Capability of the Inter-Eye Differences in Osmolarity, Break-Up Time and Corneal Staining on the Diagnostic of Dry Eye

A Comprehensive Study on Tear Meniscus Height Inter-Eye Differences in Aqueous Deficient Dry Eye Diagnosis

“…This finding has direct implications for clinical practice, offering a quantitative and objective measure for diagnostic decision making. Interestingly, and contrary to other clinical tests that demonstrate larger differences between eyes in DED participants [31][32][33][34][35][36], the present analysis found that participants without ADDE could be differentiated from those with ADDE by showing greater inter-eye differences. It is important to note that ADDE participants showed generally lower TMH values, while No ADDE participants had higher values despite these inter-eye differences.…”

“…Other parameters, such as the osmolarity inter-eye variability, have been found to be useful for DED detection, suggesting that the higher osmolarity of the two eyes could be used in clinical practice because the lower value seems to reflect the transient effects of compensatory mechanisms however, some controversy has been found regarding this point in recent publications [35]. In addition to these results, a recent report supports the above idea, suggesting that not all diagnostic parameters suggested by the TFOS DEWS II Diagnostic Methodology report are candidates for a diagnosis based on inter-eye differences, emphasizing the need to explore each parameter individually in this regard [34].…”

“…Investigating inter-eye differences may offer a more efficient and optimized approach, providing valuable insights that could enhance the diagnostic precision and expedite the identification of these ocular disorders. Nevertheless, while previous reports have explored inter-eye differences as a diagnostic tool for DED, revealing disparities in results or even tests, none have delved into the utility of these differences for subtype detection [31][32][33][34][35]. This underscores the need for validation studies based on specific designs to assess the feasibility of this variable.…”

“…In addition to the aspects previously mentioned, while prior research has explored inter-eye differences in primary diagnostic indicators such as osmolarity, the potential of TMH for the diagnosis of DED or in classifying its subtypes has not been comprehensively investigated [3,26,27,[34][35][36]. In clinical settings, TMH has demonstrated itself as a straightforward, dependable and reproducible tool for the evaluation of ADDE patients [11,37].…”