There are many chemical released into the atmosphere that can harm the eye. In our recent paper ^[1] , we focus on the harmful compounds found in smoke from military burn pits and from the East Palestine Ohio train derailment of February 3, 2023. Advanced Chemistry Development ( ACD) Labs ( Ontario, Canada) used in silico methods to determine ocular irritation to chemical compounds. A list of such chemicals was introduced for burn pits and the train derailment. Results demonstrated high ocular irritation scores for some chemicals present in these exposure events. The results reflect the first effort to relate an environmental event to ocular surface disease using an in silico chemical analysis platform. The chemicals released into the air surrounding an environmental exposure can be objectively defined. This is one method of examining potential danger. Ocular surface disease, most notably dry eye disease, may not be a high-priority concern in light of the carcinogenic and vital organ toxicity of many chemicals, but it has consequences for the quality of life, the performance of work activities and ocular pain ^[2][3][4]. It also carries a considerable economic burden ^[5][6].

It is too expensive and impractical to study a cohort of patients with sequential eye exams after a chemical exposure to determine whether there is a relationship between the exposure and long-term consequences. Thus, in examining the literature, we found no long-term studies investigating the outcomes for those individuals with post-exposure persistent eye irritation from either burn pits or the derailment or other incidents. This is the case despite the estimated 3.5 million troops who have been in the presence of burn pits ^[7][8]. Thus, our approach is to evaluate the probability that specific chemicals can influence the occurrence of inflammation, dry eyes and prolonged symptoms. It is within our ability to implement this type of assessment so that the eyes are not ignored in a comprehensive health evaluation following an exposure. 

Dry eye disease occurs when the integrity of the tear film is disrupted, leading to inflammation and a cascade of consequences that can ultimately affect vision ^[9][10]. Simple treatment such as the use of lubricants is often inadequate since this approach does not address tissue injury. Ongoing symptoms are the hallmark of chronic dry eye disease and some of these patients do not just suffer brief eye irritation, but long-lasting chronic incapacity. These patients are not without hope since there are multiple FDA-approved prescription drugs in addition to non-prescription artificial tears to treat dry eyes.

Our goal is to alert the ophthalmology community that future chemical spills may play a significant role in a given patient’s ocular health. Emphasizing the link to specific chemicals is the first step to a more exhaustive analysis.