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Ziwei Wu, Carolyn Begley, Ping Situ, Adam Winkeler, Jun Zhang, Trefford Simpson; How Does Increasing Ocular Surface Stimulation Affect Blinking?. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4354.
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Despite the importance of the blink, its control by ocular surface sensory input remains controversial. In this study, we tested the hypothesis that increasing ocular surface stimulation will lead to a significantly increased blink rate (SIBR) that we defined as a blink rate (BR) ≥ 2 standard errors from baseline.
To control attention, 10 subjects played a video game (with the screen viewed from 20 cm) while also seated behind a slit lamp biomicroscope. Air flow (AF) was directed toward the central cornea (15mm distance, temperature= 24 Celsius) through a 0.5mm diameter tube. Using an ascending method of limits, the AF producing an approximate SIBR was estimated and then, using a method of constant stimuli 0, 0.25, 0.5, 0.75, 1 and 1.25 multiples of this estimated AF were presented 3 times each (in random order). BR, interblink interval (IBI) and AF were recorded simultaneously and custom MATLAB programs determined the SIBR for each subject.
Mean (±SD) airflow to produce a SIBR was 134.9±63.9ml/min (range: 65.5 to 248.8ml/min). There was a linear correlation between AF and BR or IBI (Pearson’s correlation coefficient, r= 0.939 and -0.987, respectively). The baseline (AF= 0) BR was 16.5±6.0 blinks/min and the five tested AFs these were 20.3±5.9, 25.8±5.0, 30.0±8.3, 47.0±20.3 and 67.4±27.3 blinks/min. The baseline IBI was 4.5±2.1sec and at the five AFs these were 3.5±1.3, 2.6±0.5, 2.4±0.9, 1.6±0.5 and 1.1±0.4sec. Figure 1 demonstrates the SIBR for one subject.
These results support the hypothesis that AF stimulation of the ocular surface leads to a SIBR when mental concentration is controlled, and that the increasing stimulation produces a linear dose response at the levels of AF tested. This method may allow examination of individual differences in the ocular surface sensory response to stimulation, which may cause the variation in SIBR among subjects.
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