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Related Experiment Video

Updated: Sep 29, 2025

Comparing Objective Conjunctival Hyperemia Grading and the Ocular Surface Disease Index Score in Dry Eye Syndrome During COVID-19
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Dry Eye Symptom Severity and Visual Field Reliability Metrics.

Andrew S Camp1, Christopher P Long1, Anat Galor2

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Summary

Dry eye symptom severity is linked to increased tracking failure frequency (TFF) in visual field tests. This finding suggests TFF may need adjusted thresholds for glaucoma patients with dry eye.

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Area of Science:

  • Ophthalmology
  • Optometry
  • Glaucoma Research
  • Dry Eye Disease

Background:

  • Dry eye disease is prevalent in glaucoma patients and can worsen with topical glaucoma medications.
  • Dry eye symptoms may compromise the reliability of visual field (VF) testing, impacting diagnostic accuracy.
  • Gaze tracking (GT) offers advanced metrics for assessing VF test reliability.

Purpose of the Study:

  • To investigate the association between dry eye symptom severity and VF reliability metrics, including standard measures and GT metrics.
  • To determine if tracking failure frequency (TFF), a GT metric, correlates with dry eye severity and laterality in glaucoma patients.

Main Methods:

  • 494 glaucoma patients completed a dry eye questionnaire before VF testing.
  • VF reliability was assessed using standard metrics (fixation losses, false positives/negatives) and GT metrics (including TFF).
  • Data on glaucoma medication and artificial tear use were collected.

Main Results:

  • Tracking failure frequency (TFF) significantly increased with greater dry eye symptom severity (P=0.015).
  • TFF was also significantly higher in the left eye, which was tested second (P=0.012).
  • No significant associations were found between dry eye severity and standard VF reliability metrics or most GT metrics.

Conclusions:

  • Dry eye symptom severity may necessitate adjusted thresholds for TFF when interpreting VF reliability using GT.
  • The acceptable range for TFF might differ between the right and left eyes.
  • Further research is needed to establish specific TFF thresholds for glaucoma patients with varying degrees of dry eye.