Abstract

The fluorescein tear film break-up test is a common tear film stability test for dry eye diagnosis. This test requires applying fluorescein sodium drops to a tear film to observe the tear film break-up. However, this test is limited by using the fluorescein sodium drops, which can induce reflex tearing and reduce the reliability of the diagnosis results. This paper proposes that tear film evaporation accelerates on the fluorescein tear film break-up area (FTBA), resulting in a lower temperature area (LTA) on the tear film. A dual modality system was established to capture the thermal and fluorescent image of fluorescein-stain tear films for 48 participants. Observations showed that the LTA and FTBA were highly correlated in their location (r = 0.82) and size (r = 0.91). This is first study to show that the FTBA and LTA are essentially the same region. This study demonstrated the feasibility of using the noncontact thermograph method to evaluate tear film stability without using a fluorescein sodium drop.

© 2014 Optical Society of America

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  1. E.  Goto, Y.  Yagi, Y.  Matsumoto, K.  Tsubota, “Impaired functional visual acuity of dry eye patients,” Am. J. Ophthalmol. 133(2), 181–186 (2002).
    [CrossRef] [PubMed]
  2. B.  Miljanović, R.  Dana, D. A.  Sullivan, D. A.  Schaumberg, “Impact of dry eye syndrome on vision-related quality of life,” Am. J. Ophthalmol. 143(3), 409–415 (2007).
    [CrossRef] [PubMed]
  3. K. K.  Nichols, G. N.  Foulks, A. J.  Bron, B. J.  Glasgow, M.  Dogru, K.  Tsubota, M. A.  Lemp, D. A.  Sullivan, “The international workshop on meibomian gland dysfunction: executive summary,” Invest. Ophthalmol. Vis. Sci. 52(4), 1922–1929 (2011).
    [CrossRef] [PubMed]
  4. M. A.  Lemp, “The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007),” Ocul. Surf. 5(2), 75–92 (2007).
    [CrossRef] [PubMed]
  5. J. J.  Nichols, P. E.  King-Smith, E. A.  Hinel, M.  Thangavelu, K. K.  Nichols, “The use of fluorescent quenching in studying the contribution of evaporation to tear thinning,” Invest. Ophthalmol. Vis. Sci. 53(9), 5426–5432 (2012).
    [CrossRef] [PubMed]
  6. C.  Begley, T.  Simpson, H.  Liu, E.  Salvo, Z.  Wu, A.  Bradley, P.  Situ, “Quantitative analysis of tear film fluorescence and discomfort during tear film instability and thinning,” Invest. Ophthalmol. Vis. Sci. 54(4), 2645–2653 (2013).
    [CrossRef] [PubMed]
  7. P. E.  King-Smith, P.  Ramamoorthy, R. J.  Braun, J. J.  Nichols, “Tear film images and breakup analyzed using fluorescent quenching,” Invest. Ophthalmol. Vis. Sci. 54(9), 6003–6011 (2013).
    [CrossRef] [PubMed]
  8. A. J.  Bron, “Diagnosis of dry eye,” Surv. Ophthalmol. 45(Suppl 2), S221–S226 (2001).
    [CrossRef] [PubMed]
  9. M. S.  Norn, “Desiccation of the precorneal film. I. Corneal wetting-time,” Acta Ophthalmol. (Copenh.) 47(4), 865–880 (1969).
    [CrossRef] [PubMed]
  10. M. E.  Johnson, P. J.  Murphy, “The effect of instilled fluorescein solution volume on the values and repeatability of TBUT measurements,” Cornea 24(7), 811–817 (2005).
    [CrossRef] [PubMed]
  11. L. S.  Mengher, A. J.  Bron, S. R.  Tonge, D. J.  Gilbert, “A non-invasive instrument for clinical assessment of the pre-corneal tear film stability,” Curr. Eye Res. 4(1), 1–7 (1985).
    [CrossRef] [PubMed]
  12. R.  Mapstone, “Measurement of corneal temperature,” Exp. Eye Res. 7(2), 237–243 (1968).
    [CrossRef] [PubMed]
  13. P. B.  Morgan, A. B.  Tullo, N.  Efron, “Ocular surface cooling in dry eye a pilot study,” Journal of the British Contact Lens Association 19(1), 7–10 (1996).
    [CrossRef]
  14. A.  Mori, Y.  Oguchi, Y.  Okusawa, M.  Ono, H.  Fujishima, K.  Tsubota, “Use of high-speed, high-resolution thermography to evaluate the tear film layer,” Am. J. Ophthalmol. 124(6), 729–735 (1997).
    [PubMed]
  15. U. R.  Acharya, E. Y.  Ng, G. C.  Yee, T. J.  Hua, M.  Kagathi, “Analysis of normal human eye with different age groups using infrared images,” J. Med. Syst. 33(3), 207–213 (2009).
    [CrossRef] [PubMed]
  16. J. H.  Tan, E.  Ng, U.  Rajendra Acharya, C.  Chee, “Infrared thermography on ocular surface temperature: a review,” Infrared Phys. Technol. 52(4), 97–108 (2009).
    [CrossRef]
  17. T.  Kamao, M.  Yamaguchi, S.  Kawasaki, S.  Mizoue, A.  Shiraishi, Y.  Ohashi, “Screening for dry eye with newly developed ocular surface thermographer,” Am. J. Ophthalmol. 151(5), 782–791 (2011).
    [CrossRef] [PubMed]
  18. T. Y.  Su, K. H.  Chen, P. H.  Liu, M. H.  Wu, D. O.  Chang, P. F.  Su, S. W.  Chang, H. K.  Chiang, “Noncontact detection of dry eye using a custom designed infrared thermal image system,” J. Biomed. Opt. 16, 046009 (2011).
  19. W.  Mathers, “Evaporation from the ocular surface,” Exp. Eye Res. 78(3), 389–394 (2004).
    [CrossRef] [PubMed]
  20. A. J.  Bron, J. A.  Smith, M.  Calonge, “Methodologies to diagnose and monitor dry eye disease: report of the Diagnostic Methodology Subcommittee of the International Dry Eye WorkShop (2007),” Ocul. Surf. 5(2), 108–152 (2007).
    [CrossRef] [PubMed]

2013

C.  Begley, T.  Simpson, H.  Liu, E.  Salvo, Z.  Wu, A.  Bradley, P.  Situ, “Quantitative analysis of tear film fluorescence and discomfort during tear film instability and thinning,” Invest. Ophthalmol. Vis. Sci. 54(4), 2645–2653 (2013).
[CrossRef] [PubMed]

P. E.  King-Smith, P.  Ramamoorthy, R. J.  Braun, J. J.  Nichols, “Tear film images and breakup analyzed using fluorescent quenching,” Invest. Ophthalmol. Vis. Sci. 54(9), 6003–6011 (2013).
[CrossRef] [PubMed]

2012

J. J.  Nichols, P. E.  King-Smith, E. A.  Hinel, M.  Thangavelu, K. K.  Nichols, “The use of fluorescent quenching in studying the contribution of evaporation to tear thinning,” Invest. Ophthalmol. Vis. Sci. 53(9), 5426–5432 (2012).
[CrossRef] [PubMed]

2011

T.  Kamao, M.  Yamaguchi, S.  Kawasaki, S.  Mizoue, A.  Shiraishi, Y.  Ohashi, “Screening for dry eye with newly developed ocular surface thermographer,” Am. J. Ophthalmol. 151(5), 782–791 (2011).
[CrossRef] [PubMed]

T. Y.  Su, K. H.  Chen, P. H.  Liu, M. H.  Wu, D. O.  Chang, P. F.  Su, S. W.  Chang, H. K.  Chiang, “Noncontact detection of dry eye using a custom designed infrared thermal image system,” J. Biomed. Opt. 16, 046009 (2011).

K. K.  Nichols, G. N.  Foulks, A. J.  Bron, B. J.  Glasgow, M.  Dogru, K.  Tsubota, M. A.  Lemp, D. A.  Sullivan, “The international workshop on meibomian gland dysfunction: executive summary,” Invest. Ophthalmol. Vis. Sci. 52(4), 1922–1929 (2011).
[CrossRef] [PubMed]

2009

U. R.  Acharya, E. Y.  Ng, G. C.  Yee, T. J.  Hua, M.  Kagathi, “Analysis of normal human eye with different age groups using infrared images,” J. Med. Syst. 33(3), 207–213 (2009).
[CrossRef] [PubMed]

J. H.  Tan, E.  Ng, U.  Rajendra Acharya, C.  Chee, “Infrared thermography on ocular surface temperature: a review,” Infrared Phys. Technol. 52(4), 97–108 (2009).
[CrossRef]

2007

M. A.  Lemp, “The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007),” Ocul. Surf. 5(2), 75–92 (2007).
[CrossRef] [PubMed]

B.  Miljanović, R.  Dana, D. A.  Sullivan, D. A.  Schaumberg, “Impact of dry eye syndrome on vision-related quality of life,” Am. J. Ophthalmol. 143(3), 409–415 (2007).
[CrossRef] [PubMed]

A. J.  Bron, J. A.  Smith, M.  Calonge, “Methodologies to diagnose and monitor dry eye disease: report of the Diagnostic Methodology Subcommittee of the International Dry Eye WorkShop (2007),” Ocul. Surf. 5(2), 108–152 (2007).
[CrossRef] [PubMed]

2005

M. E.  Johnson, P. J.  Murphy, “The effect of instilled fluorescein solution volume on the values and repeatability of TBUT measurements,” Cornea 24(7), 811–817 (2005).
[CrossRef] [PubMed]

2004

W.  Mathers, “Evaporation from the ocular surface,” Exp. Eye Res. 78(3), 389–394 (2004).
[CrossRef] [PubMed]

2002

E.  Goto, Y.  Yagi, Y.  Matsumoto, K.  Tsubota, “Impaired functional visual acuity of dry eye patients,” Am. J. Ophthalmol. 133(2), 181–186 (2002).
[CrossRef] [PubMed]

2001

A. J.  Bron, “Diagnosis of dry eye,” Surv. Ophthalmol. 45(Suppl 2), S221–S226 (2001).
[CrossRef] [PubMed]

1997

A.  Mori, Y.  Oguchi, Y.  Okusawa, M.  Ono, H.  Fujishima, K.  Tsubota, “Use of high-speed, high-resolution thermography to evaluate the tear film layer,” Am. J. Ophthalmol. 124(6), 729–735 (1997).
[PubMed]

1996

P. B.  Morgan, A. B.  Tullo, N.  Efron, “Ocular surface cooling in dry eye a pilot study,” Journal of the British Contact Lens Association 19(1), 7–10 (1996).
[CrossRef]

1985

L. S.  Mengher, A. J.  Bron, S. R.  Tonge, D. J.  Gilbert, “A non-invasive instrument for clinical assessment of the pre-corneal tear film stability,” Curr. Eye Res. 4(1), 1–7 (1985).
[CrossRef] [PubMed]

1969

M. S.  Norn, “Desiccation of the precorneal film. I. Corneal wetting-time,” Acta Ophthalmol. (Copenh.) 47(4), 865–880 (1969).
[CrossRef] [PubMed]

1968

R.  Mapstone, “Measurement of corneal temperature,” Exp. Eye Res. 7(2), 237–243 (1968).
[CrossRef] [PubMed]

Acharya, U. R.

U. R.  Acharya, E. Y.  Ng, G. C.  Yee, T. J.  Hua, M.  Kagathi, “Analysis of normal human eye with different age groups using infrared images,” J. Med. Syst. 33(3), 207–213 (2009).
[CrossRef] [PubMed]

Begley, C.

C.  Begley, T.  Simpson, H.  Liu, E.  Salvo, Z.  Wu, A.  Bradley, P.  Situ, “Quantitative analysis of tear film fluorescence and discomfort during tear film instability and thinning,” Invest. Ophthalmol. Vis. Sci. 54(4), 2645–2653 (2013).
[CrossRef] [PubMed]

Bradley, A.

C.  Begley, T.  Simpson, H.  Liu, E.  Salvo, Z.  Wu, A.  Bradley, P.  Situ, “Quantitative analysis of tear film fluorescence and discomfort during tear film instability and thinning,” Invest. Ophthalmol. Vis. Sci. 54(4), 2645–2653 (2013).
[CrossRef] [PubMed]

Braun, R. J.

P. E.  King-Smith, P.  Ramamoorthy, R. J.  Braun, J. J.  Nichols, “Tear film images and breakup analyzed using fluorescent quenching,” Invest. Ophthalmol. Vis. Sci. 54(9), 6003–6011 (2013).
[CrossRef] [PubMed]

Bron, A. J.

K. K.  Nichols, G. N.  Foulks, A. J.  Bron, B. J.  Glasgow, M.  Dogru, K.  Tsubota, M. A.  Lemp, D. A.  Sullivan, “The international workshop on meibomian gland dysfunction: executive summary,” Invest. Ophthalmol. Vis. Sci. 52(4), 1922–1929 (2011).
[CrossRef] [PubMed]

A. J.  Bron, J. A.  Smith, M.  Calonge, “Methodologies to diagnose and monitor dry eye disease: report of the Diagnostic Methodology Subcommittee of the International Dry Eye WorkShop (2007),” Ocul. Surf. 5(2), 108–152 (2007).
[CrossRef] [PubMed]

A. J.  Bron, “Diagnosis of dry eye,” Surv. Ophthalmol. 45(Suppl 2), S221–S226 (2001).
[CrossRef] [PubMed]

L. S.  Mengher, A. J.  Bron, S. R.  Tonge, D. J.  Gilbert, “A non-invasive instrument for clinical assessment of the pre-corneal tear film stability,” Curr. Eye Res. 4(1), 1–7 (1985).
[CrossRef] [PubMed]

Calonge, M.

A. J.  Bron, J. A.  Smith, M.  Calonge, “Methodologies to diagnose and monitor dry eye disease: report of the Diagnostic Methodology Subcommittee of the International Dry Eye WorkShop (2007),” Ocul. Surf. 5(2), 108–152 (2007).
[CrossRef] [PubMed]

Chang, D. O.

T. Y.  Su, K. H.  Chen, P. H.  Liu, M. H.  Wu, D. O.  Chang, P. F.  Su, S. W.  Chang, H. K.  Chiang, “Noncontact detection of dry eye using a custom designed infrared thermal image system,” J. Biomed. Opt. 16, 046009 (2011).

Chang, S. W.

T. Y.  Su, K. H.  Chen, P. H.  Liu, M. H.  Wu, D. O.  Chang, P. F.  Su, S. W.  Chang, H. K.  Chiang, “Noncontact detection of dry eye using a custom designed infrared thermal image system,” J. Biomed. Opt. 16, 046009 (2011).

Chee, C.

J. H.  Tan, E.  Ng, U.  Rajendra Acharya, C.  Chee, “Infrared thermography on ocular surface temperature: a review,” Infrared Phys. Technol. 52(4), 97–108 (2009).
[CrossRef]

Chen, K. H.

T. Y.  Su, K. H.  Chen, P. H.  Liu, M. H.  Wu, D. O.  Chang, P. F.  Su, S. W.  Chang, H. K.  Chiang, “Noncontact detection of dry eye using a custom designed infrared thermal image system,” J. Biomed. Opt. 16, 046009 (2011).

Chiang, H. K.

T. Y.  Su, K. H.  Chen, P. H.  Liu, M. H.  Wu, D. O.  Chang, P. F.  Su, S. W.  Chang, H. K.  Chiang, “Noncontact detection of dry eye using a custom designed infrared thermal image system,” J. Biomed. Opt. 16, 046009 (2011).

Dana, R.

B.  Miljanović, R.  Dana, D. A.  Sullivan, D. A.  Schaumberg, “Impact of dry eye syndrome on vision-related quality of life,” Am. J. Ophthalmol. 143(3), 409–415 (2007).
[CrossRef] [PubMed]

Dogru, M.

K. K.  Nichols, G. N.  Foulks, A. J.  Bron, B. J.  Glasgow, M.  Dogru, K.  Tsubota, M. A.  Lemp, D. A.  Sullivan, “The international workshop on meibomian gland dysfunction: executive summary,” Invest. Ophthalmol. Vis. Sci. 52(4), 1922–1929 (2011).
[CrossRef] [PubMed]

Efron, N.

P. B.  Morgan, A. B.  Tullo, N.  Efron, “Ocular surface cooling in dry eye a pilot study,” Journal of the British Contact Lens Association 19(1), 7–10 (1996).
[CrossRef]

Foulks, G. N.

K. K.  Nichols, G. N.  Foulks, A. J.  Bron, B. J.  Glasgow, M.  Dogru, K.  Tsubota, M. A.  Lemp, D. A.  Sullivan, “The international workshop on meibomian gland dysfunction: executive summary,” Invest. Ophthalmol. Vis. Sci. 52(4), 1922–1929 (2011).
[CrossRef] [PubMed]

Fujishima, H.

A.  Mori, Y.  Oguchi, Y.  Okusawa, M.  Ono, H.  Fujishima, K.  Tsubota, “Use of high-speed, high-resolution thermography to evaluate the tear film layer,” Am. J. Ophthalmol. 124(6), 729–735 (1997).
[PubMed]

Gilbert, D. J.

L. S.  Mengher, A. J.  Bron, S. R.  Tonge, D. J.  Gilbert, “A non-invasive instrument for clinical assessment of the pre-corneal tear film stability,” Curr. Eye Res. 4(1), 1–7 (1985).
[CrossRef] [PubMed]

Glasgow, B. J.

K. K.  Nichols, G. N.  Foulks, A. J.  Bron, B. J.  Glasgow, M.  Dogru, K.  Tsubota, M. A.  Lemp, D. A.  Sullivan, “The international workshop on meibomian gland dysfunction: executive summary,” Invest. Ophthalmol. Vis. Sci. 52(4), 1922–1929 (2011).
[CrossRef] [PubMed]

Goto, E.

E.  Goto, Y.  Yagi, Y.  Matsumoto, K.  Tsubota, “Impaired functional visual acuity of dry eye patients,” Am. J. Ophthalmol. 133(2), 181–186 (2002).
[CrossRef] [PubMed]

Hinel, E. A.

J. J.  Nichols, P. E.  King-Smith, E. A.  Hinel, M.  Thangavelu, K. K.  Nichols, “The use of fluorescent quenching in studying the contribution of evaporation to tear thinning,” Invest. Ophthalmol. Vis. Sci. 53(9), 5426–5432 (2012).
[CrossRef] [PubMed]

Hua, T. J.

U. R.  Acharya, E. Y.  Ng, G. C.  Yee, T. J.  Hua, M.  Kagathi, “Analysis of normal human eye with different age groups using infrared images,” J. Med. Syst. 33(3), 207–213 (2009).
[CrossRef] [PubMed]

Johnson, M. E.

M. E.  Johnson, P. J.  Murphy, “The effect of instilled fluorescein solution volume on the values and repeatability of TBUT measurements,” Cornea 24(7), 811–817 (2005).
[CrossRef] [PubMed]

Kagathi, M.

U. R.  Acharya, E. Y.  Ng, G. C.  Yee, T. J.  Hua, M.  Kagathi, “Analysis of normal human eye with different age groups using infrared images,” J. Med. Syst. 33(3), 207–213 (2009).
[CrossRef] [PubMed]

Kamao, T.

T.  Kamao, M.  Yamaguchi, S.  Kawasaki, S.  Mizoue, A.  Shiraishi, Y.  Ohashi, “Screening for dry eye with newly developed ocular surface thermographer,” Am. J. Ophthalmol. 151(5), 782–791 (2011).
[CrossRef] [PubMed]

Kawasaki, S.

T.  Kamao, M.  Yamaguchi, S.  Kawasaki, S.  Mizoue, A.  Shiraishi, Y.  Ohashi, “Screening for dry eye with newly developed ocular surface thermographer,” Am. J. Ophthalmol. 151(5), 782–791 (2011).
[CrossRef] [PubMed]

King-Smith, P. E.

P. E.  King-Smith, P.  Ramamoorthy, R. J.  Braun, J. J.  Nichols, “Tear film images and breakup analyzed using fluorescent quenching,” Invest. Ophthalmol. Vis. Sci. 54(9), 6003–6011 (2013).
[CrossRef] [PubMed]

J. J.  Nichols, P. E.  King-Smith, E. A.  Hinel, M.  Thangavelu, K. K.  Nichols, “The use of fluorescent quenching in studying the contribution of evaporation to tear thinning,” Invest. Ophthalmol. Vis. Sci. 53(9), 5426–5432 (2012).
[CrossRef] [PubMed]

Lemp, M. A.

K. K.  Nichols, G. N.  Foulks, A. J.  Bron, B. J.  Glasgow, M.  Dogru, K.  Tsubota, M. A.  Lemp, D. A.  Sullivan, “The international workshop on meibomian gland dysfunction: executive summary,” Invest. Ophthalmol. Vis. Sci. 52(4), 1922–1929 (2011).
[CrossRef] [PubMed]

M. A.  Lemp, “The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007),” Ocul. Surf. 5(2), 75–92 (2007).
[CrossRef] [PubMed]

Liu, H.

C.  Begley, T.  Simpson, H.  Liu, E.  Salvo, Z.  Wu, A.  Bradley, P.  Situ, “Quantitative analysis of tear film fluorescence and discomfort during tear film instability and thinning,” Invest. Ophthalmol. Vis. Sci. 54(4), 2645–2653 (2013).
[CrossRef] [PubMed]

Liu, P. H.

T. Y.  Su, K. H.  Chen, P. H.  Liu, M. H.  Wu, D. O.  Chang, P. F.  Su, S. W.  Chang, H. K.  Chiang, “Noncontact detection of dry eye using a custom designed infrared thermal image system,” J. Biomed. Opt. 16, 046009 (2011).

Mapstone, R.

R.  Mapstone, “Measurement of corneal temperature,” Exp. Eye Res. 7(2), 237–243 (1968).
[CrossRef] [PubMed]

Mathers, W.

W.  Mathers, “Evaporation from the ocular surface,” Exp. Eye Res. 78(3), 389–394 (2004).
[CrossRef] [PubMed]

Matsumoto, Y.

E.  Goto, Y.  Yagi, Y.  Matsumoto, K.  Tsubota, “Impaired functional visual acuity of dry eye patients,” Am. J. Ophthalmol. 133(2), 181–186 (2002).
[CrossRef] [PubMed]

Mengher, L. S.

L. S.  Mengher, A. J.  Bron, S. R.  Tonge, D. J.  Gilbert, “A non-invasive instrument for clinical assessment of the pre-corneal tear film stability,” Curr. Eye Res. 4(1), 1–7 (1985).
[CrossRef] [PubMed]

Miljanovic, B.

B.  Miljanović, R.  Dana, D. A.  Sullivan, D. A.  Schaumberg, “Impact of dry eye syndrome on vision-related quality of life,” Am. J. Ophthalmol. 143(3), 409–415 (2007).
[CrossRef] [PubMed]

Mizoue, S.

T.  Kamao, M.  Yamaguchi, S.  Kawasaki, S.  Mizoue, A.  Shiraishi, Y.  Ohashi, “Screening for dry eye with newly developed ocular surface thermographer,” Am. J. Ophthalmol. 151(5), 782–791 (2011).
[CrossRef] [PubMed]

Morgan, P. B.

P. B.  Morgan, A. B.  Tullo, N.  Efron, “Ocular surface cooling in dry eye a pilot study,” Journal of the British Contact Lens Association 19(1), 7–10 (1996).
[CrossRef]

Mori, A.

A.  Mori, Y.  Oguchi, Y.  Okusawa, M.  Ono, H.  Fujishima, K.  Tsubota, “Use of high-speed, high-resolution thermography to evaluate the tear film layer,” Am. J. Ophthalmol. 124(6), 729–735 (1997).
[PubMed]

Murphy, P. J.

M. E.  Johnson, P. J.  Murphy, “The effect of instilled fluorescein solution volume on the values and repeatability of TBUT measurements,” Cornea 24(7), 811–817 (2005).
[CrossRef] [PubMed]

Ng, E.

J. H.  Tan, E.  Ng, U.  Rajendra Acharya, C.  Chee, “Infrared thermography on ocular surface temperature: a review,” Infrared Phys. Technol. 52(4), 97–108 (2009).
[CrossRef]

Ng, E. Y.

U. R.  Acharya, E. Y.  Ng, G. C.  Yee, T. J.  Hua, M.  Kagathi, “Analysis of normal human eye with different age groups using infrared images,” J. Med. Syst. 33(3), 207–213 (2009).
[CrossRef] [PubMed]

Nichols, J. J.

P. E.  King-Smith, P.  Ramamoorthy, R. J.  Braun, J. J.  Nichols, “Tear film images and breakup analyzed using fluorescent quenching,” Invest. Ophthalmol. Vis. Sci. 54(9), 6003–6011 (2013).
[CrossRef] [PubMed]

J. J.  Nichols, P. E.  King-Smith, E. A.  Hinel, M.  Thangavelu, K. K.  Nichols, “The use of fluorescent quenching in studying the contribution of evaporation to tear thinning,” Invest. Ophthalmol. Vis. Sci. 53(9), 5426–5432 (2012).
[CrossRef] [PubMed]

Nichols, K. K.

J. J.  Nichols, P. E.  King-Smith, E. A.  Hinel, M.  Thangavelu, K. K.  Nichols, “The use of fluorescent quenching in studying the contribution of evaporation to tear thinning,” Invest. Ophthalmol. Vis. Sci. 53(9), 5426–5432 (2012).
[CrossRef] [PubMed]

K. K.  Nichols, G. N.  Foulks, A. J.  Bron, B. J.  Glasgow, M.  Dogru, K.  Tsubota, M. A.  Lemp, D. A.  Sullivan, “The international workshop on meibomian gland dysfunction: executive summary,” Invest. Ophthalmol. Vis. Sci. 52(4), 1922–1929 (2011).
[CrossRef] [PubMed]

Norn, M. S.

M. S.  Norn, “Desiccation of the precorneal film. I. Corneal wetting-time,” Acta Ophthalmol. (Copenh.) 47(4), 865–880 (1969).
[CrossRef] [PubMed]

Oguchi, Y.

A.  Mori, Y.  Oguchi, Y.  Okusawa, M.  Ono, H.  Fujishima, K.  Tsubota, “Use of high-speed, high-resolution thermography to evaluate the tear film layer,” Am. J. Ophthalmol. 124(6), 729–735 (1997).
[PubMed]

Ohashi, Y.

T.  Kamao, M.  Yamaguchi, S.  Kawasaki, S.  Mizoue, A.  Shiraishi, Y.  Ohashi, “Screening for dry eye with newly developed ocular surface thermographer,” Am. J. Ophthalmol. 151(5), 782–791 (2011).
[CrossRef] [PubMed]

Okusawa, Y.

A.  Mori, Y.  Oguchi, Y.  Okusawa, M.  Ono, H.  Fujishima, K.  Tsubota, “Use of high-speed, high-resolution thermography to evaluate the tear film layer,” Am. J. Ophthalmol. 124(6), 729–735 (1997).
[PubMed]

Ono, M.

A.  Mori, Y.  Oguchi, Y.  Okusawa, M.  Ono, H.  Fujishima, K.  Tsubota, “Use of high-speed, high-resolution thermography to evaluate the tear film layer,” Am. J. Ophthalmol. 124(6), 729–735 (1997).
[PubMed]

Rajendra Acharya, U.

J. H.  Tan, E.  Ng, U.  Rajendra Acharya, C.  Chee, “Infrared thermography on ocular surface temperature: a review,” Infrared Phys. Technol. 52(4), 97–108 (2009).
[CrossRef]

Ramamoorthy, P.

P. E.  King-Smith, P.  Ramamoorthy, R. J.  Braun, J. J.  Nichols, “Tear film images and breakup analyzed using fluorescent quenching,” Invest. Ophthalmol. Vis. Sci. 54(9), 6003–6011 (2013).
[CrossRef] [PubMed]

Salvo, E.

C.  Begley, T.  Simpson, H.  Liu, E.  Salvo, Z.  Wu, A.  Bradley, P.  Situ, “Quantitative analysis of tear film fluorescence and discomfort during tear film instability and thinning,” Invest. Ophthalmol. Vis. Sci. 54(4), 2645–2653 (2013).
[CrossRef] [PubMed]

Schaumberg, D. A.

B.  Miljanović, R.  Dana, D. A.  Sullivan, D. A.  Schaumberg, “Impact of dry eye syndrome on vision-related quality of life,” Am. J. Ophthalmol. 143(3), 409–415 (2007).
[CrossRef] [PubMed]

Shiraishi, A.

T.  Kamao, M.  Yamaguchi, S.  Kawasaki, S.  Mizoue, A.  Shiraishi, Y.  Ohashi, “Screening for dry eye with newly developed ocular surface thermographer,” Am. J. Ophthalmol. 151(5), 782–791 (2011).
[CrossRef] [PubMed]

Simpson, T.

C.  Begley, T.  Simpson, H.  Liu, E.  Salvo, Z.  Wu, A.  Bradley, P.  Situ, “Quantitative analysis of tear film fluorescence and discomfort during tear film instability and thinning,” Invest. Ophthalmol. Vis. Sci. 54(4), 2645–2653 (2013).
[CrossRef] [PubMed]

Situ, P.

C.  Begley, T.  Simpson, H.  Liu, E.  Salvo, Z.  Wu, A.  Bradley, P.  Situ, “Quantitative analysis of tear film fluorescence and discomfort during tear film instability and thinning,” Invest. Ophthalmol. Vis. Sci. 54(4), 2645–2653 (2013).
[CrossRef] [PubMed]

Smith, J. A.

A. J.  Bron, J. A.  Smith, M.  Calonge, “Methodologies to diagnose and monitor dry eye disease: report of the Diagnostic Methodology Subcommittee of the International Dry Eye WorkShop (2007),” Ocul. Surf. 5(2), 108–152 (2007).
[CrossRef] [PubMed]

Su, P. F.

T. Y.  Su, K. H.  Chen, P. H.  Liu, M. H.  Wu, D. O.  Chang, P. F.  Su, S. W.  Chang, H. K.  Chiang, “Noncontact detection of dry eye using a custom designed infrared thermal image system,” J. Biomed. Opt. 16, 046009 (2011).

Su, T. Y.

T. Y.  Su, K. H.  Chen, P. H.  Liu, M. H.  Wu, D. O.  Chang, P. F.  Su, S. W.  Chang, H. K.  Chiang, “Noncontact detection of dry eye using a custom designed infrared thermal image system,” J. Biomed. Opt. 16, 046009 (2011).

Sullivan, D. A.

K. K.  Nichols, G. N.  Foulks, A. J.  Bron, B. J.  Glasgow, M.  Dogru, K.  Tsubota, M. A.  Lemp, D. A.  Sullivan, “The international workshop on meibomian gland dysfunction: executive summary,” Invest. Ophthalmol. Vis. Sci. 52(4), 1922–1929 (2011).
[CrossRef] [PubMed]

B.  Miljanović, R.  Dana, D. A.  Sullivan, D. A.  Schaumberg, “Impact of dry eye syndrome on vision-related quality of life,” Am. J. Ophthalmol. 143(3), 409–415 (2007).
[CrossRef] [PubMed]

Tan, J. H.

J. H.  Tan, E.  Ng, U.  Rajendra Acharya, C.  Chee, “Infrared thermography on ocular surface temperature: a review,” Infrared Phys. Technol. 52(4), 97–108 (2009).
[CrossRef]

Thangavelu, M.

J. J.  Nichols, P. E.  King-Smith, E. A.  Hinel, M.  Thangavelu, K. K.  Nichols, “The use of fluorescent quenching in studying the contribution of evaporation to tear thinning,” Invest. Ophthalmol. Vis. Sci. 53(9), 5426–5432 (2012).
[CrossRef] [PubMed]

Tonge, S. R.

L. S.  Mengher, A. J.  Bron, S. R.  Tonge, D. J.  Gilbert, “A non-invasive instrument for clinical assessment of the pre-corneal tear film stability,” Curr. Eye Res. 4(1), 1–7 (1985).
[CrossRef] [PubMed]

Tsubota, K.

K. K.  Nichols, G. N.  Foulks, A. J.  Bron, B. J.  Glasgow, M.  Dogru, K.  Tsubota, M. A.  Lemp, D. A.  Sullivan, “The international workshop on meibomian gland dysfunction: executive summary,” Invest. Ophthalmol. Vis. Sci. 52(4), 1922–1929 (2011).
[CrossRef] [PubMed]

E.  Goto, Y.  Yagi, Y.  Matsumoto, K.  Tsubota, “Impaired functional visual acuity of dry eye patients,” Am. J. Ophthalmol. 133(2), 181–186 (2002).
[CrossRef] [PubMed]

A.  Mori, Y.  Oguchi, Y.  Okusawa, M.  Ono, H.  Fujishima, K.  Tsubota, “Use of high-speed, high-resolution thermography to evaluate the tear film layer,” Am. J. Ophthalmol. 124(6), 729–735 (1997).
[PubMed]

Tullo, A. B.

P. B.  Morgan, A. B.  Tullo, N.  Efron, “Ocular surface cooling in dry eye a pilot study,” Journal of the British Contact Lens Association 19(1), 7–10 (1996).
[CrossRef]

Wu, M. H.

T. Y.  Su, K. H.  Chen, P. H.  Liu, M. H.  Wu, D. O.  Chang, P. F.  Su, S. W.  Chang, H. K.  Chiang, “Noncontact detection of dry eye using a custom designed infrared thermal image system,” J. Biomed. Opt. 16, 046009 (2011).

Wu, Z.

C.  Begley, T.  Simpson, H.  Liu, E.  Salvo, Z.  Wu, A.  Bradley, P.  Situ, “Quantitative analysis of tear film fluorescence and discomfort during tear film instability and thinning,” Invest. Ophthalmol. Vis. Sci. 54(4), 2645–2653 (2013).
[CrossRef] [PubMed]

Yagi, Y.

E.  Goto, Y.  Yagi, Y.  Matsumoto, K.  Tsubota, “Impaired functional visual acuity of dry eye patients,” Am. J. Ophthalmol. 133(2), 181–186 (2002).
[CrossRef] [PubMed]

Yamaguchi, M.

T.  Kamao, M.  Yamaguchi, S.  Kawasaki, S.  Mizoue, A.  Shiraishi, Y.  Ohashi, “Screening for dry eye with newly developed ocular surface thermographer,” Am. J. Ophthalmol. 151(5), 782–791 (2011).
[CrossRef] [PubMed]

Yee, G. C.

U. R.  Acharya, E. Y.  Ng, G. C.  Yee, T. J.  Hua, M.  Kagathi, “Analysis of normal human eye with different age groups using infrared images,” J. Med. Syst. 33(3), 207–213 (2009).
[CrossRef] [PubMed]

Acta Ophthalmol. (Copenh.)

M. S.  Norn, “Desiccation of the precorneal film. I. Corneal wetting-time,” Acta Ophthalmol. (Copenh.) 47(4), 865–880 (1969).
[CrossRef] [PubMed]

Am. J. Ophthalmol.

A.  Mori, Y.  Oguchi, Y.  Okusawa, M.  Ono, H.  Fujishima, K.  Tsubota, “Use of high-speed, high-resolution thermography to evaluate the tear film layer,” Am. J. Ophthalmol. 124(6), 729–735 (1997).
[PubMed]

T.  Kamao, M.  Yamaguchi, S.  Kawasaki, S.  Mizoue, A.  Shiraishi, Y.  Ohashi, “Screening for dry eye with newly developed ocular surface thermographer,” Am. J. Ophthalmol. 151(5), 782–791 (2011).
[CrossRef] [PubMed]

E.  Goto, Y.  Yagi, Y.  Matsumoto, K.  Tsubota, “Impaired functional visual acuity of dry eye patients,” Am. J. Ophthalmol. 133(2), 181–186 (2002).
[CrossRef] [PubMed]

B.  Miljanović, R.  Dana, D. A.  Sullivan, D. A.  Schaumberg, “Impact of dry eye syndrome on vision-related quality of life,” Am. J. Ophthalmol. 143(3), 409–415 (2007).
[CrossRef] [PubMed]

Cornea

M. E.  Johnson, P. J.  Murphy, “The effect of instilled fluorescein solution volume on the values and repeatability of TBUT measurements,” Cornea 24(7), 811–817 (2005).
[CrossRef] [PubMed]

Curr. Eye Res.

L. S.  Mengher, A. J.  Bron, S. R.  Tonge, D. J.  Gilbert, “A non-invasive instrument for clinical assessment of the pre-corneal tear film stability,” Curr. Eye Res. 4(1), 1–7 (1985).
[CrossRef] [PubMed]

Exp. Eye Res.

R.  Mapstone, “Measurement of corneal temperature,” Exp. Eye Res. 7(2), 237–243 (1968).
[CrossRef] [PubMed]

W.  Mathers, “Evaporation from the ocular surface,” Exp. Eye Res. 78(3), 389–394 (2004).
[CrossRef] [PubMed]

Infrared Phys. Technol.

J. H.  Tan, E.  Ng, U.  Rajendra Acharya, C.  Chee, “Infrared thermography on ocular surface temperature: a review,” Infrared Phys. Technol. 52(4), 97–108 (2009).
[CrossRef]

Invest. Ophthalmol. Vis. Sci.

K. K.  Nichols, G. N.  Foulks, A. J.  Bron, B. J.  Glasgow, M.  Dogru, K.  Tsubota, M. A.  Lemp, D. A.  Sullivan, “The international workshop on meibomian gland dysfunction: executive summary,” Invest. Ophthalmol. Vis. Sci. 52(4), 1922–1929 (2011).
[CrossRef] [PubMed]

J. J.  Nichols, P. E.  King-Smith, E. A.  Hinel, M.  Thangavelu, K. K.  Nichols, “The use of fluorescent quenching in studying the contribution of evaporation to tear thinning,” Invest. Ophthalmol. Vis. Sci. 53(9), 5426–5432 (2012).
[CrossRef] [PubMed]

C.  Begley, T.  Simpson, H.  Liu, E.  Salvo, Z.  Wu, A.  Bradley, P.  Situ, “Quantitative analysis of tear film fluorescence and discomfort during tear film instability and thinning,” Invest. Ophthalmol. Vis. Sci. 54(4), 2645–2653 (2013).
[CrossRef] [PubMed]

P. E.  King-Smith, P.  Ramamoorthy, R. J.  Braun, J. J.  Nichols, “Tear film images and breakup analyzed using fluorescent quenching,” Invest. Ophthalmol. Vis. Sci. 54(9), 6003–6011 (2013).
[CrossRef] [PubMed]

J. Biomed. Opt.

T. Y.  Su, K. H.  Chen, P. H.  Liu, M. H.  Wu, D. O.  Chang, P. F.  Su, S. W.  Chang, H. K.  Chiang, “Noncontact detection of dry eye using a custom designed infrared thermal image system,” J. Biomed. Opt. 16, 046009 (2011).

J. Med. Syst.

U. R.  Acharya, E. Y.  Ng, G. C.  Yee, T. J.  Hua, M.  Kagathi, “Analysis of normal human eye with different age groups using infrared images,” J. Med. Syst. 33(3), 207–213 (2009).
[CrossRef] [PubMed]

Journal of the British Contact Lens Association

P. B.  Morgan, A. B.  Tullo, N.  Efron, “Ocular surface cooling in dry eye a pilot study,” Journal of the British Contact Lens Association 19(1), 7–10 (1996).
[CrossRef]

Ocul. Surf.

M. A.  Lemp, “The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007),” Ocul. Surf. 5(2), 75–92 (2007).
[CrossRef] [PubMed]

A. J.  Bron, J. A.  Smith, M.  Calonge, “Methodologies to diagnose and monitor dry eye disease: report of the Diagnostic Methodology Subcommittee of the International Dry Eye WorkShop (2007),” Ocul. Surf. 5(2), 108–152 (2007).
[CrossRef] [PubMed]

Surv. Ophthalmol.

A. J.  Bron, “Diagnosis of dry eye,” Surv. Ophthalmol. 45(Suppl 2), S221–S226 (2001).
[CrossRef] [PubMed]

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Figures (5)

Fig. 1
Fig. 1

Dual modality measurement system was established to capture the thermal image and fluorescent image of fluorescein-stain tear films. A. Thermography camera. B. Fluorescent camera. C. Fluorescein-stain tear film. D. Long-pass filter (500 nm). E. Cobalt light source. F. Germanium filter.

Fig. 2
Fig. 2

The image processing steps for enhance the FTBA of the fluorescein images (a-d) and the LTA of the thermograms (e-h). The fluorescent image captured right after blinking (a.). The fluorescent image obtained at 5 s after blinking (b.). The subtraction of (a) and (b) is shown in (c). The binary image of (c.) is (d). The same processing steps for the thermograms (e-h).

Fig. 3
Fig. 3

The red circles indicate the first appearance of the LTA (a.), the FTBA (b.), respectively. O is the position of inner canthus. X and Y are the horizontal-center-distance, vertical-center-distance.

Fig. 4
Fig. 4

The scatter plots of the FTBA (fluorescein tear film break-up area) and LTA (lower temperature area), in the vertical-center-distance (a.), in horizontal-center-distance (b.), total-center-distances (c.), and the area (d.).

Fig. 5
Fig. 5

A fluorescent-stain tear film is measured by the dual modality imaging system. (A) FTBA images (B) LTA images. The time interval between each image is 1 second. The FTBA is fully developed at 3 s; while the LTA can be observed at 2 s. Red circles represent the FTBA and LTA, respectively.

Tables (1)

Tables Icon

Table 1 The correlation relation of the horizontal-center-distance (Horizontal), vertical-center-distance (Vertical), total-center-distances (Distances), and area between the LTA and FTBA (Area).

Metrics