Introducing a New Parameter for the Assessment of the Tear Film Lipid Layer

Abstract

PURPOSE. The differential diagnosis of dry eye syndrome is still a challenging task. The purpose of this study was to understand the relationship between a novel, objective clinical parameter, the ''corrected lipid layer stabilization time,'' and commonly performed clinical tests for dry eye patients.METHODS. Data were obtained from a prospective clinical study with 59 patients of different subjective severity, as determined with the Ocular Surface Disease Index (OSDI). The dynamics of the tear film lipid layer were made visible through a white light source and were stored digitally. Because the distance between the upper and lower eyelid affects the lipid layer dynamics and varies significantly between subjects, the distance of the eyelids was determined and used to correct the lipid layer stabilization time. The resulting parameter was compared with common clinical procedures.RESULTS. The corrected lipid layer stabilization time has a highly significant correlation with tear film breakup time (Spearman r ¼ À0.485, P < 0.01), Schirmer test without anesthesia (r ¼ À0.431, P < 0.01) and with the Ocular Surface Disease Index (r ¼ 0.498, P < 0.01). It also correlates with the lissamine green staining score (r ¼ 0.379, P < 0.05), but shows no correlation with the osmolarity of the tear film. Without the correction for the eyelid opening, the correlations decrease considerably.CONCLUSIONS. These data suggest that the diagnostic value of the lipid layer stabilization time for the assessment of the severity of dry eye syndrome increases considerably when it is corrected by the distance of the eyelids. (Invest Ophthalmol Vis Sci. 2012;53:6638-6644)

External eye symptoms in indoor environments

“…Correction for the eyelid opening (cm) appears to be an important parameter in correlations of PTF characteristics (BUT and Schirmer's test [production of tears]) and the ocular surface disease index; this agrees with the observation that the position of gaze influences the outcome of the Schirmer's test …”

Reproducibility in measuring tear samples using a freezing point depression osmometer

“…No participant was under any type of medication or used artificial tears at the time of the testing session . Prior to the study, subjects completed an Ocular Surface Disease Index questionnaire and were excluded if they had a score higher than 13, taken as an indicator of early stage or mild DED …”

Eliciting blinks by transcutaneous electric nerve stimulation improves tear fluid in healthy video display terminal users: A self-controlled study

“…[37] The participants were regarded as healthy individuals when their OSDI scores were less than 15, based on previous studies. [34][35][36][37][38]…”

“…Therefore, to further analyze the impact of TENS on the tear fluid, 20 healthy VDT users were recruited from Zhongshan School of Medicine and 17 subjects (6 males and 11 females), aged 24.88 ± 2.39 years, met the inclusion criteria: noninvasive Keratograph first breakup time (NIKf-BUT) 5 to 15 seconds and Ocular Surface Disease Index (OSDI) scores < 15. [34][35][36][37][38] The exclusion criteria were as follows: incapable of completing the questionnaire or understanding the procedures, the presence of ocular or systemic disease or the use of topical or systemic medications that may affect the ocular surface, previous eye surgery or contact lens wear.…”