Sir,
I read with interest the article by Isreb et al,1 where they have positively correlated the lipid layer thickness with fluorescein tear film break-up time (FBUT) and Schirmer's test (STA).
Meibomian gland dysfunction (MGD) is a fairly common condition, and the reported prevalence at one study was 38.9%.2 It is easy to guess therefore that it is one of the major causes of dry eye syndrome. It is therefore quite a useful study, and I would like to convey my appreciation to all the authors.
Meibum (Meibomian gland secretion) contains hydrocarbons, sterol esters, wax esters, triglycerols, free cholesterols, free fatty acids, and polar lipids (in decreasing order of abundance). Meibum melts at 35°C and is thus liquid at the surface of the eye.3 This property of the lipid layer is utilized in the treatment of dry eyes using hot compresses.4
The normal lipid layer thickness is stated to be ideally more than 120 nm, however, will a thickness of less than 60 nm alone with normal FBUT and STA be sufficient for a diagnosis of dry eye.2
Tandem scanning confocal microscopy is another modality for the assessment of the tear film and is thought to be more accurate than the method used by the authors. It would be nice to know the authors' opinion on this.
References
Isreb MA, Greiner JV, Korb DR, Glonek T, Mody SS, Finnemore VM et al. Correlation of lipid layer thickness measurements with fluorescein tear film break-up time and Schirmer's test. Eye 2003; 17(1): 79–83.
Hom MM, Martinson JR, Knapp LL, Paugh JR . Prevalence of Meibomian gland dysfunction. Optom Vis Sci 1991; 65(5): 390–391.
Tiffany JM . Individual variations in human meibomian lipid composition. Exp Eye Res 1985; 27: 289.
Olson MC, Korb DR, Greiner JV . Increase in tear film lipid layer thickness following treatment with warm compresses in patients with meibomian gland dysfunction. Eye Contact Lens 2003; 29(2): 96–99.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Raj, A. Correlation of lipid layer thickness measurements with fluorescein tear film break-up and Schirmer's test. Eye 19, 484–485 (2005). https://doi.org/10.1038/sj.eye.6701489
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.eye.6701489