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Effect of blinking on the measurement of tear evaporation rate
Elena Martínez-Plaza1, Lorena Sánchez-Miguel2, Cristina Arroyo-Del Arroyo2
1IOBA (Instituto de Oftalmobiología Aplicada), Universidad de Valladolid, Valladolid, Spain; Department of Theoretical Physics, Atomic and Optics, University of Valladolid, Valladolid, Spain.
Purpose:
To evaluate the reliability and agreement of tear film evaporation measurements under different blinking conditions.
Methods:
Ninety-six healthy volunteers (96 eyes) were recruited. Tear evaporation was measured using the Eye Vapometer under four randomized conditions: no-blinking, natural blinking, controlled blinking (one blink every 3 s), and eyes-closed. Raw evaporation rates were recorded in three consecutive measurements for each condition. Tear evaporation rates (TER) were calculated by subtracting the raw evaporation rate with eyes-closed from the other three conditions. Reliability of raw measurements were assessed, and agreement between TER values was evaluated using the Bland-Altman method.
Results:
Consecutive measurements taken under the no-blinking condition showed significant differences (p ≤ 0.04). The repeatability values for no-blinking, natural blinking, controlled blinking and eyes-closed were 56.12, 44.78, 42.46 and 22.32, respectively. The no-blinking condition provided significantly higher TER values than natural blinking (p < 0.001) and controlled blinking (p = 0.005).
Conclusions:
Blinking affects the reliability of evaporation measurement, with the least reliable condition being no-blinking. TER under the natural blinking condition shows good reliability and best represents physiological function during daily activities; therefore, it appears to be the most appropriate condition for TER evaluation.
