TITLE:
Tear Secretion, Tear-Film Stability, and Dry-Eye Symptoms in Women Wearing Eyelash Extensions in Kinshasa: A Comparative Cross-Sectional Study
AUTHORS:
Léon Muamba Nkashama, David Kayembe Lubeji, Yokoiwa Ryota, Nakayama Shintaro, Shimizu Eisuke
KEYWORDS:
Eyelash Extensions, Tear Secretion, Tear-Film Stability, Ocular Surface Disease Index, Smart Eye Camera, Kinshasa
JOURNAL NAME:
Open Journal of Ophthalmology,
Vol.16 No.4,
November
10,
2026
ABSTRACT: Background: Eyelash extensions are increasingly used, but their associations with tear secretion, tear-film stability, and ocular-surface symptoms remain insufficiently characterized, particularly in Central African populations. Objective: To compare tear secretion, tear-film stability, and ocular-surface symptoms between women wearing eyelash extensions and women not wearing them in Kinshasa, Democratic Republic of the Congo. Methods: This comparative cross-sectional study was conducted from January 2023 to March 2024. Women wearing eyelash extensions were recruited using a four-stage probability-sampling approach from hair salons in Kinshasa municipal markets; women without eyelash extensions were consecutively recruited from the Ophthalmology Department of the University Hospital of Kinshasa. Schirmer I testing assessed total tear secretion, fluorescein tear-film break-up time (TFBUT) was video-recorded using the Smart Eye Camera (SEC; OUI Inc., Tokyo, Japan), and the Ocular Surface Disease Index (OSDI) assessed symptoms. Both groups underwent anterior-segment examination. Continuous variables were compared using independent-samples t tests and categorical variables using Pearson’s chi-square tests. Two-sided p values Results: The analysis included 350 women wearing eyelash extensions (mean age, 30.1 ± 3.7 years) and 350 women without extensions (mean age, 30.2 ± 8.6 years). Mean Schirmer I values were higher in the eyelash-extension group than in controls (21.3 ± 5.1 vs 17.5 ± 4.5 mm; p Conclusion: In this cross-sectional study, women wearing eyelash extensions had higher Schirmer I values and OSDI scores and shorter TFBUT than controls. These associations do not establish causation or confirm a diagnosis of dry eye disease.