Abstract
Purpose :
To examine the relationship between bioaerosols and particulate matter (PM) collected from veteran homes and dry eye (DE) symptoms and signs.
Methods :
Individuals with normal external anatomy were prospectively enrolled. Subjects underwent DE symptom assessment via the Dry Eye Questionnaire 5 (DEQ5), Ocular Surface Disease Index (OSDI), short-form McGill Pain Questionnaire (sf-MPQ) and Neuropathic Pain Symptom Inventory-Eye (NPSI-E). An ocular surface examination included quantification of corneal sensitivity, self-reported pain intensity (range 0-10) to an air-puff delivered at the corneal pain threshold, palpebral conjunctivae assessment for hyperemia (0-2) and papillae (0-2), tear film break up time (TBUT), corneal fluorescein staining (0-15), and Schirmer test with anesthesia. A home visit was conducted within 7 days of the clinical visit. Indoor and outdoor bioaerosols and PM were sampled via Air-O-Cell cassettes and imaged before and after Calberla staining. Customized ImageJ plugins were used to automate bioaerosol and PM counting on stained and unstained images, respectively. Pearson coefficients (r) assessed correlations between bioaerosols and PM and DE symptoms and signs.
Results :
Among 24 subjects, 100% were male with a mean age of 56 years, 46% self-identified as white and 21% as Hispanic. Indoor pollen and mold exposure correlated with self-reported pain intensity to an air-puff (r=0.55, p<0.01; r=0.44, p<0.05, respectively). Indoor pollen counts also correlated with palpebral conjunctival papillae (r=0.44, p<0.05) and hyperemia (r=0.47, p<0.05). Small indoor PM (<0.5 μm) counts correlated with aspects of pain including soreness (r=0.41, p<0.05), itchiness (r=0.43, p<0.05), evoked pain to light (r=0.45, p<0.05), and wind (r=0.43, p<0.05), quantified via the sf-MPQ and NPSI-E. Larger indoor PM (>2.5 μm) counts correlated with self-reported pain intensity to an air-puff (r=0.50, p<0.05). Environmental metrics did not significantly correlate with DEQ5, OSDI, TBUT, corneal staining, or Schirmer scores.
Conclusions :
Aspects of DE involving evoked pain and palpebral conjunctival abnormalities correlated with bioaerosols and PM from individuals’ homes. This suggests that environmental manipulations to reduce bioaerosols and PM, which are more cost-effective and generate fewer side effects than medical therapies, should be considered in individuals with the appropriate DE profile.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.