Research Title: The Role of Oestrogen in Dry eye
Purpose: Women are more prone to ocular surface symptoms and circulating oestrogen levels have been implicated. Fluctuations in oestrogen during the menstrual cycle may influence ocular symptoms but existing research is incomplete and conflicting, partly due to paucity of validated questionnaires to assess daily ocular symptoms. This study aimed to evaluate daily fluctuations in ocular symptoms across a complete menstrual cycle and to compare symptoms in normally menstruating women and women using the combined oral contraceptive pill (OCP).
Methods: To do this, a short online tool to assess daily symptoms was developed. 36 normally menstruating women and 36 women using the combined OCP were recruited. A two-item questionnaire, the Instant Ocular Symptoms Survey (IOSS) was developed and administered on a smartphone platform every day for 40 days. The linear mixed model analysis was used to examine differences in symptom scores over time and between groups.
Results: The IOSS was found to be effective for measuring instantaneous symptoms, exhibiting good diagnostic abilities and repeatability. (AUC ± SE = 0.80 ± 0.07 and ICC = 0.75. Daily ocular symptoms showed a cyclic fluctuation across the cycle (=0.004) and highest symptoms were recorded on day 2 of the cycle when oestrogen levels are lowest. Symptom scores were significantly higher in the OCP group (p=0.02).
Conclusions: Effects of menstrual phase and OCP use should be considered in the interpretation of ocular symptoms in clinical practice. These findings enhance the current understandings of the ocular surface and systemic pain during the menstrual cycle.
Archana Boga graduated from The Bausch and Lomb School of Optometry, India with a great foundation in clinical skills. She then qualified with an MC Optom from the UK in 2007 before practicing around Glasgow for six years.
She then pursued to fulfil her dream of doing research at the renowned School of Optometry and Vision Science at UNSW. Her journey into research started with a question that popped up during her clinical practice “Why are women more prone to dry eye”. Her research aims to understand the role of oestrogen in dry eye and its symptoms in women in an attempt to improve women’s eye health.
2004 B.S. Optom - The Bausch and Lomb School of Optometry, L.V. Prasad Eye Institute, India
2007 MC Optom - The College of Optometrists, UK
Manuscript accepted by The Ocular Surface in May 2019.
- Boga, A., Golebiowski, B., Briggs, N., Stapleton, F “Instant Ocular Symptoms Score (IOSS): A two-item online tool to assess daily fluctuations in ocular symptoms during the menstrual cycle and with the use of oral contraceptives”.
- Gibson E, Boga, A. Sex hormones and dry eye disease. New Zealand Optics. 2016 (Oct):9
Recipient of the SEMO Travel Award - 15th Scientific and 9th Educators Meeting in Optometry, 2018, Melbourne.
Presented at ARVO (The Association for Research in Vision and Ophthalmology) in Washington, Seattle, May 03, 2016.
Boga, A., Golebiowski, B., Betz-Stablein, B., & Stapleton, F. Development of the 2-item Daily Ocular Symptoms Survey to assess day-to-day fluctuations in discomfort and dryness.
Presented at ICCLC (International Cornea and Contact Lens Congress) Conference, Sydney, Sep 08, 2017.
Boga, A., Golebiowski, B., Briggs, N., Stapleton, F. Role of Oestrogen in Ocular Symptoms Across a Complete Menstrual Cycle and with Oral Contraceptive Use.
Presented at SEMO (15th Scientific and 9th Educators Meeting in Optometry) in Melbourne on April 05, 2018.
Boga, A., Golebiowski, B., Stapleton, F. Effects of Oestrogen on Symptoms and Signs of Dry Eye in Women Undergoing In Vitro Fertilisation Treatment.
AFFILIATIONS AND MEMBERSHIPS
MC Optom - The College of Optometrists, UK