A comparative study to assess the clinical use of Fluorescein Meniscus Time (FMT) with Tear Break up Time (TBUT) and Schirmer’s tests (ST) in the diagnosis of dry eyes

Abstract

Introduction The clinical diagnosis of dryeye is confirmed by a suitable test of tear production and the technique commonly used today to diagnose dry eye is the Schirmer's test (ST). Although the ST is easy to perform it gives variable results, poor reproducibility and low sensitivity for detecting dry eyes. Another test, the tear break up time (TBUT) is used to assess the stability of tears which if abnormal may also cause symptomatic dry-eye. We present the results of both these tests and a new test, which shows greater sensitivity than the ST in detecting aqueous tear deficiency. The fluorescein meniscus time (FMT) is a new test developed in conjunction with one of the authors (CL) and the Department of Ophthalmology at the University Hospital of Wales. The FMT is a measure of the rate at which a fluorescent tear meniscus is formed using 2% sodium fluorescein, a stopwatch and suitable illumination with a slit lamp. Method An open controlled study in 62 patients and 51 controls was conducted to compare the ability of ST, FMT and TBUT to detect dry-eye in a group of patients diagnosed with rheumatoid arthritis and symptomatic dry eyes for a minimum period of 6 months. A separate control group of 15 subjects was tested on three separate occasions to assess the reproducibility of the FMT test. Results All three tests showed a statistically significant difference between the patient

A Simple Approach to the Repeatability of the Schirmer Test Without Anesthesia

“…Indeed, ST has been found to give varied results and poor reproducibility for detecting aqueous tear deficiency [1][2][3][4][5][6][9][10][11] because ST is easily influenced by both intrinsic and extrinsic factors such as reflex tearing, irritation by the paper, temperature, evaporation, and humidity. 6,7 The ST is most commonly performed with the patient's eyes open and blinking normally, but some clinicians prefer performing it with the patient keeping his eyes closed. 10 To the best of our knowledge, this is the first study to compare the repeatability of the 2 STs.…”

“…The ST has been found to give poor reproducibility and low sensitivity for detecting dry eye [1][2][3][4][5] because of several factors such as the positioning of the paper, reflex tearing caused by irritation from the paper, temperature, humidity, and evaporation. 6,7 This study was conducted in anticipation that closing the eyes while the test is performed may be successful in minimizing the influence of such factors, hence increasing its reliability. The repeatability of the ST administered with the eyes open (STo) and that with the eyes closed (STc) was assessed and compared.…”

Tear Menisci After Laser In Situ Keratomileusis With Mechanical Microkeratome and Femtosecond Laser

“…21,22 The importance of tear meniscus evaluation in the diagnosis of tear deficiency has been recognized, and it has been used in many dry eye studies. 15,16,23,24 Nevertheless, assessing and evaluating the tear meniscus, especially the upper meniscus, in a noninvasive manner is difficult. 15 However, with advances in technology, such as anterior segment spectral-domain optical coherence tomography (SD-OCT), the upper and lower tear menisci can now be evaluated noninvasively and quantitatively.…”

“…6,9,10 Traditional dry eye evaluations, such as a dry eye questionnaire, Schirmer test, tear breakup time, and corneal fluorescein staining, which exhibit fairly good reliability in clinics, have been widely applied in previous studies 6,[10][11][12][13][14] ; however, the conflicting results of these evaluations have been yielded because many factors exist that can influence the outcomes of these evaluations. [15][16][17][18][19] The tear meniscus holds approximately 75% to 90% of the total tears 20 and has been suggested as a useful measure in monitoring the tear volume. 21,22 The importance of tear meniscus evaluation in the diagnosis of tear deficiency has been recognized, and it has been used in many dry eye studies.…”

Comparison of Indices of Vitamin A Status in Children With Chronic Liver Disease *

“…These tests, which do not require administration of vitamin A nor drawing of blood, are based on the principle that early in vitamin A depletion, abnormalities in ocular epithelial differentiation and retinal photoreceptor function occur well before the development of other more obvious clinical signs of vitamin A deficiency. Two other tests, a Schirmer's test 24,25 and a tear film break-up time (TF-BUT), 26,27 assess eye dryness and tear production, respectively-both findings of vitamin A deficiency.…”