“…[3][4][5][6][7] In addition, some tests seem to be altered by circadian rhythms, 8 which may be related to changes in the ocular surface symptoms throughout the day; in fact, an evening worsening of visual function and symptoms have been described in patients with DED. 8 Due to the unsatisfactory results provided by the currently available diagnostic tests, some new tests have been developed recently, e.g. measurement of the tear meniscus with optical coherence tomography, 9 and others have been improved to allow easier use in the clinic; for example, tear osmolarity measurements, which had been primarily a laboratory test, is more accessible clinically for assessing dry eye due to recent technologic advances.…”