Subclinically Dry Eyes in Urban Delhi: An Impact of Air Pollution?

Gupta, Suresh; Gupta, Viney; Joshi, Shree; Tandon, Radhika

doi:10.1159/000066183

Cited by 59 publications

(48 citation statements)

References 6 publications

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“…The impact of urban pollution and environmental toxins on the ocular surface has been evaluated in a few case-control studies. These studies reported a high incidence of ocular discomfort, tear film instability, and ocular surface changes among individuals lived in highly polluted cities of the world (Table 4).Two studies in New Delhi compared the groups of individuals living inside and outside the metropolitan area (63) . A higher frequency of EDED findings with TFBUT <10 seconds, Schirmer Test (ST) <10 mm, and low lysozyme levels in tears were reported among the individuals living within the metropolitan area.…”

mentioning

confidence: 99%

Is dry eye an environmental disease?

Alves¹,

Novaes²,

Morraye³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Previous studies have revealed that eye contact with either air pollutants or adverse indoor and/or outdoor environmental conditions can affect tear film composition and ocular surface components. These effects are mediated by selective binding of the environmental agents to ocular surface membrane receptors, leading to activation of pro inflammatory signaling pathways. The aim of the current review was to examine the published evidence associated with environmental factors and ocular surface disease and dry eye. Specifically, the reader will appreciate why it is possible to refer to them as mediators of Environmental Dry Eye Disease (EDED), a singular clinical entity inside DED context, directly caused by pollutants and/ or adverse climatic conditions. The indicators and clinical findings are described along with EDE differential diagnosis in its acute and the chronic phases. Based on strong existing evidence of clinical reports and epidemiological observations regarding DED and environmental factors we conclude that there is a straight cause-and-effect relationship between ambient stresses and DED. International standards and web-based tools are described for monitoring worldwide environmental conditions referring localities and populations susceptible to EDED. This information is beneficial to health providers to pinpoint the individuals and predisposed groups afflicted with DED. Such insights may not only improve the understanding and treatment of DED but also help to identify the contributing factors and lower the frequency and progression of EDED. of DED has been studied and confirmed in animal models of human DED (13)(14)(15) . KeywordsAs indicated, a healthy and pain-free ocular surface depends on identifying and eliminating factors that cause ambient humidity, airflow and purity, and temperature to intolerable levels. Such an undertaking is needed to preserve tear film qualities commensurate with ocular surface health. This is essential to sustain sufficient corneal refractive power, visual acuity, and ocular comfort (5,16,17) . A desiccating environment can lead to increase in tear film evaporation and/or decline in its turn over and clearance. These initial events lead to exposure of the ocular surface to hazardous environmental elements that trigger or exacerbate EDED symptoms. Clinical findings have shown that increased numbers of people are affected by EDED because of exposure to environmental factors ( Figure 2).Our purpose herein is to provide a critical appraisal of the clinical and epidemiological evidence indicating that DED is influenced by environmental factors. Secondly, we delineate EDED as a single clinical entity with a unique set of symptoms and clinical findings different from that of either DED or other diseases, such as Sjögren's syndrome, diabetes mellitus or drug induced, allergic conjunctivitis, toxic or irritative conjunctivitis, and actinic keratitis. Moreover, we will describe standard tools used to monitor environmental conditions and discuss their relevance in EDED ep...

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mentioning

confidence: 99%

Is dry eye an environmental disease?

Alves¹,

Novaes²,

Morraye³

et al. 2014

Arquivos Brasileiros De Oftalmologia

View full text Add to dashboard Cite

show abstract

“…Smoking, air pollution and drugs have been suggested as risk factors in various studies [2] [7] [11]. Smoking predisposes the eye to tear film instability by its direct irritant action on the eye and represent modifiable risk factors in dry eye causation.…”

Section: Discussionmentioning

confidence: 99%

“…These include no standardization of the type of patients selected for the study, dry eye questionnaires, objective tests and dry eye diagnostic criteria. In literature there are various risk factors for dry eye which include air pollution, smoking, low humidity, high temperature, sunlight exposure and drugs [2] [7]- [11].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Dry Eye and Its Association with Various Risk Factors in Rural Setup of Western Uttar Pradesh in a Tertiary Care Hospital

Ranjan¹,

Shukla²,

Singh³

et al. 2016

OJPM

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Purpose: To study the prevalence of dry eye in a hospital based population of rural setup and to evaluate its association with various risk factors. Material and Methods: In this cross sectional study, patients above 20 years of age were screened randomly for dry eye. An 8 points questionnaires, slit lamp examination of meibomian glands, tear film breakup time, fluorescein staining of cornea, schirmer test were used to diagnose dry eye. The diagnosis was made when three of the five parameters were positive. The role of various occupations as well as role of different exposure factors like sunlight, excessive wind, smoking, drugs, and air pollution as dry eye risk factors was accessed. Result: Out of 445, 45.39% patients had dry eye. Dry eye prevalence was higher in those above 70 years of age (74%). It was higher in male population (51.82%) compare to female population (37.37%), nearly equal in rural (46.04%) and urban population (44.31%) and highest among factory workers (90%). Correlation of dry eye with drugs (P = 0.0002), sunlight/high temperature (P = 0.0003) and smoking (P = 0.03) were significant. Conclusion: This is a hospital based study which provides prevalence of dry eye in rural region of western Uttar Pradesh. It is more common in old age male population and significantly higher in factory workers. Out of different modifiable risk factors most important are drugs, sunlight/high temperature and smoking.

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“…What is believed to cause DES is the abnormality of the pre-ocular tear fi lm, a three-layered structure consisting (from posterior to anterior) of the mucous, aqueous, and the lipid layer. Various risk factors accounting for DES in literature include air pollution, cigarette smoking, low humidity, high temperature, sunlight exposure, and drugs (26)(27).…”

Section: Eye Surfacementioning

confidence: 99%

“…Gupta et al (26) described the effects of air pollution on the eyes of persons residing in New Delhi. Tear fi lm abnormalities were present in a large number of people staying within the city, in comparison to people living outside this area, who apparently had normal eyes.…”

Section: Eye Surfacementioning

confidence: 99%

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

Rozanova¹,

Heilig

Godnič‐Cvar

2009

Archives of Industrial Hygiene and Toxicology

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The Eye - a Neglected Organ in Environmental and Occupational Medicine: An Overview of Known Environmental and Occupational Non-Traumatic Effects on the EyesThe objective of this study was to give an overview of the known literature data on the influence of environmental and occupational factors on the eye. Sixty-six articles were selected by searching Medline and PubMed databases using the following key words in different combinations: occupational and environmental factors, dry eye syndrome, cataract, retinal vascular changes.Most of the studies dealt with conditions on the eye surface and used eye discomfort syndrome and dry eye syndrome to outline the effects of air pollutants. Some reported increased frequency of lens opacities due to indoor fuel exposure, in particular biofuel, and negative effects of styrene exposure on colour vision. Investigations of retinal vascular changes and retinopathy after chronic exposure to carbon disulfide (CS2) and of retinal and choroidal haemodynamics after exposure to carbon monoxide (CO) found that CS2 caused an increase in retinal venous diameters and CO caused an increase in arterial and venous diameters, retinal blood flow velocity, and fundus pulsation amplitude. This article also discusses the influence of light exposure on retinal damage. It shows that very little information is available about the influence of environmental and occupational factors on the eye, and retina and retinal vessels in particular.

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Subclinically Dry Eyes in Urban Delhi: An Impact of Air Pollution?

Cited by 59 publications

References 6 publications

Is dry eye an environmental disease?

Is dry eye an environmental disease?

Prevalence of Dry Eye and Its Association with Various Risk Factors in Rural Setup of Western Uttar Pradesh in a Tertiary Care Hospital

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

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