Impact of temporal tear meniscus height on the tear osmolarity measurements

Abstract Tear hyperosmolarity plays a crucial role in initiation of inflammatory response and damage to ocular surface epithelia. Accurate measurement of tear osmolarity is essential for dry eye. This prospective observational and experimental study was conducted in 182 eyes of 182 participants, inc...

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Main Authors: Jaekyoung Lee, Seung Pil Bang, Jae-Gon Kim, Jong Hwa Jun
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-93764-1
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author Jaekyoung Lee
Seung Pil Bang
Jae-Gon Kim
Jong Hwa Jun
author_facet Jaekyoung Lee
Seung Pil Bang
Jae-Gon Kim
Jong Hwa Jun
author_sort Jaekyoung Lee
collection DOAJ
description Abstract Tear hyperosmolarity plays a crucial role in initiation of inflammatory response and damage to ocular surface epithelia. Accurate measurement of tear osmolarity is essential for dry eye. This prospective observational and experimental study was conducted in 182 eyes of 182 participants, including 115 subjects with dry eye (Sjögren syndrome aqueous-deficient dry eye [SS ADDE], non-SS ADDE, and evaporative DE [EDE]), 36 with conjunctivochalasis (CCh), and 31 normal controls (NC). The ocular surface disease index (OSDI), tear meniscus height (TMH), Schirmer I test, tear matrix metalloproteinase-9 (MMP-9), tear breakup time, and ocular staining score were assessed. Tear osmolarity was measured using the TearLab osmolarity system (Escondido, CA, USA) by applying 1.0 μl tears collected by micropipette to the TearLab test card or by direct contact between the test card and the temporal tear meniscus. For in vitro analyses, osmolarity of 271.25, 300, 347.5, and 395 mOsm/L solutions were measured at various volumes (0.2, 0.5, 1.0, 2.0, and 5.0 μl) with a TearLab osmometer. Tear osmolarity measured by direct contact was higher than that measured by micropipette (13.7 ± 10.5 mOsm/L, p < 0.001). The difference of osmolarities was higher in the non-SS ADDE, SS ADDE, and CCh than in the NC and EDE (p < 0.001 for all). Osmolarity was negatively correlated with Schirmer score and TMH (r = − 0.346, p < 0.001; r = − 0.447, p < 0.001, respectively). The smaller the sample volume, the higher the measured osmolarity in the in vitro analysis at 300 and 347.5 mOsm/L (r = − 0.659, p < 0.01; r = − 0.579, p < 0.05, respectively). The TearLab osmometer tended to report higher tear osmolarity inversely proportional to sample volumes, possibly due to the evaporation effect. Therefore, care should be taken when interpreting tear osmolarity in patients with low tear volume or CCh.
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spelling doaj-art-e33a322f85f64acbb7cfe97332193d132025-08-20T03:04:25ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-93764-1Impact of temporal tear meniscus height on the tear osmolarity measurementsJaekyoung Lee0Seung Pil Bang1Jae-Gon Kim2Jong Hwa Jun3Department of Ophthalmology, Keimyung University School of MedicineDepartment of Ophthalmology, Keimyung University School of MedicineDepartment of Ophthalmology, Keimyung University School of MedicineDepartment of Ophthalmology, Keimyung University School of MedicineAbstract Tear hyperosmolarity plays a crucial role in initiation of inflammatory response and damage to ocular surface epithelia. Accurate measurement of tear osmolarity is essential for dry eye. This prospective observational and experimental study was conducted in 182 eyes of 182 participants, including 115 subjects with dry eye (Sjögren syndrome aqueous-deficient dry eye [SS ADDE], non-SS ADDE, and evaporative DE [EDE]), 36 with conjunctivochalasis (CCh), and 31 normal controls (NC). The ocular surface disease index (OSDI), tear meniscus height (TMH), Schirmer I test, tear matrix metalloproteinase-9 (MMP-9), tear breakup time, and ocular staining score were assessed. Tear osmolarity was measured using the TearLab osmolarity system (Escondido, CA, USA) by applying 1.0 μl tears collected by micropipette to the TearLab test card or by direct contact between the test card and the temporal tear meniscus. For in vitro analyses, osmolarity of 271.25, 300, 347.5, and 395 mOsm/L solutions were measured at various volumes (0.2, 0.5, 1.0, 2.0, and 5.0 μl) with a TearLab osmometer. Tear osmolarity measured by direct contact was higher than that measured by micropipette (13.7 ± 10.5 mOsm/L, p < 0.001). The difference of osmolarities was higher in the non-SS ADDE, SS ADDE, and CCh than in the NC and EDE (p < 0.001 for all). Osmolarity was negatively correlated with Schirmer score and TMH (r = − 0.346, p < 0.001; r = − 0.447, p < 0.001, respectively). The smaller the sample volume, the higher the measured osmolarity in the in vitro analysis at 300 and 347.5 mOsm/L (r = − 0.659, p < 0.01; r = − 0.579, p < 0.05, respectively). The TearLab osmometer tended to report higher tear osmolarity inversely proportional to sample volumes, possibly due to the evaporation effect. Therefore, care should be taken when interpreting tear osmolarity in patients with low tear volume or CCh.https://doi.org/10.1038/s41598-025-93764-1Dry eyeTear meniscus heightTear meniscus osmolarityTearLab
spellingShingle Jaekyoung Lee
Seung Pil Bang
Jae-Gon Kim
Jong Hwa Jun
Impact of temporal tear meniscus height on the tear osmolarity measurements
Scientific Reports
Dry eye
Tear meniscus height
Tear meniscus osmolarity
TearLab
title Impact of temporal tear meniscus height on the tear osmolarity measurements
title_full Impact of temporal tear meniscus height on the tear osmolarity measurements
title_fullStr Impact of temporal tear meniscus height on the tear osmolarity measurements
title_full_unstemmed Impact of temporal tear meniscus height on the tear osmolarity measurements
title_short Impact of temporal tear meniscus height on the tear osmolarity measurements
title_sort impact of temporal tear meniscus height on the tear osmolarity measurements
topic Dry eye
Tear meniscus height
Tear meniscus osmolarity
TearLab
url https://doi.org/10.1038/s41598-025-93764-1
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