In order to diagnose dry eyes with the TMH, we studied the difference in the TMH between normal eyes and dry eyes. And we measured the time that the TMH after fluorescein instillation become the same with the TMH before fluorescein instillation. Measuring thar meniscus height(TMH) is easy after fluorescir instillation, but the TMH after fluorescein instillation is higher than the TMH before fluoresceirc instillation. Therefore, we measured the time that the TMH after fluorescein instillation became the same with the TMH before fluorescein instillation, and in order to diagnosis dry eyes with the TMH, we studied the difference in the TMH between normal eyes and dry eyes. The TMH was O.19 +/- O.05 mm in normal eyes and O.10 +/- O.04 mm in dry eyes, and there was a significant difference between the two groups. The time that the TMH after fluorescein instillation became the same with the TMH before fluorescein instillation was 2.19 +/- O.81 min. in the mormal eyes and 2.29 +/- O.73min. in the dry eyes. Within 4 min. after fluorescein instillation, the TMH became the same with the TMH before fluorescein instillation in all cases and the height persisted untill 7 min. after fluorescein instillation. Therefore, measuring the TMH will be easy if it is measured at 4-7 min. after fluorescein instillation.
Diagnosis ; Dry Eye Syndromes* ; Fluorescein

The Tear Film Break-Up Time(BUT) in the diagnosis of the dry eye syndrome was widely used, but its results were variable according to the methods of measuring BUTs. Especially, the method of Fluorescein administration and concentration had a great influence on BUT. The purpose of this study was to standardize the method used in measurement of BUT, particularly fluorescein solution concentration. We measured BUT in seven groups of different fluorescein solution concentration and total subjects were 464 persons. The results were as follows; 1. The mean BUT was 14.24 +/- 2.04 seconds in 0.12% Fluorescein solution, 11.73 +/- 2.11 seconds in 0.25% solution, 11.34 +/- 3.00 seconds in 0.5% solution, 10.3 +/- 3.50 seconds in 1% solution, 9.59 +/- 2.74 seconds in 2% solution, 7.56 +/- 1.84 seconds in 5% solution and 5.55 +/- 1.20 seconds in 8% solution. 2. The more Fluorescein concentration was, the shorter BUT became and there were statistically significant decrease in 0.25%, 0.5% and 2% Fluorescein solution.
Diagnosis ; Dry Eye Syndromes ; Fluorescein* ; Humans ; Tears*

The lipid layer plays a important role in tear film stability. And several studies have reported the differences of lipid layer pattern and tear film break up time between normal and dry eye. To determine the availability of Tearscope(Keeler, UK), we observed the characteristics of lipid layer and compared non-invasive break up time(NIBUT) to invasive break up time(IBUT) in dry eye symptom and non-dry eye symptom group. By questionnaire, we selected the dry eye symptom(94 eyes in 47 persons) and the non-dry eye symptom(112 eyes in 56 persons) group. We observed lipid layer pattern and color by Tearscope, and measured NIBUT of Tearscope and IBUT of fluorescein solution. In the lipid layer, the dry eye symptom group had brown-yellow(about 112 nm) and uneven pattern. But, the non-dry eye symptom group represented amorphous(about 94 nm) and even pattern. In NIBUT, the dry eye symptom group had 9.57+/-11.40sec and the non-dry eye symptom group represented 27.42+/-20.15sec. In IBUT, two groups had 6.38+/-4.45sec and and 13.02+/-8.41sec, respectively. In conclusion, Tearscope is available in diagnosis and treatment in dry eye and also in diagnosis of tear lipid layer disorder.
Diagnosis ; Dry Eye Syndromes ; Fluorescein ; Surveys and Questionnaires ; Tears*

PURPOSE: Several sets of criteria have been proposed and used by different authors, but the patients with Sjoren's syndrome have been missed at diagnosis or incorrectly classified due both to its great variability at presentation and to the lack of commonly accepted diagnostic criteria. We proposed a criteria for Sjoren's syndrome and attempted to utilize this criteria for diagnosis and classification of dry eye patients who were suspected of Sjoren's syndrome. METHODS: We proposed and applied a set of criteria for Sjoren's syndrome, which included clinical, histopathological and laboratory features as well as exclusions for the diagnosis, to 6 dry eye patients who were clinically at Chungnam National University Hospital from January 1992 to December 1996. RESULTS: Two of the 6 patients who were clinically suspected of Sjoren's syndrome had satisfactory histopathological results. This two patients were diagnosed as primary Sjoren's syndrome. CONCLUSIONS: Our criteria would be helpful to the diagnosis and classification of the patients with Sjoren's syndrome, who were previously diagnosed as dry eye syndrome.
Chungcheongnam-do ; Classification ; Diagnosis ; Dry Eye Syndromes ; Humans

Conjunctival goblet cells are thought to be the main source of tear mucin, and it is believed that this mucin plays an important role on increasing the tear film stability and the wettability of the ocular surface. The measurement of the conjunctival goblet cell density is useful for the differential diagnosis among the various ocular surface diseases, and for the evaluation of the efficacy of the treatment. This method can be checked simply and rapidly, but the normal conjunctival goblet cell density in Korean has not been reported. We examined the goblet cell density in the 68 eyes (57 patients) of normal subjects using an impression cytological technique on the palpebral and bulbar conjunctiva. The results were as follows: 1. Normal goblet cell density was 1316.9 +/- 491.7 cells/mm2 in the inferior palpebral conjunctiva, 57.9 +/- 67.9 cells/mm2 in the superor bulbar conjunctiva. 2. There was no significant difference in goblet cell density according to sex and age ( p>0.05, t-test). 3. The goblet cell density was increased as a rise of break-up time(BUT), but was not correlated with BUT(r=0.24, 0.05). Also there was no correlation between the goblet cell density and Schirmer test value (r=-0.10, 0.09), (r=regression coefficient). It is suggested that the above findings would aid in the diagnosis of the dry eye syndrome and allow differential diagnosis among the various ocular surface diseases.
Conjunctiva ; Cytological Techniques ; Diagnosis ; Diagnosis, Differential ; Dry Eye Syndromes ; Goblet Cells* ; Mucins ; Tears ; Wettability

Measuring the tear meniscus height (TMH) is easy after fluorescein installation, but the TMH after fluorescein instillation is higher than the TMH before fluorescein instillation. Therefore, we measured the time that the TMH after fluorescein instillation became the same with the TMH, we studied the difference in the TMH between normal eyes and dry eyes. The TMH 0.19 +/- 0.05 mm in the normal eyes and 0.10 +/- 0.04 mm in the dry eyes, and there was a significant difference between the 2 groups. The time that the TMH after fluorescein instillation became the same with the TMH before fluorescein instillation was 2.19 +/- 0.81 min. in the normal eyes and 2.29 +/- 0.73 min. in the dry eyes. Within 4 min. after fluorescein instillation, the TMH became the same with the TMH before fluorescein instillation in all cases and the height persisted until 7 min. after fluorescein instillation. Therefore, measuring the TMH will be easy if it is measured at 4-7 min. after fluorescein instillation.
Dry Eye Syndromes/*diagnosis ; Fluorescein ; Fluoresceins/*diagnostic use ; Humans ; Tears/*chemistry

PURPOSE: To evaluate the efficacy of strip meniscometry test for dye eye syndrome (DES) by measuring the correlation between strip meniscometry and conventional test measurements. METHODS: All subjects were examined using the Schirmer test, tear breakup time (TBUT) and strip meniscometry using SMTube (Echo Electricity Co., Ltd., Fukushima, Japan). Tear meniscus height (TMH), tear meniscus depth (TMD) and tear meniscus area (TMA) were measured using Fourier-domain optical coherence tomography. The DES group (n = 46 eyes) was compared with the normal group (n = 30 eyes) and correlation was assessed using Spearman's correlation coefficient. RESULTS: Strip meniscometry measurement was significantly correlated with Schirmer score (r = 0.6080, p < 0.01), TBUT (r = 0.5980, p < 0.01), TMH (r = 0.6210, p < 0.01), TMD (r = 0.6080, p < 0.01) and TMA (r = 0.6370, p < 0.01). Strip meniscometry was significantly lower in the DES group (4.58 ± 1.94 mm) than the normal group (7.07 ± 2.61 mm, p < 0.05). CONCLUSIONS: Strip meniscometry was significantly correlated with other conventional test measurements for dry eye syndrome. Strip meniscometry is less time consuming and a less invasive method than the Schirmer test. Strip meniscometry could be an efficient tool to evaluate patients with dry eye syndrome in a clinical setting.
Diagnosis* ; Dry Eye Syndromes* ; Electricity ; Humans ; Methods ; Tears ; Tomography, Optical Coherence

PURPOSE: To evaluate the diagnostic value of tear film osmolarity for non-Sjogren dry eye syndrome through measuring the correlation between tear osmolarity and several conventional dry eye parameters. METHODS: In this observational cross-sectional study, 274 patients (274 eyes) with non-Sjogren dry eye syndrome were examined using tear film osmolarity and the following conventional dry eye parameters: Schirmer's test, tear film break-up time, ocular surface disease index (OSDI), and corneal staining score. The correlations between tear film osmolarity and each conventional dry eye parameter were assessed using Spearman's correlation coefficients. RESULTS: The mean tear film osmolarity of the study population was 296.34 ± 21.08 mOsm/L. The tear film osmolarity was significantly negatively correlated with the Schirmer's test value (r = -0.431, p < 0.001) and tear break-up time (r = -0.131, p = 0.031), while it was significantly positively correlated with the OSDI scores (r = 0.191, p = 0.001) and corneal staining scores (r = 0.150, p = 0.013). CONCLUSIONS: Tear film instability was significantly correlated with other conventional dry eye parameters. However, additional studies are required to determine its feasibility as a stand-alone diagnostic tool.
Cross-Sectional Studies ; Diagnosis* ; Dry Eye Syndromes ; Humans ; Osmolar Concentration* ; Tears*

The significance of tear film break-up time (BUT) was investigated by analyzing its distribution and reproducibility in 30 normal subjects and 20 dry eye patients. The BUTs* were all above 5 seconds and the reproducibility was 65% in normalsubjects. However, those were all below 10 seconds and the reproducibility was 95% in dry eye patients. These results suggest that: 1) The patient whose BUT* is below 5 seconds can be diagnosed as dry eye syndrome. 2) The value of BUT* above 10 seconds can be regarded as normal. (*The mean value of 4 different visits)
Adult ; Dry Eye Syndromes/*diagnosis ; Female ; Humans ; Male ; Tears/*analysis ; Time Factors

PURPOSE: To evaluate the repeatability of non-invasive tear film break-up time and identify its relationships with dry eye parameters. METHODS: A total of 100 participants (50 with dry eye, and 50 in the control group) were enrolled prospectively. Non-invasive keratograph first (NIKf-BUT) and average (NIKav-BUT) break-up times were evaluated 2 times using Keratograph 4 (Oculus, Wetzler, Germany), and then tear film break-up time with fluorescein (FBUT) was measured. The correlation analyses were performed between non-invasive parameters (NIKf-BUT and NIKav-BUT) and FBUT. Intra-observer agreements of NIKf-BUT and NIKav-BUT were assessed using intraclass correlation coefficients (ICC). The receiver operating characteristic (ROC) curve technique was used to evaluate the non-invasive method in the diagnosis of dry eye. RESULTS: The correlation analyses revealed positive correlation between NIKav-BUT and FBUT in both groups (dry eye; r = 0.66, p < 0.001 and control group; r = 0.77, p < 0.001). The ICCs of NIKf-BUT and NIKav-BUT were 0.72 and 0.94 in the dry eye, respectively, and 0.70 and 0.91 in the control group. NIKav-BUT was not different from FBUT in either group. The areas under the ROC curves of NIKf-BUT and NIKav-BUT were 0.917 and 0.980, respectively. CONCLUSIONS: The high ICCs verified the repeatability of NIKf-BUT and NIKav-BUT. NIKav-BUT showed no difference from FBUT and positive correlation with FBUT. NIK-BUT showed high diagnostic power and can be considered a new parameter to evaluate dry eye syndrome.
Diagnosis ; Dry Eye Syndromes ; Fluorescein ; Methods ; Prospective Studies ; ROC Curve ; Tears*