Comparison of non-invasive tear film stability measurement techniques

Clin Exp Optom. 2018 Jan;101(1):13-17. doi: 10.1111/cxo.12546. Epub 2017 May 14.

Abstract

Background: Measurement of tear film stability is commonly used to give an indication of tear film quality but a number of non-invasive techniques exists within the clinical setting. This study sought to compare three non-invasive tear film stability measurement techniques: instrument-mounted wide-field white light clinical interferometry, instrument-mounted keratoscopy and hand-held keratoscopy.

Methods: Twenty-two subjects were recruited in a prospective, randomised, masked, cross-over study. Tear film break-up or thinning time was measured non-invasively by independent experienced examiners, with each of the three devices, in a randomised order, within an hour.

Results: Significant correlation was observed between instrument-mounted interferometric and keratoscopic measurements (p < 0.001) but not between the hand-held device and the instrument-mounted techniques (all p > 0.05). Tear film stability values obtained from the hand-held device were significantly shorter and demonstrated narrower spread than the other two instruments (all p < 0.05), while no significant differences were observed between the two instrument-mounted devices (all p > 0.05).

Conclusion: Good clinical agreement exists between the instrument-mounted interferometric and keratoscopic measurements but not between the hand-held device and either of the instrument-mounted techniques. The results highlight the importance of specifying the instrument employed to record non-invasive tear film stability.

Keywords: break-up time; non-invasive techniques; tear film; tear film stability.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cornea / metabolism*
  • Cross-Over Studies
  • Female
  • Humans
  • Interferometry / methods*
  • Male
  • Prospective Studies
  • Reference Values
  • Single-Blind Method
  • Tears / chemistry*