Tear Film Quality Assessment in the Corneal Topographer via Placido's Disk as a Supplement to the Standard Tear Break Up Time Test. A Comprehensive Literature Review

BACKGROUND: Dry Eye Syndrome is a progressive disease Of the ocular surface that is increasing in frequency within the United States. Current estimates state that approximately 40% of Americans regularly experience Dry Eye symptoms. To date, most eye care professionals have relied heavily upon archaic testing methods in their diagnosis of the disorder with the advances of modern technology seemingly ignored.
QUESTION: In the 2007 Report of the Diagnostic Methodology Subcommittee of the International Dry Eye Workshop, the authors repeatedly emphasized the necessity
of noninvasive techniques to analyze the ocular surface's tear film. They, along with numerous other authors of peer- Dry Eye Syndrome reviewed literature, frequently stress that tests such as the standard are not as reliable or repeatable as once thought. This review of peer-reviewed literature and committee reports investigated the potential benefit of incorporation of modern noninvasive techniques into the management of Dry Eye patients in a modern optometric
practice.
CONCLUSION: The "gold-standard" test of the modern optometric practice known as the fluorescein TBUT remains the most practical in a modern optometric practice as it
provides adequate information for a proper diagnosis. For those practices that specialize in Dry Eye treatment and management, a non-invasive measurement of tear quantity and quality utilizing modern instrumentation is a wise investment. Nowhere would a non-invasive test such as this be more practical than at an academic institution such as the Michigan College of Optometry. As patients change examiners on a regular basis, a noninvasive technique would offer a more standardized data set to compare at
each subsequent exam giving greater consistency in patient records to aid in treatment and diagnosis.