- lifestyle report
TFOS lifestyle: Impact of societal challenges on the ocular surface
Fiona Stapleton a,*, Juan Carlos Abad b, Stefano Barabino c, Anthea Burnett a, Geetha Iyer d, Kaevalin Lekhanont e, Tianjing Li f, Yang Liu g, Alejandro Navas h, Chukwuemeka Junior Obinwanne i, Riaz Qureshi f, Danial Roshandel j, Afsun Sahin k, Kendrick Shih l, Anna Tichenor m, Lyndon Jones n
a School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia,b Department of Ophthalmology, Antioquia Ophthalmology Clinic-Clofan, Medellin, Antioquia, Colombia, c ASST Fatebenefratelli-Sacco, Ospedale L. Sacco-University of Milan, Milan, Italy, d C. J. Shah Cornea Services, Sankara Nethralaya, Chennai, Tamil Nadu, India, e Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, f Department of Ophthalmology, School of Medicine, University of Colorado Anschutz Medical Campus, Denver, CO, USA, g Ophthalmology Department, Zhongnan Hospital of Wuhan University, Wuhan, China, h Conde de Valenciana, National Autonomous University of Mexico UNAM, Mexico City, Mexico, i Cornea and Contact Lens Unit, De Lens Ophthalmics Family and Vision Care Centre, Abuja, Nigeria, j Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Nedlands, WA, Australia, k Department of Ophthalmology, Koc University Medical School, ?Istanbul, Turkey, l Department of Ophthalmology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China, m School of Optometry, Indiana University, Bloomington, IN, USA, n Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
ARTICLE INFO
Keywords:
Dry eye
Infection
Inflammation
Trauma
Autoimmune disease
Biology
Lifestyle
Socioeconomic factors
Employment
Systematic review
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.
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