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In Vivo Confocal Microscopy in the Diagnosis and Management of Dry Eye: A Focus on Imaging Protocols and Interpretation
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Concordance between common dry eye diagnostic tests.

J E Moore1, J E Graham, E A Goodall

  • 1Centre for Molecular Biosciences, University of Ulster, Cromore Road, Coleraine, Northern Ireland BT52 1SA, UK. johnnymoorebal@googlemail.com

The British Journal of Ophthalmology
|September 11, 2008
PubMed
Summary
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Common dry eye diagnostic tests show limited concordance. Only tests evaluating lipid/mucous deficiency, including Meibomian gland evaluation, goblet cell density, tear film break-up time, and dry eye questionnaires, demonstrated correlation.

Area of Science:

  • Ophthalmology
  • Ocular Surface Disease

Background:

  • Diagnostic tests for dry eye disease exhibit significant variability in results.
  • Accurate diagnosis is crucial for effective management of dry eye.

Purpose of the Study:

  • To evaluate the concordance between various common diagnostic tests for dry eye.
  • To determine the reliability of different dry eye diagnostic methods.

Main Methods:

  • 91 subjects underwent evaluation using phenol red thread test (PRT), tear film break-up time (TBUT), biomicroscopy, and conjunctival goblet cell assessment.
  • Dry eye symptoms were assessed using the McMonnies' questionnaire (MQ).
  • Statistical correlations between all diagnostic tests were analyzed.

Main Results:

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  • The phenol red thread test (PRT) results showed statistically significant differences compared to all other tests.
  • Concordance was observed only between tests assessing lipid/mucous deficiency: Meibomian gland pathology, MQ, reduced goblet cell density, and TBUT (<=7 seconds).

Conclusions:

  • A significant lack of concordance exists among many common dry eye diagnostic tests.
  • Tests focusing on lipid/mucous deficiency, such as Meibomian gland evaluation, goblet cell density, TBUT, and MQ, show better correlation for diagnosing dry eye.