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PUBLICATION EXCLUSIVE: Interpreting tear film osmolarity: One test is not enough

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Welcome to another edition of CEDARS/ASPENS Debates. CEDARS/ASPENS is a joint society of cornea, cataract and refractive surgery specialists, here to discuss some of the latest hot topics in ophthalmology. Tear film osmolarity has become a commonly used test to diagnose and monitor dry eye patients. Despite the understanding of elevated osmolarity as an indicator of dry eye disease, the value of the test and the interpretation of the results have been widely debated. This month, I will discuss how I use and interpret tear film osmolarity testing for dry eye patients. I hope you enjoy the discussion.

Dry eye disease is among the most common conditions the eye care professional encounters. It has been estimated that nearly 30 million people in the U.S. suffer from dry eyes. Due to a growing understanding of the effect of dry eyes on vision and surgical outcomes, there has been an increased emphasis on diagnosing and treating dry eye disease. The FDA finally approved another medication for the treatment of dry eye disease, and several other medications are in the pipeline. In addition, numerous diagnostic tests have become available to help diagnose and grade dry eye disease. This has led to confusion among eye care professionals as to which tests to use and how to interpret these tests.

One test that has made a significant impact on the way I treat dry eye disease is tear film osmolarity testing (TearLab). The Dry Eye WorkShop defined dry eye disease as a multifactorial disease of the ocular surface and tear film accompanied by increased osmolarity of the tear film and inflammation of the ocular surface. Testing tear film osmolarity has become a critical part of my dry eye management. Unfortunately, many physicians struggle with when to use this test and how to interpret the results. The following is my system of how I use and interpret the tear film osmolarity test.

• Click here to read the full publication exclusive, Cedars/Aspens Debates, published in Ocular Surgery News U.S. Edition, January 25, 2016.