***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Dry eye syndrome ( DES ) is a prevalent condition , but information on risk or protective factors is lacking . OBJECTIVE We aim ed to determine the association between the dietary intake and ratio of n-3 and n-6 fatty acids ( FAs ) and DES occurrence . DESIGN Of the 39876 female health professionals in the Women 's Health Study ( WHS ) , 32470 women aged 45 - 84 y who provided information on diet and DES were cross-sectionally studied . We assessed FA intakes by using a vali date d food-frequency question naire and assessed  DES  by using self-reports of clinical ly diagnosed cases . Of the sample , 1546 ( 4.7 % ) subjects reported DES .  We used logistic regression models to estimate the odds ratios ( ORs ) and 95 % CIs to describe the relation of FA intake with DES . RESULTS After adjustment for demographic factors , hormone therapy , and total fat intake , the OR for the highest versus the lowest quintile of n-3 FAs was 0.83 ( 95 % CI : 0.70 , 0.98 ; P for trend = 0.05 ) . A higher ratio of n-6 to n-3 FA consumption was associated with a significantly increased risk of DES ( OR : 2.51 ; 95 % CI : 1.13 , 5.58 ) for > 15:1 versus < 4:1 ( P for trend = 0.01 ) . In addition , tuna consumption [ 1 serving was 113 g ( 4 oz ) ] was inversely associated with DES ( OR : 0.81 ; 95 % CI : 0.66 , 0.99 for 2 - 4 servings/wk ; OR : 0.32 ; 95 % CI : 0.13 , 0.79 for 5 - 6 servings/wk versus < or = 1 serving/wk ; P for trend = 0.005 ) . CONCLUSIONS These results suggest that a higher dietary intake of n-3 FAs is associated with a decreased incidence of  DES in women . These findings are consistent with anecdotal clinical observations and postulated biological mechanisms BACKGROUND Prostagl and in F(2alpha ) analogues are effective intraocular-pressure-lowering drugs .  Dietary fatty acids affect endogenous prostagl and in F(2alpha ) concentrations and may thus influence intraocular pressure . OBJECTIVE We prospect ively examined dietary fat consumption in relation to primary open-angle glaucoma ( POAG ) . DESIGN Women ( n = 76 199 in the Nurses ' Health Study ) and men ( n = 40 306 in the Health Professionals Follow-Up Study ) free of POAG in 1980 and 1986 , respectively , were followed until 1996 if they were > or = 40 y old and reported receiving eye exams during follow-up . Potential confounders were assessed on biennial question naires , and energy-adjusted cumulative averaged fat intakes were measured by using vali date d food-frequency question naires . We analyzed 474 self-reported POAG cases confirmed by medical chart review .  Cohort-specific multivariate rate ratios ( RRs ) were obtained by using proportional hazards models and were then pooled . RESULTS Major fats and fat subtypes were not independently associated with POAG risk . Pooled multivariate RRs ( 95 % CI ) for POAG comparing the highest with the lowest quintile of fat intake were as follows : 0.90 ( 0.67 , 1.21 ) for total fat , 1.03 ( 0.77 , 1.38 ) for saturated fat , 0.76 ( 0.56 , 1.03 ) for monounsaturated fat , and 0.87 ( 0.66 , 1.16 ) for polyunsaturated fat , none of which were statistically significant . We found a suggestive positive association between a higher ratio of n-3 to n-6 polyunsaturated fat and risk of POAG [ RR = 1.49 ( 1.11 , 2.01 ) ; P for trend = 0.10 ] , which was stronger for high-tension POAG [ RR = 1.68 ( 1.18 , 2.39 ) ; P for trend = 0.009 ] . CONCLUSION A high ratio of n-3 to n-6 polyunsaturated fat appears to increase the risk of POAG , particularly high-tension POAG . Further studies are needed Purpose : Alcohol intake reduces intraocular pressure , a risk factor for primary open-angle glaucoma ( POAG ) . We investigated whether alcohol consumption is associated with a reduced risk of POAG . Methods : We followed female nurses from 1980 and male health professionals from 1986 to 2002 . Eligible participants were 40 + years old , did not have POAG , and reported receiving eye examinations during follow-up . Information on alcohol consumption , potential confounders and POAG diagnoses were up date d by using biennial question naires . We identified 856 self-reported POAG cases that were confirmed with medical record review . Cohort-specific and pooled analyses across cohorts were conducted to calculate multivariable rate ratios ( RR ) of POAG . Results : Alcohol consumption < 30 g/day did not influence POAG risk : compared with non-drinkers , the pooled RRs were 0.99 ( 95 % Confidence Interval [ CI ] : 0.83–1.19 ) for drinking < 10 g/day , 0.96 ( 95 % CI : 0.76–1.22 ) for 10–19 g/day , and 0.95 ( 95 % CI : 0.68–1.33 ) for 20–29 g/day . Although there were suggestive inverse associations with drinking > 30 g/day ( RR = 0.71 ) , this was not significant ( 95 % CI : 0.49–1.04 ) , and no significant linear associations were detected . Risks of POAG did not differ by type of alcoholic beverage consumed . To evaluate the potential for detection bias , we controlled for additional factors , such as frequency of eye exams , but results were similar . Conclusion : In this large prospect i ve study of men and women , alcohol consumption did not influence the risk of POAG Objective : To determine whether vitamin E supplementation influences the incidence or rate of progression of  age related maculopathy ( AMD ) . Design : Prospect i ve r and omised placebo controlled clinical trial . Setting : An urban study centre in a residential area supervised by university research staff . Participants : 1193 healthy volunteers aged between 55 and 80 years ; 73 % completed the trial on full protocol . Interventions : Vitamin E 500 IU or placebo daily for four years . Main outcome measures : Primary outcome : development of early age related macular degeneration in retinal photographs . Other measures included alternative definitions of age related macular degeneration , progression , changes in component features , visual acuity , and visual function Results : The incidence of early age related macular degeneration ( early AMD 3 ) was 8.6 % in those receiving vitamin E versus 8.1 % in those on placebo ( relative risk 1.05 , 95 % confidence interval 0.69 to 1.61 ) . For late disease the incidence was 0.8 % versus 0.6 % ( 1.36 , 0.67 to 2.77 ) . Further analysis showed no consistent differences in secondary outcomes . Conclusion : Daily supplement with vitamin E supplement does not prevent the development or progression of early or later stages of age related macular degeneration CONTEXT Despite nutrition information and guidelines that advise against depriving diabetic patients of the potential benefit of moderate alcohol intake against cardiovascular events , the association between alcohol consumption and risk of cardiovascular outcomes in diabetic individuals has not been determined . OBJECTIVE To examine the relationship between alcohol intake and coronary heart disease ( CHD ) mortality in persons with older-onset diabetes . DESIGN Population -based , prospect i ve cohort study conducted from 1984 through 1996 , with a follow-up of up to 12.3 years . SETTING AND PARTICIPANTS A total of 983 older-onset diabetic individuals ( mean [ SD ] age , 68.6 [ 11.0 ] years ; 45.2 % male ; 98.5 % white ) were interviewed about their past-year intake of alcoholic beverages during the 1984 - 1986 follow-up examination of a population -based study of diabetic persons in southern Wisconsin . MAIN OUTCOME MEASURE Time to mortality from CHD by category alcohol intake . RESULTS Alcohol use was inversely associated with risk of CHD mortality in older-onset diabetic subjects . The CHD mortality rates for never and former drinkers were 43.9 and 38.5 per 1000 person-years , respectively , while the rates for those with alcohol intakes of less than 2 , 2 to 13 , and 14 or more g/d were 25.3 , 20.8 , and 10.0 per 1000 person-years , respectively . Compared with never drinkers and controlling for age , sex , cigarette smoking , glycosylated hemoglobin level , insulin use , plasma C-peptide level , history of angina or myocardial infa rct ion , digoxin use , and the presence and severity of diabetic retinopathy , former drinkers had a relative risk ( RR ) of 0.69 ( 95 % confidence interval [ CI ] , 0.43 - 1.12 ) ; for those who drank less than 2 g/d ( less frequent than 1 drink a week ) , the RR was 0.54 ( 95 % CI , 0.33 - 0.90 ) ; for 2 to 13 g/d , it was 0.44 ( 95 % CI , 0.23 - 0.84 ) ; and for 14 or more g/d ( about 1 drink or more a day ) , it was 0.21 ( 95 % CI , 0.09 - 0.48 ) . Further adjustments for blood pressure , body mass index , education , physical activity , diabetes duration , hypertension history , overt nephropathy , peripheral neuropathy , lipid measures , or intake of medications such as aspirin and antihypertensive agents did not change the associations observed . CONCLUSION Our results suggest an overall beneficial effect of alcohol consumption in decreasing the risk of death due to CHD in people with older-onset diabetes The relation between dietary antioxidant intake and  primary open-angle glaucoma risk  was examined in participants aged over 40 years in the Nurses ' Health Study ( n = 76,200 ) and the Health Professionals Follow-up Study ( n = 40,284 ) . They were followed biennially from 1980 and 1986 , respectively , to 1996 , during periods when they received an eye examination .  Dietary intakes were measured repeatedly from 1980 in the Nurses ' Health Study and from 1986 in the Health Professionals Follow-up Study using vali date d food frequency question naires . The authors analyzed 474 self-reported glaucoma cases confirmed by medical chart review to have primary open-angle glaucoma with visual field loss . The authors used Cox proportional hazards models for cohort-specific multivariate analyses , and results were pooled using r and om effects models . The pooled multivariate rate ratios for primary open-angle glaucoma comparing the highest versus lowest quintile of cumulative up date d intake were 1.17 ( 95 % confidence interval ( CI ) : 0.87 , 1.58 ) for alpha-carotene , 1.10 ( 95 % CI : 0.82 , 1.48 ) for beta-carotene , 0.95 ( 95 % CI : 0.70 , 1.29 ) for beta-cryptoxanthin , 0.82 ( 95 % CI : 0.60 , 1.12 ) for lycopene , 0.92 ( 95 % CI : 0.69 , 1.24 ) for lutein/zeaxanthin , 1.05 ( 95 % CI : 0.59 , 1.89 ) for vitamin C , 0.97 ( 95 % CI : 0.62 , 1.52 ) for vitamin E , and 1.11 ( 95 % CI : 0.82 , 1.51 ) for vitamin A. In conclusion , the authors did not observe any strong associations between  antioxidant consumption  and the risk of primary open-angle glaucoma OBJECTIVE To determine the prevalence of glaucoma in a population -based sample of Hispanic adults older than 40 years . METHODS Using 1990 census data for Arizona , groups of persons living in sections of the city in Nogales and Tucson were r and omly selected with a probability proportional to the Hispanic population older than 40 years . We tried to recruit all eligible adults in homes with 1 self-described Hispanic adult . Detailed ocular examinations at a local clinic included  visual acuity testing , applanation tonometry , gonioscopy , an optic disc evaluation  , and a  threshold visual field test .  Open-angle glaucoma ( OAG ) was defined using a proposed international system for prevalence surveys , including threshold visual field defect and optic disc damage . Angle 
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RESULTS Data suggest that some lifestyle exposures ( e.g. , smoking ) are significantly associated with risk of several different diseases , suggesting that altering behaviors may decrease risk .
Where risk is inherent to an occupational or recreational activity , eye protection is likely to decrease risk .
Although data are imperfect , it seems that some lifestyle alterations may decrease the risk of eye diseases at little or no risk to the individual