Abstract
The pre-corneal tear film is the most anterior refracting surface of the eye. The large change in refractive index from air to tears makes it the surface with the greatest optical power. Therefore, a tear film of non-uniform thickness can potentially have a significant impact on the optical quality of the eye. 1.2 Many clinical studies have shown that, during periods between blinks, the tear film is not stable and does not remain uniform on the surface of the eye. Instead, it appears to disrupt locally, a phenomenon termed tear film breakup by clinicians, resulting in a tear film which is non-uniform in thickness. Although tear breakup is not usually regarded as an optical phenomenon, there is experimental evidence supporting the hypothesis that local changes in tear film thickness impact the optical quality of the eye. 3.5 The conclusions from these experimental studies are supported by clinical evidence of “blurry,” 6.7 “disturbed,” 8.9and “fluctuating” vision, and reduced visual acuity reported by dry eye patients and contact lens wearers.
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References
P. Cho, B. Brown, I. Chan, R. Conway, and M. Yap, Reliability of the tear breakup time technique of assessing tear stability and the locations of the tear breakup in Hong Kong Chinese, Optom Vis Sci. 69:879–885 (1992).
D. Korb, D. Baron, J. Herman, V. Finnemore, J. Exford, J. Hermosa, C. Leahy, T. Glonek, and J. Greiner, Tear film lipid layer thickness as a function of blinking, Cornea. 13:354–359 (1994).
L.N. Thibos, X. Hong, A. Bradley, and C.G. Begley, Deterioration of retinal image quality due to breakup of the corneal tear film, Invest Ophthalmol Vis Sci. 40:S544 (1999).
L.N. Thibos and X. Hong, Clinical applications of the Shack-Hartmann aberrometer, Optom Vis Sci.76:817–825 (1999).
R. Tutt, A. Bradley, C. Begley, and L. Thibos, Optical and visual impact of tear breakup in human eyes, Invest Ophthalmol Vis Sci. 41:4117–4123 (2000).
C.G. Begley, B. Caffery, K.K. Nichols, and R. Chalmers, Responses of contact lens wearers to a dry eye survey, Optom Vis Sci. 77:40–46 (2000).
I. Toda, H. Fujishima, and K. Tsubota, Ocular fatigue is the major symptom of dry eye. Acta Ophthalmol. 71:347–352 (1993).
K.B. Bjerrum, Test and symptoms in keratoconjunctivitis sicca and their correlation, Acta Ophthalmol Scand. 74:436–441 (1996).
C. Vitali, H.M. Moutsopoulos, and S. Bombardieri, The European community study group on diagnostic criteria for Sjögren s syndrome. Sensitivity and specificity of tests for ocular and oral involvement in Sjögren s syndrome, Ann Rheum Dis. 53:637–647 (1994).
S.H. Lee and S.C.G. Tseng, Rose bengal staining and cytologic characteristics associated with lipid tear deficiency, Am J Ophthalmol. 124:736–750 (1997).
E. Goto, S. Shimmura, Y. Yagi, and K. Tsubota, Decreased visual acuity in dry eye patient during gazing, Invest Ophthalmol Vis Sci. 39:S539 (1998).
T.O. Salmon, L.N. Thibos, and A. Bradley, Comparison of the eye’s wavefront aberration measured psychophysically and with the Shack-Hartmann wavefront sensor, J Opt Soc Am A. 15:2457–2465 (1998).
J. Liang, B. Brimm, S. Goelz, and J.F. Bille, Objective measurement of wave aberrations of the human eye with the use of a Hartmann-Shack wave-front sensor, J Opt Soc Am A. 11:1949–1957 (1994).
C. Albarran, A.M. Pons, A. Lorente, and J.M. Artigas, Influence of the tear film on optical quality of the eye, Contact Lens and Anterior Eye. 20:129–135 (1997).
G. Timberlake, M. Doane, and J. Bertera, Short-term, low contrast visual acuity reduction associated with in vivo contact lens drying, Optom Vis Sci. 69:755–760 (1992).
M.C. Acosta, J. Gallar, and C. Belmonte, The influence of eye solutions on blinking and ocular comfort at rest and during work at video display terminals, Exp Eye Res. 68:663–669 (1999).
K. Nakamori, M. Odawara, T. Nakajima, T. Mizutani, and K. Tsubota, Blinking is controlled primarily by ocular surface conditions, Am J Ophthalmol. 124:24–30 (1997).
S. Patel, R. Henderson, L. Bradley, B. Galloway, and H. Hunter, Effect of visual display unit use on blink rate and tear stability, Optom Vis Sci. 68:888–892 (1991).
C.A. Paschides, G. Kitsios, K.X. Karakostas, C. Psillas, and H.M. Moutsopoulos, Evaluation of tear breakup time, Schirmer’s-I test and rose bengal staining as confirmatory tests for keratoconjunctivitis sicca, Clin Exp Rheumatol. 7:155–157 (1989).
G. Petroutsos, C.A. Paschides, K.X. Karakostas, and K. Psilas, Diagnostic tests for dry eye disease in normals and dry eye patients with and without Sjögren s syndrome, Ophthalmic Res. 24:326–331 (1992).
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© 2002 Kluwer Academic/Plenum Publishers
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Himebaugh, N.L., Thibos, L.N., Begley, C.G., Bradley, A., Wilson, G. (2002). Predicting Optical Effects of Tear Film Break Up on Retinal Image Quality Using the Shack-Hartmann Aberrometer and Computational Optical Modeling. In: Sullivan, D.A., Stern, M.E., Tsubota, K., Dartt, D.A., Sullivan, R.M., Bromberg, B.B. (eds) Lacrimal Gland, Tear Film, and Dry Eye Syndromes 3. Advances in Experimental Medicine and Biology, vol 506. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-0717-8_160
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DOI: https://doi.org/10.1007/978-1-4615-0717-8_160
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