Related Experiment Video
Updated: May 8, 2026

Nasolacrimal Lavage as a Treatment for Ocular Surface Toxic Soup Syndrome
Published on: April 25, 2025
Noninvasive tear breakup times and ocular surface disease
Daniel G Fuller1, Katlyn Potts, Jeung Kim
1*OD, FAAO †BS ‡OD, PhD The Eye Center, Southern College of Optometry, Memphis, Tennessee (DGF, JK); and Southern College of Optometry, Memphis, Tennessee (KP).
The Ocular Surface Disease Index (OSDI) questionnaire and noninvasive tear breakup times (NITBUTs) measured by the Keratograph 4 show a weak but significant negative correlation, indicating a link between dry eye symptoms and tear film stability.
Area of Science:
- Ophthalmology
- Optometry
- Vision Science
Background:
- Dry eye disease is a prevalent condition affecting ocular surface health.
- Accurate assessment of dry eye disease relies on validated patient-reported outcomes and objective clinical measurements.
- The Ocular Surface Disease Index (OSDI) is a widely used questionnaire for assessing dry eye symptoms.
- Noninvasive tear breakup time (NITBUT) is a key objective measure of tear film stability.
Purpose of the Study:
- To determine the correlation between the Ocular Surface Disease Index (OSDI) and noninvasive tear breakup times (NITBUTs).
- To evaluate the utility of the Keratograph 4 device in assessing tear film stability in relation to patient-reported dry eye symptoms.
Main Methods:
- A prospective study included 99 participants, with no significant age or sex differences.
- Participants completed the OSDI questionnaire.
- Keratograph 4 measurements were taken for the first noninvasive tear breakup time (NITBUT(f)) and average noninvasive tear breakup time (NITBUT(av)).
Main Results:
- The first noninvasive tear breakup time (NITBUT(f)) was significantly shorter than the average noninvasive tear breakup time (NITBUT(av)).
- Both NITBUT(f) and NITBUT(av) showed identical, statistically significant, weak negative correlations with OSDI scores (r(s) = -0.20, p = 0.05).
Conclusions:
- The Ocular Surface Disease Index (OSDI) and noninvasive tear breakup time (NITBUT) measurements using the Keratograph 4 exhibit a weak but statistically significant negative correlation.
- This suggests that while subjective dry eye symptoms (OSDI) and objective tear film stability (NITBUT) are related, the association is not strong.
More Related Videos
05:00Intense Pulsed Light for the Treatment of Dry Eye Owing to Meibomian Gland Dysfunction
Published on: April 1, 2019
08:04A Rabbit Model of Aqueous-Deficient Dry Eye Disease Induced by Concanavalin A Injection into the Lacrimal Glands: Application to Drug Efficacy Studies
Published on: January 24, 2020