ReviewDiagnostics (Basel, Switzerland)2021
Tear Osmolarity in the Diagnosis of Systemic Dehydration and Dry Eye Disease.
Review in Diagnostics (Basel, Switzerland), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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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.
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Who cites it
20 citing papers in PubMed, 29 citations in OpenAlex.
- Lubratex eye ointment with polyethylene cover significantly reduces corneal abrasion in ICU patients: a randomized controlled trial.Scientific reports · 2024Trial
- Association of Tear Osmolarity With Signs and Symptoms of Dry Eye Disease in the Dry Eye Assessment and Management (DREAM) Study.Investigative ophthalmology & visual science · 2023Trial
- Ly93 Inhibits Sphingomyelin Synthesis and Attenuates Inflammation and Injury in Dry Eye Conjunctival Organoids.Investigative ophthalmology & visual science · 2026Article
- Hydration status, thirst discomfort, and ocular surface health among older adults in Türkiye: a cross-sectional study.BMC geriatrics · 2026Article
- Impact of Time of Day on Dry Eye Disease: Findings from a Large Dry Eye Clinic Cohort.Clinical ophthalmology (Auckland, N.Z.) · 2026Article
- Mesenchymal stem cell-derived extracellular vesicles for dry eye disease: principles, progress, and challenges.Extracellular vesicles and circulating nucleic acids · 2026Review
- Ocular Surface Parameters in Glaucoma Patients Treated with Topical Prostaglandin Analogs and the Importance of Switching to Preservative-Free Eye Drops-A Systematic Review.Life (Basel, Switzerland) · 2025Review
- Tear Film Osmolarity in Horses With Bacterial Conjunctivitis.Veterinary medicine and science · 2025Article
- Translating Biomarker Discovery: From Bench to Bedside in Dry Eye Disease.International journal of molecular sciences · 2025Review
- Hydration Strategies in Older Adults.Nutrients · 2025Review
- Oral Intake ofBiomedicines · 2025Article
- Review
- A Novel Noninvasive Screening Tool for Dry Eye Disease.Diagnostics (Basel, Switzerland) · 2024Article
- Review
- Article
- Advances in clinical examination of lacrimal gland.Frontiers in medicine · 2023Review
- Vision enhancement technologies, augmented reality and sports integrity considerations.BMJ open sport & exercise medicine · 2023Article
- Recent Advances in Hydrogels for the Diagnosis and Treatment of Dry Eye Disease.Gels (Basel, Switzerland) · 2022Review
- Vision through Healthy Aging Eyes.Vision (Basel, Switzerland) · 2021Review
- Editorial of Special Issue "Differential Diagnosis for Dry Eye".Diagnostics (Basel, Switzerland) · 2021Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Systemic dehydration due to inadequate water intake or excessive water loss, is common in the elderly and results in a high morbidity and significant mortality. Diagnosis is often overlooked and there is a need for a simple, bedside diagnostic test in at-risk populations. Body hydration is highly regulated with plasma osmolality (pOsm) being tightly controlled over a wide range of physiological conditions. By contrast, normal tear osmolarity (tOsm) is more variable since the tear film is exposed to evaporation from the open eye. While plasma hyperosmolality is a diagnostic feature of systemic dehydration, tear hyperosmolality, with other clinical features, is diagnostic of dry eye. Studies in young adults subjected to exercise and water-deprivation, have shown that tOsm may provide an index of pOsm, with the inference that it may provide a simple measure to diagnose systemic dehydration. However, since the prevalence of both dry eye and systemic dehydration increases with age, the finding of a raised tOsm in the elderly could imply the presence of either condition. This diagnostic difficulty can be overcome by measuring tear osmolality after a period of evaporative suppression (e.g., a 45 min period of lid closure) which drives tOsm osmolality down to a basal level, close to that of the pOsm. The arguments supporting the use of this basal tear osmolarity (BTO) in the diagnosis of systemic dehydration are reviewed here. Further studies are needed to confirm that the BTO can act as a surrogate for pOsm in both normally hydrated subjects and in patients with systemic dehydration and to determine the minimum period of lid closure required for a simple, "point-of-care" test.
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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.