{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T21:45:53Z","timestamp":1778190353212,"version":"3.51.4"},"reference-count":13,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T00:00:00Z","timestamp":1669334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Kowa Company, Ltd. (Tokyo, Japan)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The purpose of this study is to compare visual versus software detection of non-invasive tear break-up with the KOWA DR-1\u03b1 tear interferometer and investigate the relationship between non-invasive tear break-up time (NIBUT) and dry eye clinical severity. Tear interferometry with the KOWA DR-1\u03b1, together with a standardized comprehensive ocular surface\/tear evaluation, was performed on 348 consecutive eyes. Investigator visually detected or software detected non-invasive tear break-up and NIBUT were measured and compared on a subset of these examinations. The relationship between software-detected NIBUT and categorical dry eye severity based on irritation symptoms and corneal and conjunctival dye staining scores was determined. The sensitivity of visual (frame-by-frame) or software detected non-invasive tear break-up in eyes with tear instability (FBUT &lt; 10) was similar (range 63\u201369%). NIBUT, measured visually or by software, had a correlation coefficient of 0.87. NIBUT was significantly lower in severity levels 2 and 3 compared to levels 0 + 1, and level 3 was significantly lower than level 2. In conclusion, there is a good correlation between investigator visually detected and software-detected tear break-up and tear break-up time in the KOWA DR-1\u03b1 interferometric fringe images. Software-detected NIBUT is a clinically relevant measure of dry eye clinical severity.<\/jats:p>","DOI":"10.3390\/ijms232314774","type":"journal-article","created":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T01:58:46Z","timestamp":1669600726000},"page":"14774","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Non-Invasive Tear Break-Up Detection with the Kowa DR-1\u03b1 and Its Relationship to Dry Eye Clinical Severity"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9341-3482","authenticated-orcid":false,"given":"Stephen","family":"Pflugfelder","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Nakhleh","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasushi","family":"Kikukawa","sequence":"additional","affiliation":[{"name":"Kowa Company, Ltd., Tokyo 103-8433, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shin","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Kowa Company, Ltd., Tokyo 103-8433, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuya","family":"Kosugi","sequence":"additional","affiliation":[{"name":"Kowa Ophthalmic Research Laboratories, Kowa Research Institute Inc., Boston, NC 27560, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1016\/S0002-9394(14)71688-5","article-title":"Prevalence of dry eye among the elderly","volume":"124","author":"Schein","year":"1997","journal-title":"Am. 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