Related Experiment Video
Updated: Jan 17, 2026
Development of an In Vitro Ocular Platform to Test Contact Lenses
Published on: April 6, 2016
Comparison of different methods to image the tear film before and during contact lens wear
Srikanth Dumpati1, Mukesh Kumar1, Ajay Kumar Vijay1
1School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia.
Purpose:
To evaluate the repeatability and compare non-invasive tear breakup time (NIBUT) and tear film lipid layer thickness (TFLLT) measurements obtained using subjective (Keeler Tearscope-Plus) and objective (Oculus Keratograph 5M and LipiView II Interferometer) instruments before and during soft contact lens (CL) wear.
Methods:
This prospective, randomised, double-masked, crossover study involved ten healthy participants who wore two types of daily disposable soft CLs: hydrogel and silicone hydrogel. NIBUT and TFLLT were assessed under pre cornea (before lens insertion) and pre lens (over the lens) conditions. NIBUT was measured using Tearscope-Plus and the Oculus Keratograph 5M, while TFLLT was assessed with Tearscope-Plus and the LifpiView II Interferometer. Repeatability was evaluated using repeated-measures ANOVA within-subject standard deviation (Sw), coefficient of repeatability (CR), and intraclass correlation coefficient (ICC). Correlation between instruments was assessed using Spearman coefficients, while agreement was evaluated using Bland-Altman analysis.
Results:
NIBUT measured with the Tearscope-Plus demonstrated good to excellent repeatability (ICC: 0.84-0.96). TFLLT measured with the LipiView II Interferometer showed excellent repeatability (ICC: 0.92-0.96). The Oculus Keratograph 5M showed moderate to good repeatability for NIBUT (ICC: 0.67-0.85). No significant correlations were observed between NIBUT measurements from the Tearscope-Plus and Oculus Keratograph 5M (r range: 0.02-0.30; p > 0.05). In contrast, strong correlations were observed between TFLLT measurements from the Tearscope-Plus and LipiView II Interferometer in pre cornea (r = 0.72, p < 0.01) and pre hydrogel (r = 0.74, p = 0.02) conditions, with a moderate, non-significant correlation in the pre silicone hydrogel condition (r = 0.51, p = 0.13). Bland-Altman analysis revealed wide limits of agreement between instruments, indicating substantial measurements variability.
Conclusion:
Tearscope-Plus and LipiView II Interferometer demonstrated high repeatability for NIBUT and TFLLT, respectively. However, the Tearscope-Plus overestimated both NIBUT and TFLLT values compared to objective instruments, indicating that these instruments should not be used interchangeably in clinical practice or research.
