Relationship between tear-meniscus parameters and tear-film breakup

Cornea. 1997 Nov;16(6):649-61.


Purpose: Several flaws exist with the lipid-diffusion model for tear-film breakup. The aim of this study was to test an alternative model of tear-film rupture in which the negative hydrostatic pressure in each tear meniscus (related to the tear-meniscus radius of curvature) is proposed to influence the formation of breaks in the tear film.

Methods: Measurements of noninvasive breakup time (NIBUT) and tear-meniscus radius of curvature, height, width, and cross-sectional area (TMC, TMH, TMW, and XSA) were made for 15 aqueous-deficient dry-eye and 15 age-matched control subjects. An optic section of the inferior tear meniscus (colored with a minute volume of fluorescein) was photographed at x120 magnification, and images were computer analyzed.

Results: A significant positive correlation was found between log NIBUT and TMC (r2 = 0.141; p < 0.05). Furthermore, all subjects with TMC < 0.340 mm had NIBUT < 15 s, and two thirds of subjects with TMC > 0.340 mm had NIBUT > 15 s. There was a moderate linear relationship between TMH and log NIBUT, indicating an association between tear volume and tear stability. TMC, TMH, and tear meniscus XSA measurements all showed good reliability.

Conclusions: The association between highly curved tear menisci and rapid tear-film breakup times is consistent with the meniscus model of tear-film rupture. However, a causal relationship has yet to be established.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Adult
  • Aged
  • Aged, 80 and over
  • Blinking / physiology
  • Contrast Media
  • Dry Eye Syndromes / physiopathology*
  • Female
  • Fluorescein
  • Humans
  • Male
  • Middle Aged
  • Ophthalmic Solutions
  • Reproducibility of Results
  • Surface Tension
  • Tears / physiology*
  • Video Recording


  • Contrast Media
  • Ophthalmic Solutions
  • Fluorescein