A Novel Method of Measuring Tear Evaporation Rates using Infrared Thermography

Andrea Petznick1, Samantha Sze Yee Lee1, Jen Hong Tan2, U. Rajendra Acharya 2,3,4, Eddie
Ng5, Louis Tong1,6,7,8
1

Singapore Eye Research Institute, Singapore

School of Engineering, Ngee Ann Polytechnic, Singapore

SIM University, Singapore

Singapore Institute of Technology University of Glasgow, Singapore

School of Mechanical and Aerospace Engineering, Nanyang Technological University,

Singapore
6

National Eye Centre, Singapore

Duke-NUS Graduate Medical School, Singapore

Yoon Loo Lin School of Medicine, National University of Singapore

PURPOSE: Dry eye is a very common medical problem and meibomian gland dysfunction
(MGD) may be an aggravating factor. There is no single reliable diagnostic tool to determine the
presence and severity of dry eye and MGD. The measurement of dynamic tear evaporation
rates would allow for a more objective diagnosis. In this study, we present a novel non-invasive
method of measuring tear evaporation rates using infrared thermography that is reliable and
able to detect changes after heat therapy.
METHODS: Infrared thermographic sequential images of ocular surface temperature were
recorded from healthy participants (mean age SD: 247 years) while remaining in a consulting
room with a temperature of 22.080.77C and humidity of 63.820.02%. 1) Repeatability of the
equipment was tested by taking 2 measurements 20 min apart (n=16). 2) Measurements were
taken before and 60 min after 5-min heated eye mask wear (Eyegiene , US) (n=10) to test for
changes in ocular surface temperature and tear evaporation. Tear evaporation rates were
calculated based on ocular surface temperature profiles and controlled for body and room
temperature as well as room humidity using principles of thermodynamics. Statistical
comparisons were performed using paired t-test with p<0.05.

RESULTS: 1) There were significant correlations between the first and second measurements
of ocular surface temperature (r=0.94) and tear evaporation rates (r=0.98) (p<0.01). The
coefficients of repeatability were 0.42C for ocular surface temperature and 6.78 Wm-2 for tear
evaporation rates. 2) Ocular surface temperature before heat therapy was 33.660.53C which
significantly decreased to 32.500.97C after heat application (p<0.01). Tear evaporation rates
significantly increased from 65.6412.51 to 78.7221.53 Wm-2 following heat treatment (p<0.01).
CONCLUSIONS: We established that ocular thermography has a good repeatability in
measuring ocular surface temperatures and tear evaporation rates under constant conditions
and may therefore present a valuable tool for diagnosing dry eye and MGD. Findings also
suggest a drop in ocular surface temperature and an increase in tear evaporation 60 min after
heating, but it is possible that vasodilation in ocular tissues may have affected calculations of
tear evaporation rates after heating.

Funding sources: NMRC/1206/2009, NMRC/CSA/013/2009 and NMRC/CG/SERI/2010 from

National Medical Research Council (NMRC), Singapore, BMRC(TCRP)10/1/35/19/670 from
Biomedical Research Council, Singapore

Commercial interest: none

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Keywords: 479 cornea: clinical science; 549 imaging/image analysis: clinical