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Ashley M. LaFond, Keith J. Lane, George W. Ousler, III, Aron Shapiro, Endri Angjeli, Stephanie Breton, Mark B. Abelson; Relationship Between Blink Pattern and Level of Ocular Surface Exposure in a Dry Eye Population. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3845.
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The OPI 2.0 system is comprised of a number of tear film analysis technologies developed in an effort to better understand tear film and blink dynamics under natural conditions. A key feature of the system is the ability to look at tear film break up and resulting corneal surface exposure during various blink patterns. We hypothesize that dry eye subjects have largely variable blink patterns vacillating between periods of rapid blinks (when the eye compensates for an insufficient tear film) and periods when blink rate slows. These periods of slower blink rates may be caused by environmental conditions, visual tasking or simply a lack in remaining compensatory capability. This study examined a population of dry eye subjects to determine if certain blink patterns yielded higher amounts of corneal exposure using the OPI 2.0 system.
Thirty one adult subjects with a history of mild to moderate dry eye completed the study. Tear film break up time, inter-blink intervals (IBIs), and tear film break up area were recorded at baseline using the OPI 2.0 System. Subgroups were also evaluated based on tear film break up time.
Break up area was significantly greater in subjects with longer IBIs (periods of slower blink rates) than those with shorter IBIs (rapid compensatory blinking patterns. p<0.05). Subjects with faster break up times showed greater ocular surface exposure with increasing IBIs compared to those with slower break up times (p=0.031).
This study comprehensively relates the relationship between tear film break up time, blink pattern, and total ocular surface exposure. Subjects with longer IBIs and shorter TFBUTs demonstrated higher levels of ocular surface exposure. Furthermore, the results of this study support the concept that rapid blink patterns can function as a compensatory mechanism for tear film deficiency, while a period of slower blink rates in this blink pattern (yielding longer IBIs) results in increased ocular surface exposure and presumably heightened ocular surface inflammation.
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