The displayed medium sensitivity and specificity, and good positive predictive value of the LIPCOF test support the use of LIPCOF grading as a simple, quick and non-invasive dry eye screening tool.

OCT enabled a noninvasive, high-resolution method of imaging, evaluating, and classifying LIPCOFs. These new classifications correlated well with the slit lamp grade and the DEQ scores, promising a new, more objective evaluation of dry eye.

Hyperosmolarity of tear was reported as a fact of ocular surface inflammation. While in mild and moderate conjunctivochalasis tear osmolarity was similar to normal controls, increased osmolarity can refer to the presence of ocular surface inflammation in these patients with severe conjunctivochalasis.

FD-OCT could be a quick, non-invasive, quantitative method for the imaging of LIPCOF in contact lens patients. When grading LIPCOF, the mechanical forces of the lens and the tear meniscus changes caused by the lens should be taken into account as these factors influence results. Follow-up of the patients using the same methods is suggested with or without contact lenses.

Background: Seasonal allergic conjunctivitis can manifest itself through tear film instability and symptoms of eye discomfort during the pollen season. This study investigated whether seasonal allergic inflammation defines tear film instability outside the season. Methods: Twenty-three control subjects and 13 ragweed-allergic patients were involved (21 female, 15 male; mean age 26.6 ± 5.4 years). Outside the pollen season, subjective ocular symptoms, non-invasive tear film break-up time, lower tear meniscus height and the tear lipid layer’s interference pattern grade were recorded. C3a complement activation level was also measured in collected tear samples. Results: Non-invasive tear film break-up time, lower tear meniscus height, C3a complement activation level and the incidence of the different grades of tear lipid pattern did not differ significantly in the two examined groups (p ≧ 0.223). The mean eye symptom score outside the season was greater in the allergic group, but the difference was not significant (p = 0.062). The C3a complement activation level showed a significant and inverse correlation with the lipid layer grade (r = –0.343, p = 0.017). Among the participants with thinner tear lipid layers, the complement activation in the tear samples was higher than among those patients with normal tear lipid layers. Conclusion: Seasonal allergic inflammation did not cause permanent tear film instability and eye symptoms were not observed outside the pollen season.

Relatively long lipid layer spreading time was observed suggesting that the tear film build-up process did not finish completely at the end of the initial rapid tear film alteration phase. The detected initial decrease of the SRI after blink related to the post-blink tear film motion. This initial pattern is characteristic of the majority of the normal population in spite of the post-blink alteration pattern of the topographical SAI or corneal aberrations. The SRI seems to be the most useful indirect topographical parameter of the tear film dynamics.

Purpose To summarize our experiences with a non‐invasive tear interference device. Methods in thirty‐seven subjects, we measured non‐invasive tear break up time (NIBUT) three times, pictured the lower tear meniscus height (TMH) and the tear film lipid layer pattern five times after complete blinks with Keeler Tearscope Plus. Three independent observers evaluated the photos. Additionally, the lipid pattern was graded by the observers with real‐time examination in thirty‐one subjects. We analysed the repeatability of the tear parameters after different blinks, and the agreement between the observers on assessments of the photos and real‐time examination. Results The results measured after different blinks did not show significant differences in case of any tear film parameters. The intraclass correlation coefficient (ICC) with 95% confidence interval of NIBUT and mean TMH were 0.605 (0.428‐0.754) and 0.901 (0.848‐0.942), respectively. There was significant difference between the measured TMH of the observers (p<0.001). The results showed significant correlations (r≥0.912, p<0.001), but the standard deviation of the three measured TMH was meanly 11.13% of the mean of them. The graded lipid patterns of observers showed significant differences (p=0.01) in case of photos, but did not (p=0.137) during real–time examination. Conclusion The Tearscope Plus is a useful tool of non‐invasive tear film examination. However, the evaluation of the parameters is partly subjective, which reduces the reliability of the methods. The real‐time examination of lipid pattern is recommended, because the kinetics of lipid layer allows additional information for grading, therefore decreasing the interobserver variability.