Evaluation of the effects of electronic cigarettes on the tear film of Smokers using Keratograph and SM Tube

Purpose:  To evaluate the effects of e-cigarettes on tear film by comparing the tear film parameters of smokers and non-smokers using Keratograph and SM Tube. Study Design:  Cross sectional study. Place and Duration of Study:   Qasim University, from Saudi Arabia. Methods:  A total of 60 males of age group 20 – 38 years were divided into three groups (Twenty non-smokers, 20 tobacco smokers and 20 vapor users). After consent, dry eye symptoms questionnaire was given to the participants. Four different test parameters through the Keratograph (5M JENVIS). Tear meniscus height, non-invasive tear break-up time, ocular redness and lipid layer thickness were measured. The new strip menis cometry tube (SM Tube) was used to test tear production. Data were analyzed using Statistical Package for Social Sciences (SPSS) with p value of less than 0.05 considered as significant. Results:  The average tear breakup time was significantly decreased in both smokers and vapors group (10.15 ± 1.92 and 10.25 ± 2.65 respectively) than in nonsmokers (13.35 ± 2.36). There was also statistically significant difference in tear meniscus height, redness and lipid layer thickness between e-smokers and non-smokers(p > 0.05). The difference in these parameters was statistically non-significant between smokers and e-cigarette users. Conclusion:  E-cigarettes cause low tear breakup time, less tear volume and other dry eye parameters, which leads to dry eye. There is a need for strict checks and balances on E-cigarette consumption for controlling cases of vision impairments related with e-cigarettes.