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Tear film osmolarity a critical parameter in diagnosis of dry eye

AMSTERDAM — Tear film osmolarity is a critical parameter in determining  what specific form of dry eye affects the patient and what treatment should be employed, according to one specialist.

Mitchell A. Jackson, MD, reminded the audience at the European Society of Cataract and Refractive Surgeons meeting that the Dry Eye Workshop updated definition of dry eye included “increased osmolarity of the tear film” as a key factor.  And yet the Consensus Guidelines based on classification levels 1 to 4 do not include osmolarity among signs. 

A retrospective review of 100 eyes with some form of ocular surface disease symptomatology was performed.  Tear film lipid layer analysis using the LipiView interferometry (TearScience) and tear film osmolarity using the TearLab device were performed in addition to the traditional tests for dry eye. 

Abnormal osmolarity with normal tear film layer interferometry and normal osmolarity with abnormal tear film layer interferometry were key features in discriminating between aqueous-deficiency dry eye  and evaporative dry eye.  A combined form also was classified based on the presence of tear osmolarity and lipid film abnormalities.

“A significantly higher prevalence of  evaporative dry eye was found in 56% of the patients, while 24% had aqueous-deficiency dry eye and 20% had clinical signs of both,” Jackson said. 

Current advanced diagnostic technology for the evaluation of tear osmolarity and tear lipid layer should become routine in the diagnosis of dry eye disease, he concluded.

Disclosure: Jackson is in the speakers bureau of TearLab and TearScience.

AMSTERDAM — Tear film osmolarity is a critical parameter in determining  what specific form of dry eye affects the patient and what treatment should be employed, according to one specialist.

Mitchell A. Jackson, MD, reminded the audience at the European Society of Cataract and Refractive Surgeons meeting that the Dry Eye Workshop updated definition of dry eye included “increased osmolarity of the tear film” as a key factor.  And yet the Consensus Guidelines based on classification levels 1 to 4 do not include osmolarity among signs. 

A retrospective review of 100 eyes with some form of ocular surface disease symptomatology was performed.  Tear film lipid layer analysis using the LipiView interferometry (TearScience) and tear film osmolarity using the TearLab device were performed in addition to the traditional tests for dry eye. 

Abnormal osmolarity with normal tear film layer interferometry and normal osmolarity with abnormal tear film layer interferometry were key features in discriminating between aqueous-deficiency dry eye  and evaporative dry eye.  A combined form also was classified based on the presence of tear osmolarity and lipid film abnormalities.

“A significantly higher prevalence of  evaporative dry eye was found in 56% of the patients, while 24% had aqueous-deficiency dry eye and 20% had clinical signs of both,” Jackson said. 

Current advanced diagnostic technology for the evaluation of tear osmolarity and tear lipid layer should become routine in the diagnosis of dry eye disease, he concluded.

Disclosure: Jackson is in the speakers bureau of TearLab and TearScience.

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