Ocular Surface Cooling Rate Associated With Tear Film Characteristics and the Maximum Interblink Period

Abstract The surface of the human eye is covered with a protective tear film that refreshes with each blink. Natural blinking occurs involuntarily, but one can also voluntarily blink or refrain from blinking. The maximum time one can refrain from blinking until the onset of discomfort is the maximum inter-blink period (MIBP). In between blinks the tear film thins and evaporates from the ocular surface. Tear film evaporation can be measured with various instruments. Infrared thermography provides a non-invasive measure of the ocular surface temperature (OST). Due to evaporation, ocular surface cooling (OSC) generally occurs when the eyes are open and exposed to the environment. The purpose of our study was to investigate the effect of OSC on the MIBP, and to investigate the association of the MIBP with tear film characteristics in subjects who do and do not exhibit OSC. The MIBP was measured simultaneously with OST over time. Non-invasive tear breakup time, tear meniscus height, tear lipid layer thickness, and Schirmer I test strip wetted lengths were measured on a day prior to the thermography visit. Subjects were divided into cooling and non-cooling groups based on OSC rate, and demographic and tear film characteristics were tested for inter-group differences. A faster rate of OSC was associated with an exponentially shorter duration of the MIBP overall and within the cooling group alone. Faster non-invasive tear breakup time was significantly associated with a shorter MIBP in both groups. These results suggest that tear film evaporation initiates a pathway that results in the onset of ocular discomfort and the stimulus to blinking. The presence of a subset of subjects with no or minimal OSC who nevertheless have a short MIBP indicates that evaporative cooling is not the only mechanism responsible for the onset of ocular discomfort.

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Ocular surface cooling rate associated with tear film characteristics and the maximum interblink period

Scientific Reports ◽

10.1038/s41598-021-94568-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jennifer E. Ding ◽

Young Hyun Kim ◽

Sarah M. Yi ◽

Andrew D. Graham ◽

Wing Li ◽

...

Keyword(s):

Ocular Surface ◽

Tear Film ◽

Test Strip ◽

Group Differences ◽

Surface Cooling ◽

Non Invasive ◽

Ocular Discomfort ◽

Tear Meniscus Height ◽

Film Characteristics ◽

Breakup Time

AbstractThe surface of the human eye is covered with a protective tear film that refreshes with each blink. Natural blinking occurs involuntarily, but one can also voluntarily blink or refrain from blinking. The maximum time one can refrain from blinking until the onset of discomfort is the maximum interblink period (MIBP). During the interblink period the tear film evaporates and thins from the ocular surface. Infrared thermography provides a non-invasive measure of the ocular surface temperature (OST). Due to evaporation, ocular surface cooling (OSC) generally occurs when the eyes are open and exposed to the environment. The purpose of our study was to investigate the effect of OSC rate on the MIBP, and to investigate the association of the MIBP with tear film characteristics in subjects who do and do not exhibit OSC. The MIBP was measured simultaneously with OST over time. Non-invasive tear breakup time, tear meniscus height, tear lipid layer thickness, and Schirmer I test strip wetted lengths were measured on a day prior to the thermography visit. Subjects were divided into cooling and non-cooling groups based on OSC rate, and demographic and tear film characteristics were tested for inter-group differences. A faster OSC rate was associated with an exponentially shorter duration of the MIBP overall and within the cooling group alone. Faster non-invasive tear breakup time was significantly associated with a shorter MIBP in both groups. These results suggest that tear film evaporation initiates a pathway that results in the onset of ocular discomfort and the stimulus to blinking. The presence of a subset of subjects with no or minimal OSC who nevertheless have a short MIBP indicates that evaporative cooling is not the only mechanism responsible for the onset of ocular discomfort.

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Correlation between Non-Invasive Tear Breakup Time and Invasive Tear Breakup Time for Dry Eye Syndrome Diagnosis

The Eye ◽

10.33791/2222-4408-2021-1-15-22 ◽

2021 ◽

Vol 23 (1) ◽

pp. 15-22

Author(s):

K. A. Mubarakova ◽

S. A. Mukhanov ◽

I. F. Saliyev ◽

N. H. Habibullayeva

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Tear Film ◽

Optical Power ◽

Dry Eye Syndrome ◽

Non Invasive ◽

Syndrome Diagnosis ◽

Breakup Time ◽

Test Result ◽

Schirmer I Test

Introduction: in today’s digital environment, dry eye complaints step forward in all age groups. Along with dry eye syndrome, the diagnosis of which is not complicated, there are other causes of dryness such as dysfunction of the tear film and Meibomian glands, etc. For the early detection of the above conditions, invasive diagnostic methods are mainly used.Aim: to compare Non-Invasive Tear Breakup Time (NITBUT) assessed with LacryDiag ocular surface analyzer to results of invasive tests for dry eye syndrome diagnosis to determine the possibility of a wider use of LacryDiag in practical ophthalmology. Materials and Methods: 50 patients with dry eye, burning and feeling of a foreign body complaints participated in this study. Mean age amounted to 28.85 ± 5.86 years. NITBUT was assessed with LacryDiag ocular surface analyzer. The data obtained was compared to the results of Invasive Tear Breakup Time (TBUT) – Norne test, and Schirmer I test.Results: both quantitative and qualitative values of tear film stability were analyzed in all participants. Based on results of the Schirmer I test, patients were divided into subgroups: where it was greater than 21 mm, between 11 and 20 mm, between 6 and 10 mm, and less than 5 mm/ The mean value of the Schirmer I test result amounted to 15.32 ± 6.05 mm/5 min, NITBUT amounted to 9.59 ± 4.37 s, while invasive TBUT amounted to 8.98 ± 3.79 s. It was found that invasive TBUT is in a strong direct correlation with NITBUT values (p <0.001, r = 0.554). No correlation was discovered between Schirmer I test results and TBUT (p = 0.15, r = 0.207) as well as between Schirmer I test result and NITBUT (p = 0.17, r =0.228). No correlation was found between the optical power of the cornea and the tear film structure abnormalities.Conclusion: a strong correlation was found between results of invasive and non-invasive methods of tear film breakup time assessment. No correlation was found between the optical power of the cornea and the tear film disruption. The non-invasive test was found to be an effective and objective method for diagnosing dry eye.

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Assessment of the Efficiency of HP-Guar and hyaluronic Acid Tear Supplements to Control Tear Film Evaporation Rate in Dry Eye Subjects

The Open Ophthalmology Journal ◽

10.2174/1874364102115010299 ◽

2021 ◽

Vol 15 (1) ◽

pp. 299-304

Author(s):

Ali Abusharha ◽

Abdulrhman A. Shbear ◽

Raied Fagehi ◽

Mana A. Alanazi ◽

Ali Alsaqr ◽

...

Keyword(s):

Hyaluronic Acid ◽

Dry Eye ◽

Evaporation Rate ◽

Common Factor ◽

Tear Film ◽

Eye Drops ◽

Film Evaporation ◽

The Mean ◽

Tear Meniscus Height ◽

Breakup Time

Background: The most common factor that could lead to dryness is the accelerated tear evaporation rate. Controlling the tear evaporation rate is increasingly used as a method to control dry eye complications. The present study explores the effects of different tear supplements formulations on tear film evaporation rate. Objective: This study aimed to evaluate the short-term effects of Systane ULTRA and Artelac Advanced eye drops on the tear film evaporation rate. Methods: Fifteen male dry eye subjects were enrolled in the current study. Tear film parameters were observed at several time points post installation (10, 20, 30, and 60 min). The tear film parameters observed in the current study were tear evaporation rate, noninvasive breakup time (NITBUT) and tear meniscus height (TMH). Two visits were required to conduct this study. One visit was conducted to assess the physiological tear film parameters with the use of Systane® ULTRA eye drop. The other visit was conducted to assess tear film parameters with the use of Artelac Advanced eye drop. Results: The mean tear evaporation rate at baseline was 52.58 ± 23.24 g/m2 h. A box plot of tear evaporation showed a reduction in tear film evaporation rate after instillation of Systane eye drop. A drop in tear film evaporation rate of 14% was observed at 20 and 60 min time point after instillation of Systane ULTRA eye drop. A significant increase in NITBUT was found after instillation of Systane ULTRA (P = 0.01) and Artelac Advanced (P = 0.02). Conclusion: The current study indicates a significant improvement in the tear film parameters using both HP-Guar and hyaluronic acid formulations. However, it was apparent that the use of HP-Guar was superior to hyaluronic acid in controlling the tear evaporation rate in dry eye subjects.

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Efficacy of cyclosporine 0.05% in patients with dry eye syndrome

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20193451 ◽

2019 ◽

Vol 6 (8) ◽

pp. 3339

Author(s):

Jitender Phogat ◽

Ritesh Verma ◽

Manisha Rathi ◽

Sumit Sachdeva ◽

Latika Pandey

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Tear Film ◽

Dry Eye Syndrome ◽

Paper Test ◽

Inflammatory Reactions ◽

Ocular Symptoms ◽

Body Sensation ◽

Ocular Discomfort ◽

Breakup Time

Background: An even and smooth ocular surface is vital for the functioning and comfort of the eyes. Dry eye is a group of disorders of the tear film which is due to either decreased production or increased evaporation and is associated with symptoms of ocular discomfort. Smoking and drugs have been suggested as risk factors in various studies. Cyclosporine has been shown to reduce the cell-mediated inflammatory reactions associated with the inflammatory ocular surface disease.Methods: 50 eyes of 25 patients suffering from dry-eye syndrome were included in this study. Three major ocular symptoms of dry eye i.e., ocular pain, burning, and foreign body sensation were studied in this study. Each symptom was given a score from 0 to 1 so that the ocular symptoms were given a score from 0 to 3.Results: There was a significant reduction in ocular symptoms score (OSS) 2.25 before treatment to 0.6 after 3 months of treatment (p=0.01). In addition, the Schirmer's paper test scores improved from 1.23 mm to 5.91 mm, which is significantly different (p=0.001). The tear film breakup time also improved from 5.49s to 9.86s.Conclusions: Cyclosporine 0.05% has been established to be effective and safe in our study.

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Changes in Ocular Surface Disease Evaluated after Nonpenetrating Deep Sclerectomy

10.21203/rs.3.rs-845361/v1 ◽

2021 ◽

Author(s):

Carlota Fuente-García ◽

Francisco José Muñoz-Negrete ◽

Elisabet de Dompablo-Ventura ◽

Javier Moreno-Montañés ◽

Gema Rebolleda

Keyword(s):

Ocular Surface ◽

Anterior Segment ◽

Tear Film ◽

Ocular Surface Disease ◽

Control Group ◽

Deep Sclerectomy ◽

Ocular Surface Disease Index ◽

Non Invasive ◽

Group A ◽

Tear Meniscus Height

Abstract Objective: To analyse the ocular surface changes in eyes after the withdraw of anti-glaucomatous drugs when non-penetrating deep sclerectomy (NPDS) is performed.Methods: 31 patients (33 eyes) diagnosed of glaucoma that underwent NPDS, were included in this prospective study. Control group included 33 eyes of 33 age and sex-matched volunteers. Five variables were studied with Keratograph 5M (K5M): ocular hyperaemia (OH), non-invasive tear film break-up time (NI-BUT), lower tear meniscus height (LTMH) and meibography. LTMH was also measured using the anterior segment module of Spectralis Fourier-Domain Optical Coherence Tomography (FD-OCT). Also, an evaluation of corneal and conjunctival staining was performed.In addition, patients were asked to answer two questionnaires: Ocular Surface Disease Index (OSDI) and National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) before and 6-months after surgery.Results: Before NPDS, treated eyes, showed worse objective data than healthy controls (p ≤0.049). In this group, a significant improvement was observed in the questionnaires (p< 0.001), LTMH FD-OCT (p=0.037) and LTMH K5M (p=0.025), K5M OH (p=0.003), NI-BUT (=0.022) and conjunctival and corneal staining (p<0.001). No significant differences were observed between groups in FD-OCT and K5M LTMH, NI-BUT, corneal-conjunctival staining and in the most OH sector values at 6 months(p ≥0.62).Conclusion: A significant improvement in the ocular surface was observed 6 months after NPDS, suggesting that the withdrawn of the topical anti-glaucomatous treatment has a beneficial effect.

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Short Term Effect of Virtual Reality on Tear Film Stability and Ocular Discomfort

Journal of Engineering and Science Research ◽

10.26666/rmp.jesr.2020.1.7 ◽

2020 ◽

Vol 4 (1) ◽

pp. 40-46

Author(s):

Mohd Zulfaezal Che Azemin ◽

Keyword(s):

Virtual Reality ◽

Tear Film ◽

Film Stability ◽

The Public ◽

Non Invasive ◽

Significant Difference ◽

Ocular Discomfort ◽

Tear Film Stability ◽

Before And After ◽

Tear Meniscus Height

Virtual reality (VR) has been integrated and used with smartphones as one of the digital entertainments such as in gaming and movie streaming. With emergent of various VR brands in the market, it concerns the public on the possible side effects of VR on the ocular performance specifically on tear film stability and ocular discomfort. The purpose of this study was to compare the change on non-invasive keratograph tear break-up time (NIKBUT), tear meniscus height (TMH) before and after the use of VR for 30 minutes, and to measure the ocular discomfort after the use of VR quantitatively. Thirty-two subjects were recruited in this study and all the subjects were divided randomly into two groups; VR and laptop (used as a control) groups. Each subject needed to watch a movie for 30 minutes using the respective devices. The changes of tear film stability and ocular discomfort before and after the use of the devices were then compared and the results showed that there was no significant difference (p>0.05) after 30 minutes of the use. Comparison of the ocular parameters between the devices on post-watching activities was also not significant (p>0.05). Use of VR did not give any signs of dryness to the eyes and it can be used without any discomfort even after 30 minutes usage of the devices.

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Normalized ocular surface temperature models for tear film characteristics and dry eye disease evaluation

The Ocular Surface ◽

10.1016/j.jtos.2020.04.002 ◽

2020 ◽

Author(s):

Tai-Yuan Su ◽

Shu-Wen Chang

Keyword(s):

Surface Temperature ◽

Dry Eye ◽

Ocular Surface ◽

Tear Film ◽

Dry Eye Disease ◽

Eye Disease ◽

Film Characteristics

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Tear-Film Evaporation Rate from Simultaneous Ocular-Surface Temperature and Tear-Breakup Area

Optometry and Vision Science ◽

10.1097/opx.0000000000001156 ◽

2018 ◽

Vol 95 (1) ◽

pp. 5-12 ◽

Cited By ~ 6

Author(s):

Thomas J. Dursch ◽

Wing Li ◽

Baseem Taraz ◽

Meng C. Lin ◽

Clayton J. Radke

Keyword(s):

Surface Temperature ◽

Ocular Surface ◽

Evaporation Rate ◽

Tear Film ◽

Film Evaporation

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Ocular Surface Disease in Patients under Topical Treatment for Glaucoma

European Journal of Ophthalmology ◽

10.5301/ejo.5000977 ◽

2017 ◽

Vol 27 (6) ◽

pp. 694-704 ◽

Cited By ~ 13

Author(s):

Francisco Pérez-Bartolomé ◽

Jose M. Martínez-de-la-Casa ◽

Pedro Arriola-Villalobos ◽

Cristina Fernández-Pérez ◽

Vicente Polo ◽

...

Keyword(s):

Ocular Surface ◽

Treatment Duration ◽

Open Angle Glaucoma ◽

Tear Film ◽

Older Age ◽

Ocular Surface Disease ◽

Medication Group ◽

Pressure Lowering ◽

Tear Meniscus Height ◽

Corneal Staining

Purpose To examine the relationship between ocular surface disease (OSD) and topical antiglaucoma therapy. Methods A total of 211 eyes of 211 patients with open-angle glaucoma or ocular hypertension on topical medication were recruited over 10 months. Controls were 51 eyes of 51 healthy age- and sex-matched volunteers. In each patient, we recorded the intraocular pressure-lowering eyedrops used, the number of medications used, and daily and cumulative preservative concentrations (PC). Main outcome measures were fluorescein corneal staining score (Oxford scale), lower tear meniscus height (LTMH) (spectral-domain optical coherence tomography), noninvasive tear film breakup time (NI-TBUT) (Oculus Keratograph 5M), and OSD symptom questionnaire index (OSDI). Results Compared to controls, significantly higher OSDI (median [interquartile range] 10.24 [4.54-18.94] vs 2.5 [0-12.5]; p<0.001) and corneal staining (≥1: 64.93% vs 32.61%; p<0.001) scores were recorded in the medication group. The NI-TBUT and LTMH failed to vary between the groups (p>0.05). A higher daily PC was associated with a lower LTMH (R −0.142; p = 0.043). In the medication group, multivariate analysis identified correlations between benzalkonium chloride (BAK) (odds ratio [OR] 1.56) and BAK plus polyquaternium-containing drops (OR 5.09) or higher OSDI (OR 1.06) and abnormal corneal staining test results and between older age (mean ratio [MR] 1.05), longer treatment duration (MR 1.02), or corneal staining presence (MR 1.22) and a higher OSDI score. Conclusions Ocular surface disease was more prevalent in the medication group. The main factors impacting OSD were drops with preservatives, longer treatment duration, and older age.

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