Environmental Triggers and Ocular Disease Networks: Analyzing the Impact of Air Pollutants and Meteorological Factors Using Fuzzy Cognitive Maps.

Growing evidence suggests that climate change and air pollution significantly contribute to the rising incidence of ocular morbidity; however, quantifying the complex interplay of these factors presents significant methodological challenges. This study aimed to investigate the impact of multiple air pollutants and meteorological conditions on common ocular diseases utilizing Fuzzy Cognitive Maps (FCMs) and to delineate the pathogenic relationships among them. We analyzed data from 28,981 hospitalizations in ophthalmology (2019-2024) at a tertiary hospital in Wuhan, China, coupled with daily environmental data for key air pollutants (PM2.5, PM10, SO2, NO2, CO, and O3) and meteorological parameters (temperature, humidity, atmospheric pressure, wind speed, precipitation, etc.). Eleven distinct FCM models were developed via differential evolution algorithms to quantify both environment-disease and disease-disease interactions. Our findings indicated that optic neuropathy (ON) exhibited the highest environmental sensitivity, showing a positive correlation with PM10. Besides, positive associations were identified between minimum temperature and glaucoma as well as between CO exposure or temperature and cataract risk. Diseases of the Ocular Surface and Appendages (DOSA) exhibited a robust correlation with precipitation, which was negatively associated with cataract and ON. Analysis of the disease interaction network identified thyroid-associated orbitopathy (TAO) as a central hub, subject to considerable input from other ocular conditions (ON → TAO: n = 59; LDD → TAO: n = 49; DOSA → TAO: n = 57; TAO → U: n = 42; TAO ↔ S: w = 0.45; G ↔ TAO: w = 0.37; OT ↔ TAO: w = 0.72). The most robust bidirectional association was observed between ON and Ocular Trauma (OT) (average weight = 0.93). Overall, this study highlights the effectiveness of FCM for modeling in environmental ophthalmology, revealing that PM10 exerts a critical influence on optic nerve health, while temperature and precipitation serve as vital modulators in glaucoma and cataract pathways. These findings should be interpreted as offering novel insights with implications focusing on future causal validation rather than establishing deterministic relationships. These insights provide quantitative evidence supporting the potential role of environmental factors in ocular diseases, thereby underscoring the need for targeted public health strategies and optimized medical resource allocation to mitigate the ocular health hazards posed by regionally prevalent and seasonal environmentally related eye disorders.