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Evaluation of tear meniscus height using different clinical methods.

Britta Niedernolte1, Lisa Trunk1, James S Wolffsohn2

  • 1Höhere Fachschule für Augenoptik Köln (Cologne School of Optometry), Cologne, Germany.

Clinical & Experimental Optometry
|March 10, 2021
PubMed
Summary

Optical coherence tomography (OCT) is the most reliable method for measuring tear meniscus height (TMH), crucial for dry eye diagnosis. Slitlamp with a reticule is also effective, but lid margin comparisons are unreliable.

Keywords:
Dry eye diagnosiseye lasheslid thicknessoptical coherence tomographytear film volumetear meniscus height

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Area of Science:

  • Ophthalmology
  • Optometry
  • Biomedical Engineering

Background:

  • Tear meniscus height (TMH) is a key indicator for assessing tear film volume, vital in diagnosing and managing dry eye disease.
  • Accurate and repeatable measurement of TMH is essential for effective clinical practice.

Purpose of the Study:

  • To evaluate the accuracy and repeatability of different methods for measuring tear meniscus height (TMH).
  • To compare optical coherence tomography (OCT) with slitlamp microscopy and manual estimation techniques.

Main Methods:

  • Lower TMH was measured in 20 volunteers using OCT, slitlamp image analysis, and a reticule (8x and 32x magnification).
  • Comparative methods included lid-ratio and eyelash counts.
  • Inter-observer differences were analyzed using paired t-tests, method differences via ANOVA, and repeatability via ICC. ROC analysis predicted OCT-TMH.

Main Results:

  • Optical coherence tomography (OCT) demonstrated the highest repeatability (ICC=0.88).
  • Slitlamp with a 32x reticule showed good repeatability (ICC=0.70).
  • Lid-ratio and eyelash count methods were found to be unreliable for TMH evaluation.

Conclusions:

  • Optical coherence tomography (OCT) is the most reliable method for measuring tear meniscus height (TMH).
  • Slitlamp microscopy with a reticule, particularly at 32x magnification, is a viable alternative.
  • TMH assessment based on lid margin thickness or eyelash counts is not recommended.