Apparent time‐dependent differences in inferior tear meniscus height in human subjects with mild dry eye symptoms

PURPOSE: The aim of the study was to track the volume of tears contained in the inferior tear meniscus over the course of the day in subjects with symptoms of mild dry eye and a control asymptomatic group. METHODS: Forty non-contact lens-wearing subjects (aged 27 +/- 6 years) were enrolled in this investigator-masked study. They were divided into 'dry eye' (DE) and 'non-dry eye' (NDE) individuals based on their responses to the Allergan Subjective Evaluation of Symptoms of Dryness (SESOD) questionnaire. Measurement of the tear meniscus height (TMH) was undertaken on the centre of the right eye at 9:00 am, noon, 3:00 pm, 6:00 pm and 9:00 pm on the lower lid using a non-contact, non-invasive optical coherence tomographer (OCT). The TMH was determined from scanned images using customised software. RESULTS: A monotonous and significant reduction in the central TMH occurred over the course of the day in both groups (p < 0.05), with the values constantly decreasing (NDE = 0.162 to 0.125 mm; DE = 0.154 to 0.121 mm). While the TMH values in the DE group were always lower than the NDE group, these were not significantly different at any time (p > 0.05). CONCLUSIONS: A diurnal reduction in tear volume, as assessed by evaluation of the inferior TMH, may be one of the reasons responsible for the common increase in end-of-day ocular dryness symptoms reported by many patients in clinical practice.