OBJECTIVE: To compare endonasal dacryocystorhinostomy (EN-DCR) with sheath-guided dacryoendoscopic probing and bicanalicular intubation (SG-BCI) by evaluating tear meniscus area (TMA) and total high-order aberrations (HOAs) for primary acquired nasolacrimal duct obstruction (PANDO).
METHODS: We retrospectively reviewed 56 eyes of 42 patients (7 men, 35 women; age, 72.7±13.1 years) who underwent EN-DCR or SG-BCI for PANDO in Toyama University Hospital from February 2020 to June 2022. In the EN-DCR and SG-BCI groups, we measured the patency of the lacrimal passage, preoperative and postoperative TMA, and HOAs of the central 4 mm of the cornea using optical coherence tomography (AS-OCT), six months postoperatively.
RESULTS: There was a positive correlation between preoperative TMA and preoperative HOAs in all cases. Postoperative patency of lacrimal passage was 100% in the EN-DCR and 80.8% in the SG-BCI group. There was a significant difference in the number of passages between the two groups (p = 0.01). Preoperative TMA and HOAs showed a significant postoperative decrease in both groups (EN-DCR group: p<0.01, p<0.01, SG-BCI group: p<0.01, p=0.03, respectively). We then calculated the rate of change of preoperative and postoperative TMA and HOAs and compared them between the two groups. The rate of change was significantly higher in the EN-DCR group than that in the SG-BCI group (TMA, p=0.03; HOAs, p=0.02).
CONCLUSIONS: Although both EN-DCR and SG-BCI are effective for PANDO, our results suggest that EN-DCR is more effective in improving TMA and HOAs.

OBJECTIVE: To analyze the relationship between tear meniscus dimensions and higher-order aberrations (HOAs) in patients with lacrimal passage obstruction using anterior segment optical coherence tomography (AS-OCT).
METHODS: This study was a retrospective observational study of 71 eyes of 49 patients with lacrimal passage obstruction. These patients received sheath-guided dacryoendoscopic probing and bicanalicular intubation (SG-BCI) at Toyama University Hospital between August 2020 and October 2021. Using AS-OCT, tear meniscus height (TMH), tear meniscus area (TMA), and total corneal HOAs values were measured before and after surgery.
RESULTS: Surgical success was achieved in 69 eyes (97.1%). At the final observation, 62 eyes showed lacrimal patency (89.8%). The preoperative TMH, TMA, and HOAs values were 1.55 ± 0.96 mm, 0.11 ± 0.14 mm2, and 0.37 ± 0.27 µm, respectively, and the final postoperative TMH, TMA, and HOAs values were 0.97 ± 0.74 mm (p < 0.0001), 0.06 ± 0.11 mm2 (p = 0.02), and 0.29 ± 0.16 µm (p = 0.001), respectively. The results showed a significant improvement. The changes in HOAs before and after surgery were positively correlated with the changes in TMH (r = 0.3476, p = 0.0241) and TMA (r = 0.3653, p = 0.0174).
CONCLUSIONS: SG-BCI for lacrimal passage obstruction resulted in a significant decrease in measured HOAs. The decrease in HOAs was correlated with decreases in tear meniscus dimensions.

Objective. Dry Eye Disease (DED) is a multifactorial disorder, centered by loss of tear homeostasis. The diagnosis represents a challenge in the absence of a gold standard, so different questionnaires and techniques are combined. Considering that a low lacrimal secretion and a high rate of evaporation can determine changes in the tear film, the question that arises is if there are differences between the tear film thickness and the tear meniscus values of patients with DED compared to healthy volunteers, and if so, if they can be proposed as an objective diagnosis technique using Optical Coherence Tomography (OCT). Materials and methods. Ocular Surface Disease Index (OSDI) was used together with examiner confirmation for the diagnosis of DED. All the images were acquired using anterior segment Spectral Domain - OCT. Measurements were calculated using ImageJ. IBM SPSS Statistics was used for data analysis. Statistical significance was achieved if p value was <0.05, with 95% confidence intervals. Results. There were no statistically significant differences between the two groups concerning tear film thickness for the right or left eye (p=0.895 and p=0.178, respectively, p >0.05) or the difference between them (p=0.858, p >0.05). Tear meniscus area and height for each eye and the difference between the eyes reported no significant difference between the healthy and the DED volunteers. Conclusion. Tear film thickness does not record statistically significant differences between the DED and the healthy group, and neither does the sagittal area, the tear film height, or the difference between them when acquired with OCT. Abbreviations: DED = dry eye disease, ASOCT = anterior segment optical coherence tomography, REFT = right eye tear film thickness, LEFT = left eye tear film thickness, DifFT = difference between the two eyes for tear film thickness, RETMA = right eye tear meniscus area, LETMA = left eye tear meniscus area, DifTMA = difference between the two eyes for tear meniscus area, RETMH = right eye tear meniscus height, LETMH = left eye tear meniscus height, DifTMH = difference between the two eyes for tear meniscus height.

OBJECTIVE: Strip meniscometry (SM) is a new technique for evaluating tear film volume. The aim of the present study was to evaluate the efficacy of SM in detecting lacrimal obstructive diseases (LODs) in patients with epiphora retrospectively.
METHODS: One-hundred sixty-six patients (53 men, 113 women; mean age: 72.4 ± 8.0 years) who were referred to Saitama Medical University Hospital with epiphora as their chief complaint were enrolled; finally, 72 patients with and 89 patients without LOD were examined. We assessed tear volume using SM, tear meniscus height (TMH), tear meniscus area (TMA), and Schirmer-1 test values. Patients with LOD underwent lacrimal intubation surgery to treat their epiphora; their SM scores were assessed before and 8 weeks after surgery.
RESULTS: SM, TMH, TMA, and Schirmer-1 values were significantly higher in the LOD group (10.80 ± 3.63 mm, 0.49 ± 0.24 mm, 0.06 ± 0.06 mm2, 18.46 ± 8.00 mm, respectively) than in the non-LOD group (5.44 ± 3.20 mm, 0.30 ± 0.18 mm, 0.03 ± 0.04 mm2, 11.84 ± 7.16 mm). The area under the receiver operating characteristic curve (AUC) for SM was 0.88, the sensitivity and specificity were 82% and 84%. The AUC was significantly larger for SM than for the Schirmer-1 test and TMA. The SM scores significantly improved after surgery (5.30 ± 2.20 mm) compared with those before (10.69 ± 3.20 mm).
CONCLUSIONS: SM was significantly better than the Schirmer-1 test, TMH, and TMA for detecting LOD and evaluating the effect of lacrimal surgery.
CONCLUSIONS: SM, widely used for dry eye, is also useful for using epiphora.

To evaluate tear meniscus height and tear meniscus area measured by optical coherence tomography (OCT) and to determine the prevalence of dry eye disease in video display terminal (VDT) users.
This was a case-control study performed on VDT users. The case group consisted of 53 subjects who vocationally use VDT more than six hours per day and the control group consisted of 49 subjects who used VDT not more than one hour per day. The pre-vocational and post-vocational tear meniscus height and tear meniscus area measurements were performed twice in one day using OCT. Tear-film break-up time, Schirmer\'s test, Ocular Surface Disease Index score and corneal staining score measurements were performed in all subjects.
The mean age was 38.9 ± 5.5 years in VDT users and 37.8 ± 5.8 years in the control group (p = 0.426). Twenty patients (37.7 per cent) had dry eye disease in VDT users and five patients (10.2 per cent) had dry eye disease in the control group (p = 0.001). The mean tear meniscus height and tear meniscus area values (pre-vocational and post-vocational) were significantly lower in VDT users than in the control group (p < 0.001, p < 0.001, p = 0.024 and p < 0.001, respectively). The Schirmer\'s test results, Ocular Surface Disease Index scores, corneal staining scores and tear-film break-up time values revealed significant differences between VDT users and control subjects (p = 0.002, p = 0.006, p < 0.001 and p < 0.001, respectively). In addition, significant correlations were demonstrated between Schirmer\'s test results, Ocular Surface Disease Index scores, corneal staining scores, tear-film break-up time measurements, tear meniscus height results and tear meniscus area values.
Tear meniscus evaluation using OCT is an effective, non-invasive and sensitive method for detection of dry eye disease in VDT users.

BACKGROUND: Dry eye is one of the most common ocular diseases in this cyber era. Despite availability of multiple tests, no single test is accurate for the diagnosis of dry eye. Anterior segment optical coherence tomography is the recent tool which can be added in the armentarium of dry eye tests.
OBJECTIVE: To evaluate tear meniscus with anterior segment optical coherence tomography and its correlation with other tear variables in normal healthy individuals.
METHODS: In this prospective cross-sectional observational study, right eye of 203 consecutive patients were studied. All the patients were divided into three groups Group 1, 2 and 3 according to their age ≤20 years, 21-40 years and >40 years respectively. All patients underwent routine ophthalmologic examinations along with slit-lamp bio-microscopy for tear meniscus height measurement, tear film break up time, Schirmer\'s I test (with anaesthesia) and optical coherence tomography imaging of inferior tear meniscus height. After focusing of the instrument with a Cross Line (CL) centered on lower tear meniscus at 6\'0 clock of cornea, a 6 mm long scan was obtained. The tear meniscus height (μm) and tear meniscus area (mm(2)) were measured manually with help of callipers by joining upper corneo-meniscus junction to the lower lid-meniscus junction and tear meniscus height and area within the plotted line respectively and calculated by using the integrated analysis available in the custom software.
RESULTS: There was significant decrease in the all tear variables with the increase in the age. According to age groups in group 1, the mean Schirmer\'s (24.0±4.9)mm, tear film break up time (11.1±1.9) sec, tear meniscus height on slit lamp (600.2±167.3)mm were higher but decreased in group 2 (21.5±5.4,10.8±1.4, 597.5±186.3) and group 3 (19.8 ± 5.1, 10.2 ± 1.6, 485.6 ± 157.7) respectively. Schirmer\'s test values and tear film break up time were similar in both sexes (p=0.1 and p= 0.9). Tear meniscus height on slit lamp and Optical coherence based tear meniscus area were similar in both sexes (p=0.5 and p=0.1). However, tear meniscus height on optical coherence tomography was significantly higher in females (p=0.04). Value of Schirmer\'s and tear film break up time (r =0.2; p= 0.001) and Schirmer\'s and tear meniscus height on slit lamp (r=0.6; p<0.001) had positive correlation. Tear meniscus height and tear meniscus area on optical coherence tomography had positive correlation (r =.9; p<0.001).
CONCLUSIONS: On optical coherence tomography tear meniscus height and area significantly correlated. Despite higher values of Schirmer\'s, tear film break up time, Slit lamp based tear meniscus height in younger age group the tear meniscus height and tear meniscus area with optical coherence tomography were lower.