Impact of religious fasting on ocular dryness: objective and subjective assessment

BackgroundCertain religions require long hours of fasting, abstaining from fluid intake for durations extending up to 16 h. Lack of fluid intake may alter multiple physiological parameters, which can influence the ocular system. In this prospective study, we evaluated the effect of prolonged fasting...

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Main Authors: Amal F. Alomari, Sara Issa, Asma Musleh, Mohammad Abusamak, Omar Bdair, Saif Aldeen AlRyalat, Alanoud Al-Wakfi, Mohammed Jaber, Ahmad Alloubani, Haitham Sahawneh, Muhannd El-Faouri, Ayman Abdul Aziz, Muawyah Al Bdour
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1488765/full
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author Amal F. Alomari
Sara Issa
Asma Musleh
Mohammad Abusamak
Mohammad Abusamak
Omar Bdair
Omar Bdair
Saif Aldeen AlRyalat
Saif Aldeen AlRyalat
Alanoud Al-Wakfi
Mohammed Jaber
Ahmad Alloubani
Haitham Sahawneh
Haitham Sahawneh
Muhannd El-Faouri
Ayman Abdul Aziz
Muawyah Al Bdour
author_facet Amal F. Alomari
Sara Issa
Asma Musleh
Mohammad Abusamak
Mohammad Abusamak
Omar Bdair
Omar Bdair
Saif Aldeen AlRyalat
Saif Aldeen AlRyalat
Alanoud Al-Wakfi
Mohammed Jaber
Ahmad Alloubani
Haitham Sahawneh
Haitham Sahawneh
Muhannd El-Faouri
Ayman Abdul Aziz
Muawyah Al Bdour
author_sort Amal F. Alomari
collection DOAJ
description BackgroundCertain religions require long hours of fasting, abstaining from fluid intake for durations extending up to 16 h. Lack of fluid intake may alter multiple physiological parameters, which can influence the ocular system. In this prospective study, we evaluated the effect of prolonged fasting on dry eye disease using both objective and subjective measures.MethodsWe included patients who fasted for at least 12 h a day for at least 2 weeks, including the testing day, and retested them at least 1 week after the fasting period had ended with no fasting on the testing day. At each visit, Non-Invasive Keratograph Break up time (NIKBUT) and Tear meniscus height (TM) were measured using the Oculus Keratograph 5 M. Ocular Surface Disease Index (OSDI) was evaluated at each timepoint to assess dryness symptoms subjectively.ResultsThis study included a total of 40 patients. NIKBUT values during the fasting times were higher than during the non-fasting times; however, the difference was statistically non-significant. There were no significant differences in TM and OSDI measurements between non-fasting and fasting periods (p > 0.05). Lubricating eyedrop use was significantly lower in fasting patients.ConclusionOur study showed that prolonged fasting, including complete abstinence from fluid intake, did not lead to significant dryness, neither subjectively nor objectively. During fasting, patients used significantly fewer lubricating drops compared to non-fasting periods.
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spelling doaj-art-d58cd4018a974e1cada3e491cc8b51c92025-02-05T07:32:37ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-02-011210.3389/fmed.2025.14887651488765Impact of religious fasting on ocular dryness: objective and subjective assessmentAmal F. Alomari0Sara Issa1Asma Musleh2Mohammad Abusamak3Mohammad Abusamak4Omar Bdair5Omar Bdair6Saif Aldeen AlRyalat7Saif Aldeen AlRyalat8Alanoud Al-Wakfi9Mohammed Jaber10Ahmad Alloubani11Haitham Sahawneh12Haitham Sahawneh13Muhannd El-Faouri14Ayman Abdul Aziz15Muawyah Al Bdour16Department of Special Surgery, Al-Balqa Applied University, Al-Salt, JordanDepartment of Special Surgery, Al-Balqa Applied University, Al-Salt, JordanDepartment of Special Surgery, Al-Balqa Applied University, Al-Salt, JordanDepartment of Special Surgery, Al-Balqa Applied University, Al-Salt, JordanDepartment of Ophthalmology, Amman Eye Clinic, Amman, JordanFaculty of Engineering Technology, Al-Balqa Applied University, Amman, JordanFaculty of Medicine, Memorial University of Newfoundland, St. John’s, NL, CanadaDepartment of Ophthalmology, School of Medicine, The University of Jordan, Amman, JordanDepartment of Ophthalmology, Houston Methodist Hospital, Houston, TX, United StatesNational Center for Diabetes, Endocrinology and Genetics, Amman, JordanNational Center for Diabetes, Endocrinology and Genetics, Amman, JordanNational Center for Diabetes, Endocrinology and Genetics, Amman, JordanDepartment of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, OH, United StatesUniversity Hospitals Eye Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States0Department of Special Surgery, Faculty of Medicine, Hashemite University, Zarqa, JordanDepartment of Special Surgery, Al-Balqa Applied University, Al-Salt, JordanDepartment of Ophthalmology, School of Medicine, The University of Jordan, Amman, JordanBackgroundCertain religions require long hours of fasting, abstaining from fluid intake for durations extending up to 16 h. Lack of fluid intake may alter multiple physiological parameters, which can influence the ocular system. In this prospective study, we evaluated the effect of prolonged fasting on dry eye disease using both objective and subjective measures.MethodsWe included patients who fasted for at least 12 h a day for at least 2 weeks, including the testing day, and retested them at least 1 week after the fasting period had ended with no fasting on the testing day. At each visit, Non-Invasive Keratograph Break up time (NIKBUT) and Tear meniscus height (TM) were measured using the Oculus Keratograph 5 M. Ocular Surface Disease Index (OSDI) was evaluated at each timepoint to assess dryness symptoms subjectively.ResultsThis study included a total of 40 patients. NIKBUT values during the fasting times were higher than during the non-fasting times; however, the difference was statistically non-significant. There were no significant differences in TM and OSDI measurements between non-fasting and fasting periods (p > 0.05). Lubricating eyedrop use was significantly lower in fasting patients.ConclusionOur study showed that prolonged fasting, including complete abstinence from fluid intake, did not lead to significant dryness, neither subjectively nor objectively. During fasting, patients used significantly fewer lubricating drops compared to non-fasting periods.https://www.frontiersin.org/articles/10.3389/fmed.2025.1488765/fullfastinglubricationRamadantearOSDI questionnairedry eye
spellingShingle Amal F. Alomari
Sara Issa
Asma Musleh
Mohammad Abusamak
Mohammad Abusamak
Omar Bdair
Omar Bdair
Saif Aldeen AlRyalat
Saif Aldeen AlRyalat
Alanoud Al-Wakfi
Mohammed Jaber
Ahmad Alloubani
Haitham Sahawneh
Haitham Sahawneh
Muhannd El-Faouri
Ayman Abdul Aziz
Muawyah Al Bdour
Impact of religious fasting on ocular dryness: objective and subjective assessment
Frontiers in Medicine
fasting
lubrication
Ramadan
tear
OSDI questionnaire
dry eye
title Impact of religious fasting on ocular dryness: objective and subjective assessment
title_full Impact of religious fasting on ocular dryness: objective and subjective assessment
title_fullStr Impact of religious fasting on ocular dryness: objective and subjective assessment
title_full_unstemmed Impact of religious fasting on ocular dryness: objective and subjective assessment
title_short Impact of religious fasting on ocular dryness: objective and subjective assessment
title_sort impact of religious fasting on ocular dryness objective and subjective assessment
topic fasting
lubrication
Ramadan
tear
OSDI questionnaire
dry eye
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1488765/full
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