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. 2024 Jun 11;16(6):e62148.
doi: 10.7759/cureus.62148. eCollection 2024 Jun.

Evaluation of Dry Eye Parameters Among Electronic Cigarette Smokers

Rui Ping Chew  1 , Kevin Kwan Joo Ern  1 , Julieana Muhammed  1 , Akmal Haliza Zamli  2
Affiliations

Evaluation of Dry Eye Parameters Among Electronic Cigarette Smokers

Rui Ping Chew et al. Cureus. .

Abstract

Introduction The emergence of electronic cigarettes as the "healthier" version of smoking has been popular, especially among young adults. However, knowledge about the potential effects of e-cigarettes on ocular structures is scarce. Objective To compare the mean change in dry eye parameters between e-cigarette smokers and non-smokers and to correlate between dry eye parameters with device power output. Methodology A cross-sectional, single-visit study was conducted involving 85 e-cigarette smokers and 85 non-smokers. All participants were evaluated on dry eye parameters, including the Ocular Surface Disease Index (OSDI) score, tear meniscus height (TMH), tear break-up time (TBUT), cornea fluorescein staining, and Schirmer's I test. The mean change in dry eye parameters was compared between e-cigarette smokers and non-smokers. The correlation between dry eye parameters with device power output was analyzed. Results Specifically, 32.94% of e-cigarette smokers were found to have a TMH <0.2 mm, compared to only 5.88% of non-smokers (p<0.001). A significant change in mean TBUT was found between the e-cigarette smokers (10.41+2.65 seconds) and non-smokers (12.66+3.14 seconds, p<0.001). The lower mean Schirmer's I test was found among e-cigarette smokers (12.75+7.24 mm, p<0.001). No significant change in the median OSDI score and corneal fluorescein staining. The OSDI score and device power output were found to have a significant positive correlation (p=0.003). There was a significant association between dry eye signs and device power output, including TMH (p=0.047), TBUT (p=0.002), Schirmer's I test (p<0.001), and corneal fluorescein staining (p<0.001). Conclusion Electronic cigarette smokers are prone to develop dry eyes. Concern should be raised on the risk of electronic cigarette use on ocular health, and regulation on e-cigarette ban should be revisited.

Keywords: dry eye; e-cigarette; electronic cigarette smokers; meibomian gland dysfunction; smoking.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Medical Research and Ethics Committee (MREC) of the Ministry of Health Malaysia and awatankuasa Etika Penyelidikan Manusia (JEPeM), School of Medical Sciences, Universiti Sains Malaysia, issued approval NMRR-20-2446-55611 and JEPeM Code: USM/JEPeM/21010045 respectively. This study was reviewed and approved by the Medical Research and Ethics Committee (MREC) of the Ministry of Health Malaysia (IRB Approval Number: NMRR-20-2446-55611). The approval was granted on December 7, 2020. Additionally, this study received ethical approval from the Jawatankuasa Etika Penyelidikan Manusia (JEPeM), School of Medical Sciences, Universiti Sains Malaysia, on March 31, 2021 (JEPeM Code: USM/JEPeM/21010045). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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