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Isabel Serrano

Scientific Writing Spring 2017

Dr. Bruce

15 March 2017

A Review of Dry- Eye Disease Diagnostic Techniques


Our review aims to compare dDry-eEye dDisease diagnostic techniques and, emphasizeing the

mathematical approaches used to measure optical tear film thicknesses, which is an essential

feature for diagnosis.


The eyes tear film is composed of three layers: the lipid, aqueous, and mucus layers. Tears

function to provide eyes with moisture and protection (King-Smith, Fink, & Fogt, 1999).

However, dry-eye diseases, such as Dry-Eye Disease, can manifest when a tear shortage exists

(Lu, Wang, Wang, & Shen, 2014). The tear film layers thicknesses influence the rate of tears

evaporation (King-Smith, Fink, & Fogt, 1999). Thus, tear supply is correlated to the layers

thicknesses. Due to this connection, various methods have been developed to measure tear film

thickness, as this measurement is essential in diagnosis dDry-eEye dDisease diagnosis. Initially,

invasive techniques, which disturb the tear film, were utilized. However, these disturbances can

affect the measurements accuracy. Presently, noninvasive techniques, particularly

interferometric methods, are popularly used as they offer more precise results. The current body

of literature concerning optical film measuring techniques provides a wide range of thickness
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estimates. Due to the lack of consensus, this review aims to compare these techniques in the

context of diagnosing dDry-eEye dDisease.

References & Annotations (APA style Citation)

Carniglia, C.K. (1978). Scalar scattering theory for multilayer optical coatings. Optical

Engineering, 18, 104-115. doi: 10.1117/12.7972335.

Purpose: Carniglia introduces two models to measure the surface roughness of the eyes film

layers and identify the layers distinct refractive indices role in scattering light.

Presently, techniques dependent on lights reflection are popularly used to measure the eyes tear

film thickness, as shown in Fogt et al. and Lu et al.s studies. However, scattered light is essential

in accurately converting reflected light values into thickness measurements. While Lu et al.s

work acknowledges the layers varying refractive indices, the study does not account for

scattered light in their calculations. Thus, Carniglias work will be used in our conclusion to

propose improvements for these measuring techniques.

Lu, H., Wang, M.R., Wang, J., & Shen, M. (2014). Tear film measurement by optical

reflectometry technique. Journal of Biomedical Optics, 19, 1-8.


Purpose: Lu et al. developed a tool to measure film thickness by mathematically translating the

length of the light reflected from the film to thickness measurements.

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In tracing the evolution of tear film measuring techniques, we will be referring to this studys

methods and comparing them to established measuring tools, namely interferometric techniques.

Notably, Lu et al. do not rely on the effect of wavelengths collisions to interpret film thickness,

distinguishing their approach from Fogt et al.s methods. We will compare the assumptions

surrounding both studies to note underlying discrepancies and report the more effective


Fogt, N., King-Smith, P.E., & Tuell, G. (1998). Interferometric measurement of tear film

thickness by use of spectral oscillations. Journal of the Optical Society of America, A

Optics, Image Science, and Vision, 15, 268 175.

Purpose: This study aims to improve wavelength-dependent interferometric measuring

techniques by broadening the range of wavelengths used to calculate tear film layers


Our work will highlight this studys methods and contrast them to other measuring techniques. In

particular, we will compare this study to other works that sought to improve interferometric

techniques. In stark contrast to Lu et al. who rely on the amount of light reflected off of the tear

film, Fogt et al. emphasize the reflected light waves oscillations in their film measurements. In

other words, Lu et al. translate the amount of light reflected while Fogt et al. convert the light

waves characteristics into thickness measurements. Overall, we will compare these models and

identify the models unique features.

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Mishima, S. (1965). Some physiological aspects of the precorneal tear film. Archives of

Ophthalmology, 73, 233-41.

Purpose: This work aims to describe the properties of the eyes tear film layers, including the

layers thickness measurements.

As our review aims to trace the development of optical film measuring techniques, incorporating

the initial measuring approaches described in Mishimas study is essential in contextualizing the

improvements made in these techniques. Thus, we will reference Mishimas use of invasive

techniques, or methods that disturb the tear film, to demonstrate the improved accuracy in Fogt

et al. and Lu et al.s methods.

Additional Source (Source Cited in the Introduction as it offered general information, but

will not be used further in the review)

King-Smith, P.E., Fink, B.A., & Fogt, N. (1999). Three interferometric methods for measuring

the thickness of layers of the tear film. Optometry and Vision Science, 76, 19-32.