Novel methods for the evaluation of the tear film in the diagnosis of dry eye

Abstract

Dry eye is a complex, multi-factorial disease that results in a compromised tear film and ocular surface. Clinicians and researchers alike have historically relied on an individual’s symptoms to diagnose and manage the condition, due to a lack of reliable objective methods for quantifying disease presence and severity. Of late, parameters such as tear film osmolarity and tear meniscus height have shown promise as valid methods for enumerating characteristics of the tear film that may aid the diagnosis of dry eye. Two new technologies have recently been introduced that can measure said parameters. The TearLab™ is a novel handheld nano-osmometer capable of measuring tear film osmolarity on samples as small as 50 nL. The device uses electrical conductance to measure osmolarity, and the small sample requirements purportedly allows the device to minimally disturb the natural state of the tear film. The RTVue-100 is a spectral-, or Fourier-domain optical coherence tomographer that has the ability to generate high resolution, cross-sectional images of the tear meniscus, and subsequently measure tear meniscus height. As little is published on the use of these technologies to evaluate the tear film, a series of studies was completed to determine their performance in both a normal and dry eye population.