OSA's Digital Library

Biomedical Optics Express

Biomedical Optics Express

  • Editor: Joseph A. Izatt
  • Vol. 5, Iss. 8 — Aug. 1, 2014
  • pp: 2614–2619

Direct observation and validation of fluorescein tear film break-up patterns by using a dual thermal-fluorescent imaging system

Tai-Yuan Su, Shu-Wen Chang, Chiao-Ju Yang, and Huihua Kenny Chiang  »View Author Affiliations

Biomedical Optics Express, Vol. 5, Issue 8, pp. 2614-2619 (2014)

View Full Text Article

Enhanced HTML    Acrobat PDF (2017 KB)

Browse Journals / Lookup Meetings

Browse by Journal and Year


Lookup Conference Papers

Close Browse Journals / Lookup Meetings

Article Tools



The fluorescein tear film break-up test is a common tear film stability test for dry eye diagnosis. This test requires applying fluorescein sodium drops to a tear film to observe the tear film break-up. However, this test is limited by using the fluorescein sodium drops, which can induce reflex tearing and reduce the reliability of the diagnosis results. This paper proposes that tear film evaporation accelerates on the fluorescein tear film break-up area (FTBA), resulting in a lower temperature area (LTA) on the tear film. A dual modality system was established to capture the thermal and fluorescent image of fluorescein-stain tear films for 48 participants. Observations showed that the LTA and FTBA were highly correlated in their location (r = 0.82) and size (r = 0.91). This is first study to show that the FTBA and LTA are essentially the same region. This study demonstrated the feasibility of using the noncontact thermograph method to evaluate tear film stability without using a fluorescein sodium drop.

© 2014 Optical Society of America

OCIS Codes
(110.6820) Imaging systems : Thermal imaging
(170.3880) Medical optics and biotechnology : Medical and biological imaging
(170.4470) Medical optics and biotechnology : Ophthalmology

ToC Category:
Ophthalmology Applications

Original Manuscript: May 9, 2014
Revised Manuscript: July 5, 2014
Manuscript Accepted: July 8, 2014
Published: July 14, 2014

Tai-Yuan Su, Shu-Wen Chang, Chiao-Ju Yang, and Huihua Kenny Chiang, "Direct observation and validation of fluorescein tear film break-up patterns by using a dual thermal-fluorescent imaging system," Biomed. Opt. Express 5, 2614-2619 (2014)

Sort:  Author  |  Year  |  Journal  |  Reset  


  1. E.  Goto, Y.  Yagi, Y.  Matsumoto, K.  Tsubota, “Impaired functional visual acuity of dry eye patients,” Am. J. Ophthalmol. 133(2), 181–186 (2002). [CrossRef] [PubMed]
  2. B.  Miljanović, R.  Dana, D. A.  Sullivan, D. A.  Schaumberg, “Impact of dry eye syndrome on vision-related quality of life,” Am. J. Ophthalmol. 143(3), 409–415 (2007). [CrossRef] [PubMed]
  3. K. K.  Nichols, G. N.  Foulks, A. J.  Bron, B. J.  Glasgow, M.  Dogru, K.  Tsubota, M. A.  Lemp, D. A.  Sullivan, “The international workshop on meibomian gland dysfunction: executive summary,” Invest. Ophthalmol. Vis. Sci. 52(4), 1922–1929 (2011). [CrossRef] [PubMed]
  4. M. A.  Lemp, “The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007),” Ocul. Surf. 5(2), 75–92 (2007). [CrossRef] [PubMed]
  5. J. J.  Nichols, P. E.  King-Smith, E. A.  Hinel, M.  Thangavelu, K. K.  Nichols, “The use of fluorescent quenching in studying the contribution of evaporation to tear thinning,” Invest. Ophthalmol. Vis. Sci. 53(9), 5426–5432 (2012). [CrossRef] [PubMed]
  6. C.  Begley, T.  Simpson, H.  Liu, E.  Salvo, Z.  Wu, A.  Bradley, P.  Situ, “Quantitative analysis of tear film fluorescence and discomfort during tear film instability and thinning,” Invest. Ophthalmol. Vis. Sci. 54(4), 2645–2653 (2013). [CrossRef] [PubMed]
  7. P. E.  King-Smith, P.  Ramamoorthy, R. J.  Braun, J. J.  Nichols, “Tear film images and breakup analyzed using fluorescent quenching,” Invest. Ophthalmol. Vis. Sci. 54(9), 6003–6011 (2013). [CrossRef] [PubMed]
  8. A. J.  Bron, “Diagnosis of dry eye,” Surv. Ophthalmol. 45(Suppl 2), S221–S226 (2001). [CrossRef] [PubMed]
  9. M. S.  Norn, “Desiccation of the precorneal film. I. Corneal wetting-time,” Acta Ophthalmol. (Copenh.) 47(4), 865–880 (1969). [CrossRef] [PubMed]
  10. M. E.  Johnson, P. J.  Murphy, “The effect of instilled fluorescein solution volume on the values and repeatability of TBUT measurements,” Cornea 24(7), 811–817 (2005). [CrossRef] [PubMed]
  11. L. S.  Mengher, A. J.  Bron, S. R.  Tonge, D. J.  Gilbert, “A non-invasive instrument for clinical assessment of the pre-corneal tear film stability,” Curr. Eye Res. 4(1), 1–7 (1985). [CrossRef] [PubMed]
  12. R.  Mapstone, “Measurement of corneal temperature,” Exp. Eye Res. 7(2), 237–243 (1968). [CrossRef] [PubMed]
  13. P. B.  Morgan, A. B.  Tullo, N.  Efron, “Ocular surface cooling in dry eye a pilot study,” Journal of the British Contact Lens Association 19(1), 7–10 (1996). [CrossRef]
  14. A.  Mori, Y.  Oguchi, Y.  Okusawa, M.  Ono, H.  Fujishima, K.  Tsubota, “Use of high-speed, high-resolution thermography to evaluate the tear film layer,” Am. J. Ophthalmol. 124(6), 729–735 (1997). [PubMed]
  15. U. R.  Acharya, E. Y.  Ng, G. C.  Yee, T. J.  Hua, M.  Kagathi, “Analysis of normal human eye with different age groups using infrared images,” J. Med. Syst. 33(3), 207–213 (2009). [CrossRef] [PubMed]
  16. J. H.  Tan, E.  Ng, U.  Rajendra Acharya, C.  Chee, “Infrared thermography on ocular surface temperature: a review,” Infrared Phys. Technol. 52(4), 97–108 (2009). [CrossRef]
  17. T.  Kamao, M.  Yamaguchi, S.  Kawasaki, S.  Mizoue, A.  Shiraishi, Y.  Ohashi, “Screening for dry eye with newly developed ocular surface thermographer,” Am. J. Ophthalmol. 151(5), 782–791 (2011). [CrossRef] [PubMed]
  18. T. Y.  Su, K. H.  Chen, P. H.  Liu, M. H.  Wu, D. O.  Chang, P. F.  Su, S. W.  Chang, H. K.  Chiang, “Noncontact detection of dry eye using a custom designed infrared thermal image system,” J. Biomed. Opt. 16, 046009 (2011).
  19. W.  Mathers, “Evaporation from the ocular surface,” Exp. Eye Res. 78(3), 389–394 (2004). [CrossRef] [PubMed]
  20. A. J.  Bron, J. A.  Smith, M.  Calonge, “Methodologies to diagnose and monitor dry eye disease: report of the Diagnostic Methodology Subcommittee of the International Dry Eye WorkShop (2007),” Ocul. Surf. 5(2), 108–152 (2007). [CrossRef] [PubMed]

Cited By

Alert me when this paper is cited

OSA is able to provide readers links to articles that cite this paper by participating in CrossRef's Cited-By Linking service. CrossRef includes content from more than 3000 publishers and societies. In addition to listing OSA journal articles that cite this paper, citing articles from other participating publishers will also be listed.


Fig. 1 Fig. 2 Fig. 3
Fig. 4 Fig. 5

« Previous Article  |  Next Article »

OSA is a member of CrossRef.

CrossCheck Deposited