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Prevalence of dry eye disease in NHS ophthalmology clinics setting

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Session Details

Session Title: Cornea - Medical

Session Date/Time: Monday 07/09/2015 | 08:00-10:30

Paper Time: 10:07

Venue: Room 17

First Author: : N.Din UK

Co Author(s): :    F. Harman   G. Smith                 

Abstract Details


To determine the prevalence of normal and abnormal tear osmolarity compared to a masked ophthalmologist diagnosis of dry eye disease.


Hillingdon Hospital, Middlesex, Great Western Hospital, Swindon, Wiltshire and St. Peter's Hospital, Chertsey, Surrey, Maidstone Hospital, Maidstone, United Kingdom.


This was a non-randomized, multicentre, diagnosis accuracy study recruiting 705 subjects across four NHS sites. Tear osmolarity was measured using the in-vitro diagnostic TearLab Osmolarity System but was masked to the Consultant. Conventional tests for Dry Eye disease (DED) including ocular surface disease index (OSDI), corneal surface staining, tear break up time (TBUT), and meibomian gland function were performed. Tear osmolarity results were then compared to the consultant's diagnosis of DED from conventional tests.


Elevated tear osmolarity (>308 mOsm/L) was measured among 67% of subjects while the consultant diagnosed dry eye in 50.2%. 393/705 subjects had significant symptoms. 273 (69%) of these subjects had hyperosmolarity but only 222 (56%) were diagnosed with DED by the consultant (p<.001). 150 subjects had significant symptoms (mean OSDI: 35.4± 18.4) with elevated osmolarity as the only sign (mean: 326.8±19.1 mOsm/L) which is more than patients with symptoms and only one other clinical sign. Only 28.3% of these subjects were diagnosed with dry eye by the masked consultant.


The current study demonstrates that tear osmolarity testing is more sensitive than other commonly used objective and subjective tests for detecting DED. Thus, tear osmolarity measure allows the consultant to diagnose DED in symptomatic patients who may be otherwise misdiagnosed.

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