An Overview of Known Environmental and Occupational Non-Traumatic Effects on the Eyes

“…Versura et al (20) conducted a clinical study in 100 patients complaining of DES in the winter and summer using the Schirmer's test I, ferning test, breakup time (BUT), and conjunctival cytology (scraping and imprint). Data were related to sex, age, and air pollution indexes, recorded in the patients' residence areas.…”