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TFOS DEWS III
James S Wolffsohn1, José Benítez-Del-Castillo2, Denise Loya-Garcia3
1From the Optometry and Vision Science, College of Health and Life Sciences, Aston University, Birmingham, UK.
American Journal of Ophthalmology
|October 19, 2025
Summary
This study identifies key diagnostic markers for dry eye disease (DED). Objective measures like tear osmolarity and non-invasive breakup time are crucial for diagnosing DED effectively.
Area of Science:
- Ophthalmology
- Ocular Surface Disease
Background:
- Dry eye disease (DED) is a prevalent condition affecting the ocular surface.
- The Tear Film & Ocular Surface Society (TFOS) Dry Eye Workshop (DEWS III) provided updated DED guidelines in 2017.
Purpose of the Study:
- To evaluate and define objective diagnostic criteria for dry eye disease.
- To establish thresholds for key clinical signs associated with DED.
Main Methods:
- Analysis of patient data including Ocular Surface Disease Index (OSDI-6) scores.
- Measurement of non-invasive tear breakup time (NIBUT).
- Assessment of tear osmolarity levels.
Main Results:
- An OSDI-6 score of ≥4 was associated with DED.
- A non-invasive breakup time (NIBUT) of <10 seconds indicated DED.
- Tear osmolarity thresholds of ≥308 mOsm/L (right eye) and >328 mOsm/L (left eye) were identified as significant.
Conclusions:
- Objective measures are essential for diagnosing dry eye disease.
- Specific thresholds for NIBUT and tear osmolarity can aid in DED diagnosis.
- These criteria align with current understanding and guidelines for managing DED.
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