Baeza Drew C, Penso Johnathon Z, Menendez Dhariyat M, Contreras Julio A, Rock Sarah, Galor Anat, Kumar Naresh
Bascom Palmer Eye Institute, University of Miami Health System, Miami, FL 33136, USA.
Surgical Services, Miami Veterans Healthcare System, Miami, FL 33125, USA.
Int J Environ Res Public Health. 2025 Mar 17;22(3):438. doi: 10.3390/ijerph22030438.
The indoor environment can contribute to dry eye disease (DED) risk, but the effects of environmental modifications on disease are still uncertain. This study evaluated the effect of home interventions that modify the indoor environment on DED symptoms and sign severity.
The prospective study consisted of two visits (6 ± 1 months apart). At each home visit, indoor environmental conditions (temperature, humidity, and airborne particulate matter) were monitored and at each clinical visit, DED symptoms and signs were examined. After the first visit, all participants received a report of their home air quality and 10 recommendations to improve their home environment. At the 6-month visit, participants indicated which interventions they implemented.
A total of 99 subjects participated in the clinical evaluation and home monitoring at baseline and six-month follow-up. Their mean age was 61 years, and 26% identified as Hispanic. Most had mild or greater DED symptoms (5-Item Dry Eye Questionnaire, DEQ5 ≥ 6), with an average DEQ5 score of 10.49 ± 5.51 at baseline. In total, 77% (n = 76) implemented ≥1 intervention with home ventilation (42.4%), air conditioner filter change (36.4%), and exhaust fan use (31.3%) being the most frequent. Overall, with every intervention implemented, tear osmolarity (change from baseline to 6 months) declined by 2% (log-transformed β = 0.02; 95% confidence interval (CI) = 0.00-0.03; < 0.05), and Meibomian gland (MG) plugging declined by 14% (log-transformed β = 0.14; CI = 0.05-24; < 0.05). Specific interventions had specific impacts on DED signs and symptoms. For example, osmolarity declined by a greater degree in those that implemented home ventilation, while DED symptoms improved to a greater degree in those that utilized indoor plants compared to those that did not implement these interventions.
When provided with an objective report of home environmental conditions and remediation strategies, most participants voluntarily implemented low-cost home interventions, which reduced the severity of select DED symptoms and signs.
室内环境可能会增加患干眼症（DED）的风险，但环境改善对该疾病的影响仍不确定。本研究评估了改善室内环境的家庭干预措施对干眼症症状和体征严重程度的影响。
这项前瞻性研究包括两次访视（间隔6±1个月）。每次家庭访视时，监测室内环境条件（温度、湿度和空气中颗粒物），每次临床访视时，检查干眼症症状和体征。第一次访视后，所有参与者都收到了一份其家庭空气质量报告以及10条改善家庭环境的建议。在6个月的访视中，参与者指出他们实施了哪些干预措施。
共有99名受试者在基线和6个月随访时参与了临床评估和家庭监测。他们的平均年龄为61岁，26%为西班牙裔。大多数人有轻度或更严重的干眼症症状（干眼问卷5项，DEQ5≥6），基线时DEQ5平均得分为10.49±5.51。总体而言，77%（n = 76）的人实施了≥1项干预措施，其中家庭通风（42.4%）、更换空调滤网（36.4%）和使用排气扇（31.3%）最为常见。总体而言，每实施一项干预措施，泪液渗透压（从基线到6个月的变化）下降2%（对数转换β = 0.02；95%置信区间（CI）= 0.00 - 0.03；P < 0.05），睑板腺（MG）堵塞下降14%（对数转换β = 0.14；CI = 0.05 - 24；P < 0.05）。具体干预措施对干眼症体征和症状有特定影响。例如，实施家庭通风的人泪液渗透压下降幅度更大，与未实施这些干预措施的人相比，使用室内植物的人干眼症症状改善程度更大。
当提供家庭环境状况和补救策略的客观报告时，大多数参与者自愿实施低成本的家庭干预措施，这降低了某些干眼症症状和体征的严重程度。
