There is an increasing interest in the role of conjunctival microbiome in the healthy ocular surface 1 and in different ocular diseases. Although cystic fibrosis is not classically associated with ophthalmological problems, it is assumed that the disease affects all secretory epithelia, including the eye. In this group of patients, the associated ocular surface diseases are mainly keratoconjunctivitis sicca or dry eye syndrome. Inflammation is known to play an essential role in the pathogenesis of dry eye through the secretion of cytokines that are responsible for the recruitment of leukocytes to the ocular surface.
Although surface problems such as corneal dryness and thinning have been demonstrated in CF patients, the etiology of ocular changes in these patients remains unknown.
Cystic fibrosis is perhaps the most intensively studied condition with respect to the lung microbiome.
The pathophysiology of these diseases is understood to be a vicious cycle of infection, inflammation, and tissue damage which we attempt to break by eradicating or suppressing pathogenic bacteria using inhaled, oral, and intravenous antibiotics. Studies show that systemic inflammation is directly related to changes in the lung microbiome. This systemic inflammation seems to play an essential role in the appearance of dry eye in patients with cystic fibrosis, however, there are no studies that show if ocular microbioma is affected in this special group of patients.