Vol. 2 No. 1 (2019): Current Issue
Research Article

Impact of Acute Emotional Stress on the Tear Quality of Students from a Medical School in Campina Grande: Paraiba Brazil: Impact of emotional stress in the tear film of medical students

Brandt CT
Scientific Director- Faculty of Medical Sciences, Brazil
de Carvalho YO
Fellow of Ophthalmology- Faculty of Medical Sciences, Brazil
Cavalcanti Melo MCS
Senior Lecturer- Faculty of Medical Sciences, Brazil
Gadelha DNB
Residency Coordinator- Faculty of Medical Sciences, Brazil
Published October 23, 2019
  • Psychosomatic symptoms,
  • Tear quality,
  • Medical students,
  • Academic evaluation,
  • Tear breakup time


Background: Stress acts on the nervous system impairing lachrymal gland function. Thus, one can hypothesize that medical students under academic evaluation, with acute emotional stress, could suffer changes in tear quality, which was the purpose of this study.
Methods: The prospective, longitudinal, observational and analytic study was performed at Faculty of Medical Sciences-Campina Grande, Paraíba, Brazil. It was randomly recruited, 80 (5.8%) students, 42 (52.5%) women and 38 (47.5%) men, with ages ranging from 18 to 42 year-old (22.9 ± 4.9 years), median of 21.5 years. Exclusion criteria include all students who presented with any disease or condition that could affect the tear quality. The BUT was assessed before and after 35 days of academic examination. The continuous parameters were expressed by their mean ± standard deviation. Wilcoxon test was used for assessing difference between means. P ≤ 0.05 was used for rejecting the null hypothesis. The research was approved by the Institutional Ethics Committee.
Results: Stress was present in all students immediately of taking academic evaluation; ranging as follows: mild-15 (18.7%); moderate-41 (51.3%), and severe 24 (30.0%) (How was this stress assessed to arrive at mild, moderate and severe). The mean BUT in the right eye was significantly higher after the 35-day interval (before 8.5 ± 3.1 seconds versus 9.6 ± 3.0 seconds - p = 0.0016). Similarly, the mean BUT in the left eye was significantly higher after the 35-day interval (before 8.5 ± 3.1 seconds versus 9.4 ± 2.9 seconds - p = 0.0053.
Conclusion: There was a decrease in the BUT immediately before academic evaluation. However, there was no
correlation or association with the stressful parameters caused during this period with the BUT measurements,
including emotional stress levels, night sleep time before academic examination. It was observed a tendency to return to BUT baseline parameters, later 45 days after knowledge of student performance in the academic examinations.