Tear function index. A new measure of dry eye.

OBJECTIVE To develop an efficient way to evaluate tear dynamics clinically. PARTICIPANTS Three hundred fifty-two patients with dry eye, 64 of whom had Sjögren syndrome, and 55 normal subjects. DESIGN Because various forces that affect tear drainage are reflected in the values of the Schirmer test with anesthesia and the tear clearance rate, we introduced a new measure of tear dynamics, the tear function index, which is the value obtained from dividing the value of the Schirmer test with anesthesia by the tear clearance rate. RESULTS The tear function index was more specific (91.8%) and sensitive (78.9%) in diagnosing dry eye associated with Sjögren syndrome than was the Schirmer or tear clearance rate test alone. Tear function indexes below 96 were consistent with dry eye and those below 34 were seen primarily in patients with Sjögren syndrome. CONCLUSIONS The tear function index offers a new method to evaluate tear production with the Schirmer test, introduces an extended way to measure tear flow combining with tear drainage, and gives a practical measure to diagnose dry eye.

[1]  K. Tsubota,et al.  Tear evaporation from the ocular surface. , 1992, Investigative ophthalmology & visual science.

[2]  K. Tsubota,et al.  Practical double vital staining for ocular surface evaluation. , 1993, Cornea.

[3]  I. Toda,et al.  Three Different Types of Dry Eye Syndrome , 1994, Cornea.

[4]  B. Milder,et al.  Lacrimal drainage function. 1. The Jones fluorescein test. , 1972, American journal of ophthalmology.

[5]  L S Mengher,et al.  Non‐invasive tear film break‐uptime: sensitivity and specificity , 1986, Acta ophthalmologica.

[6]  I. Mandel,et al.  Diagnostic tests in keratoconjunctivitis sicca. , 1983, The CLAO journal : official publication of the Contact Lens Association of Ophthalmologists, Inc.

[7]  P R Laibson,et al.  Schirmer's test. A closer look. , 1983, Archives of ophthalmology.

[8]  K. Tsubota,et al.  Ocular fatigue is the major symptom of dry eye , 1993, Acta ophthalmologica.

[9]  H. Hamano,et al.  A new method for measuring tears. , 1983, The CLAO journal : official publication of the Contact Lens Association of Ophthalmologists, Inc.

[10]  M. Lemp,et al.  How do tears exit? , 1983, Investigative ophthalmology & visual science.

[11]  C. Robinson,et al.  Sjögren's syndrome. Proposed criteria for classification. , 1986, Arthritis and rheumatism.

[12]  K. Tsubota,et al.  The importance of the Schirmer test with nasal stimulation. , 1991, American journal of ophthalmology.

[13]  M B Goren,et al.  Diagnostic tests in patients with symptoms of keratoconjunctivitis sicca. , 1988, American journal of ophthalmology.

[14]  B. Milder,et al.  Lacrimal drainage function. 2. The fluorescein dye disappearance test. , 1972, American journal of ophthalmology.

[15]  O. P. Bijsterveld,et al.  Diagnostic Tests in the Sicca Syndrome , 1969 .