{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T10:55:55Z","timestamp":1781261755130,"version":"3.54.1"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,10,12]],"date-time":"2014-10-12T00:00:00Z","timestamp":1413072000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate the effect of non\u2010invasive tear stability assessment with forced eye opening on the lower tear meniscus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010three eyes of 23 patients with aqueous\u2010deficient dry eye and 23 eyes of 23 normal subjects were enrolled. All subjects underwent imaging with a Keratograph 5M equipped with a modified tear film scanning function. Lower tear meniscus images were captured, and tear meniscus height (<jats:styled-content style=\"fixed-case\">TMH<\/jats:styled-content>) was measured with an integrated ruler before and after non\u2010invasive Keratograph break\u2010up time (<jats:styled-content style=\"fixed-case\">NIKBUT<\/jats:styled-content>) measurements in each subject. Subjects were instructed to keep their eyes open as long as possible during <jats:styled-content style=\"fixed-case\">NIKBUT<\/jats:styled-content> measurements, and the recording was discontinued at the next blink.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">TMH<\/jats:styled-content> values of the normal and dry eye groups were 0.20\u00a0\u00b1\u00a00.05\u00a0mm and 0.14\u00a0\u00b1\u00a00.03\u00a0mm, respectively, at baseline. The <jats:styled-content style=\"fixed-case\">TMH<\/jats:styled-content> values of dry eyes were significantly smaller than those of normal eyes (p\u00a0&lt;\u00a00.001). Significant increases in <jats:styled-content style=\"fixed-case\">TMH<\/jats:styled-content> values were observed in both normal (0.10\u00a0\u00b1\u00a00.12\u00a0mm) and dry eyes (0.04\u00a0\u00b1\u00a00.09\u00a0mm) with the <jats:styled-content style=\"fixed-case\">NIKBUT<\/jats:styled-content> measurement (p\u00a0&lt;\u00a00.001, p\u00a0=\u00a00.039). A moderate negative correlation was observed between increased <jats:styled-content style=\"fixed-case\">TMH<\/jats:styled-content> and baseline <jats:styled-content style=\"fixed-case\">TMH<\/jats:styled-content> in dry eyes (<jats:italic>r<\/jats:italic>\u00a0=\u00a0\u22120.44, p\u00a0=\u00a00.03), whereas no correlation was observed in normal eyes (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.04, p\u00a0=\u00a00.85).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Forced eye opening required for the non\u2010invasive tear stability assessment influences the <jats:styled-content style=\"fixed-case\">TMH<\/jats:styled-content> measurement possibly due to reflex tear secretion, even in patients with aqueous\u2010deficient dry eye. <jats:styled-content style=\"fixed-case\">TMH<\/jats:styled-content> should be assessed before tests that require forced eye opening.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.12516","type":"journal-article","created":{"date-parts":[[2014,10,13]],"date-time":"2014-10-13T03:15:38Z","timestamp":1413170138000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":71,"title":["Effect of non\u2010invasive tear stability assessment on tear meniscus height"],"prefix":"10.1111","volume":"93","author":[{"given":"Shizuka","family":"Koh","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Osaka University Graduate School of Medicine Suita Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikako","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Osaka University Graduate School of Medicine Suita Osaka Japan"},{"name":"Research &amp; Development Division Rohto Pharmaceutical Co.,Ltd. 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