Abstract
Dry eye is a multifactorial, progressive, and chronic disease of the tears and ocular surface. The disease is multi-factorial and has intermittent symptoms. Discomfort, visual disturbance, tear film instability with potential damage to the ocular surface, and increased tear film osmolarity are known associates.Dry eye is a common clinical problem for eye-care providers worldwide and there is a large number of clinical investigative techniques for the evaluation of dry eye. Despite this, however, there is no globally accepted guideline for dry eye diagnosis and none of the available tests may hold the title of the ‘gold standard’. The majority of the techniques involved in the diagnosis of the disease, particularly for its early stages, has a large degree of subjectivity.The purpose of this article is to review existing dry eye investigative techniques and to present a new objective dry eye screening technique based on optical coherence tomography.
Highlights
Dry eye disease [1] is responsible for major population morbidity and considerable economic impact in terms of both direct and indirect costs [2] because of the disease’s progressive nature and the significant toll on quality of life [3]
In a previous investigation of the three-dimensional epithelial thickness in keratoconic eyes, [51] we identified an overall thicker epithelium that might be a result of a reactive process; the epithelium appears to thicken in less ‘rigid’ corneas due to being more susceptible to mechanical variations produced by one or a combination of factors including eye rubbing and increased blinking mechanism [57]
A new proposition In pursuit of an objective, repeatable, and quantitative clinical test that may aid in the differential diagnosis of dry eye, we introduced the concept of corneal epithelial thickness as a possible tool in dry eye assessment, and reported initial clinical results regarding threedimensional corneal epithelial thickness mapping in dry eye corneas employing the RtVue-100 OCT system [47]
Summary
Dry eye disease [1] is responsible for major population morbidity and considerable economic impact in terms of both direct and indirect costs [2] because of the disease’s progressive nature and the significant toll on quality of life [3]. It may present major challenges in a refractive surgery candidate assessment [4]. Contributing factors to dry eye may be classified as ocular, medical, pharmaceutical, iatrogenic, environmental, and contact lens wear [10]. Environmental conditions include aridity, cold/windy air, and repetitive occupational tasks that require increased concentration that affect blinking [17]
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