{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T02:25:38Z","timestamp":1789179938609,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T00:00:00Z","timestamp":1757116800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NYEE Foundation"},{"name":"Research to Prevent Blindness, NY"},{"name":"Open Philanthropy\/Good Ventures Foundation"},{"name":"Far UV Foundation"},{"name":"Flu Lab"},{"name":"Blueprint Biosecurity"},{"name":"Fondazione Roma"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Purpose: We aimed to analyze the effects of age on human tear film (TF) using a novel nanometer resolution TF imaging device (Tear Film Imager, TFI, AdOM, Israel). Methods: 44 healthy adult subjects (\u226518 years of age) without ocular or systemic diseases or prior eye treatments with ages spanning seven decades were enrolled in this prospective cross-sectional study. Subjects underwent a comprehensive ophthalmic examination and completed the Ocular Surface Disease Index questionnaire (OSDI). All study participants underwent TF imaging using the TFI, including assessment of muco-aqueous layer thickness (MALT), lipid-layer thickness (LLT), inter-blink interval, and lipid map uniformity. Associations between TFI parameters and age were tested using linear regression (accounting for multiple eyes). Results: A total of 80 eyes (44 subjects) were imaged: 19 eyes from 10 subjects in the 3rd decade of life (aged 20\u201329); 10 eyes from 5 subjects in the 4th decade of life (aged 30\u201339); 5 eyes from 3 subjects in the 5th decade of life (40\u201349); 12 eyes from 7 subjects in the 6th decade of life (50\u201359), 19 eyes from 11 subjects in the 7th decade of life (60\u201369); 11 eyes from 6 subjects in the 8th decade of life (70\u201379); and 4 eyes from 2 subjects in the 9th decade of life (80\u201389). With increasing age, MALT significantly decreased (p = 0.024), and LLT significantly increased (p = 0.001). No statistically significant linear age effects were found for the other TFI parameters (p &gt; 0.05) or the OSDI scores of study participants of different ages (p = 0.786). Conclusions: Quantitative TF biomarkers varied significantly with advancing age in healthy individuals, highlighting the importance of accounting for age in TF assessments.<\/jats:p>","DOI":"10.3390\/diagnostics15172256","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T08:06:32Z","timestamp":1757318792000},"page":"2256","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Effects of Age on the Human Tear Film Assessed with a Novel Imaging Device"],"prefix":"10.3390","volume":"15","author":[{"given":"Alice","family":"Verticchio Vercellin","sequence":"first","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4099-9547","authenticated-orcid":false,"given":"Lauren J.","family":"Isserow","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard B.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7129-2472","authenticated-orcid":false,"given":"Paul A.","family":"Sidoti","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent A.","family":"Siesky","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keren","family":"Wood","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Schanzer","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"New York Medical College, Valhalla, NY 10595, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2504-0004","authenticated-orcid":false,"given":"Francesco","family":"Oddone","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione G B Bietti per lo Studio e la Ricerca in Oftalmologia ONLUS, 00184 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0966-6311","authenticated-orcid":false,"given":"Carmela","family":"Carnevale","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione G B Bietti per lo Studio e la Ricerca in Oftalmologia ONLUS, 00184 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tak Yee Tania","family":"Tai","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masako","family":"Chen","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kira","family":"Manusis","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katy","family":"Tai","sequence":"additional","affiliation":[{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Brenner","sequence":"additional","affiliation":[{"name":"Center for Radiological Research, Columbia University Irving Medical Center, New York, NY 10032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4725-998X","authenticated-orcid":false,"given":"Norman J.","family":"Kleiman","sequence":"additional","affiliation":[{"name":"Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8073-1804","authenticated-orcid":false,"given":"Samuel","family":"Potash","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7798-7155","authenticated-orcid":false,"given":"George J.","family":"Eckert","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Data Science, Indiana University School of Medicine and Richard M. Fairbanks School of Public Health, Indianapolis, IN 46202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9897-4676","authenticated-orcid":false,"given":"Gal","family":"Antman","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel"},{"name":"Ophthalmology, Rabin Medical Center, Petah Tikva 4941492, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"108115","DOI":"10.1016\/j.exer.2020.108115","article-title":"Biological Functions of Tear Film","volume":"197","author":"Pflugfelder","year":"2020","journal-title":"Exp. Eye Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2421","DOI":"10.1016\/j.bbamem.2016.02.020","article-title":"Tear Film Lipid Layer: A Molecular Level View","volume":"1858","author":"Cwiklik","year":"2016","journal-title":"Biochim. Biophys. Acta BBA-Biomembr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"109101","DOI":"10.1016\/j.exer.2022.109101","article-title":"Biochemistry of Human Tear Film: A Review","volume":"220","author":"Masoudi","year":"2022","journal-title":"Exp. Eye Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2826","DOI":"10.1038\/s41433-020-01329-5","article-title":"Association between Dry Eye and Depressive Symptoms in an Elderly Chinese Population in Taiwan: The Shihpai Eye Study","volume":"35","author":"Kuang","year":"2021","journal-title":"Eye"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1136\/bjophthalmol-2018-312333","article-title":"Effects of Tear Film Dynamics on Quality of Vision","volume":"102","author":"Koh","year":"2018","journal-title":"Br. J. Ophthalmol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2419","DOI":"10.2147\/OPTH.S484840","article-title":"Tear Film Hyperosmolarity is Associated with Increased Variation of Light Scatter Following Cataract Surgery","volume":"18","author":"Sullivan","year":"2024","journal-title":"Clin. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"101","DOI":"10.2165\/00002512-200118020-00003","article-title":"Dry Eye in the Elderly","volume":"18","author":"Terry","year":"2001","journal-title":"Drugs Aging"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/j.1463-5224.2004.00325.x","article-title":"The Tear Film and Ocular Mucins","volume":"7","author":"Davidson","year":"2004","journal-title":"Vet. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Wu, Y., Wang, C., Wang, X., Mou, Y., Yuan, K., Huang, X., and Jin, X. (2022). Advances in Dry Eye Disease Examination Techniques. Front. Med., 8.","DOI":"10.3389\/fmed.2021.826530"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1097\/ICO.0000000000003505","article-title":"The Short-Term Effects of Artificial Tears on the Tear Film Assessed by a Novel High-Resolution Tear Film Imager: A Pilot Study","volume":"43","author":"Antman","year":"2024","journal-title":"Cornea"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1080\/07853890.2022.2056238","article-title":"Lipid Layer Thickness Decrease Due to Meibomian Gland Dysfunction Leads to Tear Film Instability and Reflex Tear Secretion","volume":"54","author":"Kim","year":"2022","journal-title":"Ann. Med."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"S\u00e1nchez-Gonz\u00e1lez, M.C., Capote-Puente, R., Garc\u00eda-Romera, M.C., De-Hita-Cantalejo, C., Bautista-Llamas, M.J., Silva-Viguera, C., and S\u00e1nchez-Gonz\u00e1lez, J.M. (2022). Dry Eye Disease and Tear Film Assessment through a Novel Non-Invasive Ocular Surface Analyzer: The OSA Protocol. Front. Med., 9.","DOI":"10.3389\/fmed.2022.938484"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1097\/00003226-199605000-00001","article-title":"Tear Film Changes Associated with Normal Aging","volume":"15","author":"Mathers","year":"1996","journal-title":"Cornea"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/S1367-0484(00)80024-7","article-title":"Age, Stability of the Precorneal Tear Film and the Refractive Index of Tears","volume":"23","author":"Patel","year":"2000","journal-title":"Contact Lens Anterior Eye"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Singh, S., Srivastav, S., Mohamed, A., and Basu, S. (2022). Non-Invasive Tear Film Assessment in Normal Population: Effect of Age, Sex, and Interparametric Relationship. Front. Med., 9.","DOI":"10.3389\/fmed.2022.894184"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1007\/s40123-023-00669-1","article-title":"Dry Eye Disease Associated with Meibomian Gland Dysfunction: Focus on Tear Film Characteristics and the Therapeutic Landscape","volume":"12","author":"Sheppard","year":"2023","journal-title":"Ophthalmol. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.clae.2010.03.002","article-title":"Tear Film Dynamics and Lipid Layer Characteristics\u2014Effect of Age and Gender","volume":"33","author":"Guillon","year":"2010","journal-title":"Contact Lens Anterior Eye"},{"key":"ref_18","first-page":"213","article-title":"Tear Film Break up Time (B.U.T.) in Non-Contact Lens Wearers and Contact Lens Wearers in Normal Indian Population","volume":"33","author":"Chopra","year":"1985","journal-title":"Indian J. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1111\/j.1755-3768.1979.tb01842.x","article-title":"Semiquantitative Interference Study of Fatty Layer of Precorneal Film","volume":"57","author":"Norn","year":"1979","journal-title":"Acta Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S1542-0124(12)70081-2","article-title":"The Definition and Classification of Dry Eye Disease","volume":"5","author":"Lemp","year":"2007","journal-title":"Ocul. Surf."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1001\/archopht.118.5.615","article-title":"Reliability and validity of the Ocular Surface Disease Index","volume":"118","author":"Schiffman","year":"2000","journal-title":"Arch. Ophthalmol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1136\/bjophthalmol-2018-313379","article-title":"Dynamic Assessment of the Tear Film Muco-Aqueous and Lipid Layers Using a Novel Tear Film Imager (TFI)","volume":"104","author":"Segev","year":"2020","journal-title":"Br. J. Ophthalmol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1097\/ICO.0b013e31823f0977","article-title":"Prevalence and Risk Factors of Meibomian Gland Dysfunction: The Singapore Malay Eye Study","volume":"31","author":"Siak","year":"2012","journal-title":"Cornea"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Li, J., Ma, J., Hu, M., Yu, J., and Zhao, Y. (2020). Assessment of Tear Film Lipid Layer Thickness in Patients with Meibomian Gland Dysfunction at Different Ages. BMC Ophthalmol., 20.","DOI":"10.1186\/s12886-020-01667-8"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"4076","DOI":"10.1167\/iovs.16-19251","article-title":"Analysis of Factors Associated With the Tear Film Lipid Layer Thickness in Normal Eyes and Patients With Dry Eye Syndrome","volume":"57","author":"Jung","year":"2016","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1769","DOI":"10.1167\/iovs.18-25822","article-title":"InflammAging at Ocular Surface: Clinical and Biomolecular Analyses in Healthy Volunteers","volume":"60","author":"Micera","year":"2019","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1016\/j.ophtha.2024.12.022","article-title":"Association between Race and Ethnicity and Severity of Dry Eye Disease","volume":"132","author":"Shen","year":"2025","journal-title":"Ophthalmology"},{"key":"ref_28","first-page":"e54028","article-title":"Dry Eye Disease: An Overview of Its Risk Factors, Diagnosis, and Prevalence by Age, Sex, and Race","volume":"16","author":"Deo","year":"2024","journal-title":"Cureus"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1080\/02713683.2020.1801758","article-title":"Gender-Specific Differences in Signs and Symptoms of Dry Eye Disease","volume":"46","author":"Borrelli","year":"2021","journal-title":"Curr. Eye Res."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/17\/2256\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:41:15Z","timestamp":1760035275000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/17\/2256"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,6]]},"references-count":29,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["diagnostics15172256"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15172256","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,6]]}}}