Tear film insufficiency: Link to ocular inflammatory conditions

Summary: Abstract Body: Tear film insufficiency (TFI) is a multifactorial condition characterized by tear prism instability, disruption of the ocular surface homeostasis, tonicity alterations and sensory dysfunction. It includes both aqueous-deficient and hyper-evaporative types, with the latter primarily linked to meibomian gland dysfunction. Despite its high prevalence, the comorbidities and systemic implications of TFI remain understudied. This study utilized the NIH All of Us (AoU) program to explore the associations between TFI and inflammatory eye disorders. A cohort of 21,740 TFI patients was matched with control subjects based on sex, age, race/ethnicity, income, and education. Logistic regression models assessed the odds of having co-occurring inflammatory eye conditions, including chalazion, conjunctivitis, dacryocystitis, episcleritis, hordeolum, keratitis, orbital cellulitis, and uveitis. The results revealed that TFI patients had significantly higher odds of developing these conditions compared to matched controls. Specifically, TFI patients had increased odds of keratitis (OR: 15.99), chalazion (OR: 6.78), and conjunctivitis (OR: 6.33), among others. After adjusting for confounders, these associations remained significant, with strong odds for keratitis (OR: 12.46) and chalazion (OR: 5.83).These findings highlight that TFI is strongly associated with an increased likelihood of inflammatory eye disorders. Recognizing TFI as an early indicator of more severe ocular and systemic conditions can help clinicians adopt a more proactive and multidisciplinary approach to treatment, potentially preventing further complications. Early detection and management of TFI could reduce the risk of developing these associated inflammatory disorders, improving patient outcomes. Rawle Sekhon¹, Amritpal Kooner², Beniamin Zeka² 1. Windsor University School of Medicine, Cayon, Saint Mary Cayon Parish, Saint Kitts and Nevis. 2. Midwestern University Chicago College of Osteopathic Medicine, Downers Grove, IL, United States. Clinical Research: Epidemiology and Observational Research