We read with interest the recent article by Estarki et al that evaluated tear film status in machine carpet weavers.¹ In the literature, there is another study by Wani et al² that showed a high rate of eye irritation among carpet weavers; however, Estarki et al¹ presented quality research that quantitatively documented parameters of dry eye in carpet weavers. Here, we would like to draw the kind attention of the authors and the readership toward our methodological remarks on this work.

Literally, they evaluated blink rate, tear deformation time, ocular staining, and ocular surface disease index (OSDI) in carpet wearers and compared it with nonweavers as the control group. Although no history of contact lens use, ocular surgery, systemic diseases, or medications causing dry eye as well as the status of anterior segment was noted precisely in the inclusion criteria; there is no mention of history of cigarette smoking, water pipe, and second-hand smoking that could have been better to be acknowledged in exclusion criteria as they are shown to alter tear film stability, tear film breakup, tear osmolarity, cornea staining, cornea parameters as well as score.^3-5

Furthermore, OSDI score of participants was assessed using an English questionnaire. As is clear, any translated questionnaire should be used only after validation, reliability, psychometric, and cultural adaptation. We wonder why the validated Persian version of OSDI questionnaire by Pakdel et al⁶ is not used here.

In addition, nonwearer workers of carpet factory have been recruited as a control group. Allocating participants into case or control arms according to weaving status may not be accurate as they are all in the same conditions as regards humidity, temperature, and light intensity.²

Taken together, it seems that this study could be more accurate if the researchers excluded smokers, used validated Persian OSDI questionnaire, and recruited nonworker individuals as their control group.

我们饶有兴趣地阅读了 Estarki 等人最近发表的文章，该文章评估了机器地毯织机的泪膜状态。¹在文献中，Wani 等人^{2 进行的}另一项研究表明，地毯编织者的眼睛刺激率很高；然而，Estarki 等人¹提出了质量研究，该研究定量记录了地毯织工的干眼症参数。在这里，我们想提请作者和读者对我们对这项工作的方法论评论的关注。

从字面上看，他们评估了地毯佩戴者的眨眼率、泪液变形时间、眼部染色和眼表疾病指数 (OSDI)，并将其与作为对照组的非织布者进行了比较。尽管纳入标准中没有明确指出隐形眼镜使用史、眼科手术史、全身性疾病或导致干眼症的药物以及眼前节状况；没有提到吸烟史、水烟史和二手烟史，因为它们会改变泪膜稳定性、泪膜破裂、泪液渗透压、角膜染色、角膜参数和分数。^3-5

此外，使用英语问卷评估参与者的 OSDI 分数。很明显，任何翻译的问卷只能在经过验证、可靠性、心理测量和文化适应后使用。我们想知道为什么这里不使用Pakdel 等人⁶验证的波斯版 OSDI 问卷。

此外，还招募了地毯厂的非穿着工人作为对照组。根据编织状态将参与者分配到外壳或控制臂可能不准确，因为它们的湿度、温度和光照强度都处于相同的条件下。²

综上所述，如果研究人员排除吸烟者，使用经过验证的波斯 OSDI 问卷调查，并招募非工人个体作为他们的对照组，这项研究似乎会更准确。