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Variability of tear osmolarity measurements with TearLab System in healthy subjects: systematic review

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Session Details

Session Title: Medical Cornea & Biomechanics

Session Date/Time: Sunday 23/09/2018 | 08:00-10:00

Paper Time: 08:00

Venue: Room A3, Podium 3

First Author: : P.Bänninger SWITZERLAND

Co Author(s): :    S. Voegeli   L. Bachmann   L. Faes   K. Iselin   C. Kaufmann   M. Thiel     

Abstract Details


To assess the variability of osmolarity measured by the point-of-care system TearLab in healthy eyes.


Systematic Review Eye Department Cantonal Hospital Lucerne, Switzerland


We searched Medline, Scopus and the Web of Science databases. The requirements for inclusion were the availability of TearLab results in healthy subjects and a minimum study sample of 20 eyes. We computed the weighted mean osmolarity using study size as the weighting factor and calculated the rate of subjects with osmolarity values >308 mOsm/L, presenting the Dry-Eye-Workshop-Report-2017’s (DEWS) cut-off value for dry eye disease. We repeated the analysis when excluding reports with possible conflict of interest or missing description of subject selection.


Searches retrieved 105 non-duplicate articles and we included 33 studies investigating 1362 eyes of healthy participants who were asymptomatic and showed no clinical signs of dry eye disease. Sixty-three percent were female and the mean age was 37.3 years (range: 21.5-69.0 years). The weighted mean osmolarity was 298mOsm/L (95% confidence interval: 282-321 mOsm/L). The result of the subgroup analysis was similar. Overall, 386/1362 eyes (28.3%) fulfilled the DEWS’s definition of dry eye disease (>308 mOsm/L).


There is a high variability of osmolarity measurements with the TearLab system. A substantial number of healthy subjects fulfills the DEWS’s definition of dry eye disease. We propose interpreting the TearLab osmolarity results cautiously and in the context of other established methods.

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