TFOS lifestyle: Impact of societal challenges on the ocular surface

Fiona Stapleton; Juan Carlos Abad; Stefano Barabino; Anthea Burnett; Geetha Iyer; Kaevalin Lekhanont; Tianjing Li; Yang Liu; Alejandro Navas; Chukwuemeka Junior Obinwanne; Riaz Qureshi; Danial Roshandel; Afsun Sahin; Kendrick Shih; Anna Tichenor; Lyndon Jones

doi:10.1016/j.jtos.2023.04.006

TFOS lifestyle: Impact of societal challenges on the ocular surface

Ocul Surf. 2023 Apr:28:165-199. doi: 10.1016/j.jtos.2023.04.006. Epub 2023 Apr 14.

Authors

Fiona Stapleton¹, Juan Carlos Abad², Stefano Barabino³, Anthea Burnett⁴, Geetha Iyer⁵, Kaevalin Lekhanont⁶, Tianjing Li⁷, Yang Liu⁸, Alejandro Navas⁹, Chukwuemeka Junior Obinwanne¹⁰, Riaz Qureshi⁷, Danial Roshandel¹¹, Afsun Sahin¹², Kendrick Shih¹³, Anna Tichenor¹⁴, Lyndon Jones¹⁵

Affiliations

¹ School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia. Electronic address: [email protected].
² Department of Ophthalmology, Antioquia Ophthalmology Clinic-Clofan, Medellin, Antioquia, Colombia.
³ ASST Fatebenefratelli-Sacco, Ospedale L. Sacco-University of Milan, Milan, Italy.
⁴ School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia.
⁵ C. J. Shah Cornea Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.
⁶ Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
⁷ Department of Ophthalmology, School of Medicine, University of Colorado Anschutz Medical Campus, Denver, CO, USA.
⁸ Ophthalmology Department, Zhongnan Hospital of Wuhan University, Wuhan, China.
⁹ Conde de Valenciana, National Autonomous University of Mexico UNAM, Mexico City, Mexico.
¹⁰ Cornea and Contact Lens Unit, De Lens Ophthalmics Family and Vision Care Centre, Abuja, Nigeria.
¹¹ Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Nedlands, WA, Australia.
¹² Department of Ophthalmology, Koc University Medical School, İstanbul, Turkey.
¹³ Department of Ophthalmology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
¹⁴ School of Optometry, Indiana University, Bloomington, IN, USA.
¹⁵ Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada.

Abstract

Societal factors associated with ocular surface diseases were mapped using a framework to characterize the relationship between the individual, their health and environment. The impact of the COVID-19 pandemic and mitigating factors on ocular surface diseases were considered in a systematic review. Age and sex effects were generally well-characterized for inflammatory, infectious, autoimmune and trauma-related conditions. Sex and gender, through biological, socio-economic, and cultural factors impact the prevalence and severity of disease, access to, and use of, care. Genetic factors, race, smoking and co-morbidities are generally well characterized, with interdependencies with geographical, employment and socioeconomic factors. Living and working conditions include employment, education, water and sanitation, poverty and socioeconomic class. Employment type and hobbies are associated with eye trauma and burns. Regional, global socio-economic, cultural and environmental conditions, include remoteness, geography, seasonality, availability of and access to services. Violence associated with war, acid attacks and domestic violence are associated with traumatic injuries. The impacts of conflict, pandemic and climate are exacerbated by decreased food security, access to health services and workers. Digital technology can impact diseases through physical and mental health effects and access to health information and services. The COVID-19 pandemic and related mitigating strategies are mostly associated with an increased risk of developing new or worsening existing ocular surface diseases. Societal factors impact the type and severity of ocular surface diseases, although there is considerable interdependence between factors. The overlay of the digital environment, natural disasters, conflict and the pandemic have modified access to services in some regions.

Keywords: Autoimmune disease; Biology; Dry eye; Employment; Infection; Inflammation; Lifestyle; Socioeconomic factors; Systematic review; Trauma.

Publication types

Systematic Review

MeSH terms

COVID-19* / epidemiology
Female
Humans
Life Style
Male
Pandemics*
Poverty
Socioeconomic Factors