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    Impact of vitamin D supplementation on the ocular surface in patients with vitamin d deficiency
    (2020) Alakus, Mehmet Fuat; Oncul, Hasan; Yilmaz Oncul, Fatma; Dag, Umut; Arac, Esref
    Aim: The aim of this study was to determine the effect of vitamin D (vit D) supplementation on the ocular surface parameters in patients with vit D deficiency.Material and Methods: In total, 63 patients with serum vit D deficiency were included. Patients were treated with an oral dose of 300.000 IU cholecalciferol. The ocular surface disease index (OSDI) questionnaire, fluorescein tears breakup time (FBUT), Oxford score, and Schirmer’s 1 test were performed for all patients. The data was obtained initially and at 4, 8, and 12 weeks after vit D supplementation.Results: Forty-nine of the patients were female and 14 were male. The mean age was 30.8±9.7 (18–58) years. All 63 patients came to the first follow-up, 57 patients came to the second follow-up, and 48 patients came to the third follow-up. The OSDI and Oxford scores yielded statistically significant decreases, while Schirmer’s 1 test and FBUT values showed a statistically significant increase after treatment with vit D. A positive correlation was observed between vit D values and FBUT and Schirmer’s 1 values; there was a negative correlation between OSDI values (r=0.286 and p0.001, r=0.219 and p=0.032, r = -0.357 and p0.001, respectively). The dry eye findings improved significantly after vit D supplementation in all cases. Conclusion: During clinical follow-up, it is important to evaluate serum vit D levels in patients with dry eye syndrome (DES). Increasing their vit D levels will help clinicians to treat DES quickly and effectively.
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    Intraocular pressure changes in the intensive care unit: The effect of spontaneous respiration, mechanical ventilation, non-invasive CPAP and medical treatments
    (2019) Oncul, Hasan
    Aim: The aim of this study was to investigate the intraocular pressure (IOP) changes in patients in intensive care unit (ICU) and the parameters that cause these changes.Material and Methods: In total, 304 eyes of 152 patients were examined. IOP and central corneal thickness (CCT) were measured. Age, sex, hospitalization (surgical/non-surgical causes), type of ventilation (spontaneous, intubated, non-invasive continuous positive airway pressure (CPAP), Glasgow coma scale, use of hypertonic solution and sedation status were evaluated.Results: The mean age was 63.52±21.47 (range: 18–96) years, and the male/female ratio was 73/79. The mean hospitalization time was 30.91±47.80 (8-297) days, and the mean Glasgow coma scale score was 9.61±4.42. While 33 patients (21.7%) had hypertonic solution, 28 (18.4%) were sedated. The mean IOP was measured as 13.81±3.58 (6–28) mmHg. In 5 patients, the IOP was more than 20 mmHg, and in 14 patients, it was less than 10 mmHg. It was observed that gender and hospitalization diagnosis had no effect on the IOP change (p=0.97, p=0.814, respectively). When the patients were evaluated according to their respiration types, there was no statistically significant difference in IOP values between patients with spontaneous respiration and intubated patients (p=0.261), but non-invasive CPAP patients were significantly different from patients with spontaneous breathing (p=0.035) and intubated patients (p0.001). In addition, the use of hypertonic solution and sedation significantly decreased IOP (p0.001 in both groups).Conclusion: Some changes in IOP were observed due to some applications in the ICU. These changes are often not significant in patients with no eye problems. However, patients with a glaucoma diagnosis or susceptibility to glaucoma, as well as patients with simultaneous IOP reduction, should be carefully monitored for IOP changes.