The potential influence of Schirmer strip variables on dry eye disease characterisation, and on tear collection and analysis

Nery García-Porta, Aisling Mann*, Virginia Sáez-Martínez, Val Franklin, James S. Wolffsohn, Brian Tighe

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Purpose: The use of the Schirmer strips (SS) as a tool in the characterisation of dry eye disease, depends upon the quantitative assessment of tear production and constituents. The aim of this study was to ascertain the extent to which the properties of commercially available SS can vary and the way in which this baseline information may relate to their comparability in clinical use. Methods: Five SS were analysed: Clement Clarke®, TearFlo®, Bio Schirmer®, Omni Schirmer® and JingMing®. Various aspects of their physical appearance and physicochemical behaviour were measured, including size, weight, and thickness together with surface morphology (assessed by SEM) and aqueous uptake and release behaviour (including the influence of each strip on protein retention and eluent osmolarity). Results: All physical parameters varied between the strips studied for example the Clement Clark was the largest, thickest, and heaviest strip assessed in this study. SEM images showed that each of the SS had unique surface morphologies. Statistically significant differences among the strips were found for uptake (p = 0.001) and release volume (p = 0.014). Clement Clarke absorbed the highest volume over a fixed time period (23.8. ±. 1.6. μl) and Omni the lowest (19.3. ±. 0.5. μl). Clement Clarke showing the highest eluent osmolarity value (5.0. ±. 0.0. mOsm/L) and TearFlo the lowest (2.8. ±. 0.4. mOsm/L). Conclusion: The five strips investigated in this study indicate that there is no standardisation of commercial strips, despite the fact that the need for standardisation was recognised over fifty years ago. This study provides useful baseline information relating to SS comparability in clinical use.

Original languageEnglish
Pages (from-to)47-53
JournalContact Lens and Anterior Eye
Volume41
Issue number1
Early online date23 Sep 2017
DOIs
Publication statusPublished - 1 Feb 2018

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Eye Diseases
Tears
Osmolar Concentration
Weights and Measures
Proteins

Bibliographical note

© 2017, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/.

Funding: partially supported by the Xunta de Galicia by a pre-doctoral grant of the Plan I2C 2011–2015 and by Fundación Barrié.

Keywords

  • Albumin uptake and release
  • Dry eye diagnosis
  • Schirmer strip characterisation
  • Tear flow measurement
  • Tear sampling

Cite this

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title = "The potential influence of Schirmer strip variables on dry eye disease characterisation, and on tear collection and analysis",
abstract = "Purpose: The use of the Schirmer strips (SS) as a tool in the characterisation of dry eye disease, depends upon the quantitative assessment of tear production and constituents. The aim of this study was to ascertain the extent to which the properties of commercially available SS can vary and the way in which this baseline information may relate to their comparability in clinical use. Methods: Five SS were analysed: Clement Clarke{\circledR}, TearFlo{\circledR}, Bio Schirmer{\circledR}, Omni Schirmer{\circledR} and JingMing{\circledR}. Various aspects of their physical appearance and physicochemical behaviour were measured, including size, weight, and thickness together with surface morphology (assessed by SEM) and aqueous uptake and release behaviour (including the influence of each strip on protein retention and eluent osmolarity). Results: All physical parameters varied between the strips studied for example the Clement Clark was the largest, thickest, and heaviest strip assessed in this study. SEM images showed that each of the SS had unique surface morphologies. Statistically significant differences among the strips were found for uptake (p = 0.001) and release volume (p = 0.014). Clement Clarke absorbed the highest volume over a fixed time period (23.8. ±. 1.6. μl) and Omni the lowest (19.3. ±. 0.5. μl). Clement Clarke showing the highest eluent osmolarity value (5.0. ±. 0.0. mOsm/L) and TearFlo the lowest (2.8. ±. 0.4. mOsm/L). Conclusion: The five strips investigated in this study indicate that there is no standardisation of commercial strips, despite the fact that the need for standardisation was recognised over fifty years ago. This study provides useful baseline information relating to SS comparability in clinical use.",
keywords = "Albumin uptake and release, Dry eye diagnosis, Schirmer strip characterisation, Tear flow measurement, Tear sampling",
author = "Nery Garc{\'i}a-Porta and Aisling Mann and Virginia S{\'a}ez-Mart{\'i}nez and Val Franklin and Wolffsohn, {James S.} and Brian Tighe",
note = "{\circledC} 2017, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/. Funding: partially supported by the Xunta de Galicia by a pre-doctoral grant of the Plan I2C 2011–2015 and by Fundaci{\'o}n Barri{\'e}.",
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The potential influence of Schirmer strip variables on dry eye disease characterisation, and on tear collection and analysis. / García-Porta, Nery; Mann, Aisling; Sáez-Martínez, Virginia; Franklin, Val; Wolffsohn, James S.; Tighe, Brian.

In: Contact Lens and Anterior Eye, Vol. 41, No. 1, 01.02.2018, p. 47-53.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The potential influence of Schirmer strip variables on dry eye disease characterisation, and on tear collection and analysis

AU - García-Porta, Nery

AU - Mann, Aisling

AU - Sáez-Martínez, Virginia

AU - Franklin, Val

AU - Wolffsohn, James S.

AU - Tighe, Brian

N1 - © 2017, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/. Funding: partially supported by the Xunta de Galicia by a pre-doctoral grant of the Plan I2C 2011–2015 and by Fundación Barrié.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Purpose: The use of the Schirmer strips (SS) as a tool in the characterisation of dry eye disease, depends upon the quantitative assessment of tear production and constituents. The aim of this study was to ascertain the extent to which the properties of commercially available SS can vary and the way in which this baseline information may relate to their comparability in clinical use. Methods: Five SS were analysed: Clement Clarke®, TearFlo®, Bio Schirmer®, Omni Schirmer® and JingMing®. Various aspects of their physical appearance and physicochemical behaviour were measured, including size, weight, and thickness together with surface morphology (assessed by SEM) and aqueous uptake and release behaviour (including the influence of each strip on protein retention and eluent osmolarity). Results: All physical parameters varied between the strips studied for example the Clement Clark was the largest, thickest, and heaviest strip assessed in this study. SEM images showed that each of the SS had unique surface morphologies. Statistically significant differences among the strips were found for uptake (p = 0.001) and release volume (p = 0.014). Clement Clarke absorbed the highest volume over a fixed time period (23.8. ±. 1.6. μl) and Omni the lowest (19.3. ±. 0.5. μl). Clement Clarke showing the highest eluent osmolarity value (5.0. ±. 0.0. mOsm/L) and TearFlo the lowest (2.8. ±. 0.4. mOsm/L). Conclusion: The five strips investigated in this study indicate that there is no standardisation of commercial strips, despite the fact that the need for standardisation was recognised over fifty years ago. This study provides useful baseline information relating to SS comparability in clinical use.

AB - Purpose: The use of the Schirmer strips (SS) as a tool in the characterisation of dry eye disease, depends upon the quantitative assessment of tear production and constituents. The aim of this study was to ascertain the extent to which the properties of commercially available SS can vary and the way in which this baseline information may relate to their comparability in clinical use. Methods: Five SS were analysed: Clement Clarke®, TearFlo®, Bio Schirmer®, Omni Schirmer® and JingMing®. Various aspects of their physical appearance and physicochemical behaviour were measured, including size, weight, and thickness together with surface morphology (assessed by SEM) and aqueous uptake and release behaviour (including the influence of each strip on protein retention and eluent osmolarity). Results: All physical parameters varied between the strips studied for example the Clement Clark was the largest, thickest, and heaviest strip assessed in this study. SEM images showed that each of the SS had unique surface morphologies. Statistically significant differences among the strips were found for uptake (p = 0.001) and release volume (p = 0.014). Clement Clarke absorbed the highest volume over a fixed time period (23.8. ±. 1.6. μl) and Omni the lowest (19.3. ±. 0.5. μl). Clement Clarke showing the highest eluent osmolarity value (5.0. ±. 0.0. mOsm/L) and TearFlo the lowest (2.8. ±. 0.4. mOsm/L). Conclusion: The five strips investigated in this study indicate that there is no standardisation of commercial strips, despite the fact that the need for standardisation was recognised over fifty years ago. This study provides useful baseline information relating to SS comparability in clinical use.

KW - Albumin uptake and release

KW - Dry eye diagnosis

KW - Schirmer strip characterisation

KW - Tear flow measurement

KW - Tear sampling

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