Abstract-The cornea is covered by a thin tear film that performs various vital functions including the provision of a high quality optical surface and protecting the cornea. Clinical methods for assessing tear film surface quality are mostly invasive and often unreliable. Recently, several non-invasive methods have been proposed. In this letter, we review three promising optical techniques based on high speed videokeratoscopy, wavefront sensing and lateral shearing interferometry, and evaluate their clinical utility.The tear film is the first optical element of the human eye. At the air/tear film interface the rays undergo the strongest refraction (from about n=1 to about n=1.336). Hence, the stability of the pre-corneal tear film surface and its smoothness are essential for the retinal image to have a good quality [1]- [3]. The tear film is broadly comprised of three distinct layers, an outer lipid layer, a middle aqueous layer and an inner mucin layer. The tear film is rejuvenated with every blink and will eventually rupture if blinking does not occur. Instability or rupture of the tear film leads to the collection of symptoms known as dry eye, one of the most commonly reported eye ailments [4].Currently, clinically accepted assessment of tear film often includes patient history, slit-lamp biomicroscope examination of corneal and conjunctival staining with vital dyes, fluorescein tear break-up time, subjective assessment of meibomian gland secretions, conjunctival hyperaemia, and evaluation of tear film volume with a Schirmer test, cotton thread test, or tear meniscus height. However, such a battery of diagnostic methods is time consuming and may be unreliable [5], [6]. Also, such methods are inadequate to study the kinetics of tear film and their influence on visual performance of the eye.In the last decade, more attention was given to the developments of non-invasive methods for pre-corneal tear film surface analysis such as repeated measure videokeratography [7] In the lateral sharing interferometer, the wavefront coming from a HeNe laser reflects from the tear film surface and creates an interferogram. The shape of interference fringes corresponds to a temporal stage of the precorneal tear film surface. The method of numerical analysis is based on combined image processing techniques and spectral analysis of the interferogram [21], [23].The high-speed videokeratoscopy method is based on the projection of a Placido disc pattern onto the precorneal tear film layer, and capturing the reflection with a video-camera. Over time, the quality of the reflected image, in particular the image coherence, provides a timevarying tear film surface quality indicator [9]- [11].For dynamic wavefront sensing, a commercially available Shack-Hartmann wavefront sensor was used (COAS TM Representative examples of data acquired from the three considered instruments from a subject diagnosed with dry eye are shown in Fig. 1, when the quality of tear film is good (left column) and after a tear film breakup was detected (right column...