ReviewJournal of optometry
Tear instability importance, mechanisms, validity and reliability of assessment.
Review in Journal of optometry. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Advances in Dry Eye Disease Examination Techniques.Frontiers in medicine · 2021Pooled it
- Reliability and efficacy of maximum fluorescein tear break-up time in diagnosing dry eye disease.Scientific reports · 2021Trial
- Regional Tear Film Quality Changes Across Eye Gaze Directions Revealed by Spatial Mapping and Threshold Sensitivity Analysis.Journal of clinical medicine · 2026Article
- Seasonal variations and environmental factors associated with allergic ocular surface disease: A prospective observational study of clinical presentation patterns in South Asian region.International ophthalmology · 2026Observational
- The prevalence and associated factors of dry eye disease amongst people diagnosed with diabetes mellitus in Bronkhorstspruit.Frontiers in clinical diabetes and healthcare · 2026Article
- Efficacy and Safety of Useul for Dry Eye Disease: Protocol for a Randomized, Double-Blind, Placebo-Controlled, Parallel, Phase 2 Clinical Trial.Healthcare (Basel, Switzerland) · 2024Article
- Evaluation of tear film function by Oculus Keratograph 5M and IDRA ocular surface analyser.International ophthalmology · 2024Article
- One Soul and Several Faces of Evaporative Dry Eye Disease.Journal of clinical medicine · 2024Review
- Agreement between invasive and noninvasive measurement of tear film breakup time.Scientific reports · 2024Article
- Lectin-Based Affinity Enrichment and Characterization of N-Glycoproteins from Human Tear Film by Mass Spectrometry.Molecules (Basel, Switzerland) · 2023Article
- Rear 4-min Schirmer test, a modified indicator of Schirmer test in diagnosing dry eye.Scientific reports · 2022Article
- Measurements of Tear Evaporation Rate in Subjects with Refractive Errors Using a Portable Evaporimeter.Healthcare (Basel, Switzerland) · 2022Article
- Effects of Oral Antihistamines on Tear Volume, Tear Stability, and Intraocular Pressure.Vision (Basel, Switzerland) · 2020Article
- Efficacy and Safety of Phospholipid Nanoemulsion-Based Ocular Lubricant for the Management of Various Subtypes of Dry Eye Disease: A Phase IV, Multicenter Trial.Clinical ophthalmology (Auckland, N.Z.) · 2020Article
- A Comparison of Efficacy and Safety of Two Lipid-Based Lubricant Eye Drops for the Management of Evaporative Dry Eye Disease.Clinical ophthalmology (Auckland, N.Z.) · 2020Article
- Dynamics of Fluorescent Imaging for Rapid Tear Thinning.Bulletin of mathematical biology · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo examine the factors which contribute to tear stability and the validity and reliability of methods used for assessing tear break up time which is a core part of an examination of tear stability in dry eye patients.
methodsA review of publications which are relevant to tear stability and its assessment.
resultsTear break up time may be more invasive than intended if difficulty avoiding blinking during assessment results in reflex tearing. Notwithstanding control of instilled volume and concentration of fluorescein, on-eye dilution is highly variable according to resident tear volume. Blinking to evenly distribute fluorescein may improve tear and lipid layer thickness so habitual tear function is not assessed. Emphasis on a role for Meibomian gland dysfunction as a cause of tear instability may be appropriate in many cases but ignores the roles for other sources of tear lipid and other non-lipid contributions to tear instability such as aqueous or mucus deficiency, desiccated epitheliopathy or anomalous blinking. Objective less-invasive methods eliminate problems of inter-observer variability and can reliably 'maintain vigilance' over wide areas of the tear layer. However less-invasive results to date include mean tear break up findings which are both shorter and longer than expected for normal controls.
conclusionsFluorescein tear break up time assessments cannot be standardised and less-invasive methods are not yet standardised. Objective less-invasive and subjective fluorescein break up time tests do not appear to be measuring the same tear phenomena although both should be performed before other invasive procedures.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.