title: Changes in tear film, corneal topography, and refractive status in premenopausal women during menstrual cycle.
abstract: OBJECTIVE
  To investigate the changes in a questionnaire based subjective symptomatology, tear film break-up time, tear volume, corneal topography, and refractive status in premenopausal women during menstrual cycle.
  
  
  METHODS
  Seventeen premenopausal females and 15 healthy males were enrolled in this prospective study. After routine ophthalmologic examination, an ocular surface disease index questionnaire was administered, tear film break-up time (TBUT), and Schirmer I tests were performed. Keratometry readings and refractive status were also obtained. All examinations were repeated at day 21, day 12 and day 2.
  
  
  RESULTS
  OSDI score in day 21 was significantly lower than that in day 12 (p=0.004) and day 2 (p=0.01) in the female patients; however, no significant change was found in the male subjects (p>0.05). No statistically significant difference was found in TBUT and Schirmer I tests, keratometry, and refraction results in both of the female and male subjects at all of the test points (p>0.05). There was a significant correlation between OSDI score and TBUT (p=0.02, p=0.03, respectively), and Schirmer I test at day 12 (p=0.004, p=0.008, respectively). A significant negative correlation was found between oestrogen level and horizontal keratometry values at day 21 (r=-0.5, p=0.03; r=-0.4, p=0.04, respectively) for the right and left eyes in the female subjects.
  
  
  CONCLUSIONS
  Our study confirms that fluctuations in the blood levels of oestrogen produce alterations in ocular surface equilibrium during the menstrual cycle and consequently affect the subjective dry eye symptoms in female patients. However, no ocular surface parameter changes were observed.
authors: Kemalpasa State Hospital, Izmir, Turkey.
authors: Ercument
authors: E
authors: Cavdar
authors: Beyoglu Eye Training and Research Hospital, Istanbul, Turkey.
authors: Abdullah
authors: A
authors: Ozkaya
authors: Beyoglu Eye Training and Research Hospital, Istanbul, Turkey. Electronic address: zeynepalkin@gmail.com.
authors: Zeynep
authors: Z
authors: Alkin
authors: Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
authors: Hande Mefkure
authors: HM
authors: Ozkaya
authors: Gulhane Military Medical Academy, Department of Public Health, Ankara, Turkey.
authors: Mustafa Alparslan
authors: MA
authors: Babayigit
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology; D000328:Adult; D003315:Cornea / Q000502:physiology*; D019781:Corneal Topography; D005260:Female; D006801:Humans; D008297:Male; D008597:Menstrual Cycle / Q000502:physiology*; D017697:Premenopause / Q000502:physiology*; D012016:Reference Values; D012029:Refraction, Ocular / Q000502:physiology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012737:Sex Factors; D013666:Tears / Q000502:physiology*
keywords: Corneal topography; Menstrual cycle; Refractive status; Tear film