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Six Technologies for Dry Eye

These devices facilitate diagnosis and patient education.

APRIL JASPER, O.D.

The diagnosis and treatment of dry eye disease (DED) enables us to positively change these patients’ lives, while increasing our bottom lines through necessary related testing and patient referrals.

Here, I discuss six technologies that can aid in the diagnosis, treatment and patient education of DED.

1 Corneal topographer

Corneal topography reveals abnormal tear film and tear quality. Also, it enables us to “show” patients their DED signs, instilling adherence to our prescribed treatment(s).

Of note: Many topographers capture external cornea and conjunctiva images, a feature that can be important in today’s climate of increased insurance audits.

2 Anterior segment camera

Photography of the anterior segment can be used to demonstrate to the patient any irregularities in the ocular surface, as well as staining patterns. Also, such photography is crucial in establishing patient understanding of DED. The Oculus Keratograph (OCULUS Optikgerate GmbH) provides meibomian gland images and contains tear film scan software to non-invasively measure tear quality and quantity. Once patients can “see” what you’re talking about, treatment compliance is strengthened.

The videography of these cameras can assist in the diagnosis, treatment and patient comprehension regarding DED because it shows corneal staining and TBUT. Further, videography allows for documentation so you can monitor DED progression.

3 Tear testing system

The TearScan MicroAssay System (Advanced Tear Diagnostics) is a point-of-care diagnostic lab test that assesses the tears for the biomarkers lactoferrin and IgE, which are essential in the differential diagnosis of DED and ocular allergy, respectively. Specifically, you use the System’s Tear Capture Device to acquire a 0.5ul tear sample from the eye’s temporal inferior lid margin, deposit it in the System’s Test kit well, add a couple drops of chase solution in the well below each sample, wait for the control lines, and place the Tear Capture Device into the System’s TearScan for the outcome. You can show patients their results while discussing DED.

4 Inflammatory marker detector

InflammaDry (RPS) is an in-office test stick that identifies DED via elevated levels of MMP-9 protein in tear samples. Samples are acquired from the palpebral conjunctiva. You can show patients test results.

5 Interferometer

The LipiView Ocular Surface Interferometer (Tear-Science), part of the LipiFlow System, captures digital images of the tear film and measures the oily lipid layer’s absolute thickness. You and your patients can see the tear film interference pattern and the blinking pattern, facilitating diagnosis and treatment compliance.

6 Osmolarity test

A failure of homeostatic osmolarity regulation results in abnormal tear osmolarity, which is a key DED feature. The higher the osmolarity, the more severe the DED. The TearLab Osmolarity System (TearLab Corporation) measures osmolarity.

Making a difference

DED is often overlooked or misunderstood. The aforementioned technology provides a clear picture of it. OM

Dr. Jasper is a Vision Source Administrator and in private practice in West Palm Beach, Fla. E-mail her at drjasper@aeswpb.com, or comment at optometricmanagement@gmail.com.