A non-invasive instrument for clinical assessment of the pre-corneal tear film stability

Mengher, Lakhbir S.; Bron, Anthony J.; Tonge, Stephen R.; Gilbert, David

doi:10.3109/02713688508999960

Cited by 237 publications

(157 citation statements)

References 6 publications

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“…64 According to this classification, NIBUT, nasal LIPCOF, and LIPCOF Sum were excellent discriminators, and TMH, PRTT, temporal LIPCOF, and LWE were acceptable discriminators. These results are not surprising, since NIBUT, 13,65 TMH, 58,66 PRTT, 46,47 LIPCOF, 13,16,18,19 and LWE 15,18,19 are accepted tests in dry eye assessment. Even though bulbar hyperaemia approached significance (P ¼ 0.055), its AUC was too small to be a predictive discriminator.…”

Section: Discussionmentioning

confidence: 88%

The relationship between clinical signs and dry eye symptoms

Pult

Purslow

Murphy

2011

Eye

148

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Purpose To evaluate (i) the relationship between traditional and new clinical tests (lid-wiper epitheliopathy (LWE), lid-parallel conjunctival folds (LIPCOF)) and dry eye symptoms in non-contact lens wearers, and (ii) that a combination of these tests can improve predictive ability for the development of dry eye symptoms. Methods Tear meniscus height (TMH), non-invasive break-up time (NIBUT), ocular hyperaemia, LIPCOF, phenol red thread test (PRTT), corneal and conjunctival staining, and LWE grades were observed in a cohort of 47 healthy, non-lens wearers (male ¼ 17, female ¼ 30, median age ¼ 35 years, range ¼ 19-70). Symptoms were assessed using the Ocular Surface Disease Index (OSDI). Results LWE was significantly correlated to both temporal and nasal LIPCOF (0.537or o0.607, Po0.05). LIPCOF and LWE were significantly correlated to NIBUT and PRTT (r4À0.248, Po0.001). Significant correlations were found between NIBUT and TMH (r ¼ 0.461, P ¼ 0.001) and PRTT (r ¼ 0.640, Po0.001). OSDI scores were significant correlated to NIBUT, TMH, PRTT, LIPCOF, and LWE (r4|0.31|; Po0.05). Significant discriminators of OSDI þ /À were NIBUT (area under the receiver operative characteristic curve (AUC) ¼ 0.895), TMH (0.715), PRTT (0.781), LIPCOF (temporal/nasal/Sum 0.748/0.828/0.816), and LWE (0.749). Best predictive ability was achieved by combining NIBUT with nasal LIPCOF (AUC ¼ 0.944). Conclusions The individual tests NIBUT, TMH, PRTT, LIPCOF, and LWE were significantly, but moderately, related to OSDI scores. The strongest relationship appeared by combining NIBUT with nasal LIPCOF.

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Section: Discussionmentioning

confidence: 88%

The relationship between clinical signs and dry eye symptoms

Pult

Purslow

Murphy

2011

Eye

148

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“…A reference value of Ͻ10 seconds for TBUT is used in the diagnosis of dry eyes. 11 The TBUT has been shown to be dependent on the reduction of surface tension by mucins and other surface-active agents but not so much on the quantity of aqueous content in tears. 12,13 Using the above value 97% of the patients had an abnormal TBUT ( Figure 5).…”

Section: Discussionmentioning

confidence: 99%

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

Kallarackal

Ansari

Amos

et al. 2002

Eye

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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

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“…Moreover, we measured the tear film break up time by a noninvasive method (NIBUT) by ocular microscopy using a small eye microscope (Keeler TearScope; Keeler Instruments, Windsor, UK). The instrument projects a grid of equidistant circles of light on the eye surface that are blurred by tear film break up (Mengher et al, 1985). The time until the blurring of the lines can be observed is counted.…”

Section: Assessment Of Tear Film Break Up Timementioning

confidence: 99%

Ocular symptoms and tear film break up time (BUT) among junior high school students in Penang, Malaysia – Associations with fungal DNA in school dust

Norbäck

Hashim

et al. 2017

International Journal of Hygiene and Environmental Health

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a b s t r a c tBackground: There are few studies on ocular effects of indoor mould exposure in schools, especially in the tropics Objective: To study associations between eye symptoms and tear film break up time (BUT) in students and demographic data and fungal DNA in schools. Methods: A school environment study was performed among randomly selected students in eight randomly selected secondary schools in Penang, Malaysia. Information on eye symptoms and demographic data was collected by a standardised questionnaire. BUT was measured by two methods, self-reported BUT (SBUT) and by the non-invasive Tearscope (NIBUT). Dust was collected by vacuuming in 32 classrooms and analysed for five fungal DNA sequences. Geometric mean (GM) for total fungal DNA was 7.31*10 4 target copies per gram dust and for Aspergillus/Penicillium DNA 3.34*10 4 target copies per gram dust. Linear mixed models and 3-level multiple logistic regression were applied adjusting for demographic factors. Results: A total of 368 students (58%) participated and 17.4% reported weekly eye symptoms the last 3 months. The median SBUT and TBUT were 15 and 12 s, respectively. Students wearing glasses (OR 2.41, p = 0.01) and with a history of atopy (OR = 2.67; p = 0.008) had more eye symptoms. Girls had less eye symptoms than boys (OR = 0.34; p = 0.006) Indoor carbon dioxide in the classrooms was low (range 380-720 ppm), temperature was 25-30 • C and relative air humidity 70-88%. Total fungal DNA in vacuumed dust was associated with shorter SBUT (4 s shorter per 10 5 target copies per gram dust; p = 0.04) and NIBUT (4 s shorter per 10 5 target copies per gram dust; p < 0.001). Aspergillus/Penicillium DNA was associated with shorter NIBUT (5 s shorter per 10 5 target copies per gram dust; p = 0.01). Conclusion: Fungal contamination in schools in a tropical country can be a risk factor for impaired tear film stability among students.

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A non-invasive instrument for clinical assessment of the pre-corneal tear film stability

Cited by 237 publications

References 6 publications

The relationship between clinical signs and dry eye symptoms

The relationship between clinical signs and dry eye symptoms

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

Ocular symptoms and tear film break up time (BUT) among junior high school students in Penang, Malaysia – Associations with fungal DNA in school dust

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