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Pilot Study of the Influence of Eyeliner Cosmetics on the Molecular Structure of Human Meibum

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Abstract and Figures

Background/aims: It has been suggested that eye makeup could interact with human meibum causing a decrease in the stability of the tear film. The aim of this pilot study was to measure makeup-human meibum interactions in vitro. Methods: Human meibum-makeup interactions were quantified by measuring order-to-disorder lipid phase transitions using infrared spectroscopy. Results: Makeup products exhibited lipid phase transition temperatures that were much higher than those for meibum. One product increased the lipid phase transition temperature by 4.2°C when combined with human meibum causing a large increase (from 30 to 49%) in the order of the meibum-lipid hydrocarbon chains and significantly decreased the minimum frequency, enthalpy and entropy of the phase transition of human meibum. Another eyeliner caused no significant (p < 0.05) change in the phase transition parameters of human meibum. Conclusion: Infrared spectroscopy may be used to measure interactions between human meibum and makeup. One makeup product increased the lipid order (viscosity) which could have adverse effects on tear film stability. Modern cosmetics are highly regulated and relatively safe to use; however, it could be beneficial to design makeup products that do not interact with meibum, especially since women have a higher prevalence of dry eye symptoms.
Content may be subject to copyright.
Short Communication
Ophthalmk
Ophthalmic
Res
2015;53:131
-
135
Received:
August
31,
2014
Research Accepted after revision: January 1,201 S
001: 10.1159/000371852
PUblished
online: February 14,2015
Pilot Study
of
the Influence
of
Eyeliner
Cosmetics on the Molecular Structure
of
Human Meibum
Morgan Huntera
Rahul
Bhola
b Marta
C.
Yapperta
Douglas
Borchman b
Dylan
Gerlach b
Departments
of
'Chemistry
and
bOphthalmology
and
Visual
Sciences,
University of Louisville, Louisville,
Ky.,
USA
KeyWords
Dry
eye·
Infrared spectroscopy' Lipids· Makeup· Meibum
Abstract
Background/Aims:
It
has been suggested that eye makeup
could interact with human meibum causing a decrease
in
the
stability of
the
tear
film.
The
aim
of this pilot study was
to
measure makeup-human meibum interactions
in
vitro.
Methods: Human meibum-makeup interactions were quan-
tified by measuring order-to-disorder
lipid
phase transitions
using infrared spectroscopy. Results: Makeup products
ex-
hibited lipid phase transition temperatures
that
were much
higher
than
those
for
meibum. One product increased the
lipid phase transition temperature
by
4.2Q( when combined
with human meibum causing a large increase (from 30 to
49%)
in
the
order of
the
meibum-lipid hydrocarbon chains
and Significantly decreased
the
minimum frequency, enthal-
py and entropy of the phase transition of human meibum.
Another eyeliner caused
no
significant
(p
< 0.05) change
in
the
phase transition parameters of human meibum. Conclu-
sion: Infrared spectroscopy
may
be used to measure interac-
tions between human meibum and makeup. One makeup
product increased
the
lipid
order (viscosity) which could
have adverse effects
on
tear
film
stability. Modern cosmetics
©
2015
S.
Karger
AG.
Basel
KAR..G
ER..
1~
0030-3747/15/0533-0131$39.50/0
are highly regulated
and
relatively safe
to
use; however,
it
could be beneficial
to
design makeup products
that
do
not
interact with meibum, especially since women have a higher
prevalence of dry eye symptoms. ©
2015
S.
Karger
AG,
Basel
Introduction
Women
and
men
have
painted
their
eyes since
prehis-
toric Paleolithic
and
neolithic times [lJ. Today,
mascara
is applied to the eyelashes to color
them.
Mineral,
linseed,
castor, eucalyptus, lanolin,
turpentine,
sesame oils
and
waxes such
as
paraffin,
carnauba
wax
or
beeswax are
commonly
mixed
with
iron
oxides for
color
[2J.
Reports
of
poisoning
in
Arabic cultures
from
the use
oflead-con-
taining black eye paste have
been
reported
[3J.
Modern
cosmetics are
highly
regulated
and
relatively safe
to
use
[2J.
A specular reflection device
indicated
that
moistur-
izers used
to
remove
cosmetics
appeared
as
oily floaters
or
oily plaques
on
the
surface
of
the
eye,
and
it has
been
suggested
that
eyeliners, eye
shadow
and
mascara
could
block
meibomian
glands,
contaminate
the
meibum
and
increase the debris levels
on
the superficial
lid
layer [4J.
Indeed, lipophilic substances applied to
the
lower
eyelid
RahuJ
Bhola.
MD
Kentucky
Lions
Eye
Center
301
E Muhammad Ali Blvd
E·Mail
karger@karger.com
Louisville,
KY
40202
(USA)
www.karger.com/ore E·Mail rObhoIOI@exchange.louisville.edu
skin are able to reach the inferior tear meniscus supracu-
taneously
and
mix
with the tear film lipid layer
[5,
6].
Maintenance
of
meibum
structure may be critical to nor-
mal tear film function [7].
Dry
eye
is
a multifactorial disease that
is
associated
with elevated tear osmolarity and ocular irritation.
It
is
one
of
the
most
common
causes for patients to consult
with an eye care professional
[8].
It
is
more
prevalent in
women [9,
10]
and, as suggested
but
not
tested (4], could
be exacerbated by eye makeup.
Materials and Methods
The work described has been carried out in accordance with the
Code of Ethics
of
the World
Medical
Association (Declaration of
Helsinki) for experiments involving humans. In this study,
two
pop-
ular cosmetics were mixed with meibum
to
test
if
they altered the
molecular structure
of
human melbum. Meibum
was
collected and
pooled
[11]
from 7 donors present in Professor Borchman's labora-
tory at the time
of
the
study:
MA2l, FC2l,
FB21,
MCS9,
MC22,
FA42
and
FA19,
where M
is
male, F
is
female,
A
is
Asian, C
is
Cau-
casian, B
is
black and the number
is
the
age
of the donor in
years.
The donors did not complain
of
dry
eye
symptoms or have any ocu-
lar
diseases.
Written informed consent
was
obtained from
all
do-
nors. Protocols and procedures
were
reviewed
by
the institutional
review boards
of
the University
of
Louisville.
Stock
(1
mg/mI) CHCl3
solutions
of
meibum alone, and meibum mixed with
25
weight per-
cent makeup were dried onto a
AgCI
window and lyophilized
for
infrared spectroscopic
analysis.
Two
popular brands of eyeliner
makeup were studied: L'Oreal
(Clichy,
Hauts-de-Seine, France) In-
fallible
pencil eyeliner and water-based
Revlon
(New
York,
N.Y.,
USA)
ColorStay liquid eyeliner.
The
L'Oreal product contains over
20
ingredients including cyclopentasiloxane, hydrogenated olive oil
esters, candelilla
wax,
microcristailine
wax,
sodium hyaluronate
as
well
as
iron oxides, titanium dioxide and ferric ferrocyanide. The
Revlon
product
also
contains over
20
ingredients such
as
water,
oc-
tylacrylamide copolymer,
Aloe
barbadensis
leaf juice, imidazolidinyl
urea, methylparaben, ethylparaben, iron oxides and Black
2.
Infrared spectroscopy
was
used to measure and quantify the
phase transitions
of
lipids
[11,
12].
The lipid hydrocarbon chain
conformational order may
be
evaluated in terms of the amount of
CH2 trans- and gauche rotamers. Conformation
is
how molecules
are arranged in space. The methylene moieties may arrange
as
ga
uche rotamers, prevalent in disordered lipids like olive
oil,
which
is
fluid at room temperature. The methylene moieties may also
ar-
range
as
trans-rotamers. more abundant in ordered lipids like but-
ter, which
is
solid at room temperature.
Meiburn and meibum-eyeliner samples were mixed in deute-
rium oxide and deuterated chloroform solvents for nuclear
mag-
netic resonance
(NlvIR)
analysis in a Varian VNMR 700-MHz
NMR spectrometer (Varian, Lexington, Mass.,
USA)
eqUipped
with a S-mm
lH[
13
C/1
SN] 13C-enhanced cold probe (Palo
Alto,
Calif.,
USA).
Data are presented
as
the
average
± the standard error
of
the
mean unless indicated otherwise. Differences were compared using
Student's t test, and a p <
0.05
was
considered statistically significant.
OphthahnlcRes 2015;53:131-135
DOl: 10.1159/000371852
132
Results
The
amount
of
makeup applied to one eyelid was esti-
mated graVimetrically by quantifying
the
amount
of
makeup applied
onto
a
30
x 1
mm
area
of
paper. The av-
erage and standard deviation
of
the
amount
of
L'Oreal
and Revlon products applied
was
0.0010 ± 0.0002
and
0.00305 ± 0.0005
g.
respectively.
The phase transitions for meibum were reproducible,
and the phase transition parameters were similar
to
those
obtained previously for normal
human
meibum
(fig.
la)
[11]. The L'Oreal product Significantly increased
(p
<
0.05) the phase transition temperature
of
meibum
lipid
by 4.2°C (fig. lb, table 1). Because the lipid phase transi-
tion temperature
of
human meibum
is
near the physio-
logical temperature
of
the surface
of
the eye, the small
increase
in
lipid phase transition temperature caused a
large increase, from
30
to
49%,
in the order
or
stiffness
of
the meibum lipid hydrocarbon chains.
The
L'Oreal prod-
uct also Significantly
(p
< 0.05) decreased the
minimum
frequency, enthalpy and entropy
of
the phase transition
of
human
meibum (table
1).
The Revlon
product
caused
no
Significant
(p
> 0.05) change
in
the phase transition
parameters
of
human
meibum
(fig.
Ie, table
1).
Because
of
the high optical opacity
of
the Revlon prod-
uct, very little infrared light
was
transmitted making it tech-
nically difficult to measure
an
exact phase transition of
the
Revlon product alone. Regardless
of
the technical difficulty,
we
observed that both the L'Oreal and Revlon products
alone exhibited phase transitions that were
at
much
higher
phase transition temperatures than for
meibum
(fig.
Id,
table
1).
Broadening
of
the
-CR
r methylene resonances
near
1.24
ppm
[13]
confirmed the interaction
of
the L'Oreal
eyeliner with meibum
(fig.
2).
The Revlon eyeliner showed
little interaction with meibum supporting the infrared
spectroscopy phase transition data.
We
also studied the
in-
teraction
of
the wax paImityl oleate with
the
two makeup
products. PaImityl oleate
was
chosen because it has a phase
transition at a temperature which could be conveniently
measured,
13.1
±0.1
0c,
The phase transition increasedsig-
nificantly (p < 0.0001) to
14.08
±0.07 and 15.32 ± 0.07"C
when the paImityl oleate
was
mixed at
25%
by
weight with
the Revlon and L'Oreal products, respectively.
Discussion
We quantified meibum-makeup interactions
in
a 25%
by weight mixture. Concentrations
of
makeup
much
higher than this could overwhelm the infrared bands
of
Hunter/BholalYappert/Borchmanl
Gerlach
2,855
c
C\
2,854
:.2
u~
2,853
~
"'E
1;;
u
.!!
;:
2,852
~
u
- C
E
~
2,851
E
0"
a-~
2,850
I
'"
2,849
U
2,848
a
2,855
C\
c
2,854
:.2
u
~
ail
2,853
~1
.l:!
C
2.852
...
c
E
'"
2,851
Eg.
2,850
-2,850
a-~
a-~
N
:£'
2,
849
1 I 2,849
u u
2,848
I I I I
2.,848
0
20
40
60
80
10
20
30
40
50
60
70
80
90
c
Temperature
(CCl
d
Temperature
(0C)
2,855
en
-_
....
_--
...
-
0
c:.
2.854
:.2
u~
2.853
~t-E
iii~
2..852
.~
Cj'
Qj
~
2.851
E ::l
E
0"
2.850
»'"
"'-l=
I
'"
2,849
u 2,848
0
20
40
60
80
0
20
40
60
80
Temperature
(CCl
b
Temperature
(0C)
2.855
en
--------
c 2.854
:.2
l::l""
2.853
""
~
§ 2.852
.~
a:
OJ
~
2,851
E ::l
E
0"
Fig.
1.
Lipid
phase
transition
curves
measured using infrared
spec-
troscopy. The lower the
CH
2 symmetric stretching frequency, the
more ordered
the
wax
hydrocarbon chains.
Lines
are
the
fit
of the
data
to
equation 1 in
Borchman
et
al.
[12].
Symbols
are
for
exper-
iments conducted on different
days.
a Human meibum. b Human
meibum plus L'Oreal
Infallible
pencil eyeliner
(25%
by weight).
Table
1.
Lipid phase transition parameters
- - - = Curve
fit
of meibum-only data from
a.
c Human meibum
plus water-based Revlon ColorStay liquid eyeliner
(25%
byweight).
- - -
:::
Curve
fit
of meibum-only data from a. d Comparison of
L'Oreal Infallible pencil eyeliner
(.)
and water-based Revlon
ColorStay liquid eyeliner
(_).
makeup alone.
Phase transition
Meibutl1
Meiburn+
Significance,
Meibum +
Significan~e,
L'Oreal
parameter L'Oreal p
Revlon
p
Minimum frequency,
cm-!
2,850.13±0.16
2,849.59±0.06
0.002*
2,849.84±0.05
0.09
2,848.3±0.1
2,849.55±0.05
Maximum frequency,
cm-!
2,854.08±0.21
2,B53.8±0.1
0.23
2,B53.84±0.OB
0.29
2,854.B±0.2
Cooperativity
B.l±1.3
6.3±1.3
0.33
7.5±0.5
0.67
B.7±0.6
Phase transition
temperature,
°C
2B.9±0.6
33.l±0.5
<0.0001*
27.7±0.3
0.08
57.7±0.6
>44.3
Lipid
order at
33.4°C,
% trans-rotamers
30.0±O.7
49.3±0.7
<0.0001*
31.4±0.3
0.07
96±1
7B.9±0.7
Enthalpy, kcallmol
196±2
120±2
<0.0001*
175±2
<0.0001'"
19l±6
Entropy, kca1/mol/degree
0.650±0.008
0.394±0.005
>0.0001*
0.5B4±0.00B
>0.0001'"
0.58±0.02
Eyeliners: L'Oreal
Infallible
pencil eyeliner and water-based
Revlon
ColorStay liquid eyeliner.
'"
p <
0,05:
statistically significant, when
makeup
was
mixed with meibum
(25%
by
weight). Data
are
the
average
± the standard deviation of the mean. p values were determined
using Student's t test.
Makeup-Meibum Interactions Ophthalmic Res 2015;53:131-135
133
DOl:
10.1159/000371852
I I I I I I I
1.26
1.2.5
1.24
1.23
1.22
1.21
1.20
Parts
per million
Fig.
2.
lH-NMR spectra
of
human meibum (bottom) and human
meibum
with
L'Oreal Infallible pencil eyeliner (toPi
25%
by
weight).
meibum, interfering with the quantification of meibum
lipid conformation. Concentrations
of
makeup much
lower
than
the
3:
1 (meibum:makeup) ratio we used (25%)
would
not
be physiologically relevant since
we
calculate
that the makeup:meibum ratio on the eyelid surface
is
much
higher, 1:10 (91%) to 1:70 (99%), based
on
the
amount
of
casual meibum on the surface
of
the eyelid
[14].
Infrared spectroscopy
was
used in the current study to
measure lipid-makeup interactions with the hydrocarbon
chains. The conformation
of
hydrocarbon chains
of
hu-
man
meibum lipids is in between that
of
fluid-like lipids
such
as
olive oil and/or solid-like lipids such
as
butter
[15]. Fluid lipids are generally
not
completely liquid, but
interact with one another and are said to be
in
a gel phase.
Solid lipids are
not
completely solid and contain some
mobility so they are said to be in a liquid crystalline phase.
We found that one makeup product caused the hydrocar-
bon chains
of
meibum to become more 'solid' and in a
gel
phase where the hydrocarbons pack tightly together and
van der Waals' interactions between hydrocarbon chains
are maximal.
When
the lipids were more fluid
and
in a
liquid crystalline phase, gauche rotamers caused the hy-
drocarbon chains to bend. The surface area
of
fluid lipids
was larger
than
that
of
ordered lipids, and
van
der Waals'
interaction between chains was minimal.
In
simpler
Ophthalmic
Res
2015;53:131-135
134 001: 10.1159/000371852
terms, one makeup product caused the meibum to be-
come more viscous.
Meibum lipid hydrocarbon chains interact with each
other viilhydrophobic van der Waal's interactions
[11,
12].
Cations, which interact with lipids ionically, do not
cause a change in human meibum packing [16]. There-
fore,
we
speculate that the reason why the Revlon-based
product did not cause a change in meibum conformation
is
that the Revlon product
is
water based and insoluble in
solvents such
as
chloroform. Therefore, the hydrophilic
ingredients did not interact with the hydrophobic chains
of the meibum. The
L'Ore<tl
product contains hydropho-
bic moieties such
as
cydopentasiloxane, hydrogenated
olive oil esters, candelilla wax and microcristalline wax.
The acyl chain esters are
all
saturated
and
very ordered.
We found that saturation
is
the major factor that contrib-
utes to hydrocarbon chain order
[11,
12]
and that when a
saturated
wax
was
mixed with an unsaturated one, the
saturated
wax
disproportionately increased the phase
transition of the mixture by apprOximately
30
° C com-
pared with the saturated wax alone [11]. The mixing
of
the saturated waxes with meibum could easily account for
the small 3°C change in the phase transition temperature
observed when the L'Oreal eyeliner was mixed with
meibum
or
synthetic
wax.
Itis doubtful
that
the CH3 moi-
eties
of
cyclopentasiloxane interact with the CH2 hydro-
carbon groups
of
meibum.
We
used the synthetic
wax
palmityl oleate to study the
interaction with makeup. Waxes are the predominant lip-
id species
of
meibum
[7].
At
present
it
is
difficult
to
make
a mixture
of
synthetic lipids
as
a good model for meibum
because meibum contains over '30,000 molecular species'
[17]
of
lipid and the composition
is
complicated by
branched chains, unsaturation and hydroxylation
and
products such
as
(O-acyl)-w-hydroxy fatty acids that are
not available commercially
[7].
The wax palmityl oleate
may be used to screen products
as
we did. We found that
the L'Oreal product increased the phase transition tem-
perature
of
palmityl oleate more effectively than the Rev-
Ion product Similarly to
the
effect it had
on
meibum. Ul-
timately, because of the complexity
of
the
human
meibum
lipidome, it
is
important
to
use human meibum to test
makeup.
As
a pilot study, one must be careful to draw conclu-
sions about the potential functional results of altering the
phase transition parameters
of
human
meibum. The
phase transition temperature
of
meibum from donors
with dry
eye
due to meibomian gland dysfunction
is
high-
er than that of meibum from normal donors [11], simi-
larly to the lipid phase transition-rising effect
of
the
Hunter/Bhola/Yappert/Borchman/
Gerlach
L'Oreal product. Maintenance
of
the lipid phase transi- toms
[9,
10].
Eye
makeup could even be beneficial
if
in-
tion temperature close to the physiological temperature gredients that enhance tear film stability were included in
may be critical to the maintenance
of
a low evaporation the formulations.
rate [18]. Lipid order (viscosity
or
stiffness) has been re-
lated to the release
of
meibum from the meibomian glands
[19]. Makeup carried withmeibum onto the surfaceofthe
Acknowledgments
eye could also affect the surface properties
of
the lipid
This
work
was
supported
by
the
Kentucky
Lions
Eye
Founda-
layer
of
the tear film. There
is
about
33
times more tion and an unrestricted
grant
from
Research
to
Prevent
Blindness
meibum
lipid
on
the eyelid surface compared with the
Inc.
Morgan Hunter's
fellowship
with the Department of Chemis-
layer
of
meibum lipid on the surface
of
tears,
so
contam- try at the University of
Louisville
was
funded
by
the National
Sci-
ination
of
the tear film could be more critical than con-
ence
Foundation
Research
Experience
for
Undergraduates.
Dylan
Gerlach's
fellowship
was
funded
by
the
Nation Institute of Health,
tamination
of
the eyelid surface [14].
Eye
makeup
is
de- Kentucky
Biomedical
Research
Infrastructure Network grant.
signed to stick to the skin and is naturally hydrophobic.
Modern cosmetics are highly regulated and relatively safe
to use; however, it could
be
beneficial to design makeup
Disclosure
Statement
products that do
not
interact with meibum, especially
since women have a higher prevalence
of
dry
eye
symp- None of the authors had a conflict of interest.
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... Power analysis showed that 54 subjects in each group were needed for statistical significance. [13] The primary outcome variables for this study were Schirmer, NTBUT, and meiboscale grading. Skewness for NTBUT, Schirmer, and meiboscale results were 0.305,-0.43, ...
... In vitro studies of pencil and liquid eyeliners show that they disturb the molecular structure of meibum by elevating its phase transition temperature. [13] In vivo observational study of 180 subjects showed a significant correlation between eye cosmetic wear and reduced tear film lipid layer thickness. [10] Prabhasawat et al. study the adverse effects of eyeliner on tear film instability and MG, concluding that materials in eyeliners may be affecting MG function by inducing inflammation around the glands, regardless of the exact location of eyeliner application. ...
Article
Full-text available
Purpose: This study was conducted to see whether eyeliner, mascara, or combined eyeliner and mascara (EM) use affects tear production, tear film stability, and meibomian gland (MG) loss. Methods: Two hundred and twenty healthy women underwent noninvasive tear break-up time (NTBUT) measurement, meibography, and Schirmer testing. Study groups were no makeup (NM) group, eyeliner-only group, mascara-only group, and those who used both EM. The one-way analysis of variance test was used for group comparisons. Chi-square test was used for meiboscale comparison. Results: NTBUT (seconds) results were 11.5 ± 4.8 (no makeup), 21.3 ± 69 (eyeliner only), 21.8 ± 6.5 (mascara only), and 22.5 ± 7.0 (eyeliner-mascara). The differences between groups were significant (P < 0.0001). All makeup groups (eyeliner only, mascara only, eyeliner-mascara) had significantly diminished values compared with NM group (P < 0.001, P < 0.001 and P = 0.003, respectively). Schirmer test (millimeters) results were 22.7 ± 6.4 (NM group), 21.3 ± 6.9 (eyeliner only), 21.8 ± 6.5 (mascara only), and 22.5 ± 7.0 (eyeliner-mascara) with no significant differences between groups (P = 0.66). Meiboscale grading revealed that NM group had significantly lower values of MG loss compared with eyeliner-only (EO) (P = 0.01), mascara-only (MO) (P = 0.002), and eyeliner-mascara groups (P = 0.007). There were no significant differences between EO and MO (P = 0.31), EO and eyeliner-mascara (P = 0.39), or MO and eyeliner-mascara groups (P = 0.91). Conclusion: None of the makeup groups had changes in Schirmer wetting. All eye cosmetic groups have significant changes of NTBUT and meibography compared with NM subjects, and yet combined use of EM does not affect ocular surface more adversely than their separate use.
... In 2011, Ng et al. reported that the ocular discomfort perception was greater when cosmetics were used (P < 0.001), while the Cosmetics users› OSD Index scores were identical to those of nonusers (P = 0.083). [33] Increased debris in the surface tear film lipid layer, meibomian gland blockage, and meibum contamination have all been linked to cosmetic product migration beyond the eyelid margins, [34][35][36] Conjunctival pigmentation results from diffuse pigmentation of the tarsal conjunctiva and conjunctival fornices leading to discrete, punctate deposits. [37][38][39] Kohl, which is popular as an eyeliner in the Middle East, Asia, and Africa, contains high concentrations of lead resulting in lead toxicity and abnormal pigmentation of the conjunctiva and lacrimal sac. ...
Article
Full-text available
Purpose: Incidences of ocular conditions, including meibomian gland dysfunction (MGD), blepharitis, and dry eye have been increasing globally. Eyelid hygiene is key to maintaining ocular surface health and improving ocular symptoms. This study investigated the awareness of eyelid hygiene among the Saudi population. Methods: This cross-sectional survey was conducted between April 2020 and May 2020 across all regions of Saudi Arabia through the distribution of an electronic self-administered questionnaire among the Saudi population. Results: A total of 1102 responses were received (women, 76.3%; men, 23.7%). Only 33.2% respondents reported consciously washing their eyelids, while 70.1% had never heard about MGD; however, most of the respondents (93.2%) had heard about dry eye. Based on the questionnaire results, the Saudi population had suboptimal (18.4%) level of awareness of eyelid hygiene. At least one ocular symptom was reported by 98.1% of the respondents. Conclusion: The level of awareness of eyelid hygiene in Saudi Arabia was found to be suboptimal, particularly among patients with MGD and dry eyes. Poor knowledge about the benefits of daily eyelid hygiene was the primary barrier to its practice. We recommend that ophthalmologists raise awareness of good eyelid hygiene among patients with MGD and eye dryness. Despite the current findings, further studies and evidence are required before recommending daily eyelid hygiene practices in the general population, including those without clinical symptoms of MGD or eye dryness.
... [10,11] Studies using infrared spectroscopy have reported that eye cosmetics might significantly increase medium viscosity, destabilizing the tear film, resulting in higher evaporation rates and dryness. [17] Other complications reported with cosmetics were mascara-laden dacryolith, and conjunctival mascaroma; which is a pigmented mass in the conjunctiva that initially causes a toxic follicular reaction, and later, results in a chronic follicular-papillary reaction. [7] Energy dispersive analysis (EDS) of our specimens indicated that C 65% and S 18% were the major elements without the presence of the lead. ...
Article
Full-text available
Purpose: To determine the incidence of cosmetic-related lacrimal sac black deposits (LSBDs) in primary-acquired nasolacrimal duct obstruction (PANDO) biopsies and the role of LSBD in the pathogenesis of PANDO, in addition to their association with dry eye disease (DED). Methods: A clinicopathological study included all patients who underwent surgical management of PANDO. We excluded patients in whom lacrimal sac biopsy was not taken during the surgery. Lacrimal sac tissues were evaluated for the presence of LSBD and related inflammation, with correlation to the demographics, clinical presentation, and pre-operative clinical assessment of dry eye. P <0.05 was considered statistically significant. Results: Of the 177 PANDO specimens, black deposit aggregates were noted in the sac stroma of 61 lacrimal sac specimens (34.5%; 95% confidence interval: 27.5-47.5). LSBDs were significantly more common in females (P < 0.001). The age, residence, past ailments, and laterality were not associated with LSBD. Dry eye was more common with LSBD (P = 0.004). Other presenting symptoms were not significantly associated with LSBD. The stromal black deposits in biopsies were mostly extracellular or in macrophages. The LSBD in only 10 specimens demonstrated birefringence. Energy dispersive spectroscopy determined that carbon and sulfur were the main elements in the black aggregates. Conclusion: Cosmetic-related LSBD is unlikely to play a role in the pathogenesis of PANDO. However, they were significantly associated with DED.
... [10,11] Studies using infrared spectroscopy have reported that eye cosmetics might significantly increase medium viscosity, destabilizing the tear film, resulting in higher evaporation rates and dryness. [17] Other complications reported with cosmetics were mascara-laden dacryolith, and conjunctival mascaroma; which is a pigmented mass in the conjunctiva that initially causes a toxic follicular reaction, and later, results in a chronic follicular-papillary reaction. [7] Energy dispersive analysis (EDS) of our specimens indicated that C 65% and S 18% were the major elements without the presence of the lead. ...
Article
Full-text available
Purpose: To determine the incidence of cosmetic-related lacrimal sac black deposits (LSBDs) in primary-acquired nasolacrimal duct obstruction (PANDO) biopsies and the role of LSBD in the pathogenesis of PANDO, in addition to their association with dry eye disease (DED). Methods: A clinicopathological study included all patients who underwent surgical management of PANDO. We excluded patients in whom lacrimal sac biopsy was not taken during the surgery. Lacrimal sac tissues were evaluated for the presence of LSBD and related inflammation, with correlation to the demographics, clinical presentation, and pre-operative clinical assessment of dry eye. P <0.05 was considered statistically significant. Results: Of the 177 PANDO specimens, black deposit aggregates were noted in the sac stroma of 61 lacrimal sac specimens (34.5%; 95% confidence interval: 27.5-47.5). LSBDs were significantly more common in females (P < 0.001). The age, residence, past ailments, and laterality were not associated with LSBD. Dry eye was more common with LSBD (P = 0.004). Other presenting symptoms were not significantly associated with LSBD. The stromal black deposits in biopsies were mostly extracellular or in macrophages. The LSBD in only 10 specimens demonstrated birefringence. Energy dispersive spectroscopy determined that carbon and sulfur were the main elements in the black aggregates. Conclusion: Cosmetic-related LSBD is unlikely to play a role in the pathogenesis of PANDO. However, they were significantly associated with DED.
... There have been similar case studies reporting the accumulation of cosmetic products in the lacrimal system and on the ocular surface (9)(10)(11). Some clinical studies have shown migration of externally applied cosmetic material along the eyelid margin (12), and this is thought to predispose eye cosmetics users to tear film instability and the development of dry eye (13,14). Dry eye disease is one of the most common diseases (15). ...
Article
Aim: The aim of this article is to investigate the relationship between ocular comfort and effect of eyeliner containing a microscale colorant, together with the Ocular Surface Disease Index (OSDI) test method. Material and Methods: The formulations were evaluated by determination of sensory, physicochemical parameters, microbial contamination and dermatological patch tests, survey study and calculation of OSDI score. Results: The physicochemical and sensorial parameters of the eyeliner formulation were appropriate for the dermal application. No microbial growth was observed. According to the patch test with 15 volunteers, the eyeliner did not show any allergic or irritant properties. All of the 20 participants who participated to the survey found that the permanence performance of the product successful, 35% of the participants think that the product does not leak or contaminate, 85% of respondents said that the product is easily cleaned and 65% of the participants stated that the product is durable in contact with water. The median OSDI score for the cohort was 22,3 (IQ range 10.4–55.6). OSDI scores were found to be 43,9 (IQ range 12.5 –6.,4) after eyeliner use. Dry eye disease severity remained moderate. 20% of the participants stated that the product caused redness around the eyes. Conclusion: This study shows that eyeliner use is associated with the effect of the chosen dye and the perception of ocular discomfort. In this study, although the participants stated that it was a 95% blacker product, the formulation containing micro dyes had to be reformulated in a discomfort-reducing way.
... The grading could be higher, i.e., worse, if double eyelid tape was used with other eye cosmetics, as the cosmetics themselves have been reported to have adverse effects on the anterior eye health. For example, eye cosmetics such as mascara and eyeliner could cause lacrimal outflow blockage, tear film instability, and meibomian gland obstruction [25,30,31]. ...
Article
Full-text available
Many East Asians apply double eyelid tape to create the double eyelid effect temporarily as a means of increasing their beauty. This study evaluated the effects of four-week wear of double eyelid tape on anterior ocular health in young adult women with single eyelids. Twenty-nine participants who met the inclusion criteria were recruited. The participants’ anterior ocular health was examined including blinking characteristics (blink pattern and blink rate), ocular surface health (presence of corneal abrasion, corneal staining, conjunctival staining, corneal curvatures, meibomian gland dysfunction), tear break up time, intraocular pressure, and subjective comfort level. Participants were required to apply the double eyelid tape for at least eight hours a day and five days a week for four weeks. The parameters were re-measured at the end of each week. There was a significant increase in conjunctival staining, corneal staining, and meibomian gland dysfunction, with a significant reduction in tear break-up time and intraocular pressure. By week 3, all participants had incomplete blinks. There was no significant change in symptoms and subjective comfort level reported. Therefore, patients and eye care practitioners should be aware of the potential implications of double eyelid tape wear on ocular health, with no significant change in subjective comfort.
... Younger ( 45 years) and female patients were found to have a higher inferior papillary reaction, and because this demographic group is more likely to use periocular cosmetics, the latter may play a role in exacerbating symptoms. Complications arising from the usage of cosmetic products near the eye have been well documented [69][70][71][72][73], including dry eye irritative symptoms [74,75]. It may also be possible that environmental factors such as pollution and dust, which are not accounted for this study, may explain the other cases of increased inferior eyelid papillary reaction. ...
Article
Purpose To determine relative contributions of various ocular surface clinical signs and predisposing factors to the magnitude of dry eye symptoms. Methods Clinical audit data were prospectively collected for newly referred dry eye patients. All 2346 patients had an initial visit evaluation of the Ocular Surface Disease Index (OSDI), and a detailed ophthalmic examination including tear breakup time (TBUT), ocular surface fluorescein staining, Schirmer's I test. Among the participants, 1414 had number of liquid meibum expressing glands (NLMEG) evaluated on standard force expression. Other variables collected included history of glaucoma or glaucoma surgery, and history of allergies. Results In patients aged 46.2 ± 14.8 years, 77.4% were women and 87.1% Chinese. The mean ± SD OSDI was 35.2 ± 21.7. On univariate analysis, higher OSDI was associated with glaucoma diagnosis (p = 0.003), glaucoma surgery (p = 0.002), greater temporal corneal staining (p = 0.002), reduced NLMEG (p < 0.001), and higher inferior forniceal papillary grade (p < 0.001). OSDI was not significantly associated with gender, TBUT, Schirmer's I test values, or the use of cyclosporine eyedrops. On multivariate regression, higher OSDI scores were associated with fewer NLMEG (p = 0.002) and increased lower eyelid forniceal papillary grading (p = 0.002). Corneal staining, glaucoma status and glaucoma surgery were not significantly associated with OSDI. Logistic regression showed that severe symptoms (OSDI>32) was associated with <2 NLMEG and [OR(95%CI): 1.34(1.08–1.66)], and presence of inferior eyelid forniceal papillae [1.50(1.17–1.91)]. Conclusions Meibomian gland dysfunction (MGD) and lower forniceal papillary reaction had significant contributions to the severity of symptoms, in contrast to traditional dry eye signs. MGD should be objectively assessed and treated to improve symptoms.
Article
In this report the use of eye cosmetic products and procedures and how this represents a lifestyle challenge that may exacerbate or promote the development of ocular surface and adnexal disease is discussed. Multiple aspects of eye cosmetics are addressed, including their history and market value, psychological and social impacts, possible problems associated with cosmetic ingredients, products, and procedures, and regulations for eye cosmetic use. In addition, a systematic review that critically appraises randomized controlled trial evidence concerning the ocular effects of eyelash growth products is included. The findings of this systematic review highlight the evidence gaps and indicate future directions for research to focus on ocular surface outcomes associated with eyelash growth products.
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Full-text available
Cosmetics are the products that are used to apply to our skin, face and hair every day and its uses are increasing around the world. The substance which are used to improve the appearance are comes under the category of cosmetics. In day-to-day life people are exposed to a great range of harmful chemicals in the form of cosmetics, from the various daily used products like dermal products, beauty products and hair products. These products are used to enhance the appearance or to maintain personal hygiene. Cosmetic products may contain various ingredients. Such substances improve the quality and shelf life of the products but may be toxic to human health. This review paper discusses the composition of various cosmetic products, their role, adverse effects and also highlights about the replacements of some of the harmful ingredients caused by cosmetic products based on the various scientific literature review.
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The use of eye cosmetics is a popular practice in modern times that dates back to ancient civilizations. In this research, Biblical verses dealing with the eye cosmetics are described. Thus, the aesthetic importance, the characteristics of the face illusion, the effect of age, the eyes painted in the art, the pattern of eye cosmetics, the usage pattern in different countries, the types of eye cosmetics, and the adverse effects of the eye cosmetics are presented. Various types of cosmetics were analyzed, such as the usage for eyelash, kohl, make-up, eye shadows, mascara, eye liner, rosin (colophony), and additional cosmetics. In the recent years, the diagnostic possibilities have been validated through scientific research and have shown medicinal value in the diagnostics and the management of conditions associated with the painting of the eyes. This research has shown that the awareness of the eye painting has accompanied human during the long years of our existence.
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The purpose of this study was to determine if the variability in the amount of lid margin meibum is from donor-to-donor or from day-to-day variations and to determine if meibum from donors with meibomian gland dysfunction (MGD) had altered levels of casual eyelid meibum or skin sebum. Lipid absorbent Sebutape(®) was used to collect sebum or meibum. Samples were collected from six donors without dry eye and 21 donors with MGD. Lipid absorbed to Sebutape(®) was quantified using infrared and visible absorbance spectroscopy. The amount of sebum from donors with MGD and donors without MGD was not significantly different. The amount of casual meibum from normal donors was 50% lower than that for donors with MGD using the spectroscopic assay, but was not significantly different using the chemical assay. The frequency and bandwidth of the infrared carbonyl band from sebum samples was significantly higher than that for meibum samples which indicates the carbonyls are in a different "dielectric" environment. The average relative standard deviation for the casual level of meibum and the level of sebum suggests that the 49% relative standard deviation of casual meibum measured once for each subject using a meibometer may have been due to day-to-day variations and not necessarily due to variations between individuals. The values measured using two different assays were correlated and therefore reliable. The idea that tear film instability is associated with the quantity of lid margin lipid is not supported by this study because the quantity did not change with MGD. The amount of forehead sebum was not a bio-marker for MGD. Sebutape(®) is an excellent vehicle to remove tenths of a milligram of meibum from the eyelid and sebum from skin for experimental analysis.
Article
Full-text available
Scientists have been interested in studying the secretions of the meibomian glands for many years, 1– 8 and diseases associated with the meibomian glands (e.g., cancers, posterior blepharitis) have been noted in the medical literature since at least the early part of the 20th Century. 9 –13 However, the term “meibomian gland dysfunction” (MGD) was only introduced by Korb and Henriquez in 1980. 14 The terminology “meibomian gland disease” was later introduced by Bron et al. 15 as an umbrella term to indicate any disease affecting the meibomian glands (see Definition and Classification). Although the etiology of MGD may differ from that of aqueous-deficient dry eye disease (which is due to insufficient lacrimal gland production), the two conditions share many clinical features, including symptoms of ocular surface irritation and visual fluctuation, altered tear film stability, and potential ocular surface compromise. When MGD is of sufficient degree, it may give rise to the second major subtype of dry eye disease, evaporative dry eye. 16 These subtypes are not mutually exclusive, as has been acknowledged. 16
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Understanding the molecular composition (e.g., proteins and lipids) of the tear film (TF) and the contribution of the meibomian gland to the TF is critical in gaining knowledge about TF instabilities, dry eye syndromes, contact lens (CL) incompatibilities, and other eye diseases. Among its functions, the lipid layer of the TF slows evaporation of the aqueous component, preserves a clear optical surface, and forms a barrier to protect the eye from microbial agents and organic matter, such as dust and pollen.1 The TF contains a complex mixture of proteins, enzymes, lipids, mucins, and salts that allows the TF to perform its functions (Fig. 1). Researchers believe the outer lipid layer is 5 to 10 molecules thick and is composed primarily of wax and sterol esters, possibly intercalated with each other and with proteins rather than forming distinct repeating layers of molecules.2,3 Evidence from interferometric studies indicate that the TF lipid layer thickness ranges from 20 to 160 nm.4 If the size of a lipid molecule is approximately 2.2 nm (22 Å), then the calculated thickness for one layer would be 11 to 44 nm. The addition of polar and nonpolar layers would add to the lipid thickness, which indicates that the lipid component of the TF may be multiple layers thick or have other contributing sources to correspond with reported thickness measurements.5 Figure 1. A proposed model of the precorneal tear film showing the relationship and interaction of lipid-binding proteins and the outer lipid layer. While the signs and symptoms of TF instability are reasonably well characterized, we are only beginning to understand the specific molecular components of the TF and their relationship with disease and TF stability. The purpose of this review is to examine the meibomian gland's contribution to TF lipids and lipid–protein interactions in health and disease.
Article
Full-text available
Instability of the tear film with rapid tear break-up time is a common feature of aqueous-deficient and evaporative dry eye diseases, suggesting that there may be a shared structural abnormality of the tear film that is responsible for the instability. It may be that a change in the normal meibum lipid composition and conformation causes this abnormality. Principle component analyses of infrared spectra of human meibum indicate that human meibum collected from normal donors (Mn) is less ordered than meibum from donors with meibomian gland dysfunction (Md). In this study the conformation of Md was quantified to test this finding. Changes in lipid conformation with temperature were measured by infrared spectroscopy. There were two phases to our study. In phase 1, the phase transitions of human samples, Mn and Md, were measured. In phase 2, the phase transitions of model lipid standards composed of different waxes and cholesterol esters were measured. The phase-transition temperature was significantly higher (4°C) for the Md compared with the Mn of age-matched donors with no history of dry-eye symptoms. Most (82%) of the phase-transition temperatures measured for Md were above the values for Mn. The small change in the transition temperature was amplified in the average lipid order (stiffness) at 33.4°C. The average lipid order at 33.4°C for Md was significantly higher (30%, P = 0.004) than for Mn. The strength of lipid-lipid interactions was 72% higher for Md than for Mn. The ability of one lipid to influence the melting of adjacent lipids is termed cooperativity. There were no significant differences between Mn and Md in phase-transition cooperativity, nor was there a difference between Mn and Md in the minimum order or maximum order that Mn and Md achieved at very low and very high temperatures, respectively. The model wax studies showed that the phase transition of complex mixtures of natural lipids was set by the level of unsaturation. A double bond decreased the phase-transition temperature by approximately 40°C. The addition of a second CH CH moiety decreased the phase-transition temperature by approximately 19°C. Unsaturated waxes were miscible with saturated waxes. When a saturated wax was mixed with an unsaturated one, the saturated wax disproportionately increased the phase transition of the mixture by approximately 30°C compared with the saturated wax alone. Cholesterol ester had little effect on the phase-transition temperature of the waxes. Model studies indicated that changes in the amount of lipid saturation, rather than the amount of cholesterol esters, could be a factor in the observed conformational changes. Meibum lipid compositional changes with meibomian gland dysfunction reflect changes in hydrocarbon chain conformation and lipid-lipid interaction strength. Spectroscopic techniques are useful in studying the lipid-lipid interactions and conformation of lipid from individual patients. (ClinicalTrials.gov number, NCT00803452.).
Article
We examined in vitro the evaporation-retarding effect of wax esters (WEs). The WEs resembled closely the most abundant WE species in meibum. A custom-built system was used to measure the evaporation rates through WE layers applied to the air-water interface at 35 °C and, as a reference, at 30 °C and 41 °C. Additionally the melting points of the WEs were determined. The organization and stability of the WE layers were assessed using Brewster angle microscopy (BAM) and Langmuir film experiments, respectively. Four out of nineteen WEs retarded evaporation at 35 °C: behenyl palmitoleate (BP), behenyl oleate (BO), behenyl linoleate (BLN), and behenyl linolenate (BLNN) decreased evaporation by 20-40%. BP was the most effective evaporation retardant. At 30 °C the most effective retardants were BLN and BLNN decreasing evaporation by ~50%, whereas BP and BO decreased evaporation by only 5-10%. At 41 °C each lipid decreased evaporation by only 2-4%. The evaporation-retardant WEs all melted within 2 °C of the physiological temperature. BAM images showed that the evaporation-retardant WE layers spread somewhat uniformly and possibly exhibited areas of condensed lipid. The isotherms suggested that the WE layers were surface-pressure-tolerant but unstable under compression-relaxation cycles. The evaporation-retarding effect is dependent on the physico-chemical properties of the WEs at given temperature and therefore the effect most likely arises from a certain phase of the WE layer. However, WEs as such are poor surfactants and need to be accompanied by polar lipids to form stable lipid layers.
Article
Recent NMR studies suggest that unsaturation may contribute to tear film instability in adults and loss of cholesteryl esters and squalene could reduce tear film stability in adults with meibomian gland dysfunction. The proton resonances were tentatively assigned in those studies. In this current investigation, meibum from seven infants and children, one adult and a pool of adult meibum have been analyzed using a NMR spectrometer with better sensitivity and spectral resolution. The goals of this work are to confirm/correct the previous assignments and to determine possible age-related changes in composition. The initial resonance assignments were confirmed using heteronuclear single quantum correlation spectroscopy. Because there were no significant interferences in the spectral region corresponding to the resonances for cholesteryl and wax esters, the areas of these resonances were used to calculate their molar ratios. We calculated a wax ester:cholesteryl ester molar ratio of 1:0.57 ± 0.05 for all our meibum samples and there were no age-related differences. At lower film thicknesses, the rate of evaporation measured in vitro was lower for wax esters mixed with a long chain cholesteryl ester compared to wax esters alone. However, the film thicknesses tested were non-physiological. Longer chain cholesteryl ester increases the interactions between hydrocarbon chains. Hydrocarbon chains were more saturated in meibum from infants and children compared to adults. Unsaturation may contribute to tear film instability in adults. Loss of cholesteryl ester and squalene could destabilize tear film in adults with meibomian gland dysfunction.
Article
Reduced tear film stability is reported to contribute to dry eye. Rabbits are known to have a more stable tear film than humans. Thus, we sought to examine the tears of rabbits and humans for metal cations, and to test how they influence tear film stability. Tears were collected from 10 healthy humans and 6 rabbits. Tear osmolality was measured by vapor pressure osmometer, and metals analyzed using inductively coupled plasma (ICP) mass spectrometry or ICP atomic emission spectroscopy. The influence of divalent cations on tears was analyzed by measuring surface tension using the Langmuir trough in vitro, using different concentrations of cations in the subphase, and grading the tear break-up in rabbits in vivo after instillation of chelating agents. Rabbit tears had a higher osmolality compared to humans. Major metals did not differ between species; however, rabbits had higher levels of Mg(2+) (1.13 vs. 0.39 mM) and Ca(2+) (0.75 vs. 0.36 mM). In rabbit tears in vitro, diminishing divalent cations resulted in a decrease in the maximum surface pressure from 37 to 30 mN/m. In vivo, an increase in the amount of tear film that was broken-up was found. In contrast, when changing divalent cation concentrations in human tears, the maximum surface pressure remained at 26 mN/m. The normal osmolality of rabbit tears is significantly higher than that in humans. While divalent cations had little influence on human tears, they appear to have an important role in maintaining tear film stability in rabbits.
Article
Use of kohl (called surma in India and Pakistan) as an eye cosmetic is very common, especially among women, children, and babies, not only in North Africa (Morocco, Algeria, Egypt), but also in the Near East and the Middle East, as well in India and Pakistan. This practice has now become widespread in European countries and North America. The cultural custom is very old and has been in use in Egypt since the Ancient Empire. In a great number of kohls available on the free market, lead sulfide is the main component and the very high lead concentration is a risk, particularly for women and children. We report the observation of a case of lead poisoning in a young Moroccan woman caused by prolonged use of a kohl and provide a review of the published literature. This case study should draw the attention of ophthalmologists in French-speaking areas to a public health problem, largely ignored, although real, considering the high lead concentrations found in the majority of kohls. Actions such as prohibition (importation and sale of eye cosmetics made of lead sulfide) have proved to be inadequate. Appropriate educational campaigns directed toward populations using eye cosmetics will be more effective over the long term.