Noninvasive Interference Tear Meniscometry in Dry Eye Patients With Sjögren Syndrome

Purpose: To compare noninvasive tear meniscus height (NI-TMH) using a tear interference device in normal subjects and dry eye patients with Sjögren syndrome (SS), and to investigate the applicability of this new method before and after the punctal occlusion procedure. Design: Prospective case control study. Methods: Tear meniscus was visualized noninvasively using a tear interference device (Tearscope plus, Keeler, Windsor, United Kingdom). Tear interference image was captured with digital video camera (SP-321, JFC Sales Plan Co, Tokyo, Japan) attached to the slit-lamp. Lower lid margin NI-TMH was measured using image analysis software. NI-TMH of 28 eyes from 17 normal subjects and 46 eyes from 27 aqueous tear deficiency (ATD) dry eye patients with SS were compared. The change of NI-TMH three weeks after the successful punctal occlusion was examined in 11 eyes of eight dry eye subjects. Results: Tear meniscus was well visualized with the tear interference device in all cases. Lower lid margin NI-TMH was 0.22 ± 0.065 mm in normal subjects, and 0.13 ± 0.042 mm in SS subjects, respectively (P < .0001). After the punctal occlusion, lower lid margin NI-TMH increased significantly from 0.12 ± 0.026 mm to 0.42 ± 0.21 mm (P = .001). Conclusions: NI-TMH was substantially lower in SS subjects and also significantly improved after punctal occlusion. This method is expected to be helpful in the diagnosis and in the evaluation of the efficacy of punctal occlusion in ATD dry eyes such as SS.