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Manual interferometric device for routine non-invasive tear film break-up time assessment
Sania Vidas Pauk1, Igor Petriček1,2, Martina Tomić3
1Department of Ophthalmology, Zagreb University Hospital Center, Zagreb, Croatia.
Insights
Non-invasive tear break-up time (NIBUT) measured with a handheld device is a reliable and objective method for diagnosing dry eye disease. This new NIBUT test shows significant differences between dry eye patients and controls, outperforming standard tests.
Area of Science:
- Ophthalmology
- Optometry
- Tear Film Dynamics
Background:
- Dry eye disease (DED) affects a significant portion of the population, impacting quality of life.
- Accurate and objective diagnostic methods are crucial for effective DED management.
- Current diagnostic tools, including standard tear break-up time (TBUT), have limitations.
Purpose of the Study:
- To evaluate the feasibility of non-invasive tear break-up time (NIBUT) assessment using a handheld instrument.
- To compare the efficacy of handheld NIBUT with standard TBUT and other dry eye diagnostic tests.
- To determine the diagnostic accuracy and predictive value of NIBUT in identifying dry eye symptoms.
Main Methods:
- 108 subjects (56 with DED, 52 controls) were enrolled.
- Dry eye severity was assessed using the Schein questionnaire.
- Ocular surface parameters measured included NIBUT, TBUT, lipid layer thickness (LLT), lid-parallel conjunctival folds (LIPCOF), conjunctival hyperemia, and corneal staining.
Main Results:
- NIBUT showed the most significant difference between dry eye patients and controls (7s vs. 17.5s, p < .001).
- NIBUT correlated significantly with TBUT, LLT, LIPCOF, conjunctival hyperemia, and corneal staining (p < .019).
- Short NIBUT values were superior predictors of dry eye complaints compared to TBUT and other tests (AOR = 0.87, p < .001).
Conclusions:
- Handheld NIBUT is a simple, accessible, practical, reproducible, and objective method for assessing tear film stability.
- NIBUT assessment holds potential for regular clinical use in diagnosing and monitoring dry eye disease.
- This non-invasive technique offers a valuable alternative or adjunct to existing dry eye diagnostic methods.
Abstract:
Purpose: To determine the feasibility of non-invasive tear break-up time (NIBUT) assessment using the Handheld tear lipid layer thickness assessment instrument and compare it with the standard tear break-up time (TBUT) test and other dry eye tests.Subjects and methods: 108 subjects were enrolled, 56 with and 52 without dry eye symptoms. Schein questionnaire was used to determine the severity of dry eye symptoms. Ocular signs were assessed by NIBUT, TBUT, lipid layer thickness (LLT), lid-parallel conjunctival folds (LIPCOF), conjunctival hyperemia, and corneal staining.Results: Median NIBUT and TBUT, and other clinical test values significantly differed among the dry eye symptoms group and control group. NIBUT yielded the most significant difference between the groups (NIBUT: 7 sec vs. 17.5 sec, p < .001, Z = 5.94; TBUT: 5 sec vs. 10 sec, p < .001, Z = 4.38; LLT: p = .007; LIPCOF: p < .001, conjunctival hyperemia: p < .047, corneal staining: p < .010). Spearman's test showed a significant correlation between NIBUT and TBUT (p < .001), NIBUT and LLT (p = .001), NIBUT and LIPCOF (p = .019), NIBUT and conjunctival hyperemia (p = .002), and NIBUT and corneal staining (p = .012) in the dry eye symptoms group. NIBUT did not significantly differ among the three measurements in both groups of patients (p = .061, p = .096), while TBUT values did in the control group (p < .001). Short NIBUT values were the main predictors and indicators of dry eye complaints (AOR = 0.87, p < .001), superior to TBUT (AOR = 0.88, p = .008) and other tests even after adjustment for age and gender.Conclusion: NIBUT measured by Handheld instrument is a simple, accessible, practical, and, most of all, reproducible and objective method that might allow NIBUT assessment on a regular basis.
