High-Resolution Ocular Surface Imaging: Real-Time Visualization of Tear Film Dysfunction.

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Medical Imaging

Background:

• Advancements in infrared sensing enable real-time visualization of tear film dynamics.
• Blinking is a critical factor in tear film quality assessment.
• The OCULUS keratograph (K5M) is a tool for dry eye diagnostics.

Purpose of the Study:

• To evaluate tear film quality during blinking using real-time infrared sensing.
• To correlate infrared-based tear film grading with existing dry eye diagnostic results.

Main Methods:

• Retrospective clinical evaluation of infrared videos of the tear film.
• Grading tear film perturbations in patients compared to healthy controls.
• Correlating tear film grading with Ocular Surface Disease Index (OSDI) scores, tear film breakup time (TFBUT), tear meniscus height (TMH), corneal staining, redness, and meibography data.

Main Results:

• Infrared imaging revealed dynamic tear film characteristics, distinguishing normal from abnormal tear films.
• Abnormal features included absent or hindered tear film spreading and instability.
• Grading of features correlated with TFBUT and TMH, but not significantly with other K5M diagnostics.
• Tear film spreading speed positively correlated with TMH.

Conclusions:

• Infrared sensing provides noninvasive, reproducible, and rapid assessment of tear film health.
• Direct visualization across the palpebral aperture offers a novel method for tear film evaluation.