Dynamic Changes in the Lower Tear Meniscus After Instillation of Artificial Tears

Purpose: To compare the dynamic changes in lower tear meniscus area (TMA) and height after instillation of artificial tears in patients with dry eye and healthy controls. Methods: Twenty-two eyes of 11 patients with dry eye and twenty eyes of 10 age-and sex-matched healthy subjects were included. The inferior tear meniscus height and area measurements were taken before and after instillation of 35 mu L carboxymethyl cellulose (CMC) 0.5% and 1.0% (Allergan, Irvine, CA) on 2 consecutive days. The measurements were obtained before and 1, 5, 10, 15, and 30 minutes after instillation using anterior segment optical coherence tomography, RTVue-100 (RTVue, Optovue, Inc). Results: The baseline lower TMA and height in the dry eye group were significantly lower than in the control group. A significant increase in TMA and height was found at 1 minute post instillation of 0.5% CMC in both groups, with findings returning to baseline levels at 5 and 10 minutes post instillation in the control group and dry eye group, respectively. The increase in TMA and height persisted for a longer time period in both groups with 1% CMC, versus 0.5% CMC. At 15 and 30 minutes, both tear meniscus parameters were still significantly higher in the control group and dry eye group, respectively. Conclusions: Artificial tears provide a significant yet temporary improvement in the tear meniscus. The anterior segment optical coherence tomography is valuable to measure dynamic changes in the tear meniscus.