Measurement of ocular surface protection under natural blink conditions

Richard Abelson, Keith J. Lane, Endri Angjeli, Patrick Johnston, George Ousler, Douglas Montgomery

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Purpose: To evaluate a new method of measuring ocular exposure in the context of a natural blink pattern through analysis of the variables tear film breakup time (TFBUT), interblink interval (IBI), and tear film breakup area (BUA). Methods: The traditional methodology (Forced-Stare [FS]) measures TFBUT and IBI separately. TFBUT is measured under forced-stare conditions by an examiner using a stopwatch, while IBI is measured as the subject watches television. The new methodology (video capture manual analysis [VCMA]) involves retrospective analysis of video data of fluorescein-stained eyes taken through a slit lamp while the subject watches television, and provides TFBUT and BUA for each IBI during the 1-minute video under natural blink conditions. The FS and VCMA methods were directly compared in the same set of dry-eye subjects. The VCMA method was evaluated for the ability to discriminate between dry-eye subjects and normal subjects. The VCMA method was further evaluated in the dry eye subjects for the ability to detect a treatment effect before, and 10 minutes after, bilateral instillation of an artificial tear solution. Results: Ten normal subjects and 17 dry-eye subjects were studied. In the dry-eye subjects, the two methods differed with respect to mean TFBUTs (5.82 seconds, FS; 3.98 seconds, VCMA; P = 0.002). The FS variables alone (TFBUT, IBI) were not able to successfully distinguish between the dry-eye and normal subjects, whereas the additional VCMA variables, both derived and observed (BUA, BUA/IBI, breakup rate), were able to successfully distinguish between the dry-eye and normal subjects in a statistically significant fashion. TFBUT (P = 0.034) and BUA/IBI (P = 0.001) were able to distinguish the treatment effect of artificial tears in dry-eye subjects. Conclusion: The VCMA methodology provides a clinically relevant analysis of tear film stability measured in the context of a natural blink pattern.

Original languageEnglish (US)
Pages (from-to)1349-1357
Number of pages9
JournalClinical Ophthalmology
Volume5
Issue number1
StatePublished - Sep 22 2011

Keywords

  • Forced stare
  • Interblink interval
  • Ocular protection index
  • Tear film breakup time

ASJC Scopus subject areas

  • Ophthalmology

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  • Cite this

    Abelson, R., Lane, K. J., Angjeli, E., Johnston, P., Ousler, G., & Montgomery, D. (2011). Measurement of ocular surface protection under natural blink conditions. Clinical Ophthalmology, 5(1), 1349-1357.