Abstract
The purpose of this presentation is to propose tear osmolality measurement as a new gold standard for the diagnosis of keratoconjunctivitis sicca. Agreement on the diagnostic criteria is needed in order to permit meaningful comparisons of scientific results obtained from varying patient populations. The method employed is a review of previous studies of clinical symptoms, signs and diagnostic tests employed in making a diagnosis of keratoconjunctivitis sicca. Data from previous studies are reviewed and the results of individual and combinations tests are compared in regard to sensitivity, specificity and overall efficiency in establishing accurate diagnoses. The results are that the measurement of tear osmolality measurement provides the greatest sensitivity, specificity and overall efficiency of a single test. Adding either the Schirmer test without anesthetic or tear lactoferrin measured by the Lactoplate™ method in parallel to tear osmolality measurement did not increase the sensitivity of diagnotic testing beyond 90% which was obtained by using tear osmolality measurement alone. The specificity of such combination diagnostic testing was increased only from 95% to 100%. The simplicity of tear osmolarity measurement and its established reliability supports the conclusion that this test is a reasonable candidate for a new international gold standard in the diagnosis of keratoconjunctivitis sicca.
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© 1994 Springer Science+Business Media New York
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Farris, R.L. (1994). Tear Osmolarity — A New Gold Standard?. In: Sullivan, D.A. (eds) Lacrimal Gland, Tear Film, and Dry Eye Syndromes. Advances in Experimental Medicine and Biology, vol 350. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-2417-5_83
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DOI: https://doi.org/10.1007/978-1-4615-2417-5_83
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