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Objective determination of the tear break up time with placido discs

Poster Details

First Author: A.Arias-Puente SPAIN

Co Author(s):    L. Modamio-Gardeta   E. Escobar-Martin   L. Martin-Perez   N. Kim   S. De Manuel-Triantafilo   J. Fernandez-Garcia     

Abstract Details


To analyse the ability to determine subjectively and objectively the tear film break up time (BUT) in a non-invasive way using a newly developed corneal topography system based on placido discs with a special lighting system.


A sample of 49 patients (12 asymptomatic controls and 37 patients with dry eye symptoms) was examined at the ophthalmology department of Hospital Universitario Fundación Alcorcón of Madrid.


The tear film stability was measured in all patients using the Oculus Keratograph 5M®, a corneal topography system based on placido discs with LED (light-emitting diode) lighting system that allows the assessment of NITBUT (non-invasive tear break-up time). The system detects and analyses the quality of the image reflected in the tear film, quantitatively records the elapsed time in seconds and accordingly classifies the stability of the tear film in levels (0 = stable; 1 = suspicious, 2 = abnormal; x = time too short (tts).


The quantitative and objective analysis of NITBUT in the control group was: Level 0: 41.8% (5 eyes); Level 1: 33.4% (4 eyes); Level 2: 16.4% (2 eyes); ttc: 8.4% (1 eye). In the symptomatic group it was: Level 0: 24.3% (9 eyes); Level 1: 16.2% (6 eyes); Level 2: 37.8% (14 eyes); tts: 21.7% (8 eyes). According to the results, 59.5% of symptomatic patients had an abnormal tear film stability compared to 24.8% of the asymptomatic group.


This automated system based on placid discs is able to obtain quantitative and objective values of BUT in a non-invasive and standardised examination. Future studies are needed to assess the validity and reliability of the measures in patients with dry eye syndrome

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