Posters

Tear film in normal subjects, a pilot study

Poster Details

First Author: I.Van Der Meulen THE NETHERLANDS

Co Author(s):    H. van Vliet   C. Nieuwendaal   S. Hofman   R. Lapid-Gortzak           

Abstract Details

Purpose:

Measuring the osmolarity and the non-invasive break-up time of the tear film can help to discriminate between two major contributors of dry eye disease (DED): acqueous deficiency and the effects of an abnormal lipid layer. The purpose of our investigation was to evaluate the use of these tear film parameters in the clinical setting, to improve diagnosis and treatment of patients with dry eye disease.

Setting:

Department of Ophthalmology, Amsterdam University Medical Center, Amsterdam, The The Netherlands

Methods:

The tearscope© was used to measure the non-invasive break-up time (NIBUT), the height of the tear meniscus, the thickness of the lipid layer through interferometry and to perform meibomography of the upper and lower eyelid on 21 students of the Amsterdam UMC with normal eyes. The osmolarity was measured with the tearlab©. We also measured the best corrected Snellen visual acuity, stray light with the C-Quant© , the acqueous production with the Schirmer test and the tear break-up time (TBUT) with fluorescein. The students also completed the ocular surface disease index (OSDI) questionnaire.

Results:

The results of 21 subjects, 12 females and 9 males, are reported for the right eye. The results of the left eye are not significantly different of the results of the right eye. Most parameters, as expected in a healthy group, were within normal range. Only the height of the tear meniscus was low (0.18 mm, sd 0.04, normals >0.20 mm) and the meibomography of the inferior eyelid showed more loss of glands than normal (average 38 %, sd 11 %., normal values not indicated in literature yet, the tearscope indicates less than 30 % as normal ) . Also the TBUT was quite short (average 3.7 seconds, sd 1.6 sec., normal 5-10 seconds), the NIBUT was in 55% not detectable, and when detectable significantly prolonged compared to the TBUT (7,1 sec., sd 3,2 sec.). To categorise the lipid layer thickness with interferometry was difficult with a low inter observer agreement (0.26). The reliability of the meibomography was questionable, as it was not possible to fully underline the total surface of the Meibomian gland by automated detection.

Conclusions:

The tearscope© is a promising instrument for implementation in the clinical setting. The measurements can be done relatively fast with little burden for the patient. However the reliability of several measurements important to DED (meibomography, NIBUT) has to be improved.

Financial Disclosure:

None