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A New Measure of Dry Eye

Ke-Ping Xu, MD; Yukiko Yagi, ORT; Ikuko Toda, MD; Kazuo Tsubota, MD

Arch Ophthalmol. 1995;113(1):84-88.

Abstract
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.

Author Affiliations
From the Department of Ophthalmology, Tokyo Dental College, Chiba, Japan.

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