Vaegan Seminar: Exploring the toxicity of skin lipids on the ocular surface

Abstract 

Introduction: The concept of skin lipids entering the eye has not been thoroughly investigated even though sebum exists in volume adjacent to the ocular surface. 

Methods: Swabbing the skin with a suture or eye lash and then applying this substance to the ocular surface was visualised with fluorescein, lissamine green and a novel technology called Tearview®. This was then followed up with applying known skin lipids to the ocular surface to try and determine their individual effect. 

Results: Some skin lipids were shown to be very toxic to the tear film and the ocular surface. Applying a skin swab on the lid margin demonstrated not only tear film break up but also activation of the meibomian glands.  Applying a skin swab in the lacrimal lake demonstrated tear film break up, corneal staining and activation of the sweat glands around the eye lids. Not all skin lipids seemed to irritate the ocular surface. 

Conclusion: It is possible that if the lid margin is overwhelmed by skin lipids entering the ocular surface, dry irritated eyes could then manifest. There are many recalcitrant cases of dry eyes that possibly are a result of this. This talk will discuss ways of attending to this possible cause of dry eyes.

Bio: Dr Jim Kokkinakis graduated in 1983 from the School of Optometry and Vision Science, University of NSW. He is primarily a clinician with special interests in customisation of contact lenses for corneal disease and myopia control. Other interests include dry eye disease, ocular therapeutics, computer vision syndrome and customisation of complex prescription spectacles. He is the CEO and optometric director of The Eye Practice in Sydney’s CBD. Jim started part-time clinical supervision at the School of Optometry UNSW in 1990, which evolved into lecturing at both an undergraduate and postgraduate level. In 2011 he was appointed an Adjunct Senior Lecturer. Between 1996 and 2002 he was a part-time Clinical & Liaison Optometrist for The Eye Institute responsible for its optometric education program in ocular disease and refractive surgery. Dr Kokkinakis has been a regular presenter both nationally and internationally to optometrists, ophthalmologists, general practitioners and pharmacists since 1998 and is currently an active member of The International Society of Contact Lens Specialists, The American Academy of Optometry, Optometry Australia, The Cornea & Contact Lens Society of Australia, The Tear Film & Ocular Society of Australia and The International Keratoconus Academy of Eye Care Professionals. During COVID after giving up on trying to improve his tennis game, he started a PhD, which hopes to Solve the Enigma of Dry Eyes and Ocular Rosacea.