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

Wang, Yan MD; Zhuang, Hong MD; Xu, Jianjiang MD; Wang, Xin MD; Jiang, Chunhui MD; Sun, Xinghuai MD

doi: 10.1097/ICO.0b013e3181bd476c
Clinical Science

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 μL 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.

Author Information

From the Department of Ophthalmology, Eye and ENT Hospital of Fudan University School of Medicine, Shanghai, China.

Received for publication March 17, 2009; revision received August 7, 2009; accepted August 19, 2009.

Supported by Shanghai Rising-Star program (08QA1401800), the Joint Key Project of New Frontier Technology in Shanghai Municipal Hospitals, Shanghai, China (no. SHDCI2007104), and the National High Technology Research and Development Program of China (863 Program, no.2008AA02Z422).

Drs. Y. Wang and H. Zhuang contributed equally to the work and request acknowledgment for double first authorship.

Reprints: Jianjiang Xu, Department of Ophthalmology, Eye and ENT Hospital of Fudan University School of Medicine, 83 Fenyang Rd, Shanghai 200031, China (e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.