New Tearscope Made of Paper for Lipid Layer Evaluation in Tear Film–Related Disease

Tuesday, April 21, 2015: 8:31 AM
Room 3 (San Diego Convention Center)
Hosik Hwang, MD, PhD
Eunchul Kim, MD
Man Soo Kim, MD, PhD

To introduce a new tearscope (Hosik’s Tearscope) made of paper for lipid layer of tearfilm and to present the findings of dry eye syndrome, meibomian gland dysfunction (MGD) and ocular GVHD (Graft versus host disease) patients.

We made this tearscope with a common copying paper (3 x 6 cm). We made a round hole (diameter 6.0 mm) at the 1/4 end of the paper for observation window. After positioning the tearscope in front of the patient eye (1 cm from the cornea), we found interference patterns on the cornea through the hole with slit lamp. After adjusting magnification, we captured the images by CCD (charge coupled device) camera connected to the slit lamp. We took photographs of tearfilm of dry eye syndrome, MGD and ocular GVHD patients. Additionally, we measured BUT (tear break up time) and took photographs of upper lid margin and cornea stain patterns.

Colors of lipid layer were grey color (thin, meshwork, wave, amorphous), color (a few color, many color) depending on the thickness and quality of lipid layer. In healthy subject, meshwork, wave or amorphous patterns with grey color were observed. In dry eye syndrome patients, thin patterns with grey color were observed frequently. In MGD or GVHD patients, many colors (red to violet) were found and globus or clumping were found in severe cases. It took less than 10 seconds to take photographs of lipid layer using this tearscope and it could be used easily. Interference patterns of lipid layer could be saved as image files and dynamic changes of tearfilm by blinking could be saved as movie files.

This new tearscope made of paper was easy to use and effective to evaluate the lipid layer in tearfilm related disease.