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Long-term use of antiglaucoma eye drops was associated with alterations in meibomian gland morphology and function.

PURPOSE. We investigated whether the tear interferometric pattern was able to identify differences in tear film kinetics among clinical subtypes of dry eye. METHODS.A total of 138 eyes of 76 subjects (38 men and 38 women; mean age 6 SD, 61.6 6 16.2 years) with or without dry eye who visited Itoh Clinic from May to August 2015 were enrolled in a cross-sectional study. Clinical diagnosis of dry eye subtype was based on tear film parameters. The pattern of tear film kinetics determined by interferometry was classified as 0 (monotonous gray or multicolor interferometric fringe with a noninvasive breakup time [NIBUT] of ‡5 seconds), 1 (multicolor interferometric fringe with a NIBUT of <5 seconds), or 2 (grayish amorphous interferometric fringe with a NIBUT of <5 seconds), and reliability of classification was evaluated. Lipid layer thickness (LLT) for the tear film was also determined by interferometry. RESULTS.Interrater j values for evaluation of interferometric patterns ranged from 0.57 to 0.94 for both physicians and nonphysicians with reference to a dry eye expert, the latter of whom showed an intrarater reliability of 0.90. The distribution of eyes among interferometric patterns 0, 1, and 2 coincided well with the clinical subgroups of normal tear condition, nonSjögren syndrome aqueous-deficient dry eye, and meibomian gland dysfunction, respectively. A multicolor interferometric fringe was essentially observed only at an LLT of >70 nm. CONCLUSIONS.Tear interferometry was able to reliably distinguish clinical subtypes of dry eye by reflecting the balance between the lipid and aqueous layers of the tear film.Keywords: tear interferometry, dry eye, meibomiangland T he tear film consists of aqueous, mucin, and lipid layers with different levels of complexity.1 The quality and quantity of each layer, as well as their interactive relations, are important for homeostasis of the tear film. Impairment of the quality or changes in the quantity of tear film components can result in dry eye disease, which is categorized as either aqueous-deficient dry eye (ADDE) or evaporative dry eye (EDE).2,3 Dysfunction or hypofunction of lacrimal glands and the consequent reduced volume of the aqueous layer of the tear film thus underlie ADDE. Similarly, dysfunction or hypofunction of meibomian glands (which produce the lipid components of the tear film) or reduced production of mucin proteins by conjunctival goblet cells increases the evaporation of tear fluid and results in EDE.Interferometry has been applied as a noninvasive method for visualization of the lucent lipid layer at the surface of the tear film. 4 Tear interference images associated with surface phenomena of the tear film have thus been obtained 5-8 based on a principle first described by Newton. 9 This approach has been adopted to study tear dynamics in individuals with Sjögren syndrome 10 or dry eye, 11 including EDE, 12 as well as in contact lens wearers. 6,13 It has also been used to measure the thickness of the lipid layer of the tear film in normal subjects, 14 in...