Medical Hypothesis Discovery & Innovation in Ophthalmology
Association of tobacco smoke exposure with dry-eye symptoms and ocular surface signs
By Mohammed Aljarousha, Mustafa Abdu, Kareem Allinjawi and 5 others.
Abstract
Background
Dry eye disease is a multifactorial ocular-surface disorder. Tobacco smoke exposure has been associated with ocular discomfort and altered tear-film measures, although findings remain inconsistent. This study compared dry-eye symptoms and ocular-surface signs between tobacco smoke-exposed and non-exposed participants.
Methods
This cross-sectional reanalysis used a retrospective, de-identified dataset collected in Gaza in 2023. The sample comprised 81 participants: 40 tobacco smoke-exposed and 41 non-exposed controls. Exposure was defined by a pooled self-reported binary item encompassing cigarette smoking, shisha use, passive smoke exposure, or combinations thereof. Arab Ocular Surface Disease Index (Arab-OSDI) score was the primary outcome; tear break-up time (TBUT), Schirmer I test with topical anesthesia (STT), and corneal fluorescein staining (CFS) were secondary outcomes. All 81 records were analyzed with adjustment for sex and age category. Arab-OSDI, TBUT, and STT used ordinary least-squares regression with HC3 heteroscedasticity-consistent standard errors (SEs); CFS used proportional-odds ordinal logistic regression with HC3 covariance. Sensitivity analyses included median quantile regression for Arab-OSDI, log-transformed TBUT regression, and age-category frequency matching.
