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      Measurement of ocular surface protection under natural blink conditions

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          Abstract

          Purpose

          To evaluate a new method of measuring ocular exposure in the context of a natural blink pattern through analysis of the variables tear film breakup time (TFBUT), interblink interval (IBI), and tear film breakup area (BUA).

          Methods

          The traditional methodology (Forced-Stare [FS]) measures TFBUT and IBI separately. TFBUT is measured under forced-stare conditions by an examiner using a stopwatch, while IBI is measured as the subject watches television. The new methodology (video capture manual analysis [VCMA]) involves retrospective analysis of video data of fluorescein-stained eyes taken through a slit lamp while the subject watches television, and provides TFBUT and BUA for each IBI during the 1-minute video under natural blink conditions. The FS and VCMA methods were directly compared in the same set of dry-eye subjects. The VCMA method was evaluated for the ability to discriminate between dry-eye subjects and normal subjects. The VCMA method was further evaluated in the dry eye subjects for the ability to detect a treatment effect before, and 10 minutes after, bilateral instillation of an artificial tear solution.

          Results

          Ten normal subjects and 17 dry-eye subjects were studied. In the dry-eye subjects, the two methods differed with respect to mean TFBUTs (5.82 seconds, FS; 3.98 seconds, VCMA; P = 0.002). The FS variables alone (TFBUT, IBI) were not able to successfully distinguish between the dry-eye and normal subjects, whereas the additional VCMA variables, both derived and observed (BUA, BUA/IBI, breakup rate), were able to successfully distinguish between the dry-eye and normal subjects in a statistically significant fashion. TFBUT ( P = 0.034) and BUA/IBI ( P = 0.001) were able to distinguish the treatment effect of artificial tears in dry-eye subjects.

          Conclusion

          The VCMA methodology provides a clinically relevant analysis of tear film stability measured in the context of a natural blink pattern.

          Related collections

          Most cited references24

          • Record: found
          • Abstract: found
          • Article: not found

          The ocular surface and tear film and their dysfunction in dry eye disease.

          The ocular surface, tear film, lacrimal glands, and eyelids act as a functional unit to preserve the quality of the refractive surface of the eye and to resist injury and protect the eye against changing bodily and environmental conditions. Events that disturb the homeostasis of this functional unit can result in a vicious cycle of ocular surface disease. The tear film is the most dynamic structure of the functional unit, and its production and turnover is essential to maintaining the health of the ocular surface. Classically, the tear film is reported to be composed of three layers: the mucin, aqueous, and lipid layers. The boundaries and real thickness of such layers is still under discussion. A dysfunction of any of these layers can result in dry eye disease.
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            The oily layer of the tear film and evaporation from the corneal surface.

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              • Abstract: not found
              • Article: not found

              Formation and rupture of the tear film.

              F E Holly (1973)
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                Author and article information

                Journal
                Clin Ophthalmol
                Clinical Ophthalmology
                Clinical Ophthalmology (Auckland, N.Z.)
                Dove Medical Press
                1177-5467
                1177-5483
                2011
                2011
                22 September 2011
                : 5
                : 1349-1357
                Affiliations
                [1 ]Arizona State University, Tempe, AZ, USA
                [2 ]Statistics and Data Corporation, Tempe, AZ, USA
                [3 ]Ora, Inc, Andover, MA, USA
                Author notes
                Correspondence: Richard Abelson, Statistics and Data Corporation, 21 E 6th St, Unit 110, Tempe, AZ 85281, USA, Tel +1 480 632 5468, Fax +1 480 632 5469, Email rabelson@ 123456sdcclinical.com
                Article
                opth-5-1349
                10.2147/OPTH.S22017
                3198408
                22034554
                a40904e3-6dae-4af8-b386-2b58c7aecd97
                © 2011 Abelson et al, publisher and licensee Dove Medical Press Ltd

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                History
                Categories
                Original Research

                Ophthalmology & Optometry
                ocular protection index,tear film breakup time,interblink interval,forced stare

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