Objective optical assessment of tear-film quality dynamics in normal and mildly symptomatic dry eyes

“…Unlike wave-front sensors, the DP technique provides combined information of both aberrations and small-angle intraocular scatter [2]. A method to objectively measure the amount of small-angle scatter from the analysis of DP images has been used for cataract classification and for dry-eye diagnosis among others [3,4]. A modification of the DP method using an optical integration approach also allows estimating the wide-angle scatter and straylight [5].…”

Section: Introductionmentioning

confidence: 99%

Impact of scatter on double-pass image quality and contrast sensitivity measured with a single instrument

Bueno¹,

Pérez²,

Benito³

et al. 2015

Biomed. Opt. Express

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Abstract:We compared objective Double-Pass (DP) image quality data with subjective visual parameters measured within the same modified instrument for different amounts of scatter. The original DP imaging channel of a clinical instrument was maintained intact and two additional channels were included, one for visual testing and another for tear film (TF) imaging by using a retro-illumination technique. Contrast sensitivity (CS) was compared with measurements of the Objective Scattering Index (OSI) obtained from DP retinal images corresponding to different scatter levels induced by pre-defined filters. OSI values were correlated with the change in CS for different spatial frequencies measured with the same instrument. Since TF and DP images were recorded at the same rate, this provided additional information about the dynamic spatial stability of the tear film. This new DP instrument has been proven to provide accuracy and repeatability, and to be suitable for clinical diagnosis, with a complete evaluation of the eye's performance by a simultaneous objective and subjective assessment under the same experimental conditions.

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“…13 Because the tear film is the first refracting structure for the incoming light, an inhomogeneous tear film is also often the reason for transient changes in visual performance after a blink. 14,15 Due to the diversity of risk factors and etiology, as well as the complex interactions between the layers, the precise diagnosis of DED is challenging. A number of standard assessment procedures for tear film disorders have been developed and can be divided into subgroups: questionnaires to assess the subjectively reported symptoms; investigations of ocular surface damage via staining; the demonstration of the tear film instability by tear film break up time (TFBUT) as determined with fluorescein; and the lacrimal gland production capacity through the Schirmer test.…”

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confidence: 99%

Introducing a New Parameter for the Assessment of the Tear Film Lipid Layer

Ring

Rabensteiner

Horwath‐Winter

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. The differential diagnosis of dry eye syndrome is still a challenging task. The purpose of this study was to understand the relationship between a novel, objective clinical parameter, the ''corrected lipid layer stabilization time,'' and commonly performed clinical tests for dry eye patients.METHODS. Data were obtained from a prospective clinical study with 59 patients of different subjective severity, as determined with the Ocular Surface Disease Index (OSDI). The dynamics of the tear film lipid layer were made visible through a white light source and were stored digitally. Because the distance between the upper and lower eyelid affects the lipid layer dynamics and varies significantly between subjects, the distance of the eyelids was determined and used to correct the lipid layer stabilization time. The resulting parameter was compared with common clinical procedures.RESULTS. The corrected lipid layer stabilization time has a highly significant correlation with tear film breakup time (Spearman r ¼ À0.485, P < 0.01), Schirmer test without anesthesia (r ¼ À0.431, P < 0.01) and with the Ocular Surface Disease Index (r ¼ 0.498, P < 0.01). It also correlates with the lissamine green staining score (r ¼ 0.379, P < 0.05), but shows no correlation with the osmolarity of the tear film. Without the correction for the eyelid opening, the correlations decrease considerably.CONCLUSIONS. These data suggest that the diagnostic value of the lipid layer stabilization time for the assessment of the severity of dry eye syndrome increases considerably when it is corrected by the distance of the eyelids. (Invest Ophthalmol Vis Sci. 2012;53:6638-6644)

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Objective optical assessment of tear-film quality dynamics in normal and mildly symptomatic dry eyes

Abstract: The new objective optical method to evaluate the quality and stability of the tear film was sensitive in detecting mild symptoms of dry eye and differentiating from normal cases. The procedure may allow early detection and follow-up of patients' tear film-related complaints.

Cited by 113 publications

References 25 publications

Comparison Among the Four Examination Methods for Dry Eye (OQAS test, TBUT, Schirmer Test, McMonnies test)

Comparison Among the Four Examination Methods for Dry Eye (OQAS test, TBUT, Schirmer Test, McMonnies test)

Impact of scatter on double-pass image quality and contrast sensitivity measured with a single instrument

Introducing a New Parameter for the Assessment of the Tear Film Lipid Layer

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